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5 l <br /> ' Please print or type,(Form designed for use on_elfte(12•pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS -Generator b Number 2.Page t of 3.Emer�enW R sa Phone nKasf Trac(dng Num e <br /> WASTE tl§ANiFEST. tt3355717 ri$ tt1�r7010 359 8, FLE <br /> 5.Generators Name and Mailing Address Generators Site Address(d different than mai;ing address) <br /> 1. SAL S'vt RECYCILING ktti WIVAzin tdotidonea <br /> 3200 -151£}s 1. <br /> ockton,CA <br /> Generator's Phone: 2 <br /> 6.Transporlar 1 Company ame U.S.EPA ID Number <br /> Union Pacific Liles Co riL3$790 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 8,Das gnatiiFsdlity Name and Site Address U.S.EPA ID Number <br /> ECM 1 Weest 14 may 123 UTC0930Mni <br /> 8451 East C ,UT 64523.1 USA <br /> Fa0ity s Phona: <br /> 99, Sb.U,S.DOT Description(including Proper Shipping Nam,Hazard Class,ID Number, 10.Contatnare 11.Total 12,Unit <br /> HM and Pecking Group(if any)) No. Type Quantify WL/Vol. 13:Waste Codas <br /> 1a¢, : a fcaet 3>.ra. rtae i rev z�' +r+4�v <br /> z 2. <br /> a. <br /> 4. <br /> 14,Special Handling lnstructions and Additional Information <br /> I.fN1`, i SERI JtCfff IRIECYGWPROJECT RAILCAR NO. Lj <br /> ECDC ProlUE0 404 116 <br /> 15. GENERATOWNFFEROR'S CERTIFICATION: I hereby dadare that the contents of this consignment aro fully and accurately described above by the,proper WWng name,and aro dalsslw,pac wqW, <br /> marked and lahela&placarded,and are In all respects In proper condition for transport adirtg ocorto spplicalae international and national governmental regtrfatiors.If export shipment and I am the Primary <br /> Exporlar,I cartffy that the contents of this cMBV--mwt cadorm to the terms of tha`attached EPA Aolmm ledgment of Consent. <br /> I certify that the waste minimization statement Identified In 40 GFR 262.27(x)(if I am a large quantity generator)or(b)(if 1 am a small qua ntltygenerator)Is true. <br /> GweratorWOffemes nt NNarm �.s ay Year <br /> a 16.International Shipments <br /> F- a Import to U.S. ❑Export nom U.S, Port of enbywli ; <br /> 2 Trans ' e s' sture for exports only): Date leaving U.S.: <br /> twit 17.TmrsporterA�IntafRecoptofMaterials .. <br /> t2 Transporter 1 Printeldflirw Nam' Day <br /> Year <br /> Transporter 2 Pnnladffyped Name <br /> Month Day Year <br /> _ . <br /> 18,Discrepancy <br /> 18a,Discrepancy Ind cation Space ❑ Quantity Type M Residue F-11 Partial Rnjaction ®Full Road. <br /> Manifest Reference Number. <br /> 166,Alternate Facility(or Generator) U.S.EPA ID Number <br /> v <br /> LU 18c.Signature ofARemate Pawkily(or Generator) Month Day Year <br /> 19.Haiardous Waste Report Man meal Method Godes(i.e,. for hazardous wasto livatment,disposal,and recycl ng systems), <br /> ® 1. J 2. 3: 4. <br /> 20,Designated Facility Raynor or C perator.Centifisatiar of refit of frazaidotrs materials covered 8y Na manifest except as noted in Ilam 18a k <br /> Pdntedliyped Namigrmture M th , Day Year <br /> �( � I <br /> EPA Form 8700.22(Rev.3-05) Pfeviou sdrdons are obWete. SIGIdATEC$FACIL$TY TO`GEN6RATOR <br />