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Please print or type.(Form designed for use on elite(12-pitch)typewriter) Farm Approved.OMB No.2050-0039 UNIFORM HAZARDOUS [1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking.Number _ WASTE MANIFEST 164 61�i J J K 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) ABC Trans missions.,Tnc. 193 9.il Rd, Mahteca, CA 950337 Generator's Phone: 209-918-°2650 G.Transporter 1 Company Name U.S.EPA ID Number SACRAMENTO yASTE OIL 534 912 7.Transporter 2 Company Name U.S.EPA ID Number 7 STst®es lRc. CAk UC:U 175 422 8.Designated Facility Name and Site Address U.S.EPA ID Number Transfer Facility '5500 S US Highway 95 , Yu.-st?s Arizona 8556 Facility's Phone: 928-344-9828 R X00 521 146 ga. _ $b.U.S.DOT Oesciiptlon(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13,Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt,,'Uol- 1. a aT —kCRA HAZARDOUS WASE SOLIDS IX (011 Solids) ��2 M L LU ca j 4, 14.Special Handling Instructions and Addtional Information k 1NED AND USE PPE 15. GENERATOR'S10FFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and Iabeledlpiacarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.if export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement'odentified in 40 CFR 262.27(a)(if I am a large quantity generator}or(b)(if I am a small quantity generator)is true. Generatoi'slOfferor's PrintedlTyped Name Signature Month Day Ye ` 316.intematicrtal'Shipments w F ❑Import to U.S. ❑Export from U.S. Port of entry'exit: --_ Transporter signature(for exports onl Y) Date leaving U.S.; 17.Transporter Acknowledgment of Receipt of Materials Ll Transporter 1 PrintedlTyped Name Signature Month Day Year 4. Albert Mi.- PeY'l't313$�.E�'�' a Transporter 2 PdntedlTyped Name 'Signature Month Day Year 18.Discrepancy `-1 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Fill Rejeclion Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA 1D Number U LL Facility`s Phone: L 18c.Signature of Alternate Facility(or Generator) Month. Day Year 4 Z 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) a 1. 2. 3. 14. 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 1 Ba PrintebTyped Name Signature Month Day Year EPA Form 8700-22(Rev.3-05) Previbus editions are obsolete. DES]GX, E0 FACILITY TO GEM -1 AOR