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SSL SK SHIP# 226825299 <br /> Y,: , <br /> Pleas�pri or type. < ' <br /> r, Form Approved.OMB No.2050-0039 <br /> U ., RIS HAZARDOUS 1 Generator ID Number 2.Page 1 of 3: m Rgsgopse Ptd 4.Manifest Tracking Number <br /> WANE MANIFEST CAI- 34 75 1 "t�st� 1 d4� <br /> SKS <br /> 5.Generators Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> 'ADESA �. ( bid, at ADESA — .Golden tate <br /> 18501 West St lnford Rd Attn Sanue1--fthenry 18551 Stanford Rd <br /> TRACY <br /> . CA 95377 Atte Lester Sabo <br /> ' Generator'sPhone: pp yyS 1m5374 TRACY CA 35377•-97 <br /> 08 <br /> 6.T' SYSTEMS INC U.S.EPA ID Number �XR+��8t�81e"85 <br /> 7-Transporter 2 Company Name F U.S.EPA ID Number <br /> t <br /> 8.Designated Facility Name and Site Address VTY--KL CALIFORNIA U.S.EPA ID Number <br /> NEWARK <br /> AVE ® <br /> 51 --795f-x'400 � CA 9456 <br /> Facility s Phone: CAD990887418 <br /> 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> HM•. 'and Packing Group(if any)) No. Type Quantity WLNoi• 13.Waste Codes <br /> o 001 <br /> '' NCN .RCRA HAZARDOUS WASTE9 LIQUID TT G 133 <br /> ,ETHYLENE SLYCOL`' 'SOLUT'IO (LESS THAN 58%) <br /> Ujr <br /> 3 � . <br /> a <br /> 4. <br /> r <br /> 14.Special Handling Instructions and Additional Information 'f; <br /> TSD s EVO ', AA8194 a CSS <br /> 24H EMER CYC 5-468--1760—CISK/TTI—tonVio�`t"' :e xp; by genera <br /> tor confers o a� y n Mari y <br /> on ieiitiai trans to ter t <br /> 15. GENERA CERTIFICATION:I hereby declare that the contents of this co ignment are fully and actr <br /> curately described above by the proper shipping name,and are classified,packaged, <br /> marked and labeled/placarded,and are in all respects in proper condition for transport p jrding to applicable intemationai and national governmental regulations.if export shipment and I am the Primary <br /> Exporter,I certify that the contents of this si nment confor91 the erns ofth ala EPAAckno ent of Consent. <br /> I certify that the waste minimization statemnt(e •lad in ¢ 2.27(a)(if Iain a large quantityg erator)or(b)(if I small quantity generator)is truer t <br /> Generator s/Offeror's Printed/Typed Name Signature ^4IL ' Month Day Year <br /> 16.International Shipments <br /> 3 ' <br /> H <br /> El import to U.S. F71Export from U.S. Port ofentry/exit " <br /> ? Transportecsignaturei(forexports.only): <br /> Date leaving U.S.: <br /> W 17.Transporter Acknowledgment of Receipt of Material§ ; <br /> a> <br /> O <br /> Tran rter4,Printed/Typed me Si ture <br /> Y Month DaYear <br /> °i� <br /> ZTransporter rinted./Iyped Name Signature l r Month Day k.Year <br /> ' 18.Discre anc �• t.�i,i ''. � <br /> . t <br /> p y <br /> 18a.Discrepancy Indication Space Quantity ❑T e " <br /> ,. YP ❑Residue El Re�ec(on ❑Full Rejection <br /> •. , <br /> 18b.Alternate Facility(or Generator) Manifest Reference Number: <br /> > U.S.EPA ID "tuber <br /> ua- Facility's Phone: <br /> w 18c.Signature of Alternate Facility(or Generator) Month Day Year <br /> Q <br /> Z . ; <br /> S2 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> LU <br /> 1. ZA/ <br /> 2. 3, 4.; <br /> 20.Designated Facilitycaner or O.PeratoruCertification of receipt of"hazardous materials covered by the manifest except as noted in it 18a i <br /> Printed/Typed Na <br /> v Signature Month Day Yea I <br /> EPA Form 8700-22 Rev.12-17) Previous editions are o solete. pESIGNATED FACILIfi TO T I <br /> i}652�15��i3 <br />