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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAL 0 0 0 3 3 0 4 2 3 1 (800)424-9300 01817 0 3 4 8 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Q AND M, DEA TRACY CHEVROLET-0AN001 3400 AUTO PLAZA bVAY TRACY CA 95304 Generator's Phone: 209 835-4500 6.Transporter 1 Company Name U.S.EPA ID Number WORLD OIL ENVIRONMENTAL SERVICES C A D 0 2 8 2 7 7 0 3 6 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number WORLD OIL RECYCLING 2000 N.ALAMEDA STREET COMPTON CA 90222 CAT 0 8 0 0 13 3 5 2 Facility's Phone: q-n1,�7 on 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt.Nol. rr 1'RQ, UN1993, WASTE FLAMMABLE LIQUID, N.O.S.,(GASOLINE, y 0 DIESEL). 3, PG II / D M �0 I Z 2. w 0 3. 4. 14.Special Handling Instructions and Additional Information EMERGENCY CONTACT: CHEMTREC 1-800-424-9300 WOES TERMINAL: CERES CS NAERG#9131 : 128 *PROFILE#9B1 : 421485 GASOLINE, DIESEL * *APPROPRIATE PPE EQUIPMENT 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 sm9f quantity generator)is true. Geratot`2/0 11P n- eror s Pr dffyped Name Signature Month Day Year J Lvu, 71 ZZK I Z/ 12-21/z --r 16.International Shipments H ❑Import to U.S. ❑Export from U.S. Port of entry/exit: z Transporter signature(for exports only): Date leaving U.S.: W17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year za Transporter 2 Prinledrryped Name Signature Month Day Year fY t- 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection El Full Rejection Manifest Reference Number: F. 181b.Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facility's Phone: C3 18c.Signature of Alternate Facility(or Generator) Month Day Year Q z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LU in 1. 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printedrryped Name SignatureMonth Day Year v �� Z EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILI Y TO DESTINATION STATE(IF REQUIRED)