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please print or type. (Form da4rled for use on elite (12•plIO) typewrilor.) Form Approve4. OMB No, 205x0039 <br /> UNIFORM HAZARDOUS 1 . Ganeratoi ID Number 2, Papa 1 of 3. Emerger cy Re�pansa Pnone an est aC um rt <br /> WASTE MANIFEST C A L U 0 U 2 5 7 5 2 ? 5 JJ K <br /> 8. anaratars Name and aping Address Generators Re Addtoss (it different than melfingeddr0ss) <br /> r CABP,AL CI-IRYSLCR W Sl' i:' RN INAOYOPf ' . (;AEOIJ. <br /> P . O . (SOX 21136 <br /> MANTECA WA 95330 1 i 45 VJ 't`GaEtvliTE AWE <br /> Oenera(ofa Phone: 0 7 32311 &8 RrANYLCA A 953 7 <br /> 8. Transporter t Company Name U.S, EPA fD Number <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 J 2 7 f 0 $ 6 <br /> 7, ranspo ilt 2 ompany.Narr U. EP Id Number <br /> u WORLDWIDE, RECOVERY SYS TEM INC. C A R 0 0 0115 4 2 2 <br /> 8, Designated fadtty Name ind Site Address U: , EPA ID Number <br /> YUMA Yi"S LLC <br /> 2730 E 13TFi ST <br /> YUMA AZ £353615 A Z R O O 0 515 9 2 4 <br /> FaGlily's Pfiana; • ? • t - � ' I <br /> Oat 9b. U.E. DDT Description (including Proper Shopmg Nams, Hazard Ctass, 0 Minter, !o. Containers 11 . TOlal 12. Unit 13, Waste Codes <br /> Hlrl and Picking G(WP (it any)) No. Type Quaobly YAW01. <br /> 0 tNON-f3CRA HA?ARDOUS WAS'1 E. SOLID ( t310 :S�1rtif' <br /> 411) . +' ER f'i1: l: (35j <br /> a: <br /> f <br /> 1 : Sp%iai Handlhy lMtruolions and Additlonot Worrnetion <br /> 3pAG11300 WOF.,iTfRMNAL : PROFILE # 963. : : 0 � , 0OILY SOLID.ENfiCC \'CY CONTACT : CEMIZEC 1-£3Q0-424-U <br /> PAPER FILTERS APPROP RIAU PPL EQU (PWW #,�07 p �, <br /> Y8. GIINEWORrSIOFFEROR'S CSRri;16 TION: I herebydetdare"'thal the witailrs or d is C6ruitgnmeni are tatty end wMotaly described &tire by the prowsNpping name, and are da9slfl0¢, packaged, <br /> marked and labetedrplacarded; and are In al respects in proper condition rot hanspon according to appficaale intemationrd and national governmental reguia8ons. If oxoon shipment raid i am the Prirr ary <br /> i EY.i)ortar, t uftt'iry that the contents of tNs consignment conform to the terms ortne attached EPAAckpoowledgmant of Consent <br /> i cerfily Uratthe waste ittbumizatbn statement Won ifnftl 1x40 CFR 282,27(0) ( f i ant a iwgo qupntiry ganeratot) ar b) f l ani _ lax GuanItty.generator) is Yost <br /> t ar alJRot A Pdn +d yped Noma Slg a Month Day Year <br /> A kv o I P I 1 <br /> .5 1 . International Sgments <br /> F L J Imprn to U.s, 0 Export from U.S_ P t of entryloxil _ -- <br /> y Z, Tran5po00sign9lure(foraxparlsonly)! 051 seating U.S.. <br /> t tY. Trars rterAckncvAOdgmnotReceipt offlatad04a <br /> Transom yp rd a Signaiwa hton Day year <br /> MonTn a Year <br /> ' t�+�7-•. ran Drtar. dfW ed NamO '.Stgnatl3to Q � . <br /> f8. 01serepancy r'--1 _ rr--���1ttt--��--il <br /> 18a. Discrepancy indication Spsce Quantity U Type L J Re0410 ❑ Partial Rejection 0 FUN Rejection <br /> iranilestRererence Number: <br /> _ 18b. AlterratoPadfity (or Generatoaj t1.S. EPA iDNumber <br /> w FacRrysPlione: <br /> 180 Signature Of AlternateFoaxy or Generator) month Day Year <br /> :c <br /> z <br /> 0 9 Kwrdous Waste Rapon Rlanngnmenl Method Corina (r.o., codas lot hazardous wasto vaaunai;t, disposal, ano rocyctng systems) <br /> Uj <br /> 20, Designated Faddy Garner of Operator; CwVrcatlon of receipt of hazardous nklteriais covered by 8ta alarY`est axcePt as wed m item 188 <br /> t�in-ed ypa Name <br /> n � onta Day Year <br /> EPA Fo rh 70 •2 (Rev. 31r05) rev us editions are obsolete. 0ESfGWkTCW A,CILIYY 'I.O E)ES411NA'f ION S'T'ATE (11= F3EQUIRED) <br />