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Please print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAL 0 0 0 3 5 8 9 7 3 1 (800)424-9300 026707833 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) TRACY SHELL 1450 N BENSON AVE,STE A UPLAND CA 91786 3725 N TRACY BLVD Generators Phone: 951300-8264 TRACY CA 95304 6.Transporter 1 Company Name U.S.EPA ID Number WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 7.Transporter 2 Company Name U.S.EPA ID Number S.Designated Facility Name and Site Address U.S.EPA ID Number WORLD OIL RECYCLING 2000 N.ALAMEDA STREET COMPTON- CA 90222 CAT 0 8 0 0 13 3 5 2 Facility's Phone: ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers II.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 0 1RQ, UN1203,WASTE GASOLINE, 3, PGII D001 D018 343 IDM G z Z. w C7 3. 4. 14.Special Handling instructions and Additional Information EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 WOES TERMINAL:CERES CS NAERG#961:128 *PROFILE#961: 527576 GASOLINE/WATER * *APPROPRIATE PPE EQUIPMENT '-SS- 15, GENERATOR'SfOFFEROR'S CERTIFICATION: 1 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,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowiedgment 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)(If I am a small quantity generator)is true. Gen7tor erors Printed(fyped Name Signature Month Day Year �gZ6z4 16.Interiation I Shipments F ❑Import to U.S. Export from U.S. Port of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials LLJ Transporter 1 P'ntedRyped Name Signature Month Day Year a Transporter 2 PrintedfTyped Name Sign Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection El Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month pay Year. Q z us 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2. 3. 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 Yea EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTE