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Pie?se print or hoe. I <br /> UNIFORM HAZARD Ge c aldr <br /> OUS Form Approved.OMB No,2050•-X3g <br /> WASTE MANIFEST CAL000374268 2.Paq,'cf 3.Emergency Response Phore q• <br /> 1 1lvlfest Tracking Nvrrlbv <br /> 5 Gereretrr:Iiar.eard'vlai'in ^drays 87757721569 non FLE <br /> Dollar General #13593 '�4 c"e A(idr=ssdilterent sham mailing address) <br /> 2098008822 4232 E MAIN Dollar Seneral#13593 <br /> Cie"era:o�'s pi-.0 , S'TOCKTON CA •�• 4232 E MAIN <br /> *rar:;porter t Cumpa�y Nama 95215-5 722 STOCKTON CA <br /> 95215-6722 <br /> Steric cle 5 ecialt Wwste Solutions In- <br /> Worldwide <br /> 7.'-ransp;rtar a COCIP--9ny Name M1V90fd�110924 <br /> Worldwide Recover us.lPAloNunher <br /> R. <br /> 120 r, ityryNameandSite Address 5 e015 CAR000175422 <br /> Yuma Yes, LLC <br /> 2730 E. 12th Street U.S EPA ID Number <br /> Yuma, AZ 85365 <br /> c,i,r s r`hanr 9 S <br /> 9a yh U S DCT Descepiicn(including proper Shippirq Name,ka 3rdiClass,.D f:umhar. AZ ROI` 51 592 <br /> f,.l and Packing Group{;f ary-" ti.Containers <br /> ?I.Tota' 12.Unif <br /> ' Non RCRA hazardous waste, 03 id (Consumer No TYps Quantity W,INol. 13 Waste Codes <br /> P- Products), 1 DF 00057 P 331 <br /> W <br /> z - <br /> w <br /> a <br /> ,,:;rtro'.kantllr,3 Inst;,l::tkns anrj,4Qditrnat:ntt:,^tyrypr 1. 11 529 tNon-RCRA Solid Waste (CA On 1 Y) - Loose ack) <br /> P <br /> 7.'. GENE:and la SIOFFEROR'S CERTIFICATit]H; I hereby declare ih tt lice contents of this::onsignment are faNy and a.curataly descnbed above try the er sripp;ng name,aEqvDrtndLrare classfied,packaged <br /> marked and labeled! <br /> RThe conte and are m at respects in proper cond an cr r ftfe alll a:cordng to applicable in[ernauondland national governmental regulatirns.ff export shipment and I am the Pri ary <br /> r"!fyt t file wasthate <br /> the contents of nygnment conform m to lh term o't e attached EPA Acknowledgment of Consent <br /> erify that the was a minimization statementIde..,aed in 10 CFR 2 <br /> G'e_ara`9 Sr:71f r 2T{r•ISI am a targe quanf_tq genytor}dr{b1 fit am c,al. nti s <br /> erv's Pnrye :Name 7 a ty genera,or),s Irue <br /> y "lam m clay <br /> -Z veru <br /> ..I ,f::r173 rn,3,ji`In T+±lYS ! <br /> __. <br /> �– in,-,on to u S I 04 04 eye <br /> ? T, arortc.tgnatnrb:Nor exports oni}) L Expor.turn U,S P:.t, <br /> Q: I' T•ransporte,Ackncwledgment of Recp p;o`14etena9 Ca?e tear-rq J S.'Cx: `-- <br /> "ransnotter I grirtedrTy'bed <br /> a Kr'st opher Al manta so f"ra <br /> :. Month <br /> ire nar2 r' YPedf�la q �–'.'_... _�.r-'-' gay rev <br /> c ......_.. <br /> r04 <br /> Ci L 7' /CL T V alb; re th 201 <br /> A1n �Y Year <br /> :d pisaepancy .�,,,, <br /> J <br /> 'Sa Discrepancy hrdiralion Space <br /> LJ Quantity L7 Tyoa <br /> J Res due ❑Partial Rejection <br /> Full Rejection <br /> t8h ARernate racdty{or Gerfer�prj 51 Nf@l'01 W Nurrlber <br /> _J <br /> V U S.EPA ID NlfrnDar <br /> LL Fatlldy'4 Phone <br /> W 1 $ <br /> NO P,SIg n F {nr Ci4rlefalpr} <br /> a <br /> x <br /> Onth Day Year <br /> N 19 Hazardcus Waste Repot kRSnegerl*M Mathcd Codes{i.e.,cures for p,, mus wade treatment,dispcsar,and roc rain <br /> a t 2 Y g systems) <br /> ' 3 <br /> 4. <br /> 20 Designated Fa*ty Owrw or Qperalor:Cenificaton otreceipt of n <br /> " y"d MM*torared by the rrarifeit except as noted in item 1 Be <br /> EPA Form 8700 2 {Rev. 2-1 1 arious eft s are 0 'f j <br /> I E..C1NA'r hG FACILITY T O EPA's e-MANIFEST SYSTNX <br />