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Pease print or type.(Form designed for use on elite(12-pitch)typewriter.) Farm Approved.OMB No.2050-0039 UNIFORM HAZAROOU5 1•Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number - WASTE MANIFEST -: a . 364 610 iA �.. 2 s JJ n 5.Generators Name and Mailing Address Generators Site Address(if different than mailing address) A BC + '.93 S. Union Rd, Manteca, CA 95337 Generator's Phone: ')9-918-2650 B.Transporter 1 Company Name U.S.EPA ID Number SACRAMENTO WASTE SAIL 534 912 7.Transporter 2 Company Name U.S.EPA ID Number 8,Designated Facility Name and Site Address U.S.EPA ID Number _ . .___. este Trans"ter Facility 6500 S US Highway 95 , Yuma, Arizona 85365 3 Facility's Phone: � _344-9825 a- ga Rb.U,S.DOT Description(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 Not 1. 0 fiON—RCRA HAZARDOUS WASTE SOLIDS (Oily Solids)LU 2. LU CD 3, 4, s 14.Special Handling Instructions and Additional Information — 'a L t—E RAINED AND USE PPE 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurateE described above by the proper shipping name,and are classified,packaged, marked and labeledlplacarded,and are in all respects in proper condition for transport according to applicable intemational 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(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. GeneratoisloAlrror's PrintedrTyped Name Signature , Month bay Year 16.International Shipments ❑import to U.S. ❑Export from U.S. Port of entrylexit Transporter signature(far exports only): Date leaving U.S.: 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Prini Name Signature Month Day Year QTransporter 2 Printedi7yped Name ; Signature Month Day Year 18.Discrepancy 18a.Discrepancy indication Space ❑ Quantity ❑Type ❑Residue ❑Podia!Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number U L Facility's Phone: unrr 18c Signature of Alternate Facility(or Generator) Month Day Year Q z 19.Hazardous Waste Repert 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 cove ed by the manifest except as noted in Item 18a Printedl7yped Name Signature Month Day Year EPA Form 8700-22(Rev.3-05).Previous editions are-obsolete, DESIGNATED ACILI]a TO CaENERAT0R