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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMS No.20500039 UNIFORM HAZARDOUS 11.GeneratorlDNumber 2.Page 1 of 3.Emergency Response PhoneManifest Tracking Number T016051520 WASTEMANIFEST CAL 000 364 610 l 916-849-0144 . JJK 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) ABC Transmissions, Inc. 193 S.U pion Rd, Manteca, CA 95337 Generator's phone: 209-918-2650 8.Transporter 1 Company Name U.S.EPA ID Number SACRAMENTO WASTE OIL ICAL 913 534 912 I.Transporter 2 Company Name U.S.EPA ID Number Worldwide Recover S stmes Inc . ICAR 000 175 422 8.Designated Facility Name and Site Address U.S.EPA ID Number Yuma Yes 2 Waste Transfer Facility 6500 S US Highway 95 , Yuma , Arizona 85365 Facility's Phone; 928-344-982$ JAZR 000 521 146' 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)) 13.Waste Codes - No. Type Quantity1NtNW. 1. Of a NON-RCRA HAZARDOUS WASTE SOLIDS DV +'�( P (Oily Solids) 352 z z. L 3. 4, 14.Special Handling instructions and Additional information HANDLERS TO BE TRAINED AND USE PPE 15. GENERATOR'StOFFEROR'S CERTIFilCATION: 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 labeted<piacarded,and are to all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Pdmary Exporter,I cetly that the contents of this constgnment conform to the terms of the attached EPAAcknowledgmenl of Consent. I certify Thal the waste minimi ion slatem identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(ifjW a small quantity generator)is true. Genera emr's Printed/Typed me Sign Month Da Y u-�G f P 1 16.Inter ' na Shipments i- ❑Impart to U.S, ❑Export from U.S. Port of eatryfexil: Transporter signature for exports only):0n Po Y): Date leaving U.S.: 131: 17.TransporterAcknowledgmenl of Receipt of Materials Transporter 1 PdMed/Typed Name Signature Mo th Day Y Albert M. Hernandez Q Transporter 2 PrintedlTyped Name ignalura + MonthDay year U V11W 0-+ 18.Discrepancy 18a.Discrepancy Indication Space El Quantity 1:1 Type ❑Residue ❑Partial Rejection ❑Full Refection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number C? Facililyls Phone: 18c.Signature ofAllernals Facility(or Generator) Month Day Year a Z S219.Hazardous Waste Report Management Method Codes(i.e..codes for hazardous waste treatment,disposal,and recycling systems) © 1. 2. 3. 4. 20.(signaled Facility Owner or Operator,Certification of receipt of hazardous materials covered by the manifest except as noted in Item PrijileIrTyped Name Signature MonthDay Year EPA N87 *2(Rev. 05) Previous editions ar6 obsole e, DESIGNATED I CILITY T4 DIwSTlNATIQN STATE(IF REQUIRED)