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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. 024548714 JJ K 5.Generators Name and Mailing Address ! Generator's Site Address(if different than mailing address) Ai,Tom Robins.' United#.5447. United#5447.: 4130 Cover Street -1469 E.Hammer LN,. Lon Beach'CA g 00808 Stockton:CA 96210 . Generators Phone: : '• 6.Transporter 1 Compan a e U.S.EPA ID Number Bayview-Industrial,Servites,.lnc ,, C-A:L 0 0 0 ,4:. 7.Transporter 2'Company Name : U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number D.emenno-Kerdoon 2000 N Alameda_Street:';. -Compton;=Ck90222 Facility's Phone:•,,, 9a• 9b:U.S.DOT Description(includinig 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 Wt.Nol. 1,'UN 1993,MSTE Flamm able liquids rl o s 3,PGIII(Gasoline) w 2 Z w 3. 4. 14.Special Handling Instructions and Additional Information. ;1)G as.station test water,( 1,X.559a1),ERG#128.•.BI S#;22806 fff 23171:,3.I nvoice,disposal,to,Bayview l ndustnil,job#,22806;.,,, POD 15. GENERATOR'S/OFFEROR'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 intemational 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. 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 aMAsmall quantity generator)is true. Generators/Offerors Printedffyped Name Signature Month. Day Year �a S140' 16.International Shipments j.., ❑Import to U.S. ❑Export from U.S. Part of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: OC W 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year a Nick CleVel nd 1 z Trans,7 Prin (fyp d N e Sig Month ay ear 18.Discrepancy. 18a.Discrepancy Indication SpaceElQuantit y ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J , Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year Q N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) G 1 2. 3. 4. 05 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18i Printed/Typed Name Signature Mo Year el �' l �'u ��t �eS i ZZ EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM .