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RECEIVED 10/31/2018 Please prim or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved OMB No.2o5Q-o 739 UNIFORM HAZARDOUS 1 1-Generator ID Number 2 Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CALOOD412175 1 408-363-,t78 015884359 JJ K 5 Generator's Name and Mailing Address Generators Site Address(if different than maiiing address) COSMOPROF BEAUrf#9331 1453 MARCH LANE STOCKTON,CA 95207 Generators Phone2[t�9 4 6,Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD982492399 7.Transporter 2 Company Name U.S.EPA ID Number TEMARRY RECYLING,INC. CAR000194217 B,Designated Facility Name and Site Address U.S.EPA ID Number RECICLADORA TEMARRY DE MEXICO MXG130619001 CARRETERA FEDERAL NO.2 MEW SAN PABLO, TECATE EIC Facility's Phone: ga, 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11,Total 12.Unit 13-Waste Codes HM and Packing Group(if any}} No. Type Quantity Wt.Nol. a x 1 UN1950,WASTE AEROSOLS(Each No Exceeding 1L Capactty), y O .331 D001 0035 0 FLAMMABLE,N.O.S.,2.1 l C L }( 2 UN1993,WASTE FLAMMABLE LIQUIDS,N.O.S.,(ACETONE. 331 D001 D035 ISOPROPANOL),3,PG II X 3 UN1479,WASTE OXIDIZING SOLID,N.O.S.(POTASSIUM ` '7 ,f) 141 ?0001 PERSULFATE,SODIUM PERSULFATE),5.1,PG III I Z Y 4. NON RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, n 561 GLYCOLS) T` 14 Special Handling Instructions and Additional Information 1) 8091613 1 W Imo' 'f (Aerosol) PRIMARY EXPORTER: TEMARRY RECYLING INC POW A11440 2) R J 7C,{ Mi (Flats Ul 3) R F (OIUfzer) 4}R 1 a OLPb (Ni 15, GENERATOR'S10FFEROR'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 labeledfplacarded,and are in all respects in proper condition for 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 EPA Acknowledgment of Consent. I certify that the waste minimization statement identified n 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quan;ily generator)is true. GeneratorslOfferors PnnledQyped Name Signature Month Day Year .J 1 . emational Shipments F— ❑Import 10 U.S. Export from U.S. Port of entrylexit: _ Z Transporter Signalure(for exports only): Date leaving U.S,', - T 17.Transporter A nowledgment of Receipt of Materials LLITransporter 1 Pr a Name SignatureMont bay Year ua (D I --7 QTransporter 2 Prinled7Typed Nae S.gnat Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space Quanti ly ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number U 4a. Facility's Phone; w 18c-Signature ofAltemate Facility(or Generator) Month Day Year a Z 19.Hazardous Waste Report Management Method Codes(i e,codes for hazardous waste treatment,disposal,and recycling systems) G 1. 2. 3. 4. �. — 1)� *?, 20 Des nated Facility Owner or Operator Cerlificatict of receipt o hazar eus ma pals covered by the manifest except as noted in Item 1 Prin d Name Signature Month Day Year 11 ' �. `/� , EPA Form 0-22(Rev.3- Previous editions are❑ DESIGNATIfffFILITYTb DESTINATION STATE (IF REQUIRED)