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Please print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone , 4.M ifest Tracking Number WASTE MANIFEST CALLOW<.' C!. f E 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Thaldw CompwJ/of CallfbrNa 1010 irtdmum %e ,31 .i.ton, CA 962M Generators Phone: j.fy7{�sj 6.Transporter 1 Company Name U.S.EPA ID Number Ad4et'a4Ed ClWMCA TMMport MC-MBA ACTfdnWo t:..AxUffl[iti70W 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number iwU pox /:;..fi6 J-,11 Ma IS Beatty P�+,f1' 1woo Beatty, NV 89W3 Facility's Phone: 77&55.Z-2M3 ga 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 Wtivol. 13.Waste Codes o x TN3244,�r,�<:aste� OF P r�3rrag a orrcash�e� quki,ra.o. s5 t ¢Hydrochbnr_ Acid,Absorbet-9).8,PGR �a .. . n .�....._ w W 2 iv 1759,Corrosive soWs,mos. (mum hv�arrc:iti a' t bsorbenll).8,Ptd 314i:2aster Co roswe ' s,toxic,m.o.s. , ydrrwhinrif- i2l D002 0607 Acki,Chromivan),S(6.1),Pt i1 4-Non-RC.RA Hazardous Waste lApad(INalamac:eous Fartla 34,13 14.Special Handling Instructions and Additional Information P"ect Nimbef 214.4ti- 0M-JMW)t#, t1 ;,: W4 1)ERGli154; 07012000% THIP- _ 3)ERG#154: i}its 2)ERG#154, 0701274915-32565 THtJ� `_� 4:) 070131510.2435 T1k*kL 15. GENERATOR'SIOFFEROR'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 EPAAcknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(x)(if I am a large quantity generator)or(b) ifI am a small quantity generator)is true. Generator's/Offers nnted/Typed Name Signature r� ✓ , Month Day Year y J 16.International Shipments F- ❑Import to U.S. ❑Export from U.S. _Port Ql/entry/exit: Z Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials t- Transporter PrintedfTYPed Name a Signature Month Day Year a t. Z Transporter 2 Printed/Typed Name Signature Month Day Year F 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: UO 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z V5 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 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 18a Pdnted/Typed Name Signature Month Day Year t EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY