Laserfiche WebLink
Please pKrit or type. (Form designed For use on sifts (12•pltch) typewrlter,) <br />UNIFORM HAZARDOUS 1-Generatcr ID Number 2, Paga 1 <br />WASTE MANIFEST CAL 0 0 0 3 7 1210 <br />5, Generator's Name and filing Address Gei <br />MORGAN AUTOMOTIVE REPAIR MANTECA <br />2073 E YOSEMITE AVE. <br />MANTECA CA 9533E <br />Generalors Phoria: 209 830-9300 <br />6. Transporter 1 Company Name <br />WORLD OIL ENVIRONMENTAIL SERVICES <br />T. Transporter 2 Company Name <br />8. Designated Facility Name and SiteAddress <br />DEMENNO/ KERDOON <br />2000 N. ALAMEDA STREET <br />COMPTON CA 90222 <br />Facility's Phone: r3101537-7100 <br />9a. 9b. U.S. DOT Description [including Proper Shipping Name, Hazard Class, ID NLMl <br />HM and Packing Gmup (f any)) <br />rr 1UN1993, WASTE FLAMMABLE LIQUID, N.O.S., (GASOLINE, DIESEL), 3, <br />PG fl <br />w <br />z z. <br />LU <br />Form Approved. OMB No. 250-0039 <br />ima gency Response Phone d. Maalfest Trapping Number <br />(800) 424-9300 017696699 UJ G <br />CAD028277036 <br />CATOBOO13352 <br />f0. Centainers 11. %cal 12. Urilt <br />No, Type Quantity wtNol. 13. Waste <br />- l oat aQ1 <br />DM yr, <br />EMERGENCY CONTACT: CHEMTREC 1-800-424-9300 WOES TERMINAL: CERES CS * PROFILE # 961: 111817.01 GASOLINE <br />.DIESEL' *APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT Iff4liv <br />ysf <br />15. GENERATOR'SlOFFEROR'S CERTIFICATION: 1 hereby declare that the contents of Ihis consignment are fully and eccurately described above by the proper shipping name, and are classified, <br />marked and laheledlplacarded, and are in all respects in proper condition for transport according to applicable International and national governmental regulations. If export shlpment and I am the <br />Exporter, I certify that the contents of this consignment conform to Iho terms of the attached EPA Acknowledgmsnl of Consent. <br />I cerlity that Ihewaste minimizaWn statement identified in 40 CFR 262.27(a) (f I am a large quafflygeneralor) or (b) (if I am a smaitq t .gene ator Is t ue. �. '� <br />Grk atorslo{PrinalTyped Name <br />I i -VqMonth <br />L—JImportto U.S. f IJ Fxpart from U.S. Port of entrylexit: <br />Transporter signature (for exports only): Data leaving U.S: <br />17. Transporter Acknowledgment of Receipt of Materals n <br />Year <br />18. D screpancy <br />18a. Discrepancy Indicator, Space 0 Quantity, ❑Type ❑ Residue ❑ Partial Rejeclion ❑ Full Rejection <br />Manifest Reference Number. <br />18b. Alternate Facility jor Generator} U.S. EPA ID Number <br />J <br />C? <br />u- Faolfttyrs Phone: <br />Y18c. Signature ofAltemate Facility (or Generator) Month Day Year <br />a <br />z - <br />19. Hazardous Waste Report Management Method Codes (i.e., codes far hazardous waste treatment, disposal, and recycling systems) <br />LLJ <br />i <br />20. Designated Facility Owner or Operator. Certification of receipt of hazardous materials covered by the manifest except as need in Item 18a <br />telPdntedfiyped Signature Mordp� JDa1 Ye <br />EPA Form 8700-22 (Rev, 3.05) Previous editions are a6solete. DESTGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />