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i 1 Please print ortype. Farm Approved.OMB No.2050.0039 UNIFORM HAZARDOUS 1,Generator ID Number 12.Page 17317h&genEy esponse Note 4.Manifest Tracking NuM6,4 her WASTE MANIFEST _ 015 9 5 6 418 F L E 5-Generator's Name and Mailing Address Generator's Site Address(I different than mailing address) Pep Hays #710 Pep Boys#710 (209) 464-6066 845 Dr.M.L. King Jr. Blvd 845 Dr.M.L. King Jr. Blvd Generator's Phone: CQ 9521 95209 6.Transporter 1 Company Name PA umbel 0016A I 10924 7.Transporter 2 Company Name U-S.EPA ID Number 8 Designated Facility Name and Site Address General Environmental Mgt, LLC US EPA ID Number 11855 White Rock Road Rancho Cordova, CR 95742 FaciEity's Phone: � ga 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10 Containers 11.Total 12.Unit 13-Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt./Vol. X 1UN1950, Waste Aerosols, Cflameatfle, teach not 1 CP 00005 P 2141 DO01 ` a exceeding I L capacity)] 2. 1, ERC#126 i LU 2, i LU ca 3 4. 14.Special Handling Instructions and Additional Information j , 78?,7,,j(A er o s o 1 s, Flammable) 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name.and are classified,packaged, marked and labeledfplacanded,and are in all respects in proper condition for transport according to applicable internationaland national governmental regulations,If export shipment and I am the Primary Exporter,I certity that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent, i certify that the waste minimization statement identified in 40 CFR 21(if I am a large quantity generator)or(b) 'f I am a small quantity generator)is true Generator'slOfferor's PrintedfTyped Name Signa re Month Day Year 1 ` 1 061 24 1 20Z 16,International Shipments � ❑import to .S. L1 Export 61U.S. Port of entrylexit: Transporter signature(for exports only): Date leaving U. .. W 17.Transporter AcknoWedgment of Receipt of Materials LLj Transporter 1 PrintedfTyped Name Signature Month Day Year OR Trent Pittman iii P46AL Z Transporter 2 PrintedfTyped Name Signature Month Day Year f- 18,Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number U rai Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year a a 19.Hazardous Waste Report Management Method Codes(i.e„codes for hazardous waste treatment,disposal,and recycling systems) 4. 3, Q 1 2' 20.Designated facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in item 18a PrintedfTyped Name Signature Month DayYear , 0 (5 EPA Farm 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNAT iLITY TO EPA's e-MANIFEST SYSTEM VIII-22_121,: — —