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Please pont or type. (Form designed for use on elite (12-pitch) typewriter,) Form Approved. OMB No. 2050-0039 2 Page 1 of 3; Emergency Response Phone 4, fdanifesl Tracking Number UNIFORM HAZARDOUS t. Generator ID Number WASTE MANIFEST it A L 0 0 0 2 6 4 1 3 2 1 (800) 42¢9300 017 6 9 6 911 JJ K S. Gen_ralofs Nance and lu1ai in Address Generators Site Address (if different than mailing address) h 711 tYAi ERIA ?NC - 711002 PO Boil 319]. i' usGtSTC: A y5 a4 27141STAGECDACH . GeneratorRhone: 209 943-4730 STOGKTON CA 9521.5 6, Transporter 1 Company Name U.S. EPA ID Number tM'ORLDOIL EINIRONMENTALSEP,VIOES - CAD028277036 7. Tmnsecler 2 Company Name - U.S. EPA ID Numher WORLDWIDE. RECOVERY SYSTEM IiNC. � CAR 0 0 017. 5 4 2 2 ' B. Designated Facility Nameand Site Address U.S. EP AID Number 4 YUNIA YES LLC iu 2730 E 13TH ST YUMA - PZ 85365 - AZR000515924 Fadlily's Phone: . (928)344-9828 - ga 9b. U.S. DOT Descnpton (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 71. T tat 72. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Ouanfity WLNoI. NON-RCRA H.AZARDOLS WASTE, SOLID OILY SOLID,. PAPER FILTEP,S) 352 z. c� a, 74: Special Handling Inslm 1 'ds andAdditional� inr6miahpn - EMERGENCY CONTACT. : CfiEMTREC ' 180.OL4249300 WOES TERMINAL; CERES CS : PROFILE t 981 162623N.P,S711002 r OILY SOLID, PAPER FILTERS * APPROPRIATE* APPROPRI,ATEPERSONAL PROTEO`l1VEE0010ENT 15. 'GENERATOR'SlOFFERORS' CERTIFICATION� I herebydedare (hat th 1' nls of this consignmapt aiefully andaauratelyd olmdd ahoveh 8i propeI lit trig am , and are d -ified, packaged;, .marked and labelled/placarded, and are In all respects in proper,.condilion for transport accordmgb ppl_cable intema6onal%afM national governmental regulations. If export shipment and am he Primary . Exporter, I cerffy that thecontents of thisconsignment nronn to the tehn f th attached EPAAckno d rdgm t of Cons . n(, ability that thew lemnlmizationstatement identified m 40CFR26227(s, g laiyequ nbtyg nemidr) or @) ('Fl am asmallq antity general r) is We. GeneralofslOferors PnntedRyped Name Signature- `Month 'Oay Year -18. fnlemafonal Shipments . - F- ❑ Import to U.S. :. ❑ Fxportfmm U.S; .. P9rl pf enUY/exiC z Transporter signature (for exports 'renly): - ` Date leaving US.r - ^' �" 17. TanspoAerAcknwel dgmentof ReceiptafMaterials - - TrompeterI Pnntedlfyped'Name Signature Month Day Year I o on 0 / 1 /0 i - - - Month -Da Year G Tansporier2 PrinledRyped Name Signature y 18. Discrepant( 18a Discrepancy Ind cation Space ❑ Quantity ❑ Type _ ❑ Residue ❑ PatV (Rejection El Full Refection ` Manifest Reference Number. I 18b. Alternate Facility (or Generator) - U.S, EPAID Number J U a Facility's Phone: 0 18c. Signature ofAfternale Facility (or Generator) Month Day Year Z 10. Hazardous Waste Report Management Method Codes (i.e., codes her haiardous waste treatment, disposal and recycling systems) of 4. p 2. Desi2ored Facility Owner or Operator. Certification of receipt of hazardous materials covered by the manifest except as noted in Item tea Prinledfryped Name Signature Month . Day Year j ' EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete, DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)