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Please print or type.(Form desjgoed.for use on elite(filch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generaloi ID Number 1 Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST 5 �J I C,;ALOOG R4 07 ) t, 5.Generator's Name and MailingAddross Generators Site Address(If different than mailing address) PEP BUYS f"s)5-012 2W E OR WARD STREETw Hmowp[.4 NJ 08037 '1401 8.011TH"CHTFROKER LANE ' Gonerator`&Phone:' 2M3 5.0175 LOUt QA l 8,Transporlerml Company Narne U:S,EPA ID Number 1 D 0 2L$-�17 0 e16 7,Transporter 2 Company Name. tf.5.EpA lD Number e.Designated Facility Name and,Site Address U.S.EPA ID Number :1920 MORGAN {ifs, CERE8 CA 95135A Fadl€ s Phone: f'A 1..0 0 vins 8 o ga, 9b.U.S.DOT Qescriptlon(including Proper Shipping Name,Hazard Class,ID Number, 10.Conlafners ti.Total 12.Unit I' HM and Packing Group(if any)} 13.Waste Codes No. Type Quantity Wt.Nol. E✓. 1.NON-f,RA 14AMiI)OL1S�f;�.e3TE,t IQUJD(0100 INATFR) 7-1 2. uu 3. 4, 14.Special Harrdling Inslntcilons andAdditional fnfornialion I i;. t € tkP G CNOY.f 3't'A1; 't r � 1".C" '.800.424-93fNO-E,g€ERMHKA CEPES � s�J ' tf 1 r'E;;St H kL PR i ECT!" EQUlt"s EENT'"0AE IVINCY CONTACT CHE TKO800-42.-931M 'a TRUCK�—._j 15, GENERATORVOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by ifte proper shipping name,and are classified,packaged, marked and labeledlplacarded,'bnd aro In all respects In proper condition for transport according to applicable International and national governmental regulations.If export shipment and t am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAoknm*dgment of Cansgnt I cerlily(hat the vrasle minimization statement Idanlified in 40 CFR 262.27(a)(if 1 am a large quantity generator)or(b)Of 1010mali quantity gane€a(or)is true, Generalor'slOfferor' P'nleci fyped Name Signature ;;;. M i;9' .. . Month Day Year ��-f .t=, I x"'-.• /'r 331 .:r �_ y (r} ........ .� •� "F:'� ��= r 10.International Shipments i— ❑Impart to U'S' ❑Export from U.S, Port of enhylexil: ? Transporter signature(for exports only): Rate leaving U.S.: WW V.Transporter Acknovdedgmenl of Receipt of Materials „ H Tr spotfirl Print ed,Name... Sign u ,r . Month :.'.:Day:. Fear. ...:'." cL Transporter 2 Printedifyped Name S tine ref Month Day - 'Ya r 18.Discrepancy 18a.Discrepancy Indfcation Space ❑ Guano a ty ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b,Alternate Faclllty(or Generator). U.S.EPA In Number J ua- Facillty'a Phone:.: ' 18c.Signature of Alternate Facllily:(or Generator) Month • . Day ' Year. ' 13.Hazardous Waste Report Management Method Codes(I.e.,codes far hazardous waste treatment,disposal,and recycling systems) 4. 20.Designated Facility Owner or Operator:Certificallon of receipt of hazardous materials covered by the manifest except as nded in Item 18a Prtnledllyped Name Signature Month Day Y. EPA Form 8700.22(Rev.3-05) Previous editions are obsolete. r+i'` pE51GNATtdf3 FACILITY TO GI=[dRA7C3I