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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMS No.2050-0039 1.Generator ID Number 2 Page 1 of 3,Emergency Response Phone 4.Manifest Tracking Number IJNIFDRM HAZARDOUS 017 416 7 6 4 JJ K WASTE MANIFEST CALOOD41 1327 1 408-363-3678 5.Generator's Name and Mailing Address Generators Site Address(if different than mailing address) SALLY BEAUTY SUPPLIES#f752 678 N.WILSON WAY,#F&33 STOCKON,CA 95205 Generator's Phone'209-941-0258 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD982492399 7.Transporter 2 Company Name &4rLLtNh US EPA ID Number TEMARRY ROQ44=14Q,INC. CAR000194217 8.Designated Faci€iiy Name and Site Address U.S.EPA lD Number RECICLADORA TEMARRY DE MEXICO MXC130619001 CARRETERA FEDERAL NO. 2 MEX SAN PABLO, TECATE BC Facility's Phone: 1 ga 9b.US.DOT Description(including Proper Shipping Name,Hazard Claes,ID Number, 10.Containers 11,Total 12.Unit 13.waste Codes HM and Packing Group(if any)) No. Type Quantity WOVol. OC X t UN1950,WASTE AEROSOLS(Each No Exceeding 1LCapa ity), � �� ,n 331 Ill D035 00 FLAMMABLE.N.O.S.,2.1 �) i1� LU X 2 UN 1993,WASTE FLAMMABLE LIQUIDS,N.Q.S.,(ACETONE, 331 Dill D035 ISOPROPANOL),3,PG II 1�� I FOOT W s UN1479,WASTE OXIDIZING SOLID,N O.S.(POTASSIUM 141 DWI PERSULFATE,SODIUM PERSULFATE).5.11,PG III 1 Z a ANON RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, 561 GLYCOLS) l 14.Special Handling instructions and Additional Information 1) 8091613 f '0 I f Y (Aerosol) PRIMARY EXPORTER: TEMARRY RECYLING INC4). PON A11721 2) R 1 (Flam i 3) R f 5t (OxIc2mr) 4)R 1 c D [)C3UL��(NRL--CP) 15 GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately describer above by the proper shipping name,and are classified,packaged. marked and labeledlplaoarded,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 EPAAcknowledgment 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 f am a small quanti enerator)is true. Generator'sOjerods PnntedfTyped Name 5i to 1 ) Month Day Year Ak r--. 3 .J 16.international Shipments H ❑Import to U Export from U Port of entrylexit: - ? Trans orter signature(for exports onl p g po yl: Date leaving U.S-: W17,Transporter Acknowiedgment of eceipt of Materials Ll Transporter 1 PrintedlTyp Nam Signature Month Day Year QTransporter 2Printetl yped Name Signature Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space El Quantity 11 Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 11 Alternate Facility(or Generator) U.S-EPA ID Number V Facility's Phone. LLj 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z F0 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment.disposal,and recycling systems) 0 1. 2. - kJ 20 e gnated Facility Owner or Operator Cerfeefor,of r ipt of hazard s materials covered by the manifest except as noted in m 8a P t yped Name I i ` Signature Month Day Year t L 7 EPA Fvrm0-22(Rej35) Previous editions are olete.� DESIGNA FACIL Y TO DESTINATION STATE (IF REQUIRED)