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SK SHIP# 2.30954640 Please print or type Farm Approved.OMB No.2059-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Pagel of 3.Emergency Response Phone 4.Manifest Tracking Number �+11�+ WASTE MANIFEST CACM311052489 t i—Fil,710--4E;�- t 76, a7ve KS 5.Generator's Name and Maiiing Address Generator's Site Address(if different than mailing address) Maa%Dnite Corporation 340 W Scotts Ave STOCKTON CA 9553-0000 Generator's Phone: <!09--948-01537 6.Transporter 1 Company Name U.S.EPA ID Number SAF''LTY--KII-LEN SYSTEMS INC TXRi 00061205 7.Transporter 2 Company Name U.S.EPA ID Number i-i...�� tV H#'tNi]I[li ENV SVC INC. B.Designated Facility Name and Site Address CL F AFr HARBORS OF Al)T-rgNW I LE OW U.S.EPA ID Number 050+ i-QKERN ROAD �3UTTONWILLOW , CA 93c'06 Facifi 's Phone. 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 Wt.Nol. 13.Waste Codes 1 NCN RCRA f PzARDOUS WASTE LIOUIDS ?] LiTE:X PAINTS} t# A uJ 3, 4. 14.Special Handling Instructions and Add'ftiolrat Information 1 t7)D i 5L 6 L 6 t .1.4h 1 l'°cF,i4c:!1X% -CH/SK/TI—Contract retained by generator nFOpay r 1 Vti-i- t 5. GENERATOR'S10FFEROR'5 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 Iabeledlpiacarded,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. Generalor'slOHerors PrtnledlTyped Name Signature Month Day Year fY 16.international Shipments ❑Import to U.S. ❑Exportfrom U.S. Port of entrylexit: ? Transporter signature(far exports only), Date leaving U.S.: iX U.11 17.Transporter Acknowledgment of Receipt of Materials F- Transporter 1 PrintedlTyped Name Signature Month Day Year O CL iTransporter 2 PrintedlTyped Name Signature Month Day Year 18.Discrepancy 18a,Discrepancy Indication Space ❑ Quantity Type ❑ ❑ I ❑Full Rejection ❑T e Residue Partial Rejection Manifest Reference Number, 18b.Allemale Facility(or Generator) U -EPA ID Number J_ V Facility's Phone: w 1Bc,Signature of Alternate Facility(or Generator) Month Day Year a Z 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) O 1. 2. 3. 4 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 16a Printed/Typed Name Signature Month Day Year FPA Form 8700-22(Rev.12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY I