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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1,Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4,Manifest Tracking Number <br /> WASTE MANIFEST CAC003348715 1-866-547Addre -2857 020183606 F LE <br /> $ T4�n i�dd8PNTER MAILING Generators SUPER KINC31%ODtCENTERaddress) <br /> 8626 N. LOWER SACRAMENTO ROAD STE_ 20 1449 W. MARCH LANE <br /> STIOCKTON, CA 95210 STOCKTON, CA 95207 <br /> Generator's Phone:(925)201.351 1 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> Atlas Environmental Solutions AROW295220 <br /> rrem°roliment&f"Management Technologies, Inc, uAS.RA0001m83574 <br /> rl ��t317mf1Ldl �'3ieJOlUilOI1S, Inc. U,S.EPA ID Number <br /> 31915 Industrial Lane AOR000520478 <br /> Parker South, AZ 8534.4 <br /> Facility's Phone: <br /> ga. 9b.U.S.DOT Description{including Proper Shipping Name,Hazard Class,iD Number, 10 Containers 11 Total 12-Unit 13.Waste Codes <br /> HM and Packing Group(if any)) No Type Quantity WLIVOI <br /> on- HA Hazardous Waste, Liquid (Surfactants) 181 <br /> o 3 DM �Q� P - -; - - <br /> C1 <br /> 2. 117dci�S vv�+�� , Luft+ �L�k�c �o►,'nf) OF 130 ' ' <br /> 3.Narl- Q0A k2orik,,6 wane, L�gu,'z C 3-5� u-,il <br /> Q'MI;4 <br /> 4 ,)DAF WA R02V&4,,1s � +� ► Z � �Veye+fade bi- 1S E <br /> 1Qt'�� <br /> 14 Racial Ha liq n ctions and Additional Information 9414964 <br /> 1 WS Y3 a�ws q 3�r3� 3) s y3ga9 <br /> 1x55_ X15 1 xs Bill to: Atlas <br /> 15 GENERATOR'S10FFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,arta are classified,packaged, <br /> marked and labeledlplacarded.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 Acknowledgme of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a)(ii I am a large quantity generator) r b}(ifI am a small quantity generator)is true. <br /> Generatoesl0fferors PrintedlTypeddame Signatur Month Day Year <br /> zc g7 12S <br /> 16.International Shipments <br /> ❑Import to U.S. Export fromU. Port of ertrylexiL _ <br /> Z Transporter signature(for exports only): Date leaving U.S., <br /> LC 17.Transporter Acknowledgment of Receipt of Materials <br /> F- T Transporter 1 PrinledlTyped Name Signature Month DDaajy Year <br /> 0 ,1 19 1 125- <br /> aTransporter 2 Printed/Typed Kw4 Signature - Month jay Year <br /> F J Ca* <br /> 18,Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number <br /> 16b.Alternate Facility(or Generator) U S.EPA ID Number <br /> J_ <br /> U <br /> Facility's Phone: <br /> w 18c.Signature of Alternate Facility(or Generator) Month bay Year <br /> t— <br /> Q <br /> x <br /> 19.Hazardous Waste Report Management Method Codes(i e., odes for haz rdous waste treatment disposal,and recycling systems) <br /> 0 1 2.4� <br /> 3. 4 <br /> 20-Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest exceptiosQated m Item 180 <br /> Priritedtlyped Na:Am <br /> I � \U !4allQ <br /> /+� SignEPA Form 8700-22(Rev.12-17) Previous editions are obsolete. ESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />