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J� r , lea Vrin�ortype. 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 C A -L 0 0 0 4 0 7 0 3 0 1 610-662-6181 024549124 JJ K 5.GU f11t217 My Mailing Address tt Tom Robins Generator's Site Address(if different than mailing address) U U 7 United#5447 4130 Cover Street 1469 E Hammer LN. Long Beach CA 90808 Stockton CA 95210 Generator's Phone: 3 1 0 1 - 3 2 3 - 3 9 9 2 6.Transporter 1 Company Name U.S.EPA ID Number Bavriew Industrial Services, Inc CAR 0 0 0 3 4 7 4 9 2 7.Transporter 2 Company Name U.S.EPA ID Number eAll Clean H�amzardous Waste Removal Inc C A D 9 8 2 4 9 2 3 -9 9 8 D V.7.agCOIOlNIVeYadae Address U.S.EPA ID Number Higli*,95;11 South of Beatty - Beatty NV 89003 Facility's Phone: 800 239-3943 N V T 3 3 0 0 1 0 0 0 0 9a 9b.U.S.DOT Description(including 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 1326,MSTE Flammable solids,organic,n.o.s. o X` -4.1,PGII DM P D001 D018 352 Z 2. w c7 3. .. 4. 14:S I dlin Instructions and dditional Iotorma' n ; e A�mpapted vvi�t pasoline. rofile#070318587-0. ERG#133 Invoice disposal to Bavview Industrial Job#?2806. BIS#22806.;' 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,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 a small quantity generator)is true. GeneratoXOfferor's Printed/Typed Nam Signature Month .Day Year 16.Intemational Shiprfients F- • ❑Import to U.S. ❑Export from U.S Port of entry/exit: z Transporter signature(fog exports only): Date leaving .S.: W 17:TransporterAcknowledgment of Receipt of Materials LU Transporter.1 Printed(fyped Name Signature Month Day ', Year a Nick Cleveland 0 1 g 2,3 Z Transporter 2 Printed(fyped Name Signature Month Day'. Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ = ' Quantity El ❑Residue Partial Rejection ❑Fuh''R.ejection- Manifest Reference Number: F 18b.Alternate Facility(or Generator) U.S.EPA ID Number :3 U LL Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year Q = Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LU 1. . I 2. 13. 4. 20.D signated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Print yped Na a Si lure Month Day Ye rLl rA - p� EPA Form 8700-2 (Re 121-117) Previous editions are obsolete. DESIGNATED FACILITY TO-EPA's e-MANIFEST SYSTEM