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urae^iP@ of it <br /> mm <br /> Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved-DMB No.2050-W39 <br /> UNIFORM HAIARDOU5 11-GeneratoriONLimber 2.Page 1 of 3.Emergency Response Phone 4,Manifest Tracking Number <br /> WASTE MANIFEST 015893115 JJ K <br /> 5-Generator's Name and Mailing Address Generarods Site Address(if differenl than mailing address) <br /> SALLY BEAUTY SUPPLIES 9752 <br /> 678 N.WILSON WAY,X19-33 <br /> Generalods Phon STOCKON.CA 95205 <br /> 6.Transporter 1 Company ame U-S-EPA ID Number <br /> ALL CLERK HAZARDOUS WASTE REMOVAL INC. <br /> 7.Transporter 2 Company Name U.S.EPA 10 Number <br /> TEMARRY RECYLING,INC. CAR000194217 <br /> S.Designated Facility Bane and Site Address U.S.EPA ID Number <br /> RECICLADORA TEMARRY DE MEMO MXC130619001 <br /> CARRETERA FEDERAL NO-2 MLrK <br /> SRN PA9LO, TEI:ATE 8C <br /> FSCIIi[y'S Phone: <br /> ga 96.U.S.DDT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers11.Total 12-Unit 13.Was#e Codes <br /> HM and Paclung Group(d any)) No. Type Quantity WI.Nol. <br /> a K 1 UK 1950,WASTE AEROSOLS[Each Na EneeGing 1L Capaal . � G� �1 � 331 D001 0.036 <br /> v FLAMMABLE,N.Q.S.,2.1 <br /> x 2' UNI 993.WASTE FLAMMABLE LIQUIDS.N.O.S-,(ACETONE. + 331 DOO1 D035 <br /> ISOPROPANOL),3,PG II [ <br /> rvaa <br /> 4' NON RCRA HAZARDOUS WASTE LIQUIDS.(DETERGENTS, i 551 <br /> GLYCOLS) <br /> 14.Special Handling instructions and Additional information <br /> 8091813 f 4 ) kf- MARY E}b�ORTER: TEMARRY RECI'LING INC POUF 10541 <br /> 3) R 1 [Base Hal roMCtxr W) 4)R ! •Lfo (NRL-CP} r d- <br /> 15- GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this eansignmenl are fully and mtely described above by the proper shipping name,aro are dassified,packaged, <br /> mark nd labetedlptacarded,and are in all respects in proper condition for transport according to applicable int and national governmental regulations.If export shipment and I am the Primary <br /> Ex ,1 certify that the conlents of this consignment conform to the terms of the attached EPA Ackmwledg of C sent. <br /> I t the waste minimization statement identi>3ed In 40 CFR 2132.Z7(a)(if I am a Targe quant ty ge l or(h t am a small quen[ry eneratd e <br /> Gen icor Typ N ign Month Day Year <br /> 4,13 �[, <br /> lfflntenniu6nal S ipmen <br /> Import m U.S. Export fro U.S. Port o <br /> Transporter signature(for exports onift11 9 <br /> Dale leaven U.S. icy <br /> 17.Transporter Acknowledgment of Receipt of Materials <br /> Tran ar 1 Printed+Typed Name Signature Month pay Year <br /> O L1 v r.{ <br /> ell ►+►t L� <br /> 4 Transporter 2 PrintedFyped Name Signature nth Day Year <br /> Sb VQki 46 <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quantityyp e <br /> T e p Residue Partial R}e' coon Full Rejection <br /> AlEeftgmc <br /> fo 946 N.NVA4"ZILkAj, C� Manifest Reference Number: �+ <br /> 18b.Alternate Facif aRdi EPA ID Number <br /> J_ <br /> tai Facility's Phone: <br /> w 18c,Signature of Alternate Facility(or Generator) 7nth <br /> Day Year <br /> a <br /> 2 <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment•disposal•and recycling systems) <br /> LU 1, 2. 3, 4. <br /> 29.Designated Facility Owner or Operator:Certification of recaipt of hazardous materials covered by the manifest except as rated rn item <br /> Pd yped Name - u <br /> 1 Signature Month ay Year <br /> EPA Form <br /> 00- <br /> O (Rev- -05) Previous editions are obso e�� DESI! T FACILI O DESTINATION STATE(IF REQUIIiED) <br />