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Please pent or type. (Form designed for use on elite (12-1Lfi) typewritar.) <br />Farm Approved OMB No. 20.50.0039 <br />EPA Forst 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FAQILJ I T 10 ura "moki ION STAIL (It ftwulRED f <br />UNIFORM HAZARDOUS <br />1 Garerator lDNumeb� <br />C A R O U 0 2 2 0 7 0 7 <br />2. Page f of <br />1 <br />3. FrnergArnyRaepo ms Peons <br />24-2543 <br />Trsoking Namber <br />7402 <br />WA87MANIF" <br />(+405) <br />007 FLE <br />5. s ng Aftess GanerDrs Sb Address (d ditmnt than MAIN <br />Love's CountStores of California Loee's Cauatrp Store= of California $223 <br />P_q.. Sox 8099 1553 W_ Calony Road <br />Rancho Santa Margarita, CA 92688 Ripon, CA 95366 <br />Oeneretar% Phone: <br />ran r1 y <br />U.S. EPA ID umber <br />BELSHIRE v MU <br />I CARO 0 0 18 3 9 13 <br />7. Tmnaporfar 2 C rrperry Name U.3. EPA ID Motber <br />APR 0 6 2015 <br />S.9na anxi U.3. EPA ID Number <br />S. EC01?s�gy Ne da Operatifone H V T 3 3 0 0 1 0 0 0 0 <br />Highwap 95, �� » es s_ at ea tty ENVIRONMENTAL <br />Beatty, NV 89003 <br />(775) 553-2LJd!FA'-u'1CDA0TRACNIT <br />Fed Pbate: <br />g& <br />9b, u3. DOTDosrllwa, (incising Proper Shippiv tramp- Hazard Glass, ID Nr,AW. <br />10. Gears <br />11, Total <br />12 unit <br />73. Waffia Codes <br />No. <br />TW.Ouentily <br />HM <br />�� <br />P9 �P (d anY)) <br />"old. <br />a <br />t. Non—F&TA lUsafrdotitsl ]rlast e e 90.11A MRG $171) <br />P <br />252 <br />kD01 <br />001 <br />pM <br />X00 <br />i <br />2. <br />W <br />3. <br />4 <br />ex <br />14.3pec HaridOn9lnsVwWreand AddWcna Mwmation Writ* is exempt from SESI ' 2 5 3 3 6 2 E <br />6tnerator is a FWRA CE596 tinder .i0 CFR Stat4 and Land <br />261, 5. 001.8 erode 1r reasaaa:te waste that DisDoaal Rextriation: <br />ER <br />ut <br />is RrU ..fdents•f3.*d bnot; RCPA <br />re�u] sled. PROMIX # 1370127$99-206 <br />16. GkNERAT(XM0WUM'9 CMIFICATION' l JxYM dada., d.1 Ilk mntarrm of tris conaigtrnant ere fury and accu raWV desefbW above by the proper Std PN tome, and are dax&d, pedwgad, <br />marlaartand taheledlplacsrded. and are in ell r06p9CfG n pNpd'tond*M for transportewoWQ b & Wkv� 1nWfM0pnal std nar%nel govrrnmar sl regulefmm. 8 export slvprrcent and I am ft Pematy <br />Exporter, I off* 1hat era aYftntg of Ede ax>WmarA mnk m bo ttrw Terme of Itw attached EPAAdmv,,W nwnl of Cwseflt. - <br />I ce * ftttt* waste nlni**Yi slafGnem pkntlAeO H 40 CFR 2ii227(ay (d I amp lenge qWM ftY generMor} or (b)(f I am a I ganerd(or] is+n,¢. <br />cenorawVONMrs PdrrlecYiyped Name D ay Ym <br />LRgry Moothaxt of Brat on Imahalf of generaur 0 <br />2 11.51 <br />❑ Import b US. Export tom US. Port at entrylWde <br />Tran on : We lea U.s.. <br />4' <br />17. HfvwrAe�9ment . of hlaterlats <br />Tranapartar1 PnrtxVTYPdt i,, -: ,gnalue th th ay <br />STe VE P4 M E PJ DMA o OZ <br />Taster Nara <br />a <br />18. Discrepancy <br />18e. Qlisc soy tl Woe Space ❑ Qwrtty ❑ Type ❑ fias;due ❑ Parft Rel Wm ❑Ful Re C*c <br />Manifest Rgerenoa Number: <br />18b. A6 rnsba Feo@y (or Garw gtor) U.S. EPA 10 Nunbar <br />U <br />LL <br />- <br />Fad s phone: <br />W <br />i8c, a ofAlianote FKft (or Gewrator) <br />19. Hazardous WadD Report Management Md" Codes (1.e„ codes for f>amrdoue neva treabraarrt, dlspobel, avid MOVOing "11M) <br />1. 2. <br />in <br />71- <br />20.Dem Fed1ty Ovner or Clpewtor, Ceft]doatlon of reoeo of hazardop4 r atarlela =ieree by #* rpanffeat exnspt as nobad in Item 18a <br />SfgniNtC MDW Day est <br />EPA Forst 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FAQILJ I T 10 ura "moki ION STAIL (It ftwulRED f <br />