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Please print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Mai t T g flu e WASTEMANIFEST CAMIDIM� 1 WS-M-7225 y FLE 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Aisin El_CtrortioG Iris 199 Frank V&St Stockton, CA 9a2Of B Generator's Phone: 2094W-701 6.Transporter 1 Com any Name U.S.EPA ID Number Ad%&1C*d ICP#t+e�r 001 ThVISPart kic.JDBA ACT1 rrr CARO00070540 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number LIS EPO BOX � � 10M Beatty, W Facility's Phone: 775m&W2M 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 1. • ' ,i., � Mix@"CAWOSAVe li,I'll ,1) tl1)U 8mliC,tl.O.SDF P 1.21tai rZ 21 /tl •i " gij%ftD, [i i 1J.D.S. ArsevHC, igY'ri))iu ), L { P X 9.PCA32 ,w� - I D4.4Sf ML'TS , 9 PGM err � P 4. 14.Special Handling Instructions and Additional Information HG' [' Lrtt r 0 E; 15t, 070137711-8244 AP-., :,/- 3,.5t-eV133 ERG*171; 0701 011-15743 AN-AW/-t 5 '2.XZ- Z)EIG#t71; 0701 -12508AKj-�/%, ' 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, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary 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 I am a s h quantity generator)is true. GenwratoeslOfferor's Printedffyped Name S;gnature Month Da jy Year 16.International Shipmepjp F ❑Import to U.S. ❑Export from U.S. Part of entrylexit: Z Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials LLI I,-X- Transporter 1 PrintJlr-ed/Typed N me Signature Mon Day �jYteaarr� IL Z Transporter 2 Printed/Typed Name Signature Month Day Year H 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity El Type ❑Residue ❑Partial Rejection El Full Rejection Manifest Reference Number: 181b.Alternate Facility(or Generator) U.S.EPA ID Number J Q LL Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year a z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) G 1. 2. 3. 4. i20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a I Printed/Typed Name Signature Month Day Year EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY