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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAD 0 2 8 2 7 7 0 3 6 1 (800)424-9300 01746 8 7 5 7 JJK S.Generator's Naive and MaIllangAd&= Generators Slte Address(if differeni.than malling address) WORLD OIL ENVIRONMENTAL SERVICES 3-300 S SAN f A FE AVE nrri6jPTO N CA 90221 Gcrnoa;iror';Phone: 310 886-3400 6.Transporter 1 Company Name U.S.EPA ID Number WORLD OIL ENVIRONMENTAL SERVICES CAD 0;2 8 2 7 7 0 3 6 7.TfarFspvrler 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and.SkAdilms U.S.EPA ID Number ASBURY ENVIRONMENTAL SERVICE-CERES 1920 MORGAN RD- CERES CA 953ES CAL000393650 Faclli 's Phone: (209)541-1825 ga 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 0 1NON-RCP,A HAZARDOUS WASTE, LIQUID(USED OIL/MIXED OIL) 21 993 G Z 2. W 3. 4. 14.Special Handling Instructions and Additional Information EMERGENCY CONTACT : CHEMTREC 1-800-424-9300 WOES TERMIINALAPPROPRIATE PERSONAL PROTECI'IVE EQUIPMENT , EMERGENCY CONTACT CHEMTP,EC 800-424-9300 TRUCK# 4/001 'rV3 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. Generatof's/Offerar's PrintedlTyped flame Signature Manlh Day Year i1 r� —J 16.International Shipments F— ❑Import to U.S. ❑Export from U.S. Port of entry/exit: K Transporter signature(for exports only): Date Ieaft U.S.: LM 17.Transporter Acknowledgment of Receipt of Materials Transsppoorter 1 Printedrryped Name Signature Month Day Year 4 Transporter 2 Printed/Typed Name Signature Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue Partial Rejection El Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number _J V LL Facility's Phone: w 18c.5ignafure oTAllernate Faci ily(or Generator) MonthDay Year Q z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) UJ 1. 2. 3. 4. 1 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Nnledffyped Nemo Signa[ure Month Day Year N21VIA h 1 a K\)II I 0 f$ EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)