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Please print a type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved,OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.G®nemtw ID Ntwun r 2•Page 1 of 3•Emergency Response Pune 4.Manifest Tracking Number i <br /> WASTE MANIFEST C A L 0 0 0 3 6 6 2 1 1 1 800 424-9300 018 2 3 3 9 2 8 JJ K <br /> 5.Generator's Name and Malting Address Generator's Site Address(d different than mairmg address) <br /> FIRESTONE#028746 <br /> 7.20 E. HAMMER LANE <br /> STOCKTON CA 95210 <br /> Generator's Phare: 209 951-2403 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number. <br /> ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7.Transporter 2 Company Name U.S:EPA ID Number <br /> 8.Deallinated Facility Name and Site Address U.S.EPA ID Number <br /> DEMENNO/KERDOON. <br /> 2000 N.ALAMEDA STREET <br /> COMPTON -CA 90222 C"A T 0-80013352 <br /> i <br /> Fadq";$_R,hone: 7-7100 <br /> 9a.. 9b.U.S.DOT" ' n(Including Proper ShipPte9 Narie,Hazard(lass.ID Number, 1O.Cowlifters 11.Total 12.Unit 13.Waste Codes <br /> ({� and Paddng Group(1fany)) No. Type On-* WLW <br /> 1'NON-RCRA HAZARDOUS WASTE.LIQUID(BRAKE FLUID) �� 3 <br /> ~ D M. G <br /> z� 2. <br /> W - <br /> 3. <br /> 4 <br /> i <br /> 14.Special Handling hmInneftis and Additional Information <br /> EMERGENCY CONTACT:CHEMTREC 1- 24- WOES TERMINAL:CERES CS NAER 9B1:171-*PROFILE#9B1: <br /> • i <br /> 375884 BRAKE FLUID* *APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT <br /> ✓� �,,� , <br /> 15. 'GENERATORWOPFEROWSCERTIRrATION: dared ' <br /> and n.c�arded,aril Are in aN m fur and national Sovemmelital ins.O export and-1 an 111e7�rtary <br /> I c:"la <br /> 'y @tat Y W:COntenta 0't1� m txxlfOfrtl 11��t111S Ot the ed EPA Bik of <br /> 1 Otat mirtimizaOon m idenNlJ&t 40 CFR 262.27(a)(O 1 errs a tenga3 or(b){t[I mefi gdanOry is heie <br /> =.1. <br /> Prin-a 16.tmatiorrai Std L�. rCfran U.S. Port of entry/exO <br /> (_ • . �Import to <br /> U.S. i <br /> aDate icevng U.S <br /> T signature(for.expprte oniyt: - <br /> 99 17.Tmnspoder erd of Rec*ofM9tedaq <br /> rkrtedlTyped Stnatue month Day Yew <br /> o h �� <br /> Transporter 2Pnnted/.Typed Name Signature mom 06y <br /> qy <br /> 18.Discrepancy <br /> 18a.Discrepancy indication Space Quantity [:]Type ❑Residue n Partial Rejection Fu,R'Rejection.Rgfirenca <br /> . <br /> r. <br /> 18b: FwMly(or Generator) U.S.EPA ID Number <br /> t3 <br /> V , <br /> w FadIlty's Plmrre J <br /> tic.Sowwre of Alternate FwW(or Generator) TO. Day Year <br /> 19.Hazardous Waste Report Management Method Codes P.a.,code ldr hazardous wade treaftneK disposal.arm ngdN9 systems) <br /> ® 1. 2 3. 4 <br /> 20.Designated FacilityOwneror0paralw.Caffilcation of receipt of hazardous materiats covered by the manOest except as ndedht item 18a <br /> PrintedifTyped Name Signature Mordh Day Year " <br /> EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO'DESTINATION STATE(IF REQUIRED) <br /> i <br /> I <br />