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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.Manliest Tracking Number WASTE MANIFEST CAL000411327 1 408.36.3-3157s I 017 3 6 9 9 5 3 JJ K 5.Generators Name and Mailing Address Generator's Site Address(6 different than mailing address) SALLY BEAUTY SUPPLIES 5752 678 N.WILSON WAY,SB-33 STOCKON,CA 95205 Generators Phone 0_341-0256 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. C.A0982492399 7.Transporter 2 Company Name LLS-EPA ID Number TEMARRY RECYCLING,INC_ :.-ROOi1342^ 8.Designated Facility Name and Site Address RECICLADORA TEMARRY DE MEXICO U.S.EPA ID Number CARRETERA FEDERAL NO 2 MEX MXC730619001 SAN PABLO, TECATE BC Facility's Phone: 619-270-9453 gra 9b.U.S.DOT Description including Proper Shipping Name,Hazard Class,ID Number. 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Parking Group(if any)) No. Type Quantity WINOI. X 1_ UN1950,WASTE AEROSOLS(Eacn No Exceeding l l-CapaM), /1 s3I D001 i D035 o FLAMMABLE,N.O.S..2.1 z X 2. UN1993,WASTE FLAMMABLE LIQUIDS,NO S..(ACETONE, D001 0035 cW7 ISOPROPANOL). 3,PG If 1 r I /� J/ -003 X 3. UN1479,WASTE OXIDIZING SOLID,N.O.S.(POTASSIUM 141 D001 PERSULFATE,SODIUM PERSULFATE),5.1,PG IIt ZS 4. NON RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, ^ 5_ GLYCOLS) CK s CA (u/ 14.Special Handling Instmcdons and Additional Info axion 1) R091613 f 01 I (Aerosol) PRIMARY EXPORTER' TEMARRY RECYLING INC4)- PO# 12803,'#27 2) R f Flam Llq) 3) R (ORItlKer) 4)R / 1NRL-CP) 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 labeled/placarded,and arta in all respects In proper condition for transport according to applicable intemati0nd natianal governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terns of the attached EPA Acknowledgment of Con (It. I certify that the waste minimization statement Identified in 40 CFR 262.27(a)(i(I am a large quantity generator)o5(6)(6 a small quantity glitagual<M true. Genemtorsl r Pnn dlTyped NameSi aN Month Dayr Yeer a-la �J / 16.Intemadonal hipmenis p- ❑Import to U 5. _ Export from .5. Pon olenirylextt: klpff P, CA Transporter signature(for exports only): Date leaving US.: omr-o)-- Ic w 17.TmnsporterAcknoWedgmenlof Receiptof Matenals Transco 1 Printedrryped Name Signature Mo ih Day Year � a Z p Q TranntedRyped Name Signature Month Day Year nspo r v d t18aler5repancy - - 18a.Discrepancy lndicauon Space ❑ Quantity ❑Type Residue ❑Partial Refection ❑Full Rejection Manifest Reference Number: 16b.Alternate Facility for Generator) U.S.EPA ID Number J U W Facility's Phone: w 18c.Signature of Alternate Facility(Or Generator) Month Day Year 6 2 H19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 1. 2. 3. 4. 20. hated Facility Owner or Operator Certification of_rgmipt of hatsirdous materials covered by the manifest except as noted in Iterif 18a - - 1 Pant Signature Name Month Day Year . r4r t � EPA Fan 8700-22(Rev.3 5) Previousedibons are obsolete. DESIGNATED I TO DESTINATION STATE (IF REQUIRED)