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"Plaase print or type, "" � Form Approved.OMB No.2050-0039 A UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3,Emergency Response no 4.Manifest Tracking Number WASTE MANIFEST CA R ala 0 2 6 6 2 4 7 � 7818.008 001801181 VES 15..�Gonerr+sttor's Name 7a�nnd7 Melling Address .Lr(JLIS�A G�L�jAI�I Generator's Site Address(if different than mailing address) 4 zFED F:YA��.�L�yGR5OUIN EI SAME , 5655 HOOD WAY TRACY,CA 45.37'7-7217 Generator's Phone: 6.Transporter 1 Company Name U.S.EPA ID Number VEOLIA ES TECHNICAL SOLUTIONS IN J D 0 0 0 d 3 1 3 $ 9 7.Transporter 2 Company Name U.S,EPA Number 7� !� V U/ Designated FxililyWama and Sate A dress,�,EOLIA'ES TECHNICAL SOLUTIONS U.S.EPA ID Number s HIGHWAY 73 3.5 MILES W. OF TAYLOR'S BAYOU FacillysPhons: 4D9 PORT ARTHUR,TX 77640 T Y D a 0 Q B 3 B 8 0 6 9a. 9b.U.S.DOT Descriptlon fincluding Proper Shipping Name,Hazard Class,ID Number, 10,Containers 11.Total 12,'Untt 13.Waste Codes HM and Packing Group(if any)) No, Type Quantity Wt./Vol, 0 1 NOON-RC'RA WLZARDOUS WASTE LIQUID,WE'X PAINT, 331 2 G F 3 70 P GUTS2 9K i 2. f c~y r 3. 4. i 14.Special Handling lnstnrctions and Additional Information LR Service Contracted by VESTS + Conloact retained by enerator confers agency at ority on initial transpotter to add or substitute additional transporters on generator's behalf -1-� If W:71529 A: 15, OENERATOR'S10FFEROR'S CERTIFICATION:I heieby declare that the contents of this consignment are fully(and accurately described above by th i proper shipping name,and are dassified,packaged, marked and labeled/placarded,and are in all respects In properconditton for transport according to appllcabte intemationaland national governmental r6gulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment omform to the terms of the attached EPAAcknowledgment of Convent. I certily that ft waste minimization statement Identified In 40 CFR 262,27(x)(if I am a large quantity generator)or(b)Of I em a small quantity generator)is true. Generator'sfOfferors Printed/Typed Name Signature Month Day Year _.r 16,International ShipmentsEl ❑ 1, Import io U.S. Expat from U.S. Port of entrylexll: Transporter signature(for exports only): Date leaving U.S.; tau 17.Transporter AcknowiedgmenfofReceipt ofMaterials r t2 Transporter 1 PrinlednWed Name Signature Il Month Day Year IL M Transporter 2 Printedlf Name Sfgnat, sl Month Day Year f Z ILP / 18.Discrep cy 189.Discrepancy Indication Space ❑ quantity . ❑Type ❑Residue ❑Par6i Rejection ❑Full Relectien Manifest Reference Number. 18b,Alternate Facility(or Generator) U.S.EPO}A ID Number L FaciliVs Phone: W 16c.Signature of Allemale Facility( (or Generator) l Month Day Year I r 1 S.Hazardous Waste Report Management Method Codes(i.e.•codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2, 3, 4:I 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest a sept as ncled in Item 18a 1Md Na � atu Month Day ear C� EPA Fort 8700-22(Rev.12-17) Previous edition are obsolete. DESIGNATED FACILITY TO EPA's e•MANIFEST SYSTEM