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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Farm Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1,Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAL000411327 1 40&-36,3-3578 015884321 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(l1 different than mailing address) SALLY BEAUTY SUPPLIES#752 678 N.WILSON WAY,#8-33 STOCKON,CA 95205 Generator's Phone209-941-0258 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD9824923% 7.Transporter 2 Company Name U.S.EPA ID Number TEMARRY RECYLING,INC. CAR000194217 8.Designated Facility Name and Site Address RECICLADORA TEMARRY DE MEXICO US.EPA ID Number CARRETERA FEDERAL NO.2 MEX MXC134519001 SAN PAELO, TECATE EIC Facility's Phone:6196270-9453 ga 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10 Containers 11.Total 12-Unit 13.Waste Codas HM and Packing Group(if any)) No Type Quantity Wt,Nol. X 1. U 1 950,WASTE AEROSOLS(11i No Exceeding 11-Call 331 DOW 0035 FLAMMABLE,N.O.S.,2.1 a i X 2. LIQUIDS,N.Q.S.,(ACETONE, l 331 0001 D036 LU ISOPROPANOL),3,PG II 1 n �C/ F003 X 3. UN1479.WASTE OXIDIZING SOLID,N.O.S.(POTASSIUM 141 D001 PER SULFATE,SODIUM PERSUIFATE),5.1.PG III a. N CRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, 1 11 r 561 GLYCOLS) 14.Special Handling Instructions and Addition I rmation ` (� \ i f 1) R09ifi13 1/ 1 /x 1 (Aerowl) PRIMARY EXPORTER: TEMARRY RECYLING Ill POP ATTR 2)R ! (FI8n ii 3) R I (Oxidizer) 4)R i ill ) (NR1l 15- GENERATOR'SIOFFEROR'S CERTIFICATION: I heresy 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 are in all respects in proper condition tar 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. that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity ge r b)(if I am a small itillaniratvr is true. erafor f erors P6nte yped NameSi at My h Day Ye�L_hA" r J 16 In ern tion Shipme s F- liki ❑Impart to U.S. Fxpnn Pram U.5 Port of enlryfexit: vim &tly on ,CA. Transporter signature(for exports only): 00niDate leaving U.S. Ina , rax 17,TransporterAcknowiedgmeni of Receipt of Materials 1— Transporter 1 'nted,T ad Name Signature Month Day Year CL f Z Transporter 2 rintedlT ed Name Signature M�jy Day Year � i p 1-t- AJC �1 i6.Discrepancy 18a.Discrepancy Indication Space Quantity ❑Type i�e [I Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 1131.Alternate Facility(or Generator) US.EPA ID Number J rai Facility's Phone', LL, 18c,Signature vfAlternate Facility{or Generator) Month Day Year a z , Fn- 19.Hazardous Waste Report Management Method Codes(i.e,cedes for hazardous waste treatment.disposal,and recycling systems) C 1. 2. 3. 20 De'gna d Facility Owner or Operator:Certification of recq ardvus mal 'als covered by the manifest except as noted in Item 16a Pr riled p Name Signature Month Day Year �� EPA Form 8 0.22(R v.3-0 Previous editions are ob DESIGNATE6TILITY T6 DESTINATION STATE (IF REQUIRED)