Laserfiche WebLink
i <br /> Pleqse print or type.{Form designed for use on elite(12-pitch)"writer.) Form Approved,OMB No.2050-0038 <br /> UNIFORM NAZARDOUS 1•Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manliest Tracking Number <br /> WASTE MANIFESTCAWON <br /> JIM7 015893331 JJ K <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than malting address) <br /> SALLY BEAUTY SUPPLIES 0752 <br /> 578 N.WILSON WAY,09-33 <br /> 9TOCKON,CA 95205 <br /> Generator's Phv <br /> 6.Transporter 1 Company Name U.S.EPA 10 Number <br /> ALL CLEM HAZARDOUS WASTE REMOVAL INC. CAD282492399 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> TEMARRY RECYLNG,INC. CAR000194211 <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> RECICLADORA TEMARRY DE MEXCO MXC1 3lX19D01 <br /> CARRETERA FEDERAL NO.2 MEX <br /> ^SAN PABILO, TECATE BC <br /> Facility's Phon96 19-270-94W <br /> 9a• 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Cless,ID Number, 10.Containers 11.Total 12.unit <br /> i <br /> HM and Packing Group(if any)) No. Type Quantity NltNol 13.Waste Caries <br /> 1.LN1950,WASTE AEROSOLS(Enh NO EXZR@dWV 1 L Capp AM. 331 D001 0035 <br /> FLAMMABLE,N.O.S.,2.1 Q <br /> z.UNI 993.WASTE FLAMMABLE UOUIDS,N.O.S.,(ACETONE, , � � � 31 D001 D035 <br /> ISOPROPANOL),3.PSa M 003 <br /> 3. <br /> 4.NON RCRAwaZAJtDOW WASTE LIOLMS.(DETERGENTS, 1 1 <br /> GLYCOLS) <br /> 14.Special Handling Instructions randAdditional information <br /> 1) 8091613 110 <br /> 10 (I V:1D Fla msol) PRIMARY EXPORTER TEMARRY RECYLNG INC POUF 1025 <br /> ( Uq) <br /> 6 4)#R I-���(NRL-CP) <br /> 15. GENERATOWSIOFFEROR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fully and accurately described above by the proper sh;pping name,and are classified,packaged, <br /> marked and labeledlplacarded,and are in all respects in proper condilion for transport according to applicable intemabonaI and n0onal governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to Bre terms of the attached EPA Acknowledgment of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(ay(if I am a large quantity generator)or(b)(if I am a Aall quanbly g nor r)is true. <br /> t "s <br /> ]rV0%er s Prino ya� an � ign ture Nlpnth pay �Y ar <br /> 16, n0rational Shipments .1 � �_J 1 <br /> importS. Export from U.S. Port of antrylexr[: {� �j�r�(�- <br /> -- Transporter signature(for exports only); �• Dale leaving U.S.: <br /> LU 17•Transporter Acknowledgment of Receipt of Materials <br /> Transporte 1 Print ped Name Signature Month Clay Year <br /> a <br /> a Transpa Printedffyped Name Signature Month Day Year <br /> ar-y 4I AI &Q <br /> 18.Discrepancy <br /> I 8a.Discrepancy Indication Space ❑ Quantity ❑Type <br /> ❑Residue Partial Rejection Full Rejection <br /> III=CEEjLhff'3= Manifest Reference Number: G41111:GCC989M <br /> 1$b•Alternate Fa#*&§2@1M U.S.EPA ID Number C-4 <br /> U <br /> epi Facility's Phone. <br /> in 18c.Signature of Aftemate Facility(or Generator) Month Day Year <br /> a <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Q 1 2. 3. 4. <br /> PrEllJ t � <br /> 20.D <br /> led Facility Owner yr Operator:Corti n o re pt of hazardous materia s covered by the manifest except as ed in Item 18a <br /> Print ped Name Signature M th Da Y <br /> EPA 8700.22(Rev. -05} revious editions are obsol e. DESIGNATE GILITY O DESTINATION STATE(IF REQUIRED) <br />