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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CALO00411327 1. 1 408-163-3678 1 017417654 JJ K 5.Generator's Name and Mailing Address Genemtots Site Address(if different than mailing address) Sally Beauty Supplies A 752 678 N WILSON WAY i 15-33 STD=N, CA, 95205 Generatafs Phone: 9119 941—n 958 8.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REVIDYAL INC f-.An9R?4Q710Q 7.Transporter 2 Company Name U.S.EPA ID Number TPMARRY RECYCLING INC. 8.Designated Facility Name and Site Address U.S.EPA ID Number RECTCLADORA TEMARRY DE MEXICO CARREIERA- FEDERAL NO- 2 MET, SAN PABLO TECATE OC Fadlity's Phone: 61.9-270-9453 gra 91b.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(BaryU No. Type Quantity WLNoI. 1.QN1950, WASTE AEROSOLS (Each Ne Easceedinq 1L D001 D035 331 p X Capacity) , ET-522VbLE, H.O.S. , 2 .1 ` P z 2. LE LIQUIDS, N.O.S, D001 D035 F003 out a (ACETONE, ISOPROPANOL) , 3, PG II '1 p p 1 l 331 3. 79, WASTE OXIDIZING SOLID: N.O-S. D001 141 (POTASSIUM PERSULFATE, SODIUM PERSULFATE) , j 5 .1, PGIII 1 1) 4,HUM RCRA IIASARDOUS WASTE LIQUID , 561 (DETERGENTS-GLYCOLS) ; n �j ( p 14.Special Handling Instructions and Add allnfonnation \ w 1) 8091613 e t9( Aerosol) 2) R_&I (Flaw Liq) 3) R_/J(L-(ONi.dixer) 4) E_AJ (NEL-CP) 1%?#A PRIMARY EXPORTER: TEMARRY RECYCLING INC. POA 12526 41 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 labsedlplacerded,and are in all respects In proper condition for transport according to applicable international and national governmental regulations.It export shipment and I am the Primary Exporter,I certify 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 261(If I am a large quantity generator)or(b)(if I am a small quantity generator)Is true. G im's/Ofiemys N tedi ped N e Si re Month Day Year 3 ay F F16.Intemationa hipm nts ❑Import to U. 0Exportho U.S. Port of entry/exit: 1-4�A CA - z Transporter signature(tor exports only): Date leaving U.S.: v11-11-1K w 17.Transporter Acknowledgment of Receipt of Materials Transporter rintedRypa Name Signature Month Day Year a z g GT rter rinte yped Name ��,� //� �q.S Si re Doth Da Year } 8.Discrepar6y fee.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 181 Altemate Facility(or Generator) U.S.EPA ID Number V U Facility's Phone: W 18c.Signature ofAltemate Facility(or Generator) Month Uay Year a z H19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling Systeme) LU 1. 2. _ 3. I- \ 1 1-� ' ) L')'— c 20. wn nated Facility Omer or Operator:Certifi n of receipt of hazardous J terials covered by the manifest except as noted in Item rin ed Name `\ x Signature Month, Day Year `j C \,V, EPA Form 5700-22(Rev.3-0 ) Previous editions areete. DESIGNATE6'FJLr TO DESTINATION STATE (IF REQUIRED)