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"••r`7�yi�. RECEIVED SEP 7 20 <br /> Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM[HAZARDOUS 1.Generatorfir}Number 2.Page 1 ofE&Em;rg�aricyy Response Phone ML <br /> Tracking Number <br /> WASTE MANIFEST CAt)0295r}37033 1 +__I 1 � G B F <br /> 5.Generator's Name and Mailing Addres Generator's Site Address(if different than making address) <br /> �rA�+LlwY ELECTRIC MOTORS <br /> 1520 E MINER <br /> }} STOCKTON. CA 35205 <br /> Genoralors Phon?:v��94�7321 <br /> 6.Transporter 1 Company Name US.EPA ID Number <br /> NuIERiCAN VALLEY WASTE Ofd, th6C. GARUOO272342 <br /> 7.Transporter 2 Company Name EMU.S.EPA ID Number <br /> WORLDWIDE RECOVER'(SYSTEMS i1VC; CAROOO175422 <br /> 8.Designated Faality Name and Sfte Addr'-s MA YES 2 WASTE TRANSFER FACiLFTY U.S.EPA ID Number <br /> 65M US HIGF1WfAY G5 AZROD0521146 <br /> YUMA.AZ 85305 <br /> Fac lily's Phon$28-34+4428 <br /> ga 9b.U.S.DOT Descrrptior(including Proper ShippMg Name,Hazard Class,ID Number, 10.Containers 11,Total 12.Unit <br /> HM and Packing Group(if any)) 13.Waste Codes <br /> No. Type Quantity Wt1Vol. <br /> 1• MON-RCRA HAZARD011 WASTE SOLD,ABSORBENTS, DIRT d,04L, Z LMrt 150 P �=� <br /> 0 PAPER FILTERS i <br /> z 2. <br /> L <br /> � ; I <br /> 3. <br /> i <br /> 4. <br /> c s aP Information <br /> f4. a1 I�r]Q(ng f S dd..i) ER FILTERS ERGO 1 T1 <br /> EMERGENCY CO'iTAOi: KEODKA <br /> 15 GENERATOR'SIOFFEROR'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, <br /> marked and labeledlplacarded,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 <br /> Exporter,t certify that the contents of[his consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(€f LW a small quantity generator)is true. <br /> Geaerat4r r9rg,PrintedlT ed Na Signature. Month Day Year <br /> t <br /> 16.TnleeEonail Shtpments <br /> ZLlImport to U.S. ❑Export from U.S. Pod of enbyla*t: <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> o �Tray e a Month Day Y <br /> CL <br /> TraPrVF <br /> r2/rirte ,�ylped Name Slgnatura <br /> s IS t�\ L�� �J �y,.2 Y r <br /> 18.Discrepancy l <br /> 18a.Discrepancy Indication Space Quantity Type L1 Residue ❑Partial Rejection ❑Full Rejection <br /> a <br /> _ Man fest Reference Number: <br /> 18tL.Altemale.Earx of GeriaraEor - <br /> ta-5-EFA IO Number <br /> U <br /> LL Facility's Phone: <br /> Uj <br /> 18c.Signature afAllemata Faciljlyy(or Generotgr) Month Day Year <br /> a <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(I.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 1. <br /> o �-1- !� 2_ 3. 4. <br /> 20,Designated Facility Owner or Operator,Certification of receipt of hazardous mateNais covered by the manifest except as noted in item 18a <br /> ri yped Name <br /> 1 Si na r Month Day Year <br /> EPA Form 8700-2 (Rev.12-17) Previous edifions are obsolete. DESIGNATE ACILITYTO GENERATOR <br />