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FofmAp raved.OM8 No.20,M-0039 <br /> f'Iease print or typa. Fonn designed far Use oo elite(12-plich)l aWhtar. q,IkarrHeetTrsckln umber <br /> UNIFORM HAZARDOUS 1.Oereralor ID Number Z Page 1011 3,Emolyancy Raspcurse Phone 11 <br /> I. ��law 'Im-fr30o 01853012 5 JJK <br /> WASTE MANIFEST C A L Q 0 f� 3 fi 8 G l <br /> 5.Gvnorr tnds Name and Mailing Address Ganoraw'a 6lto Address(if d N Net than me»r g addraAs) <br /> IMPI=RIAL TRur, WASH AND REPAIR JA-7"GFl QLIP <br /> 2142 W.YOSEMITE AVE JA27 GROUP INC <br /> MANTECA Cly h;337 <br /> Generawes Mw US,239-$111 U S.EPA ID Number <br /> 6.Transputer 1 Company Name C A D 0 2 8 2 7 7 0 3 6 <br /> WORLD OIL ENVIRONMIENTA!_SERVIGES <br /> U.S.EPAfD Number <br /> 7.Trcnspoder2Cumlany Name CAR 0 0 0 1 7 5 4 2 2 <br /> wool- WIDE RECOVERY SYSTEM INC <br /> U,S.EPAID Number <br /> B-Designated Faciaty Name and Sltalrlddress <br /> YES MANAGEMENT, INC. <br /> 6500 U8 HIGHWAY 85 <br /> YUMA AZ 8=3°6j AZR000521146 <br /> Facia s Phone: (928)344-9828 <br /> ir&d Proper Sh1 to Name,Raza d Class,ID Number, 10.Coniainars 11,Total 12,Unk 13.Waste Codas <br /> 9a. 90,U.S.DOT Despiptfon( �9 � Pp A ty WkNof. <br /> HM and Packing Getup(if any)) Nu. Type <br /> '.{VON-NONHAZARDOUS WASTE, SOLID(PAPER FILTERS 352 <br /> o ` OM P <br /> UjUj <br /> 2. <br /> C7 <br /> 3. <br /> 4. <br /> 14.5PociatHandt3ng nstrudlonsendAdd,'tonallnformaHen <br /> EMERQENCY CONTACT ;CHEMTREC 1-800-424-9300 WOES TERMINAL:GERES CS NAERG#9131.17 . *'PROFILE#951 <br /> 162623NRSIMP072 PAPER FILTERS " *APPROPRIATE PPF EQUIPMENT 202 x S15- <br /> 15. 4ENERAT4R'SiOFFERDR'3 CERiIFIGATtOH; I hereby declare chat Bra contents of this ctxisipment erre ltdly and=sratnly descfibad above by the proper shipping Rama,errs era classified,packaged, <br /> marked and laboledlplacardrsd,wwaro In all respects In proper oowrdon for Iransp i acr ordlrQ to nMtabla international and rtatlonal govemmentai regulations.If expod shipment and I am tho Primary <br /> Exporter,I lordly that the aontonls cf i%consignment eanfawm to the terms of the attached EPAAdUr MW9�t f risent- <br /> a small Bfltl anerala la true, <br /> I corny that IN waste mfny 2j&n statement ldanttad 1n 40 GFR 262.27(a)(if I illi a I$MMe 4uandly g ) (} ty 9 ) Month Day Year <br /> atodslOfferere Print Namo Sign ua <br /> r 0111 P Z6 <br /> .r 16,tntrxrsatbnsl Shipments lrrpo to U.S. ❑Eg d tram U.S. Prat aI ontrylaxl --- -- <br /> Traneportor eklnatura(for experta on y: Dflld ipaung U.S.: <br /> ix 17.ubmporier Adv Wt4dgnsnnt of Recatpr of MaMrtals <br /> Tran it r 1 Prinladl lam Slgnalura Month Day Year <br /> t] V� <br /> 0 <br /> TmWodar 2 P nl d ams Signalvm Month Dayqq Year <br /> 0E <br /> AAjT <br /> 18,Discrepancy <br /> 18a,Dlsompancy Indication Space ❑ Quantity ❑Tye+ ❑Residue ❑Partial Re,01 n ❑Full Roladton <br /> Manifest Relerence Number. <br /> 18b,Ntemale Facility(of Genrata) U.S.EPA M Nwtw <br /> 1 <br /> C3 <br /> Farilitys Phone: Monty Day Year <br /> w 16c.Signature of Allemala Fadtty(or Generator) <br /> 18.Hazafdous Wasle RopQd Management Method Codes 0,a.,codes Jor hazardous waste treatment,disposal,and recycling sysloms) <br /> A 1, 2. <br /> 3, 4. <br /> u <br /> 20.Destgnaled FacJiy Omer ct Operator:Certifiootlon of waipl of tmardous materials covered by Iho munifest excepi as Woad in I[An 188 <br /> prtniadrrypad Nam 16 Sigrratura Month Day Year <br /> EPA Form 8700.22(Rev. -05) revious adiflons ar obsalo e. DESIGNATE FACIt,IT T ESTINATION STATE (IF REQUIRE[ <br />