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Please print or type. U! �' 1 Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest TrackiNumber WASTE MANIFEST CAD981456023 2 800-633-8253 ,00 0 217:426 DAT 5.Generatoes.Name and Mailing Address .ATTN:Mike Ublck Generator's Site Address(if different than m0ailing address) j UniversityOfThe Pacific University Of The Pacific 3601 Pacific Ave 3601 Pacific Ave Stockton,CA95211 Stockton,CA 95211 Generator's Phone: 209-946-2908 6.Transporter 1 Company Name U.S.EPA ID Number Ingenium (Sacramento)(****ERI PHONE-Gust ID#8766-0004****) CAR000179747 7.Transporter 2 Company Name U.S.EPA ID Number Ingenium {Milpitas)(****ERI PHONE-Gust ID#8766-0002****) CAR000179747 8.Designated Facility Name and Site Address U.S.EPA ID Number Covanta Environmental Solutions LLC INR000127621 5625 Old Porter Rd Portage,IN 46368 Facility's Phone: 260-240-2461 ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) No. Type Quantity Wt.NOI, 13.Waste Codes o: 1'Non-RCRA Hazardous Waste Liquid(MOBIL VACTRAOIL NO,2 AND WATER) O �✓ C 221 2'Non-RCRA Hazardous Waste Solid(rags,waste oil) 352- r � P 3. Non-RCRA Hazardous Waste Liquid(latex paint) 291 06 4 14.Special Handling Instructions and Additional Information D90970 SO 169203 1)110003388 2)41465$61 ` 3)41466318 ; l O ontract retained by generator confers agencyauthority on initial transpe'rterto add or substitute additional transporters on generators'behalf. 15. GENERATOR'S/OFFERQR'S CERTIFICATION: I hereby declare that the contents of this consignment are.fuliy and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,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 Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent, I certify that the waste minimization statement Identified in 40 CFR 262.27(a)(if I am a large quantity generator)or,(b)(III am a small quantity,generator)is true. Generator's/Offeror's Printed/ryped Name SI Month Day, Year t4y9 16.International Shipments I— ❑Import to U.S. ❑Export from U.S. Port of entrylexit ? Transporter signature(for exports.only): Date le 'ng U.S. LU 17.Transporter Acknowledgment of Receipt of Materials E` Transporter 1 Pdntedfryped Name Signature Month Day Year TV Transporter 2 Printedlryped Name Signature Month Day Year a' r 18.Discrepancy 18e.Discrepancy.Indication Space ❑ Quantity ❑Type I_I Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 3 18b;Alternate Facility(or Generator) U.S.EPA ID-Number Facilitys Phone: w 18c.Signature ofAtlemate Facility(or Generator) Month.. Day Year a z .. 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) i 1. 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted In Item.18a Pdnted/ryped Name 7 Signature Month Day Year EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM