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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 Ila Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST Q6UWQ41 I 015886662 JJ K 5.Generator's Name and Mailing Address Generalors Site Address(if different than mailing address) SALLY BEAUTY SUPPLIES 7f752 678 N.WILSON WAY,#13-33 STOCKON,CA 95205 Generators Phone 209-941-0255 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD982492399 7.Transporter 2 Company Name U.S.EPA ID Number TEMARRY RECYLING,INC. CAROW194217 8.Designated Facility Name and Site Address U.S.EPA ID Number RECICLADORA TEMARRY DE MEACO MXCi30519001 CARRETERA FEDERAL NO.2 MEX SAN PABLO, TECATE BC Facility's Phone: 619-270-94M 9a. 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 1NLNol. O bt 1. UN1950,WASTE AEROSOLS(Each No Exceeding 1 L Capaclty), 331 DOWW D035 F FLAMMABLE,N.O.S..2.1 UJ X 2. UN1993,WASTE FLAMMABLE LIQUIDS,N.O.S.,(ACETONE, Q 331 D001 D035 ISOPROPANOL),3,PG II d F003 X 3. all Beet 4. NON RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS. GLYCOLS 14.Special Handling Instroctions and Additional Information 1) R091613 11,6 (Aerosol PRIMARY EXPORTER; TEMARRY RECYLING INC PON 10941 se H 4)R 1 q6 )�f��fIt(NRL-CP) 15. GENERATOR'SIDFFEROR'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 Iabeled)placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAdmowledgment of Consent. I certify that the waste minimization statement identified In 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true, Ge er I rslOtfel PrintedlTyped Name gnature Month DY Xa r 116.1"te6ati6ifal Shipments `` F ❑Import to U.S. Export to-MI, om S. Port of entryfexit: 5� b E Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials Transporter rintg�If ame0VF Signature hQegth Day Ye r O (`\� a Z Transporter 2 Printed/Typed Name Signature Month Day Year Q 7- a 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 18b,Alternate Facility(or Generator) U.S.EP J Off 09��RiM U ra 1 acilily's Phone: W 18c.Signature of Alternate Facifty(or Generator) Month Day Year a Z tr-n 19.Hazardous Waste Report Management Method Codes(Le.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2. 3. 20. si ated Facility Owner or Operator:CertificatiqpahVE-5-1p7bf hazardous materials covered by the manifest exoel5i as noted in I Prin ed Name Signature Month Day Y arm G r-• EPA $�74022(Rev. -0 Previous editions ar o soiete. DESIGNAT ACILITY TO DESTINATION STATE (IF REQUIRED)