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writer. Form Approved.OMB No.2059-0039 <br /> Plasia and a type. Farm desi nod for use on elate(112-pitch) pe I Phone 14,Monitan!Tracking NumOer <br /> UN1F't?RM HAIARp0U3 1,Generator l0 Number 2.Page 10 . morg;nc,,4R,.10poA64 �����®�� � ���( <br /> WASTE MANIFEST t;;a L:}0 G 3 6� a'] 3 i (60 ) 224-3300 K <br /> 6,Geitetstoa 9 Nanta a4 Failing Address Gez1t falor a Site ddress(If dli[erant Man mti11Ay address) <br /> IMPERIAL TRUCK VifASH AND REPAIR-JAll CROUP <br /> 21 2 N'J yob-,r 1ITC AVE JA-tl DROP MC <br /> MANTECA CA 95337 <br /> ooneraWs Phone: 209 U.&EPA IQ Number <br /> 6.Ttansparter 1 Company Name C AD 0 2 4 2 7 7 0 3 t; <br /> WORLD OIL ENVlROhtMENTALSERVICP,C <br /> U.9.EPA ID Number <br /> 7.Transporter 2 Compm Name <br /> WORI_D'*1DE RECOVERY SYSTEM INC. CAR 0 0 0 1 7 5 4 2 2 <br /> U.S.EPA 10 Hurrrber <br /> B.Oeslgnated Facefty Nine and stm Address <br /> .rES MANAGENIE"NT, INC. <br /> 6600tJSHIGHWAY:75 r412F�0UQ6;21146 <br /> YUMA A2 815365 <br /> Favi s Rwo: CURIA <br /> 9b.U.S.CLOT DOSCO ton(IndudkV Proper Stip N Namb,Hazard Class,10 Number, 10,COMabters 11.w Owit �FO 13.Watde,codae <br /> Mo,Packing Group of any)) N <br /> J3 <br /> D 1`Ptt]N-RL'RA HAZARDOUS WASTE,"OLID{PAPCP FILTERS) -_.. <br /> oM P <br /> e3i 2. <br /> s _ <br /> k. <br /> 14.SpecialHand np Inalrrrtom and Additional IAWroa on W [ 19 0:5 5' <br /> EPAERC,ENGY CONTACT :CHEWREG 1-80&424-9300 WOES TERMINAL:CERES rs NAERG#9131 :171 "PROFILE#961 <br /> 26262314f2SIMP072 31 P-R F ITERS "' "`APPROPRIATE APE EQUIPMENT � <br /> 16, GENERATOR'SIDFFEROR'8 CERTI KATION;t hereby doctor,that ttw adntenks of thte'egn entare fatty arvd accurstaty deaaibed above by the proper atrf If export <br /> nom0.Ordma orad I amid,Packaged: <br /> marked and tsheterilplacardad,and are M all respar.(e M properowidU for transport a 4 to applicable Intemadwi and wtimal gow omental requtatkxrs.Neicpai shipment and I am the Primary <br /> Exporter,I usrtlfy that the oontenls of this consJpnwt con"to ata tarts of the attached EPA t of COnsanL <br /> t certify That the wasto minlmizabon statement wonao in 40 CFR 262.27(x)(if I am a Iarpe quantity generator)or(bI(if 1 am a smBfk quan8ty generator Montt pay Year <br /> GBneretG('7r011uroe3 PrintedlTyped Mame f , <br /> '4 l j`, F <br /> 18.Inrematpnal Shipments ❑Import to U.S. ❑Export icor U,9. pod of entiyfeldl <br /> z Transporter signature(far t Xpods only), <br /> 17.Trams wter Admowledpinonlof R64Pt Of Fatefiats Month pay Year <br /> Transportar 1 printodfTyped Name Signehue + J <br /> D(A f <br /> rans;wdeT 2 PanWffyped Name 19 <br /> 5 tisre <br /> 4tarsth pay Year <br /> s8.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ QuanUly ❑Type ❑Residue ❑Farft R.*tlon ❑Ful!Rejecton <br /> I <br /> WOW Reference Number. <br /> leh.Alternate Facikly(or Generalor) U.S.EPA Ip Number <br /> i <br /> J <br /> ti Facillty7 Phone: <br /> Mcnlh pay Year <br /> 189 tune of Alternate Fadiity(of Generator) <br /> 4 <br /> x <br /> 0 19,Hazardous Wasis Deport Management MOVwd Codas(i,e.,00406{or hazardous vrasteheatrs+ont,2isposal,and:rarydng aYeterna) <br /> 43 <br /> +fil <br /> 20:E)*Oiuited Facility Owns aw..C"ftation of reeetpt o1 hazatdcxA rrAtw al9 covered by the manitastexcepl as noted In hem 18a <br /> Punt ams Signahrre month Day Year. <br /> EPA Form 87CO-22(Rev.3-04PrOVIOUS edll m are Obsolete, (� DESIGNATED F CIUTV T STINATION STATE{IF neQUIRED) <br />