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RECEIVED 10/31/2018 <br /> pleqse print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-6039 <br /> UNIFORM 70l51 Generator ID Number 2.Pa e t of 3.Emergency Response Phone 4.Manifest Trackin Number <br /> WASTE MANIFEST tAL000412178 2 48363-368 015885 <br /> 8 4 JJ K <br /> S.Generator's Name and Mailing Address Generators Site Address(if different than mailing address) <br /> COSMOPROF @EAUTY 09331 <br /> 1453 MARCH LANE <br /> STOCKTON,CA 95207 <br /> Generator's Phone:2M956-49192 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD982492,90 <br /> 7 Transporter 2 Company Name U.S.EPA ID Number <br /> TEMARRY RECYLING,INC_ CAR000194217 <br /> 8.Designated Facility Name and Site Address RECICLADORA TEMARRY DE ME1000 U.S.EPA ID Number <br /> CARRETERA FEDERAL NO.2 ME}{ M'rr7Ci 30519001 <br /> SAN PABLO, TECATE 9C <br /> Facility's Phone: 619-270-9453 <br /> 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class.ID Number. 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> HM and Packing Group(if any)) No. Typs Quantity Wt.NDI. <br /> K 1 UN1950,WASTE AEROSOLS(Each NO Eneeding 1 L Capacity), 331 D001 D035 <br /> FLAMMABLE,N.O.S.,2.1 <br /> K 2 UN11993,WASTE FLAMMABLE LIQUIDS,N.O.S.,(ACETONE, 331 D00f 0035 <br /> ISOPROPANOL).3.PG 11 [ 1 <br /> 1 ! Faa3 <br /> }t 3. AS —eaf D8B2 <br /> n (E-3 C <br /> 4. NODI RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, 561 <br /> GLYCOLS) <br /> 14.Special Handling Instructions and Vditional Inf ation <br /> 1) 8091513 1 I <br /> 01 " r (AerDSW) PRIMARY EXPORTER: TEMARRY RECYLING INC PON 10871 <br /> 2)R f (Elam LIq) ) d)R 1 a f r s17F (NRL-CP) <br /> 1.5. GENE RATDR'S4 FFEROR'S CERTIFICATION: I hereby declare that the contents of lhls consignmant are fully and accurately described above by the proper shipping name,and are classified,packaged. <br /> marked and labeiedlplacarded,and are in all respects in proper condition for transport according to applicable inlemationaI and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. <br /> I car*that the waste minimization statement identified in 40 CFR 262.27(a)(it I am a large quantity generator)or(by(if I am a small quantity generator)is true. <br /> GeneratoesfOffemr's Ponted(fyped Name Signature Month Day Year <br /> 2 <br /> 16.International Shipments bn <br /> i— ❑ to U.S. Export horn U.S. Por!of enbylexi <br /> Z Transporter signature(for exports only): I ZLYN,1 JAIL tu Date leaving U.S.: A <br /> 17.Transporter Acknowledgment of Receipt of Matenals <br /> aTransporte t Prince ped Nam Signaturef th Day Year <br /> O 1 <br /> 4 Transporter2 PrintedlTyped Name Signature Month Day Year <br /> 3 <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Spate y ❑Type ❑ ❑Partial Rejection ❑Full Re <br /> ❑ Quandt T Residue jeclion <br /> Manifest Reference Number; <br /> 1 Bb.Altamate Fadiity(or Generator) U.S.EPA 10 Number <br /> U <br /> uQ Facility's Phone: <br /> W 1Be-Signature of Alternate Facility(or Generator) Month Day Year <br /> a <br /> z <br /> N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment.disposal.and recycling systems) <br /> In 1. � 2. 3. 4. <br /> 20. signaled FaCll ty Owner or Operator <br /> SAKkation of receipt of hizardous materials covered by the manifest except as noted i 18a <br /> Prito yped Name Signature U1�7 Day Y r <br /> EPA Fa 700-22[Rev. D5) Previouse ions areobsol e. DES IC� ED FACT ITY TO DESTINATION STATE(IF REQUIRED) <br /> u <br />