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Form Approved.CMB No.2050.0039 <br /> Please print or type. <br /> UNIFORM kAlARDOUS 1.Generator ID Number 2 Page i of 3.Emergency Response P1mra 4.Manifest Tracking Number <br /> WASTE Ii1ANIFEST CAL 000333052 1' If SOO)424-9300 020380823 JJ K <br /> 5.Generafars Name and Maging Address Generators Site Address Qf durent than ma Ping address) <br /> REEVE TRUCKING-REE008 <br /> PO BOX 5126 ATT:SAFTEY DIRECT 8 <br /> STOCKTON CA 95205 050 CARPENTER RD <br /> Generators Phone: 209 940-2623 STOCKTON CA 05215 <br /> 6.Transporter 1 Company Name US.EPAID Number <br /> . WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> WORLDWIDE RECOVERY SYSTEM INC. CAR 0 0 01 7 5 4 2 2 <br /> a.Designated FaaTity Name and SdeAddress U.S.EPAID Number <br /> YES MANAGEMENT.INC. <br /> 6500 US HIGHWAY 95 <br /> YUMA AZ 85365 AZR000521146 <br /> Facilit es Phone: (9281344-,9828 <br /> 9a. fib.U.S.DOT Desorilgan Qnclud'og Proper Shipping Name.Hazard am,10 Number, 10.Containers 11.Tatar 12.Unit 13.Waste Codes <br /> HM andPaciftGroup(dany)) No. Type QuantityWtNd i <br /> ez "NON-RCRA HAZAROUS WASTE.SOLID(PAPER FILTERS) 352 <br /> 0 <br /> o� D M O O P <br /> z 2. <br /> w <br /> r.� <br /> 3. <br /> 4. t <br /> 14.Special Hmrdltrg Instructions and AddMonal Information <br /> EMERGENCY CONTACT:CHEMTREC 1.800-424-9300 WOES TERMINAL:CERES CS NAERG#981:171 +PROFILE#9B1: <br /> 162623NRSREE008 PAP R FILTERS * *APPROPRIATE PPE EQUIPMENT ;L Lf (I 11 x (s <br /> 15. OENERATOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fugy and accurately described above by the proper stuping name,and are dassifii d,packaged, <br /> marked and fabeledlptacardod,and am Ind respects In propercmUon for transport accordng to apRgcab le Intemalionatand national So tat regulation if export stdpment acrd I am the Primary <br /> Exporter.I certify that ffo contentsof lids mrs%nment conform to the tennis of the attadied EPAAdoowtadgment of Consort. <br /> 1 ceNy that the waste minimization statement Identified in 40 CFR 26227(a)(f I am a large quantity,generator)or(b)(III am quanny generator)is M. <br /> GeneratorsrOfferces Printedtiyped Name Signature Month ar <br /> '' Day Ye <br /> K �1 �-�— V <br /> 110111 <br /> -j 16.tntemattaral Shipments to U.S. ❑Export from U. . Pat of entrylexit• <br /> M Transporter signature(for exports only): Date leaving U.S.: <br /> W 17.TransporterAdomgedgmenl of Receipt of Materials <br /> Transporter 1 Pdntadff Name Signature Q Year <br /> co <br /> 0 Dayp <br /> Trartspatrl2 Priv rune S MonthO ray Year <br /> 1e.Die«eparny <br /> 18a.Discrepancy indication Spate ❑ Ooantay ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number. <br /> 18b.Alternate FacOy(or Generator) U.S.FPA ID Number <br /> J <br /> U <br /> I Facffrys Phone: <br /> do <br /> w 18t.Signature o1 Alternate Fady(or Generator) Month Day Year <br /> a <br /> z <br /> N19.Hazardous Waste Report Management Method Cates Q.e.,codas for hazardous haste treatment disposal,and recycling systems) <br /> 0 1. F <br /> 2 4, <br /> L I-h <br /> 7 <br /> 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the man,'[est except as noted In Ilam 18a <br /> Printedrfyped N Signature Month Day Year <br /> ma Vv- 0 <br /> EPA Form 8700-22(Rev.12-17) Previousedfio areabso!ete. ",YSGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />