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Plea pie. Form Approved.OMB No.2050-0039 )KIFORn1 n11ZARD0US 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 14.Manifest Tracking Number WASTE MANIFESTt j/ j 1 800-535-5053-INFOTRAC �-,! 11`j�- f (�� WAS 5.Generators Name and Mailing Address Generator's Site Address(it different than mailing address) 1 r f Generator's Phone: 6.Transporter 1 Company Name U S.EPA ID Number ; CLEANTECH ENVIRONMENTAL INC. ZAL-000368-136 7.Transporter 2 Company Name U S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number CLEANTECH ENVIRONMENTAL INC. CAL000330453 5820 MARTIN ROAD IRWINDALE,CA 91706 USA Facility's Phone: 626-812-7200 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(d any)) No. Type Quantity WINol. 1. NON-RCRA HAZARDOUS WASTE SOLID (USED ABSORBENT) DM P 352 0 r^- Z 2, NON-RCRA HAZARDOUS WASTE SOLID (ABSORBENT/PAPER DM rjf P 352 Uj FILTER MEDIA) t J 3 NON-RCRA HAZARDOUS WASTE SOLID (OILY SOLID WASTEWSED - DM r P 352 METAL OIL FILTERS) / 4. I 14.Special Handling Instructions and Additional Information 9B1) PROFILE# 9B2)PROFILE# USE GLOVES AND GOGGLES (ABSORBENT) (PAPER FILTER) 9B3) (METAL FILTERS) CALLER MUST IDENTIFY CLEANTECH ENVIRONMENTAL AS REGISTRANT: INFOTRAC 800-535-5053 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 intemationaland national govemmentai 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 slatement 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. Generator'sl0fferor's Printed/Typed Name Signature Month Day Year J 16.International Shipments F ❑Import to U.S. ❑Export from U.S. Port of entrylexil. ? Transporter signature(for exports only): Date leaving U.S.: of 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 PrintedlTyped Name Signature f Month Day Year a - -- — i Z Transporter 2 Pnnled(Typed Name Signature Month Day Year f- 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Altemate Facility(or Generator) U.S.EPA ID Number J U LL Fac lily s Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z 0 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 PrintedfTyped Name Signature Month Day Year l EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY