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Please prim at type. Form Afpmvtd. OMB No. 2450-0039 <br />UNIFORM HAZARDOUS <br />7. C.&M Oto Narnber 2 Page t of <br />3. Enw gancy Respanee Rhona AL en Tracking Number <br />WASTE MANIFEST <br />CAL 0 0 0 4 15 4 6 0 1 <br />(800) 424-9300 020383479 JJ K <br />5. Generwfdt's Name acid Malliq AMMO Gencfeies Site Addram (pI ffimi 8mrt rn0% address) <br />TEC OF CALIFORNIA - LOUISE AVE <br />2050 E LOUISE AVE <br />LAI HROP CA 95330 <br />Gert mimes Phone: 209 858.4110 <br />D. 71ansaariar t Ga rvaltly Nam* U.S E If] NuyQw <br />WORLD OIL ENVIRONMENTAL SERVICES CA CIO `03t6 <br />7 Tra,spWa< s mpany Name U -S, EPA 10 M <br />WORLDWIDE RECOVERY SYSTEM INC CAROODI75d22 <br />6, arslgnetod Fahy Nemo and SM Addmaa WN rl'A IU Numbar <br />YID MANAGEMENT, INC. <br />6500 US HIGHWAY 95 <br />YUMA A4 85365 AZR000521146 <br />1`361 ya Phone: (9'' )3449828 <br />ga- <br />9b. U.$ DOT Boserip m [hdAng PmW Shipping Nerve, Namd Cl lass. IU Number', <br />ip. Cnrttiners <br />11. Tow12. <br />Unk <br />Hm <br />and Pgddng �p {d any)) <br />Chtmttty <br />1NihtW <br />13, Wade Codes <br />Np. <br />Type <br />o <br />HAZARDOUS 't4ON-RCRAA HARDOUS WASTE. SOLID (OILY SOLID) <br />s�2 <br />f�>� <br />� <br />c� <br />3. <br />4.,5—q 3, 6 <br />14. Speoai riadreq lmihcWm and AddWW Iribmiatim <br />EMERGENCY GONTAC7 : CHEMTREC 1-SOO-424-9$00 WOES' TERMINAL: CERES CS NAERG# 961: 171 } PROFILE #9131: <br />! �. <br />162623NPSTECS05 OILYSOLID * * APPROPRIATE PPE EQUIPMENT ZZDf e2l <br />15. CENERATOR'StOFFERCR'8 CFRTtflCATION; I hereby dedem Ihat me wntents of thl, cxs> nmenl are AnIY end 3m"WY destxibed 00^ 11Y tfre proper/ st>Ipgng name. Nd art da&si ed. packaged, <br />mlarW and labeledfplacarded, and are to as mswxb In t oondbon for transport accarding to a WkW mm imermsbonaiand naijNuo govemmental flora, N e "p°`' ah�n er t I em the Pr miry <br />Exporter, I =fVy that dte contents cf this co sr gnment conform io the [mama offt adached EPAAdnrovdodgrnent O Consent <br />certify that rhe waste rNnimtLation sUtemeni kleniifiad of 4Q CFR Z�S2, �7(p) (if I am a large Quenuly geracata) a am a emelt quarrGn gertarAtp•r ts true. <br />G' si�ifefOiS Piv Signauae htpnlh lj}j3y Year <br />�•r moTNarr a <br />-S <br />os C7 % <br />� t . MSnrnAtrOnei Rfa <br />❑ Impart W U.B. ❑ E xpon tlpn 11 i Port of , It <br />Transperiar stgnatvre {(itr of pprts DnH1- Date ttsasmva li,S.: <br />17.?tansfsorierAdmnxbdgrrkrta[R*cegtt atr,tertele <br />ui <br />Tmmglw 1 fzrinted+Typed Plank SNna _Mom - Lin YAar <br />��� � /� <br />t7. r <br />? Transpxtar 2 Pmtadffypad N _ StgrssA¢* 1.. Day foe <br />0.0.Q L 1 ' f k -s7 <br />fB. Ct�pallCj' r <br />ff''ii 11ii <br />I8a, lkacreoancy Indabon Sox* LJ (]uansty i.1 Typt ❑ Raw. 1 mtlai R*ckn ❑ Ful Ra)Klim <br />S <br />ReldcMSCr Number, <br />i8b. Wmato €ac" (pr Generator) <br />U.S. EPA 10 Number <br />V <br />►i F8eKY3 Phare: <br />of <br />k.0Ik &9nahm OMemata FaciNty (w Gversiar) Gkvrth Day year <br />Hszardmm Ylesie R*port MmmgKm4 MOW Codes p,a., codas for hazardaae waste treatment, dspomi. and rorrianj syt —e <br />`L <br />24. Designated FaCft Owner cr Operator, Certification of ibtekm of hazardous matarIalE www,?d by the marVftl exoW as nded In Ilem 18e <br />PrArredrryped Nx" BignaN2 Man Cray <br />1Yea <br />u 01 <br />42VA <br />- EPA 1" 8700-22 (R". ,.-17) Pisvtaus editions are obWeta. DEBIGNATEM FA01LITY TO EPA's e -MANIFEST SYSTEM <br />