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) J <br /> t t <br /> Pleasa print or t (Form d9ai neat for use on elAe�12 itch)lypewrlJer Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS' 1.Generator lD NumbeP #r - 2:Pagel of 3,Emergency Response Phone ' 4.—manifest Tracking Nombar �/ <br /> WASTE MANIFEST, _ ,N CATOBOD11240 1 904-721-2038 000459169. JJ K <br /> 5.Generators Name and MaingAddress Generator's SlleAddress(If different than mailing address) <br /> SFPP LP Novy prise <br /> 1100 Towne&Country Road 2947 2947Stockton,CA 95ZOR <br /> Orange,CA 92966 ' <br /> Generators Phone: 204-465-7,iffi <br /> G.Transporter l Company Name " U.S.FPA ID Number <br /> Filter RecycCngSelaYioas,Inc. CAD982444481. <br /> T.Transporter 2 Company Name .•* r% E U.S.EPA ID Number <br /> B.Designated Facility Name and Site Address U.S.EPA ID Number <br /> Veolla EG'Technical Solutions LLC - - CAD00UD2903 <br /> 1704 W.Firs Slraet <br /> Azusa,CA 91742 <br /> Facility's Phone: 826.334.5117 <br /> ga, gin.U.S.DOT Description(Including PmperShlpping Name,HazardClass,ID Number, 101Conlelnn11.Told 12.Unit 13.Wade Codes <br /> HM and Packlrg Group(Ifar l) No. type Ouantlty, WWd.. .. <br /> tY x1' Wastaftmirablevolid,organic,n.c.s.(gasoline),4.1,UN1325,P.GNDM P DWI 018. .352 <br /> p r' Seo <br /> u=1 k z. Hazardous Waste Solid,n.o.s..,peac)9,1)N3077,PGIII DM P <br /> f39i41` Dal <br /> 52 <br /> 3. <br /> 4.. <br /> 1 .S Handling Instructions andAdditlonal Information <br /> 9b1)Contaminatedabsorbentwfgasoline Profltes*521186 WP.erAppropriate PPE Invoice V28663 <br /> 9h2b,Soltwlead Prsafiled' h^r.r'�`�'I . <br /> 16. GENERATOR'SIOFFEROR'S CERTIFICATWN:.I hereby declare that the contents of this consignment are fully and accurately descdbad above by the proper shipping name,erd are dangled,packaged, <br /> marked and labeled/placarded,and are In all respects in proper conditlon for transport according to applicable International and national governmentd regulators.If export sNpment and I em the Primary <br /> .Expoder,l-cenlfy that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I ceNly that Ihawaste minimization statement Identified In 40 CFR 282.27(a)(if I am a large quantltygenerator)or(b)(ifI am a small quaMiry generator)Is We. <br /> Oe'q.{etl�tarslOBerars PdntedRyped Name Slg r§ Ma/nlhJ ,�Da1y/ Year <br /> /' ./""i".e' <br /> 16.International Shipments <br /> El Import to U.S. ❑Expadfnxn U.B. Pat of entrylexk <br /> = Transporter signature(for exports only): Dale leaving U.S.: <br /> W 17.TrensportaAckwwler: t ofRecelptof Materiels <br /> F" Trinleplonar.l PrusedRyped Name - Signature — !" (, Mopih Day, Year <br /> 0 96r <br /> QTransporter 2 PdntedlTyped Name Signalure - Month Day Year <br /> oc <br /> 1- <br /> 18.Discrepancy <br /> 1 Ba.Discrepancy Indication Space. ❑'Ouenuty. . - ❑Type. ❑'RrkYW `' r❑F01 Reiectim <br /> Ma Hand Rears=Number. <br /> 18b.Alternate Facllity(or Generalor) - U.S.EPA ID Number ;tt yr <br /> J <br /> U <br /> raz. Factlity'a Phone: 0 <br /> aW 18c.Signature ofAearnate Facility(or Generator) Month DN ' <br /> 2 <br /> 65 19.Hazardoygy1`'aste Report Management Method Codes p.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 0 1. ,,rj, 2. ' 3. 4. <br /> 28.Designdetl FedgtyOwner or Operator Cargill of mcdp(gf hazemxbus materials wvared by the manifest except as noted in Item 18a <br /> 1 PrIntedl ma Signore ^� Monlh )YeJfa__ <br /> EPA Form 8700-2Z(Ftev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br /> r";;: <br />