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Address Storer Transportation, 1909 Argonaut St., Stockton CA 95206 Record ID PRO515892 <br /> Date 9/13/2022 Program: HW <br /> PHOTO 3: <br /> Signed uniform hazardous waste manifest copy not available on site. <br /> 'D, PEMa <br /> p, dt or rype.(Fonndesignetl for use on elite(12-pituh)rypewdtec) Form ApProvetl.OMe No.2050-0039 <br /> ORM HAZARDOUS 1.Gen-saIDNmelam 2.Page lof 3.Emagerwy Res—PMre 4.ManMestlTrackin NpumCCer <br /> Plea) STE MANIFEST CAL000336676 1 (600)4249-WO Qy'�Js,7���JJK <br /> Oi <br /> eramh Name and Manirrgg Atltlraae Gereraloh Sim Odtlress(d dMeremtlan nwLrg atlEress) WING <br /> I �TORER TRANSPOR970051- <br /> 3619 MC DONALD AVEODESTO CA 9535&9770 1909 S ARGONAUT STREETems Phcna: 209644-5114 STOCKTON CA 99206gC"e�r LE)(ENVIRONMENTAL SERVICES D S CAD02827 7036'RADWWRECOVERY S-MEM INC CA!000175422 <br /> gnaletl Fatal'M Name artl Site POtlress U.S.EPAIDNenber <br /> ES MANAGEMENT.INC500 US HIGHWAY 95 <br /> OMA AZ 66365 AZR000521146 <br /> ,Phapau (928)344-982R <br /> ga. so.U.$.DOT Deacdptian lindon ing P—,ShiWin Name.H—al Co.,IO Nomber, 10.Conminera 11.Toml 12,Unit 13.Wmm Codes <br /> HM end Packlrp GrooP(darty)) No. Typo Wanhry WYNG. <br /> 1NON-RCRA HAZARDOUS WASTE.SOLID(OILY SOLID) <br /> DM P <br /> 2. <br /> c <br /> 3. <br /> 4. <br /> 14.Special Handling Instructions andMdifianal Infarmadon <br /> EMERGENCY CONTACT CHEMTREC 1-804424-93M WOES TERMINAL CERES CS NAERGN 9B1.171`PROFILE N 981: <br /> 162623NRSSTOO51 OILY SOI IDS.`APPROPRIATE PPF.EQUIPMENT <br /> 15. GENERATOR'S/OFFEROR'S CERTIFICATION:I hereby declare that Ne dentents of Nis cansignment are fullyand accoratelydescribedabovebytheprepershiPPingname.dpdma Gassified,packaged, <br /> marked and labeledlplacarded,and are in all respects in proper condition for lman pod according to applicable Intemadonal and national governmental regulations.It export shipment and I am Ne Primary <br /> Exporter,I meaty that the contents of this consignment conform m the teens of Ne anached EPAAcknowledgment of Consent, <br /> Identify that the waste minimization statement identified In 40 CFR 262.271a)liflamalarge quantity generator)or(b)(ifl erne smallquanhry genemtonMonth Da, Year <br /> Geneatofs/OReroh Pdnled/Typed Name Signature <br /> 16.International Shipments ❑lmportto U.S. ❑Expodfram U.S. Podofsntrylexif. <br /> Data leaving US.: <br /> Tmnspader signature(for experts only): <br /> W 17.Transporter Acknowledgment of Receipt of Materials Month Day Year <br /> 17 <br /> Transporter 7 Parts,yped Name Signature <br /> O - r <br /> I at- Month Day Year <br /> Z Transporter 2 Pdnted/Typed Name r Signature <br /> Q <br /> Q' <br /> r <br /> 18.Discrepancy <br /> 78a,Discrepancy Indication Space ❑Quantity El Type ❑Residue Pallial!election ❑Full Rejection <br /> Manifest Reference Numher: <br /> U.S.EPA ID Number <br /> 18b.Alternate Facility(or Generator)Zi <br /> U <br /> I Facility's Phone: Month Day Year <br /> W <br /> 18c.Signature ofNtemate Facility(or Generator) <br /> ZZ <br /> h19.Hazardous Waste Report Management Method Codes(Le.,modes for hazardous waste treatment,disposal,and recycling systems) <br /> W <br /> 4. <br /> 1 <br /> C3 <br /> 1 20.Designated Facility Owner or Operator,Cedificatme of receipt 01 hazardous materials covered by the manifest except as noted in Item 18a Month Day Year <br /> Pdnted/ryped Name Signature <br /> EPA Form 8700-22(Rev.3-05)Previous editions are obsolete. GENERATOR'S INITIAL COPY <br /> Gabriela Garcia-Mejia, EHS Page 3 of 3 <br />