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Fcr::tA: rc:ed.1_N,BNJ .2054-r.t,•c <br /> Plea_a pont or type.;"motto designed for use on elite(12-pich)typeueritec) )_ _,� <br /> UNIFORM HAZARDOUS 1.Genoraar to Number 2.Page 1 or 3.Eme Sency Resperse Phrme 4.Manifest Tracking nlumFer <br /> WASTE MANIFEST _,.-y ;y , .z-rF. 011385088 F L E <br /> .. <br /> Genera:^'s Nr,e a^•]P.?;ri:-na:.d:ras; Gereals's Safe Pd..-,..,,,�.pf rir.'areni than r:na-i,J a?:i-e=�? <br /> i yah iodu 1.101"Lts J'�1�•' Lit 1) Z L;odi-i,. 1 ti'. <br /> 094'L9339 ►)5k'I PACIFIC AVE, 41CtlEt�;ifl7W(U MILLI' 3F'Hlt_ t'15it1 t'AGI>=iC AVE <br /> Generators Mere: - q5-0" qTnEETnim - <br /> 6.Transporter t Company Name U.S. PA W tJu tce� <br /> - - - Liprr i Al+ 4- <br /> f 7.Transporte,2 Company va na U S.E=.410 Ycmt:.r <br /> 1_(: pi -r eQl= vA(tc9ri�+tll r 7 - <br /> 8 Desr._:'1ate;:Fa5'ry Narne and Site.4edress t15.EP;;!D N:,rd;a: <br /> Yuma Yee. L-Lr <br /> 2.730, E. 13th St-re2t <br /> Yuma. AZ 85'.365 <br /> l'aC4 i s Pnore:92864Zr813,zCj L71c e. <br /> gb U.S.DOT Des_pfon iinduch-q Proper Shipping Name,Hazard Class.)D Numter. 10.Canfainers 11.iota` 12.`Jr <br /> and Packing Group(it ary); 3.ti'luste C•e__- <br /> h'a. Tyre Quarsty - <br /> 'Non RERA i;a2a►-dou= wa=_te. liquid (Soaps. c DF 01322_ F <br /> - t_a� ions). <br /> LU i <br /> LU <br /> 04. <br /> i <br /> i <br /> r <br /> I <br /> 14 Special Handi;na Ins!r.ECfoas and Add t oral Inlomation i. 1 109-i `'1: <br /> 1z1_'.� t t;•_• Re g u l tii;ed L 1•1 r_t).CI i _ <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully ar. ccu-afely described ab by tete proper s`ipt:icg name_an,i are classil ed,pa:? <br /> marked ana labeledtpiacardeo and ate in all respects in proper canditioe for tra^spdn acr crding to applicable intereationa'and"et onai ge n-nental reg as'an;.Ir exp?:sr r:::.:nt aryl I am!te Pcr. , <br /> F4poCer,t certify tat rhe conter.:s of this consignment conform to the terms oft^e attached EPAAckncWedgmen'.,f -n r ) <br /> I cenify that the wasteminimizaban staterrenttiidenlifted in 40 CFR 2fi227(a)(i1!am a large quantity generator) r(b)(. am a sx .ntit;,er4ra <br /> �c,:alcrs: f e•M s ri:aea'.'ip`_.1 N'or=,G C� ;gratur -1, t arta 3: <br /> 32i'i1iT' -7)i Lliu:t'= <br /> J ?c.:rt•_rrata'a�Shi(x t5 - --t - <br /> .Z ;mncrt:,G.S Exporr,from li r•::n 4f antra; a:------ <br /> r,a„'crtar selcature i'or e+pars n�:'ri. tf,'ate i0a,w U.S.. <br /> W 17.Transperte:Acknowledy:cent of R®reip:of Materials <br /> a Tansporer 1 Prin!ed/TypeU Nana ignaPur .crli: ay -a <br /> CL <br /> Ant' n v Mack <br /> z T'ar c + drvam� Si aur <br /> t! <br /> < e Iia. t <br /> I screpa.). <br /> 18a.-Discrecarc;Ind' n Space Ouantit, pe T ;ue <br /> Y ❑Parliat RFFall Re;�.,,r <br /> Manifest Reference Number: <br /> 18b_Aftemate FwCty(or Generator) U.S_EPA ID Nbirte <br /> J <br /> U <br /> Q <br /> LL Facili 's Phone: <br /> W 18c.Skptature of Alternate Facility(or Generator) f.;cs!h a; <br /> Q <br /> Z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recyc ing systems) <br /> 03 <br /> 0 1. 2. 3. 7- <br /> -4A <br /> 20.Designated Falzfity Owner or Operator:Certification of receipt d hazardous materials covered by the manifest except a d in!tem 18a <br /> rinse ed am <br /> YF -ralure 1 ; 1!or:t:^. Cay Yb,r <br /> y �t l Y <br /> EPA Form 8700-2 (Rev.3-05)Previous effi Ions are cbsolete. :••.,. - ;t <br /> ;, i)F2ii,t•..dFi ;(;)`..I'i',= iL) :,'TIiiali(' <br />