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Please print or type. Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 1 . Generator 10 Number 2. Page 1 of 3. Emergency Response Phone 4. Manifest Tracking Number WASTE MANIFESTCAL00489 1 1 0122, 85151. FLE 5. Generators Name and Mailing Address Generators Site Address (if difleram than mailing address) 15 1 ESP LTD 15700 MCi Avenue snwri. t+ethea@rmodernusa. com i_athrop, CA tel) Generators Phone: 6. Transporter 1 Company Name U.S. EPAIO Numher Advanced Chemical Transurat Inc./DBA ACTENARO CAROrxj070540 7. Transporter 2 Company Name U.S. EPA ID Number B. Designated Facility Name and Site Address U.S. EPA 10 Number Advanced Chankal Treatmwvt 8133 Edith Bhd NE NMLXD0 1M32- Albuquerque, NM 87107 Facility's Phone: 505.349-55270 ga. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 . Total 12. Unit HM and Packing Group (h any)) No. Type Quantity WLNoI. 13. Waste Codes 1 ; • roc.:, . asieuFlanirnablesolids, organic, n-os. _ LI p [�1 17�,� r= � r. !ACETONE, METHANOL), 4. 1 PGR w FC03 FOD5 352 z 2. w C.9 3. 4. 14. Special Handling Instructions and AdtliGonal Information ect 172 Oocuriel 0207978 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, markedand labeled/placarded, and are In all respects in proper condition for transport according to applicable international and national governmental regulations. fexport shipment and I am the Pdmary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment 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 am a small quantity generator) is true. GeneratorS/Offeroes Printed?yped Name Signature Month .Day Yeav J 16. International Shipments ❑ Import to U.S. ❑ Export from U.S. Porto eentrymxit: 3 Transporter signature (for exports only): Date leaving U.S.. W 17. Transporter Acknowledgment of Receipt of Materials Lull aTransporter 7 Printed(Typed Name Signature . • MElFullRejecUon Transporter2 Prnted/Typed Name Signature 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ T eyP ❑ Residue ❑ PartialRejection Manifest Reference Number. rte., 18b. Alternate Facility (or Generator) U.S. EPA O umher U LL Facility's Phone: .� w 18c. Signature efAltemate Facray (or Generator) Month Day Year Q z N19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) 3. q 20. Designated Facility Owner or Operator, Certification of receipt of hazardous matenals covered by the manifest except as noted in Item 18a Printedl Typed Name Signature Month Day ear EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY