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Ple N ,( or type . (Form designed for use on elite ( 12-pitch) typewriter.) Form Approved . OMB No. 20%0039 UNIFORM HAZARDOUS 1 , Generator ID Number 2. Page 1 of 3. Emergency Response Phone 4. Manifest Tracking Number WASTE MANIFEST 0112 0 9 2 6 2 FLE 5. Generators Name and Mailing Address Generators Site Address (if different than mailing address) CALAMCO Califomia Ammonia Co, Califomia Ammonia Company (CALAMCO) 1776 W. March Ln 2323 Part Road G Stockton , CA 95207 tockton , CA 95203 enerator•s Phone: 2_ 6. Transporter 1 Company Name U.S . EPA ID Number Advanced Chemical Transport Inc. (SV ) CAR000070540 T Transporter 2 Company Name U.S. EPA ID Number Worldwide Rewwry System , InG GAR000175427 8, Designated Facility Name and Site Address U.S. EPA ID Number Yuma YES , LLC AZROD0515924 2730 E . 13th St Yuma, AZ 85365 Facility's Phone: 928�,W^9828 9a r 91b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 , Total V. Unit 13, Waste Codes HM and Packing Group (if any)) No. Type Quanbly wtNol, a if on-PCRA Hazardous Waste Solid, (Oil filters) r DM p 352 Lu 2 . A)(;(._) r2c t4 "Z PJZ ' — J t 2, _ WJ0 �Zj SC 1 _ 3. a . 1A. Special Handling InsUuctions and Additional Info b=1hat ect Number 153937 Document * D184790 1 ) 176207 CAY 6C615. GENERATOR'SIOFFEROR'SCERTIFICATION : Ihis consignment are fully and accurately described above ipping name , and are classified, packaged, marked and labeledlplacarded, and are ' all re cts in proper condition for transport according to applicable international and tional governmeIf export shipment and I am the Primary Exporter, I certify that the contents of i cons' mens conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the w s minim nation admen i nbFied in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a II quantify gen" eneratoes/ e s ' /Type Signature on ay ear 1 ==j16. lntemationa pment mport to U.S. ❑ Export from U.S. Port of an /exit: Transporter signature for exports only): Date leavi U.S.: Of 17. Transporter Acknowledgment of Receipt of Materials _ Transporter I Prinled/Typed Name Signature on e a N L b z ransporter2 Printe ped m gnature onth ay Year t�,f*MG► b2 2 1 �a 18, Discrepancy 18a . Discrepancy indication Space ❑ Quanbty ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) U .S. EPA ID Number J U 4 u Fadli s Phone: w 18c. Signature of Alternate Facility (or Generator) Month Day Year a z 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste Uealment, disposal, and recycling systems) 2. 3. 4 20, Designated Facility Oxner or Operator: Certification of coipt of hazardous materials covered by the manifest except as noted in Item 18a PrintedrTypiad Name Signature MonUt Day agar J EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)