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Pleasep int or-type N.-tri ` desi nod for use on elite : l2 pitch) iy wridlec) Form 1p :ioved: OMB No. 2050.0039. <br /> r <br /> UNIFORM HALIRDOUS t . Geneialor iD Number 1,2, pagelof 3. Emergency Response Phcna 4. manifest Tracking Number <br /> WASTE MANIFEST <br /> CAL000257527 1 (800) 4249300 01. 7468621 JJK . <br /> 5. - <br /> Genertors Se Address (ildil(erenl than mailing addross) <br /> �R ' g �MTERN. MOTORS CAB01 <br /> P;O, <br /> BOX 2186 <br /> MAN T ECA CA 95336 1145 W YOSEMITE AVM <br /> 209 823-1148 MANTECA CA 95337 <br /> Generator's Phone: <br /> 6, Transporter 1 Com an TR <br /> a S: EPA ID Number <br /> WORLD O�L IRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> +T Tii+nCPorior2'Co o)yKilo Si.EPA1G `irmtiar <br /> 8. Desinaffed FacBiryty htime'a d;SllaKdd{ens ' <br /> DMENNO / 1 COON <br /> 2000 N4f' 1 AMED STREET <br /> COMPTON CA 90222 CAT 0 8 0 0 13 3 5 2 <br /> FatlGtyuPhone: (.'3;10) . , 37. 7100 — <br /> 9a, 8b, U.S. DOT Descdpl n (including Proper shipping Name, Hazard Class, ID Number, 10, Containers . :...._: ,. 11 :Total 12. Unit 13, Waste Codes <br /> HM and Pecking Group (it y)) No; Typo Quantity WlNoi <br /> VN1993, WASTE FLAMMABLE LIQUID , N .O,S. , (GASOLINE, DIESEL )001 b018 `43 <br /> VtA EM) ,3, AGI ------ . - - -- - - - -.. — D M19 <br /> G <br /> W: <br /> CD <br /> 3 <br /> did <br /> r <br /> '1+{, poclhtltoti ifi9 irtSiiuceo �:antl'AtldflioPal'intritriwiloli , <br /> EMERGENCY CONTACT : CHEMTREC 1.800-424. 9300 WOES TERMINAL: NAERG# 9131 ; 128 * PROFILE # 9B1 : 396041 <br /> GASOLINE , DIESEL, WATER * * APPROPRIATE PPE EQUIPMENT <br /> 15 " iS- NERA70R'51r)FFER R'SGEj2TIFICAffON, lhcray:decierotfi@1lhapnisnts'gith ca sfgninentorafv`lynndoccurdlal�dask`r(1t`a�d-:SbaV$byihe�ropef ishtppngrt3rre nrdnrodasfiodypackaged, <br /> h tiarktdrutdla!fcdgdlpla riled;:sndaro:IneGrespacts jhprupormcui(iloryforkyl¢porloccbrdngiooyplkobieLttomato artdnetfd gov¢mrrentplroqutailan lf.expOrtrhlprntntW.. F;amUePdmary <br /> xpai¢ry I ccditgihaldha ntairts of ttils ronsEjnrnenl cmn(otm tb the loans of.iho flllached EfjAlCcknoP/lodgmeDl or , o1jt, <br /> } r rtity that lAe�vasto i am+A ml�l(nizatlon sla',amnnt iin8fiad in Atl:C6R 252.27(a),(il largo quaniitg pbnerator} ot j (� am 3tl u$n0iy 99,ners drJls hire; <br /> Gen ratre's101(a Ys a iS ed.Romb 0 lure 6tinlh Y <br /> , <br /> F. 1& .I1 ornaibna(Shipipih(y <br /> Q Import to to U.S, t Export from U.S. Por[dhflrylpZdt! <br /> Z - ,� D51 -:19avig0 U.S:: <br /> ,—: TtijtS{sbrtcr �1gn sura{lora ex ds �J7tp)t <br /> w 17 Tra <br /> onsponerAckno�edgme t of Receipt of Matoriols• <br /> F sertnipro Mcn7l� DY)e2y�r1 <br /> TtalsbAprlai nt�ditj eti mo V lU <br /> o - <br /> ;Z Tlansparro �nntedfType4 r, e - ._ . . <br /> Signature. . . _ . _ _. . _--- - - - -- -Month._ . Day Year — <br /> Q I - -- .._ <br /> 18. Discropancy <br /> 18a. Discrepancy indication Srace El Quantity ❑ �r��1 Type [:] Residue l 7 Partial Rejection ❑ Full Re)ecgon <br /> 1•fer�tC5l, RetomncaNumtmr: <br /> 7. 18b. Alternate Facility (or Generator) U.S. EPA 1D Number t <br /> fP <br /> w Facility's Phone: Month Day Year, <br /> w 16c. Signature of Ntemate "( 1111V (or Generator) r; .1 1r <br /> N10, Hazardous Waste Report management Method Codes (Le., cedes for hazardous waste treatment, cisrosai, and recycling sys(oma) <br /> wo 1 1. <br /> 3. 4. <br /> 0 HP <br /> Wq — <br /> 20:besignatc8 Farce: ty owner r Operator: Ceni6calion of receipt of hazardous materials covered by the manifest except as nded in Item, .1 <br /> Plb to 7rtyp d ama Signature 1 Aicnti day <br /> Vl. G �Gt'� j <br /> EPA Form 8700.22 (Rove 3�05) Previous ediGonsare obsolete, DES . ATED FA TO DESTINATION STATE ( IF REQUIRED) <br />