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RECEIVED 3/7/2019 Form Aooroved. OMB No. 2050-0039 EPA Form 8700-22 {Rev. 3w5) Previous editions are obsolete. Q DESIGNATED FfL7 TO DESTINATION STATE (IF REQUIRED) UNIFORM HAZARDOUS 1. Generator ID Number 2. Page 1 of 3. Emergency Response Phone 4. Manifest Tracking Number 017369660 JJ K WASTE MANIFEST CALOOD411973 y 408-363-3673 5, Generators Name and Mailing Address Generator's Site Address (if different than mailing address) SALLY BEAUTY SUPPLIES #3634 1240 WEST 1 i Tri STREET TRACY, CA 85376 �0�332-1146 Generalcrs Phone: 6. Transporter 1 Company Name U.S. EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD962492399 7 Transporter 2 Company Name U -S. EPA ID Number TEMARRY RECYCLING, INC. CAR000184217 8. Designated Facility Name and Site Address RECICLADORA TEMARRY DE ME)OCO U.S. EPA ID Number MXC130619001 CARRETERA FEDERAL NO. 2 1 SAN PABLO, TECATE BC Facili s Phone: 614270-9453 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10, Containers 11. Total 12. Unit 13, Waste Codas No, Type HM and Packing Group (4 ani Quantity Wt.Nol- }( 1. UN 1950, WASTE AEROSOLS (Each Na Exceeding 1 L Capacity), ,n 331 1 D035 O FLAMMABLE. N.O.S., 2.1 fi W GD }� 2- UN1993, WASTE FLAMMABLE LIQUIDS, N.0.5., (ACETONE, ISOPROPANOL), 3, PG 11 �J K{ 331 D001 D035 FO03 �� X 3. UN1479, WASTE OYIDIZING SOLID, N.O.S. (POTASSIUM PERSULFATE, SODIUM PERSULFATE), 5.1, PG III n 141 D001 ! ( 4. NON I HAZARDOUS WASTE LIQUIDS, (DETERGENTS, GLYCOLS) CA {J 561 Ce 14. Special Handling Instructions and Additional Information 1 R091613 1101' �3�'C (Atdr0501) PRIMARY EXPORTII TEMARRY RECYLING INC4). PO# 127041#23 2) R 1 0 1 K (Flam li 3) R 1"Z6% (Oxldllizeo 4) R 1 4 ! (NRL-CP] 15. GENERATOR'S10FFEROI 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 labeledlplacarded, and are in all respects in proper condition for transport according to applicable intemational 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 In 40 CFR 21 (if I am a large quantity generator) or (b) (if j.WA a small quantity ge erator} i true. Gen lorsl0$e rs tri 1edlTyped Name � 5' ria re � � � Month DayJZi�' ar `0Shipments F. 16. lntemalion ElImport to US Export from U.S. Part of entryfexit- Z Transporter signature (lar exports only): Date leaving U.S,: — W 17, Transporter Acknowledgment of Receipt of Materlals 1� Transporte 1 ledlT Name Signature Month Day Year CL a Z Transporter 2 PrinteelTyped Name Signature Month Day Year 1 18, Discrepancy 18a- Discrepancy Indication Space ❑ Quantity ❑ Type ❑Residua ❑ Partial Rejection ❑ Full ReJeCtlen Manifest Reference Number. 18b. Alternate Facility (or Generator) U.S. EPA ID Number t, Facility's Phone: DLit 18c_ Signature ofAltemate Facility (or Generator) Month Day Year a Z co 19. Hazardous Waste Report Management Method Codes (i.e, codes for hazardous waste treatment, disposal, and recycling systems) Q 1. 2. 3. 4 [ a Facility Owner or Operator Certifcation of receipt of hazardous materials covered by the manifest except as noted in Item 11 t20ignatacl /Year ed Name ` Signature Month On G �O `. Si2i I� EPA Form 8700-22 {Rev. 3w5) Previous editions are obsolete. Q DESIGNATED FfL7 TO DESTINATION STATE (IF REQUIRED)