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<br /> Please riot or type.(Form designed for use on elite(12-pitch) writer. �
<br /> P 9 ( P }h'Pe ) Form Approved.OMB No.2050-0039
<br /> UNIFORM HAZARDOUS 11.Generator ID NumberPag
<br /> 2. e 1 of 3.Emergency Response Phone 4.Manifest Tracking Number
<br /> WASTE MANIFEST 373 7�. 1 009156168 FLE
<br /> 5.Generator's Name and Mailing Address Generator's Site Address(it different than mailing address)
<br /> ,..1ar Genpt', 1 ?I 1359 C;1 i a Gt'rla359:=
<br /> 310. W DR MARTIN UTHER KING JR 310 W DR MA-VIN 1 I_tTHER MNG jR
<br /> Generator's Phone:
<br /> ST3CKTf7Pl, CA 95206-1763TON, A trt ._1763
<br /> 6. ransporter 1 Company Name U.S.EPA ID Number
<br /> Ster-1cyc—Ie wC:ecialtx Waste Solutions Inc I iIII NSV)00 i 109E-14,
<br /> 7.Transporter 2 Company Name U.S.EPA ID Number
<br /> 8,Designated Facility Name and Site Ad cess l 2f1erd: tnVlt^Onm?nva! ?TtDT.•, LLL U.S.E r
<br /> 1185;5 White Rock Read
<br /> Rancho Cordova, CA 95742
<br /> Facili is Phone: i 6351/0980 I CAD96088418--'
<br /> ga, 9b.U.S.DOT Description(induding Proper Shipping Nene,Hazard Class,ID Number, 10.Containers 11 Total 12.Unit
<br /> HM and Packing Group(if any)) 13.Waste Codes
<br /> No. Type Quantity Wt./Vol.
<br /> X 1. UI 1350, Waste Aerosols, flammable 2, 1, ERG#12E 1
<br /> CF OM8 F° 33 I)001
<br /> 0
<br /> ZX 2. LIN1993, Wasto Flammahlte Iigrtids, n, D. s. i CF 00015 P 33 D0011
<br /> CD (Alcohol), 3, PG II, ERG#128
<br /> X 3• UN3139, (Waste Oxidizing liquid. n. o. S. 1 CF 000014 P 14 D001
<br /> (Hydrogen, peroxide), 5. 1, PIS II, ERG#140
<br /> 4. Non RCRAI hazardous waste, solid (Consumer
<br /> I?roduct s)
<br /> 14..Special Handling Instructions and Additional Information 1. 2 ,)e r 0 5 01 g) e, ?051 g(r a m m a l e ; i Q u i?d s — I_Q co s e o ac k) 3.
<br /> 110525(0xidizer's, Liquid — Looseloack) Ga 110: 29:° Ion--RCRA Solid Waste (CA unl>)
<br /> Loosel;ack)
<br /> 15. GENEFIATOR WOFFEROWS CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged,
<br /> marked and labeledlplacarded,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
<br /> Exporter,I certify that the contents of this consignment conform to the terns of the attached EPAAcknowledgment of Consent.
<br /> I certify that the waste minimization statement identified In 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. `
<br /> a Name 1ga{nrE Month Day Year
<br /> 2j 201 r
<br /> —j 16.International Shipments
<br /> ZImport to U.S ❑Export fromh".' Port of entry/exit:
<br /> Transporter sinnature(for extorts only): Date Ieavinq U.S.:
<br /> W 17,Transporter Acknowledgment of Receipt of Materials
<br /> Transporter 1 Printed/Typed Name Signature Month Day Year
<br /> a Tt hon; Hamer I I 04 24 2017
<br /> ZZ Transporter 2 Printed/Typed Name Signature L Month Day Year
<br /> 18.Discrepancy
<br /> 18a.Discrepancy Indication Space Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection
<br /> Manifest Reference Number:
<br /> 18b.Altemate Facility(or Generator) U.S.EPA ID Number
<br /> J_
<br /> V
<br /> u I
<br /> �- F 's Ph ne:
<br /> W 18c.Signature of Alternate Facility(or Generator) Month Day Year
<br /> r I I
<br /> h19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) l4 /
<br /> LU 1• I2. � f3. I4. ! f ✓1
<br /> r
<br /> 20.Design ad t Owner or Operator.Certification of rete pt of ous materials oovman'rfe1jlexcept as 186
<br /> Pon Name5 0 Year 111
<br /> 04 9
<br /> EPA Form 8700-2 (Rev.3.05) Previous editions are obsolete. ESIGNAT D FACILITY TO DES ATICN STAIE(IF REQUIRE )
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