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Form Approved.OMB No.2050.0039 <br /> Please print or type.(Form designed for use on elite(12•pitch)typewriter,) 2,Rage 1 of 3,Emergency Response Phone 4.Manitast Tracking Number <br /> UNIFORM HAZARDOUS 1•Generator ID Numhar 016 s 7 013 6 JJ K <br /> WASTE MANIFEST CAL 0 0 0 3 3 3 0 5 2 1 (800)424-9300 > <br /> Generatojis Site Address(if different than mailing address) <br /> 5.GDreratoes Name and maiiin,Address <br /> REEVE TRUCKING-REE008 <br /> PO BOX 520?- CA J:720J -0050 CARPENTER RD <br /> STOCKTON STOCKTON CA 95215 <br /> Generators Rhone: 208 940-2623 U.S.EPA ID Number <br /> 6.Transporter 1 Company Name CAD 0 2 8 2 7 7 0 3 6 <br /> WORLD OIL ENVIRONMENTAL SERVICES <br /> U.S.EPAlO Number <br /> 7,Transporter 2 Con+pang Name CAR 0 0 017 5 4 2 2 <br /> WORLDWIDE RECOVERY SYSTEM INC. <br /> tilts.EPA ID Number <br /> 8,Deslwa d FFaY� LLC end silo Address <br /> 2730E 13T{15T <br /> YUMA AZ 85365 A Z R O O O 515924 <br /> Faclity's Phone: 928 344-9828 <br /> 10.Containers 11.Total 12,Unit 13.Waste Codes. <br /> go go.U.S.DOT Description(.nc`:udirg Proper Shipping Name,Hazard Class,ID Number, No. Type Quantity WUVal. <br /> HM <br /> and Packing Group(if any)) <br /> w 1•NON-RCRA HAZAROUS WASTE.SOLID(OILY SOLID,PAPER FILTERS) P 352 -- <br /> o DM <br /> LU <br /> t9 <br /> 3. <br /> fl. <br /> 4. <br /> 14.Special Handling ius;n,ctions and Additional tnflrmatort <br /> EMERGENCY CONTACT:CHEMTREC 1-800.424.9300 WOES TERMINAL'CERES CS w PROFILE#9131:162623NRSREE008 <br /> OILY SOLID.PAPER FILTERS* *APPROPRIATE PPE EQUIPMENT yr s�L 2)(1557 - 0 611 <br /> 15. GENERATOR'SfOFFEROR'S CERT[FICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, of are classiried,packaged, <br /> lYexport shipment and t am the Primary <br /> and iabe!ed:placardod,and are in ati respects in proper condition for transport according to applicable intomationaland national gotemmenlal regulations. <br /> Exporter,1 certify that the contents of this consignment conform to the terms of the attached EPAAcknov,tedgmont of Consort. <br /> I certify that the e1asto.and:imnation statement identified in 40 CFR 262.27{al(if t am a largo quantify gen fetor r(b)(if t smai quantity generator)is true. Month Day Year <br /> Generator fforOes PrintetirT 0.Pd�laq'e <br /> Si atone <br /> � ��-►1`•� °"� �,lam'" <br /> r '6.tnternatronai Shq;me^ts E);Po-i from U.S. Pot of enuvtex+t: <br /> _.. U.S <br /> import:o U.s. <br /> M DDtu ii;DvtnQ U.S.: <br /> Z Transcotter stgnalwe ffor <br /> w 17.TranspcnorAcknoviledgmere of Receipt of Watenals Month Day Year <br /> Signature <br /> TI nspada 'Printed:'Typed Noone 0/ <br /> Q Month Day Year <br /> Q ?nmsporter 2 Printedityped P.ama 51^yf fat <br /> a <br /> of � <br /> .� <br /> 16,Discrepancy �--IEl <br /> L�Partial Rolection Full Rejection <br /> 18a.Discrepancy indication space ,- ow—Miily ._�Typo, r_ Residur. f <br /> htaritust Rafemrce Number: <br /> U.S.EPA ID Number <br /> �;, 18b.Aitemato Faciia far acaerdnri <br /> rs FaciftysPirona: <br /> Month Day Year <br /> UO 18c.Signalure cf Atternalu Fas'i!ily(or venerator) <br /> 19.Hazardous Waste Report fv'.anayemenl Mediad Codes(i.e.,codes for hazardous waste treatment,d sposal:and recycling systems] 4 <br /> a <br /> UJ 1 2. <br /> 20.Designated Facility Ovmer er Operator:Ceitificatlon of roceipt of hazardous materials covered by the manifest except as noted in horn 18a PAo h pa Year <br /> ?gna ore <br /> "r'r1!ndrTypi:d ,a. .� r - • 611.. <br /> RI QOIREO)1�=� INKIIOC STKFE(IF <br /> DE- -NA' 13`roGso!ote. :00-22(Rev. us editions are Form 87 5i Prev <br />