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Please print or type. UNIFORM H�ARD ID OUS f•Generator WASTE MANIFEST N�mbar Form Approved.OMB No.2050-0039 Ivv,,�,, 2•Page 1 of 3.Emergency Response Phone 4.MantleatTracking Number 5.Generator's Name and Mailing Address-Ge 1 01992 413 FLE ° Cana_ioc .kt n e�b� �� Generator's Site Address(if dbferent than malting address) I Genera Generators P no: AQV rter 1 Company Name AEr)CHEMICAL.TRANSPORT LLC U.S.EPA ID Number 7.Transporter 2 Company Name � fY�`: : _. CAf'ZQQQQ7Q�Q . ,. U.S.EPA ID Number 8.Designated Facility Name and Site Address Sarnex U.S.EPA ID Number Andador V ycll Tachnoio�les S/A DE C.V. T)juana, 8� �• 3902 Co(. �/afie Redondo Facility's Phone: 62(W41 97A-d&.r,9 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10,Containers 11.Total 12.Unit HIM and Packing Group(if any)) 13,Waste Codes No. Type Quantity WtNol. a X 1UN2924,Waste Flammable lfgyids,corrosive,n,o.s, OF ^^ p 212 D001 D002 {Methanol.Potasslum Hydroxide),3(8),PGII e� F003 F005 LL, z 2. W C7 3. 4. 14.Special Handling Instructions and Additional Information PI0]6Gt Njumber 5e829 DocurtlB d A D72MO 1)ERG#132; 29983 GAS- 1 x 3` �G'TP� CAr-boy 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,ard are classified,packaged, marked and labelediplacarded,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 EPAAcknowledgment of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(Ill am a small quantity generator)Is true. Month Day Year Generator's/Offeror's Printed/Typed Name Signature S 1 30 16.Intema oval Shipments Import to U.S. ❑Export from U.S. Port of en Date leaving U.S.: ? Transporter signature(for exports only): 17,Transporter Acknowledgment of Receipt of Materials Signature Month Day Year O Transporter 1 Prin d yped Name C� 5 30 r n- /vJ s Signature �~ Month I Day Year Z Transporter 2 Printed/Typed Name F- 18.Discrepancy El 18a,Discrepancy Indication Space quantity Type Residue Partial Rejection Full Rejection Manifest Reference Number: U.S.EPA ID Number 18b.Attemate Facility(or Generator) J U Facility's Phn oe; Month Day Year Alternate Facility(or Generator) 18c.Signature of 0 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disp3 sal,and recycling systems) 4 2, W 1 of hazardous materials covered by the manliest except as noted Month Day Year 20,Designated Facility Owner or operator Certification of receipt Signature In Item 8a Printed(Typed Name EPA Form 8700-22 Provious editions are obsolete, DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM (Rev.*17)