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°fa")Ik°f <br />Wanes a,;rr ev f— XRrm &tinsel fnr <br />on alila 111.nitchl tvnewdlerI <br />• <br />Form Approved. OMB No. 2f150-0039 <br />EPp'Form MM22 (Rev. 3.05) Previous ediGensy9re Db-Olele. -' — / DESiGNATED FACILITY TO GENERATOR <br />UNIFORM HAZA DOUS <br />1 • Genemlolr D Number <br />11 2 4 4 Q C1 T r1 <br />2. Page 1 d <br />+ <br />3. Emergency Hwsponse Phase <br />s. Em 41 y Respo 0 <br />4. irlartreal Trackutg Humber <br />007433535 JJ K <br />WASTE MANFEST <br />c A i] -S <br />Cienersioer, Mame artd Malin AJ*m Cmie(alora Silo Address {ddfferent than mailing address) <br />SIMS HIM NEO - STOCKT(Y-l1 tOOO S. AURORA ST <br />1000 S. AURORA ST <br />STOCKTON CA ST4CKTONA <br />Creneratoh Phone: 200 948.4WO <br />b. TrxupoAer I Company Name U.S. EPA ID Number <br />G A >? o a 0 2 7 3 r*� <br />A:�, MY EWRONWNTAL SERACES <br />T. Transporter 2 Company Nanne U.S. EPA ID Number <br />S. Desgnated Faoity Nama and SkeAddress V.S. EPA ID Number <br />l NNO ! KEROOON <br />X000 NORTH AIJ%EOA STREET - <br />CA C A T 0 8 C1 0 1 3 3 E+ 2 <br />F hG(iNPTON 1tJ15,3l-7100 <br />9, <br />9b. U.S. DOT DimcepGon CrdudN Pmiw StiWV Name, Hazard Chn, ID Nuroer, <br />10. Coria mm <br />11• TOW <br />12. IJri <br />13, Waste Cases <br />No. <br />Type <br />HM <br />and PadngGroup (iang}4 <br />oanaly <br />YM Nd. <br />1. <br />74t <br />tY <br />° <br />N0N-RGRA HAZARDOUS WASTE, LIQ1.1117 {HALOGENATED OIL 01lE€i <br />/ <br />� � <br />1 <br />� f�1 <br />U <br />1000 PP <br />STREAM HAS BEEN QUALIFIED <br />i1i1S WSTE• <br />- r 1'VI4hT Ai'IH7~ <br />3. DeMEiiOf L.CC�P rrr� LiY <br />itYIGS*kS �i E ECESSARY <br />AS <br />REAM <br />4. - <br />i4UIgLJER I� cATaaGp1335 . <br />Eek, <br />14. SpadA Handling Inskueftm and AdMonal Infonmabo <br />° E*R(3ENCY CONTACT'. CHEWREC 800-424,9300 PROJECT At6F,330A1 ORDER #4-5073D <br />PROFILE # 081 327170 <br />Q0213290' ADDITIONAL EPA GODES . 981:, NONE" APPROPRIATE PERSONAL PROTECTNE EQIAPNENT <br />15. GENERATOR OFFEROWS CERTMA7M: I hereby dedare Olaf the =dents of M oonsigwort are tally and n urately described above by the proper shipping name, and are classilled, packaged, <br />marked and labeladlplacaMed, arrtare In as mvemis in proper condilon for nnsportacmd's:g lo &VIcable Inlemadanal and rmlhrrot go"mmentd mguil"ow. If etpa1 shipment and I ani Ora Prig" <br />Exporter, I oar* hM the oontenO of Itis consigrrrnard cenkrm to the tanks of the ana&ed EPAAdmnwkdgzntmt of Conaenl. <br />e, <br />I certify vim u e waste minimtzakn statementtdeadfed in Off CFR 28227(al III I am a large quannly generator} or (b) (dI am a small quantity generator) Is We. <br />alarslOHeW3 PWKedffypW Name Si alum Month Day Year <br />11 <br />J/ <br />1 .Inleme hIpmenls <br />o lnnpart b U.S. ❑ Evw frau U.S. Port of enkyfea <br />Transpolar signature (faf aapogs orly): Dale Ieau'wg U.S.: <br />OC <br />f7 TraoBpoderAcknowbdgmens of I;rxeipl d Meleriag <br />T 1' lcdlT Na *nature M <br />pllapaz--rZ <br />T-17// <br />th S <br />R <br />Z <br />Tran er 2 Prim ad Nana kXa Month Day Year <br />18.Onaeponcy <br />is& Disaapsncy k dkation Spacs Llquan sly ❑Type ❑ Residue L_J P,,,U Rejeaan L J Fun Rsl ctlon <br />Mam. os Relerenr�Nrn6er. <br />18b, Allemale Facility (or Gerw4or) U.S. EPA ID Number <br />v <br />FacWs Phone: <br />W <br />titL. Signanre o AJlerttale FadLty {er iCe} 7 Year <br />d <br />19. Hazardous Wasle Repast Management Method Codes (i e., codes for hazardous wa3te Imaamew. dsposal, and recyetng syslerm) <br />LU <br />1, � � <br />2. 3. <br />4. <br />20, Designated Faaily (Meer orCperator: Certfiaion of rareipt of hazardous maierfal5 corered by the manifest except as mored in Iwm 8a <br />rLame Sign ave Mark ay Year <br />o <br />EPp'Form MM22 (Rev. 3.05) Previous ediGensy9re Db-Olele. -' — / DESiGNATED FACILITY TO GENERATOR <br />