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I11I�IIH E R� � Please print or type. 60140 95Form Approved.OMB No.2050-0039 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest I rackin Number WASTE MANIFEST UNIFORM HAZARDOUS CAL00tav92478 1 (87 7) 577-x'669 015 01702 F L E 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) O' Reilly Auto Parts O' Reilly Auto Fart s#; 567 417874757 1440 EAST HARDING WAY 1440 EAST HARDING WAY STOCKTON, CA 9505 STOCKTON, CA 95205 Generator's Phone: U.S.EPA ID Number 6.Transporter 1 Company Name Clean Earth Specialty Waste Solutions MNS000110924 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address General Environmental Mgt. LLC U.S.EPA ID Number 11855 White Rock Road Rancho Cordova, CA 9574 Facility's Phone: 9163510980 CAD980884183 9a 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 WtWol. 1X X 1UN1950, Waste Aerosols, Flammable 2. 1, ERG#126 1 DF 00056 R w21 D001 z 2. W 3. ( 4. 14.Special Handling Instructions and Additional Information 1. 100663(Aero s o l s, Flammable) 15. GENERATOR'SIOFFEROR'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 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 Exporter,1 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 262.27(a)(if I am a large quantity generator)or(b)(ifl am a sm II quantity generator)is true. Generator'slOfferorr''ssPrintedrryped Name Signature Month Day Year 16.International Shipments F p ❑Import to U.S. ❑Export from U.S. Port le ving U.S.: Id Z Transporter signature(for exports only): Date leaving .S rY 17.Transporter Acknowledgment of Receipt of Materials WMonth Day Year t— Transporter 1 Printed/Typed Name Signature nom. John Lain th �0` Month Day Year Z Transporter 2 Printedffyped Name Signature F- 18.Discrepancy 18a.Discrepancy Indication Space ElQuantity ❑Type ElResidue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facility's Phone: Lu 18c,Signature of Alternate Facility(or Generator) Month Day Year Q Z y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2' T. 4. 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year 2l EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. ES AT ITY TO EPA's e-MANIFEST SYSTEM 8700-22 12v3 CAL40000003 541097203 04203659E M PD033@?1 SD@33021 _-