COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

RECEIVED 2/14/2019 Pease print or type.(Form designed for use on elite(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 CAL000412060 1 108-363--3678 017 3 6 7 3 7 7 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(If different than mailing address) SALLY BEAUTY SUPPLIES 4 10229 10710 TRINITY PKWY V C STOCKTON-_ CA, 95219 Generators Phone: 9nG 477-5ARS 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC CAD982492399 7.Transporter 2 Company Name U.S.EPA ID Number T"LARRY RECYCLING. IHC_ CAR000194217 8 0'noted Facllilt��N__ame and Site Address U.S.EPA ID Number CLA.ORA TF3+IARRY DE MEXICO CARRETERn. FEDERAL NO. 2 M!EX, SAN PALO TECATE BC FaciliYsPhone: 619-270-9453 faci30€19001 gar 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class.ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wl.t. 1. UNT94u, wis -1-t ArxU2iULYr tk—noh No LuizeedLing DOO ID035 331 ce Capacity), E'LPMIABLE, N_O_S _, 2 _1 1 S p O i t w 2. IQ[1ID5, N.0-S' _ .001 .035 E'O03 t9 (ACETONE, ISOPROPANOL) , 3, PG II ' r„ P 3. ON:L479, WASTE OXIDISING SOLID, N.O.S- 111003 141 s (CONTAINS POTASSIM PERSULFATE AND SODIUM � � .� � P PERSULFATE) , 5.1, PGIII 4. 561 (.ETERGENTS .GLYC CLS) Cf � p 14,Special Handling Instructions and Additional Info ation VL 1) 8€341813 /kj/ I X561? (Aerosol) 2) R / Z►11 VSbTe (Flan Liq) 3) R / 301 /X'3D ILf Iii (Oxidizer) 4) R / rfil !?, 3C t,?g (NRL-CP) PRIMARY EXPORTER: TEMA.RRY RECYCLING INC- PO# 12225 15. GENERATOR'SIOFFEROR'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 labeWlplacarded,and are in all respects in proper condition for transport according to applicable international and national govemmentai regulations.If export shipment and I am the Primary Exporter,I certify 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)(ifI am a small quantity generator)is true. GeneratorslOfferor' Pn'ntedrryped Nae Signatur Month 'D'aay., Year j 16.Interna onal hipments H ❑Import to U.S, Fxport from U.S. Port of entrylexit:Z rs0 Z Transporter signature(for exports only): Date leaving U.S.:12-2 9- 17-Transporter Acknowledgment of Receipt of Materials a TranspontedlFyped Nam S9gnature Month Day yYear Z Transporter2 PrintedlTyped Name Signature onth Da Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 181b.Alternate Facility{or Generator) U.S.EPA ID Number U LL Facility's Phone: LU 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z V519.Hazardous Waste Report Management Method Codes(i e.,codes for hazardous waste treatment,disposal,and recycling systems) Lij 1. 2. l -70' 3. 4. ^ rl 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 16a L/�]`�/f�J PrinledlTyped Name - y ,^ Signature Month Day i e EPA Form 8700-22(Rev.3.05) Previous editions are obtolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)