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Please print or type. .‹ GENERATOR UNIFORM HAZARDOUS <br />WASTE MANIFEST <br />1. Generator ID Number <br />CAL000332779 <br />2. Page 1 of <br />1 <br />3. Emergency Response Phone <br />209-648-8060 <br />4. Manifest Tracking Number <br />003623335GBF <br />Generators Name and Mailing Address Generators Site Address (if different than mailing address) <br />VANCO TRUCK & AUTO PLAZA <br />1033W CHARTER WAY <br />STOCKTON CA, 95206-1105 <br />Generators Phone: 209-406-0833 I <br />Transporter 1 Company Name U.S. EPA ID Number <br />ALL ENVIRONMENTAL SERVICES LLC 1CAL000421863 <br />Transporter 2 Company Name U.S. EPA ID Number <br />WORLDWIDE RECOVERY SYSTEM INC 1 CAR000175422 <br />Designated Facility Name and Site Address U.S. EPA ID Number <br />YUMA YES WASTE TRANSFER FACILITY AZR000515924 2730 E 13TH ST <br />YUMA AZ, 85365 <br />Facility's Phone: 909-909-2783 I <br />9a. 9b. U.S. DOT Description (induding Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit <br />jim and Packing Group (if any)) No. Type Quantity Wt.Nol. 13. Waste Codes <br />1. Non-RCRA Hazardous Waste, solid (diesel, dirt, absorbents) <br />3 DM 735 P <br />331 <br />2 <br />3 <br />I <br />4. <br />14. Special Handling Instructions and Additional Information <br />Profile no#: 26102218 <br />WO#: Y21061; Line 1: <br />15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby dedare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, <br />marked and labeled/placarded, 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 <br />Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent <br />I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true. <br />Generators/Offeror's PrintedfTyped Name Signature Month Day Year <br />Brian Espinoza 1 Brian Espinoza 1 10 1 09 1 2020 <br />-1 <br />I- <br />16. International Shipments <br />II Import to U.S Export from U.S. Port of entry/exit: <br />Transporter signature (for exports only): Date leaving U.S.: TRANSPORTER 17. Transporter Acknowledgment of Receipt of Materials <br />Transporter 1 Printed/Typed Name Signature Month Day Year <br />Brian Espinoza 1 Brian Espinoza I 10 1 09 1 2020 <br />Transporter 2 Printed/Typed Name Signature Month Day Year <br />Kimberly Jordan 1 Kimberly Jordan 1 10 1 09 1 2020 I -4-- DESIGNATED FACILITY ---- 18. Discrepancy <br />Discrepancy Indication Space Quantity LITYPe Residue Partial Rejection Full Rejection <br />Manifest Reference Number: <br />Alternate Facility (or Generator) U.S. EPA ID Number <br />Facility's Phone: I <br />Signature of Alternate Facility (or Generator) Month Day Year <br />I I I <br />19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />1. <br />H141 <br />2. 3. 4. <br />20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br />Printed/Typed Name Signature Month Day Year <br />Patricia Alvarez 1 Patricia Alvarez 1 10 1 12 1 2020 <br />EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM