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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved,OMB No.2050-0039 <br /> UNIFORM HAZARDOUS i.Genre or ID Number 2.Page 1 of 3.Emergency Response Phone 4,Manliest Tracking Number <br /> WASTE MANIFEST CAL000411327 1 400-363-3678 017 4 0 3 4 4 3 JJ K <br /> S.Generators Name and Mailing Address Generators Site Address(if different than mailing address) <br /> Sally7 6eaut7 Supplies i 752 <br /> 678 H WILSON WAY i E-33 <br /> STOCK-MR, CA, 95205 <br /> Generators Phone. 90a 041-075R <br /> 6.Tmnsporter 1 Company Name U.S.EPA ID Number <br /> ALL CLEAN NASARDOUS WASTE REMOVAL INC CAD982492399 <br /> 7.Transporter Company Name U.S.EPA ID Number <br /> TEMARRY RECYCLING, INC. CAR000194217 <br /> B.Desynatetl Facili Name and SideAdBdrRT ess DE �I� U.S.EPA ID Number <br /> CAntaETEQA- FEDERAL NO- 2 HEX, SAN PAULO TECATE 13C <br /> Facility's Phone: 619-270-9453 MXC130619001 <br /> 93go U S DOT Description(including Proper Shipping Name.Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> and Packing if an 13.Waste Codes <br /> 9 Grou <br /> HM D( any)) No. Type Quantity WLNoI. <br /> 1 UNIL950, WASTE AEROSOLS (Each No Ewceeding SL D001 D035 331 <br /> c X Capacity) , FLAMMAOSLE, N-O-S-, 2-1 1 p -- <br /> 9 <br /> z 2 unlYY3, WASTE FLAMMABLE LIQUIDS, N-O-S, ` D001 D035 F003 <br /> X (ACETONE, ISOPROPANOL) , 3, PG II 1tr p <br /> y1 331 <br /> 3. UB1479, WASTE OXID1333IG SOLID, N-O-S. 1 DO01 141 <br /> X (POTASSIUM PERSULFATE, SODIUM PERSULFATE) , 1 Cf o (� p _ <br /> 5-1, PGIII 1- yw <br /> 4 561 <br /> (DETERGENTS-GLYCOLS) ` �j p _ <br /> 14.Special Handling Instructions an nation ICJ' Iv1Y <br /> 1) 8091613 /10 Ae osol) 2) R_ (F as Liq) 3) R_/101 (Oridicer) <br /> s) s_/��(NRL-CF) IML)V <br /> PRIMARY EXPORTER: TEtlARRY CYCLING INC- PO/ 13167-60 <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: 1 hereby dedare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> marked and Iabeledlplaarded,and are in all respects in proper condition for transport according to applicable intemabonal and nabDral governmental regulators.If export shipment and I am the Primary <br /> Exparter,I cert'rfy that the contents of this consignment conform to the terms of the attached EPAAcknowledgmenl of C sent. <br /> Ice waste minimization statement identified in 40 CFR 262.271a)In I am a large quantity generator) r am a small qua gen tor)is true. <br /> Gane rsl a 's PdntedRyped Name ffgnaW M ay Year, <br /> nae a io alShipments ❑ U.S. <br /> F Import to Export fro U.S. Pon of entry/exit Z SO6 <br /> = Transporter signature(for exports only). Date leaving U.S.: if Z✓ 1 <br /> w 17.TransponerAcknowledgment of Receipt of MaterialsAQ <br /> Transporter 1 Pn edkped Name Signature Month Day Year <br /> O <br /> a <br /> N <br /> Q TransPn tlRy N e Sig M e <br /> L� <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quang <br /> ty Type Ll Residue Partial Rejection FUII Rejection <br /> Manifest Reference Number. <br /> 181a.Alternate Facility(or Generator) U.S.EPA ID Number <br /> 7 <br /> U <br /> LL Facility's Phone: <br /> w 18c.Signature of Alternate Fadlity(or Generator) Month Day Year <br /> Q <br /> 2 <br /> y19.Hazardous Waste Report Management Method Codes(i.e..codes for hazardous waste treatment disposal,and recycling systems) <br /> G 1. 2. 3. 4. <br /> 20.Designated Facility Owner or Operator Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a <br /> 1 <br /> Print yped Name 1 Signature Month Day Year <br /> V 0 T;' *%/4 U U <br /> EPA Form 8700-22(Re.3-05) Previous editions amobsolet . DESIGNATED FkC1yfryf0DESTINATIONSTATE(IFREQUIRED) <br />