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.,m designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 ,LARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number MANIFEST CAD 9 8 1 9 6 7 6 8 0 1 (800)424-9300 017791228 JJ K gyrator's Name and Mailing Address Generators Site Address(if different than mailing address) STOCKTON DODGE INC 3333 AUTO CENTER,CIRCLE STOCKTON CA 95212 Generators Phone: 209 477-3669 6.Transporter 1 Company Name U.S-EPA ID Number ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 7.Transporter 2 Company Name U.S.EPA ID Number WORLDWIDE RECOVERY SYSTEM INC. CAR 0 0 01 7 5 4 2 2 8.Designated Facility Name and Site Address U.S.EPA ID Number YUMA YES LLC 2730 E 13TH ST YUMA AZ 85365 AZR000515924 Facility's Phone: q7 aqR 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) No. Type Quantity WtNol. 13.Waste Codes 0 1'NON-RCRA HAZARDOUS WASTE,SOLID(OILY SOLID,PAPER FILTERS) 1 / 352 ti (/ DM ( 2,0 P LU 2. w c7 3. 4. ` 14.Special Handling Instnxiions and Additional Information EMERGENCY CONTACT:CHEMTREC 1-800-4249300 WOES TERMINAL CERES CS *PROFILE.#9131:162623NRSST0627 OILY SOLID,PAPER FILTERS * *APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT # i x�S 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping narhe,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international d national governmental regulations.ti export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowiedgment of n. I certify that the waste minimization statement identified in 40 CFR 26227(a)(d I am a large quantity generator r I small quantity generator)is true. en tors/Offeroes Printed/Typed Name S'natur I MD* Day YM � � -� i�' 116.International Shipments F ❑Impart to U.S. ❑Export from U.S. Part of enbylexib Z Transporter signature(for exports only): Date leaving U.S.: 17.TransporterAdmowledgment of Receipt of Materials Trans e 1 Printed/Tyed Narrp Signature MOrf9i Day Y IL �' - r7 1 t Z Transporter 2 Printed[Ty0d ame Signature Mort Day Year a 18.Discrepancy 18a.Discrepancy Indication Space Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 18b.Alternate Facility(or Generator) - U.S.EPA ID Number J LL Facility's Phone: W 18c.Signature of Alternate Facility(or Gene ator) Month Day Year Q� z REC- iml IED y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1 2. 3. MAY' 0 .7 2018 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrintediTyped Name Signature ENVIR ON171—JNJ I L Month Day Year HEALTH DEPARTIIM-- , ,, I I EPA Form 8700-22(Rev.3-05) Pievidus editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED)