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Please print or type. Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 1 . Generator ID Number 2. Page 1 of 3. Emergency Response Phone 4, Manifest Tracking Nu% ummber ryry WASTE MANIFEST CAL 18W7& 7725 " "1 °i 8 j °1 12 FLE 5. Generator's Name and Mailing Address Generators Site Address (if different than mailing address) ._ Dragon ESP LTD 15/00 McKinley Ay„enue slilerri. he[iTea@niodeernusa. com Lath? CA. Generators Phone: 6. Transporter 1 Company Name U.S. EPA ID Number Advanctx• ==DBA ACTENVIR0 CARI"70540 7. Transporter Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number Achanced Chemical Treatment 6133 Edith Blvd NE NMOOO�,)8827 \ibuquerque, I4M 87'10% Facility's Phone: 5Q5-�-5� 9a 9b. U.S. DOT Dwrtription (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 . Total 12. Unit 13. Waste Codes HM and Packing Group (ifany)) No. Type Quantity Wt./Val. z 1dUN 1325, Waste Flammable solids, organic, n.o s. Ctv1 DD01 CG35 FicjD4 Cx (ACE'TONE. METHANOL), 4. 1 , PGR FIM F005 262 cM 2. Ulu c� 3. 4. I 14. special Handling Instructions and additional Information P"ect NuIrbw 177,142 DOcii # 1321W,457 1 ) ERG1133; AGT."22`20 DRA:- - 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 labeled/placarded, 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 Exporter, I certify that the contents of this consignment conform to the tens 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. Generator's/Offerors PrintedlTyped Name Signature Month Day Year 16. International Shipments ❑ Import to U.S. ❑ p Export from U.S. Port of entry/exit: 9 Transporter signature (for exports only): Date leaving U.S.: W 17. Transporter Acknowledgment of Receipt of Materials Transporter l Ichmed/Typed Name Signature Month Day Year O Go aGo Transporter2 PrinteOyped Name. Signature Month Day Year C 18. Discrepancy 18a. Discrepancy Indication Space ❑ quantity ❑ Type ❑ Residua ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: F 18b. Alternate Facility (or Generator) U.S. EPA ID Number zi U LL Facility's Phone: w 18c. Signature of Alternate Facility (or Generator) Month Day Year z y19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) C3 1 . 2. 3. 4. 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/I yped Name Signature Month Day Year EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY