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RECEIVED 2/14/2019 Please print or type.(Form designed for use on eEite(12-pitch)typewriter.) Form Approved.OMB No.2050.0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAL000412080 1 408-363-3578 017416742 JJ K 5,Generators Name and Mailing Address Generators Site Address(if different than mailing address) COSMOPR.OF BEAUTY#8762 624 SAN PABLO AVE.,#E PINOLE, CA 94564 Generators Phoned 0^724-6352 6-Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CA0962492399 7.Transporter 2 Company Name gEJ,46,,1A,0 U.S.EPA ID Number TEMARRYHE-1611OHNO,INC. CAR000194217 8.Designated Facility Name and Site Address U.S.EPA ID Number RECICLADORA TEMARRY DE MEXICO CARRETERA FEDERAL NO. 2 MEX MXC13J619001 SAN PABLO, TECATE BC Facility's Phone;619-270-9453 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Totai 12,Unit HM and Packing Group(if any)) 13.Waste Codes No. Typo Quantity Wt.Nol. }{ 1. UN1950,WASTE AEROSOLS(Each No Exceeding IL Capacity), L ' 331 D001 D035 o FLAMMABLE,N.O.S.,2.1 }( 2 UN 1993,WASTE FLAMMABLE LIQUIDS,N.O.S.,(ACETONE, a /� 331 Do01 D035 c� ISOPROPANOL), 3,PG 11 }{ 3 UN1479,WASTE OXIDIZING SOLID,N.O.S.(POTASSIUM 141 D001 PERSULFATE,SODIUM PERSULFATE),5.1,PG Ili n l 10 4, NON RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, 1/ 561 GLYCOLS) �{ 14.Special Handling Instructions and Additional Information 1) 8091613 1{L-ld (Aeroef3l) (Za PRIMARY EXPORTER: TEMARRY RECYUNG INC POUF Al 1712/#26 2) t (Flare LIIo p 3) R r w 0�)4)R tccfi-ym (NRL-CP) 15. GENERATOR'SfOFFEROR'S 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. marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and 1 am the Primary Exporter,I cerlify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent 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. Ge eratorVotleroes Printed rTyoeme Signature Month Day Year ZI III _..r 16.International Shipments 1:1Import to U.S. Export from U S Port of entrylexit: ��'s< /�i3 4- CA, Transporter signature(for exports only): Date leaving U.S.: O :4- O W 17.Transporter Acknowledgment of Receipt of Materials Trans er 1 Printedrryped Name J Signature Month Day Year Q 110 4-1 y J 4 Z }� CL Z Transporter 2 Printed/Typed Name Signature Month Day Year i s ✓Y CJ�l7 Z� 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection _ ❑Full Rejection Manifest Reference Number: 186.Alternate Facility(or Generator) U.S.EPA ID Number J U Li- Facility's Phone: W 18c.Signature of Atemate Facility(or Generator) Month Dav Year a 05 05 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) p 2. 3, 20 signated Facility Owner or Operator Certification of receipt of ha4arcous.materials covered by the manifest except as noted in Item 18a P�fTypName ., Signature MOnih Day Year EPA Form 8700-22 Previous edition solete. DESIGNATED FAC Y ESTINATION STATE(IF REQUIRED)