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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1 1,Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST 0 A 1 0 0 0 3 3 6 3 0 2 1 (800)424-9300 016870065 JJ K <br /> 5.Generators Name and Mailing Address Generators Site Address(if different than mailing address) <br /> GARTONTRACTOR-GAR616- <br /> P.O. BOX 6219 <br /> STOCKTON CA 95381-1849 2924 FRENCH CAMP TPKE <br /> Generators Phone: q 11 _ 1 q ,)0F <br /> 6.Transporter 1 Company Name US.EPA ID Number <br /> WORLD OIL ENVIRONMENTAL SERVICES C A 0 0 2 8 2 7 7 0 3 6 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> DEM ENNO/KERDOON <br /> 2000 N.ALAMEDA STREET <br /> COMPTON CA 90222 <br /> CAT080013352 <br /> Facility's Phone: -" <br /> GQ <br /> ga 9b.U.S.DOT Description(Including Proper Shipping Name,Hazard Class,ID Number, 10.Containew 11.Total 12.Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wtivol. 13.Waste Codes <br /> 1. <br /> o UN1993,WASTE FLAMMABLE LIQUID, N.O.S.,(GASOLINE, DIESEL).3, q <br /> PG II DM 100 G <br /> z 2. <br /> W <br /> 47 <br /> 3. <br /> 4. <br /> 14.Special Handling Instructions and Additional Information <br /> EMERGENCY CONTACT: CHEMTP,EC 1-800-424-9300 WOES TERMINAL:CERES CS NAERG#9131 :128 *PROFILE#981: <br /> 406105 GASOLINE, DIESEL * *APPROPRIATE PPE EQUIPMENT Lq 3x <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment am fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> 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 <br /> Exporter,I certify that the contents of this consignment conform to the terns of the attached EPAAcknowledgment of Consent. <br /> 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. <br /> Gene tors/Offerors Printedrryped Name ign m Month Day Year <br /> zEUz � 21FL�' <br /> 16.Intema0onal Shipments <br /> F ❑Import to U.S. ❑apart from U.S. Pod of entryleAt <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> w 17.TmnspoderAckndwledgment of Receipt of Materials <br /> Trans e1Pimledrr dNam Signature Month Day Year <br /> o Z Z <br /> a <br /> n <br /> QTransporter 2 Printed/typed Nale Signature Month Day Year <br /> C <br /> 1-- <br /> } 18.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quantity ❑T ❑Pallial Re ecton <br /> ype Residue J ❑Full Rejection <br /> Manifest Reference Number. <br /> 181b.Ntemate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Facilitys Phone: <br /> W 18c.Signature of Alternate Facility(or Generator) Month Day Year, <br /> cc <br /> Z <br /> y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 0 1 2. 3. 4. <br /> 20.Designated Facility Owner or Operator.Codification of receipt of hazardous materials covered by the manifest except as noted In Item 18a <br /> Pdntedfryped Name Signature Month Day Year <br /> Em`t�;o VAoyrates I O—e Z 1 fl 100 <br /> EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />