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'lease print or type. (Form designed for use on elile (12 -pitch) typewriler.) <br />HAZAR170US <br />CanaatpID Nwi, ber Wage <br />. 1 ar <br />3. gcr3oUNIFORM <br />WASTE (MANIFEST <br />CAL 0 0 0 41 5 4 6 0 1 <br />800 42433( <br />92 <br />S. Ganaratar's Name and Wiling Address <br />Gunar Site Address {II <br />T[C 4E CALIFORNIA LOUISf; AVE <br />2050 E LOU ISE AVE <br />LA HROP CA 95330 <br />Generoto?s Phone: 209 fS�(S qty (y <br />S. Transporter 1 Company Nanru <br />WORLD OIL ENVIRONMENTAL SERVICES <br />7 Transporlar 2 Cmrtpeny Name <br />WORLDWIDE RECOVERY SYSTEM INC. <br />8 DPaspnn3n l Fahy Namo and Va A,ddrorr <br />YUMA YES LLC <br />2730 E 13TH ST <br />YUMA AZ 85365 <br />Fnstr <br />11 Phone: 9 8 11 <br />g,r <br />95, U.S. DOT Descriplion oruaading Proper 5hirprng Name Hazard Cass. fD ti'umoe, <br />Cr.nfairers <br />HM <br />and Packing Gro!fp lif any)) <br />1 NON-RCRA HAZARDOUS WASTE, SOLID ( OILY SOLID, PAPER FILTERS) <br />Q <br />c� <br />4 <br />Form Approved, Clvt9 No, 2050.0039 <br />ng Numbor <br />D 96326 JJK <br />CA0028277036 <br />U -S, EPA IU Number <br />CAR000175422 <br />U.S. FPA )D Number <br />AZR00051,5924 <br />11 Total FP <br />Typo Ouanlily 13, Wasla Codas <br />�,1 I <br />D M ,1 1 Q352 <br />14 SWiN Hnndlir:p Insimclions and Additdonal Intornln'rcn ( I <br />EMERGENCY CONTACT : CHEMTREC 1.800.424.9300 WOES TERMINAL: CERES PROFILE # 981: 162623NRSTEC605 <br />OILY SOLID PAPER FILTERS " '"APPROPRIATE PPE EQUIPMENT <br />All A- r aw :4r Z-40fit ` <br />- GENERATOR'SIOfFEROR'S CERTIFICATION: I :'s,foy deciafc !ha! ter rcah.. I� u, If Hs ca7s,9n:ne!l orY filly ar.rl uccerarer dasciood above oy Me prop sh opil9 name. ant ,,-rre clatstfsed, paccagE <br />marked and labeledlpfucardrd, ono are iq II mspecls tR prelrer uorldi!ion tar Iranii:dn a, corfiry fc cljp'icobie inlenraional an! nafiunm tPvernweniaf regulefons, ff export shipment and } am Ina Primary <br />Exporter, I eerlify [hal !l!e convents 0! ileis consigMmo.at conform to the terms of the n+:tamed EPAAckna.va:d,munl of Cans,,n!. <br />- I-, miry that the wvasie minlmizaGon s1 temnnt klamlined In 40 CFR 262 27(,1) (it I am a largo quan!Ity' rg;cr) cr (b) (if I arm a small Qu-mMy ge ,eralor) ;s True, <br />LJ Imperl Ic i15 <br />Transpor€ea srgnaltfre (ror vpesa ordy); <br />17. Transpnrlor Acknuwladq,ev er Rnce,pt of h!0!prfals <br />rarxporrrx F Prinredffyprrd Nama <br />n� _ / , /, <br />v ✓, v i+ff Cr.~✓ <br />18, bisaepancy <br />18a. Discrepancy Indication Space <br />❑ Quantity <br />7 <br />10b. Arernate Fr,cility lo; Generator! <br />J <br />a Fac!!tty's Pllom <br />18e 3igrtafure pf ARemale Fgddty (or Generator) <br />t <br />19, Hazardous Nlas4a Repaniartagamcnt hleti od Codi <br />1 I 2 <br />Exrort from U 3 <br />❑ Type <br />codes for hazardous waste treatmanl, disposal, and <br />Port of entry(exit: <br />Dare ir:avrnd U.S.: <br />--f <br />❑,Rrsid!fe ❑Par€inlReeclinn <br />EPA ID Number <br />f�it7tl!n Dov <br />❑ gull Reeclior <br />20 Designated Facllly Ownar or Ogorater Cenilicalion of recoipt of ha7.e110u9 matar:ols coverod by the niv test e)teal as ncted In item 180 <br />Pr;r,!edlType al. r r;Gpalcr h€en!h ay fear <br />E L]I� 1 <br />AForm 8700-22 (Rev. 3 05) Pravloua edititls}5 aro obsolete. L} 5It iIVfS`1'lak;l I DCII~ i'C) i3ErS t"li1IL1'I'fUIL S'r�1'i C: (11= f1LGIUlr{��L�) <br />