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016772854JJ K <br /> �A <br /> Please print or Form designed for use on eft(124td,)typewriter.) Form .OMB No.2050.0039 <br /> UNIFORM HAZARDOUS 1.Grmralor ID Number 2.Popo 1 d 3.Eirargency Respmrre Phone l Traddnp Number <br /> WASTE MANIFEST CAL 0 0 0 3 7 7 5 5 2 1 800 424-9300 016772854 JJ K <br /> 5.Generators Name end Mang Address Geraretn/s SNo Address(If dMaren flan mapng address) <br /> TRACY VW INC DBA TRACY VOLKSWAGEN - <br /> 2266 KlTTYHAWK ROAD <br /> LIVERMORE CA 94551 2605 AUTO PLAZA WAY <br /> Gerwators Phoney 925 456.1281 TRACY (A QS14171A <br /> 6.Transporter,Company Narne U.S.EPA D Num br <br /> ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7.Traneporb 2 Company home U.S.EPA D NurnDer <br /> 8.Desipmaod Fw ty Name and SNe Address U.S.EPA ID Number <br /> US ECOLOGY VERNON INC <br /> 5375 SOUTH BOYLE AVENUE <br /> LOS ANGELES CA 90058 CAD097030993 <br /> Facifitft Phone: <br /> (313412 7-1500 <br /> 9a. 1 9b.U.S.DoT Do Ww ferdjft Paper Sk Pci g Name.Hazard Claes,IDNumbr. 10,CaRairws 11.10w 12.UnA 13.Weals Codes <br /> HM ar'dPKM Gragfdmay)) No. Type ousnoy wuVol. <br /> t' NON-RCRA HAZARDOUS WASTE,SOLID,(OILY PAPER FILTERS) 92 <br /> 'J <br /> DIV P <br /> LJIJ— <br /> z z <br /> W <br /> 11R <br /> 13, <br /> i,P i V1 NNI 'NTAHE urH <br /> 4. )EPA MIEN]' <br /> 11.Special Harming h+svdm loand Addlforal kdmrvs8on <br /> EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 NAERGO 981:171 *PROFILE N 9B1:P209259 OILY PAPER FILTERS <br /> P500-OW30262 *APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT + r,J5-1�;— <br /> ,5. GEN0uT0WWFiER0R%CE.RnFr-ATK*I hereby declare fiat the cnraenb d ark ox*O m aro lint and a0Gaa*desa0ed above by the proper shppm names,and am desalfisd,peclrapad, <br /> marked rd IabaleArpbcarded,and N in all rapetiz In proper condillon her transport acmrdng to appAcaDo Inoroatlonlard neMord povermwrlal ragdaliors.b export shpnsrt and lam the Pnrnry <br /> ExDoM.I ON"M the aonlank of thio carsiprwwd codorm tD Ow lams of Ow sttachd EPA Adarowladgmert or Consent <br /> I or*drt Fs wasle m"m4mbon slaWnera hdw ilhod in 40 CFR 262Z7(o)(d I am a krge QurIy genendor)or(b)(M I em s smeA q 9erwabr)is tme. <br /> tecilTyPd Nam foulum Month �Dayar <br /> r Ye <br /> G� <br /> 6. ❑Import b U.S. entrylebt <br /> TrauPorter dproihae(for eW-only): Date leaving U.S.: <br /> W 17.TrarxpoewAdnowiedrowA of Rerepi of Matrink <br /> ~ 1 Hrne MONA YM <br /> gIt 7NZt (7 <br /> Transporter 2 Math Day year <br /> 18.Dkaepancy <br /> 19e.Dmnprmy Indication Specs ❑dura ly ❑Type ❑Reskkw ❑Partial R*cibn ❑Ful Rejection <br /> Mardest Reference Number: <br /> ,sb.Alenala Facility(a Generated U.S.EPA D"bar <br /> a <br /> v <br /> Q <br /> LLp Facitys P,om <br /> u3 8c.*nffwm dA rnew Fad4(or <br /> F Mor>Rm Day Yew <br /> Z <br /> 19.Hazwdas Naso Report Management Melhod Codes(i.e.,mdes kr hazardous waste bsernwC dspoad.aro"ng system) <br /> D t 2 3. 4, <br /> 20.D;*,g wlad Faddy Owner a Operalcr Cerbfiotlon of moehpt d haiardare rnowws owerw by ins mertlest except as Mad n Item 1 se <br /> Prsded(TypdNw* 1 7(asC- Sqwture <br /> Moroh Day <br /> EPA Form 8700.22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY 1111RIESTINATION STATE OF REQUIRED) <br />