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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST CAC003083150 1 209-648-8060 003623313GBF <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> DTL TRANSPORT 800 E PESCADERO AVE <br /> 4375 N GOLDEN STATE BLVD. TRACY CA,95304 <br /> FRESNO CA,93722 <br /> Generator's Phone: 559-2894424 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> ALL ENVIRONMENTAL SERVICES LLC CAL000421863 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> WORLDWIDE RECOVERY SYSTEM INC CAR000175422 <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> YUMA YES WASTE TRANSFER FACILITY AZR000515924 <br /> 2730 E 13TH ST <br /> YUMA AZ,85365 <br /> Facility's Phone: 909-909-2783 <br /> ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> HM and Packing Group(ff any)) No. Type Quantity Wt.Nol. 13.Waste Codes <br /> 1.NON RCRA HAZARDOUS WASTES SOLID DIET DIET&DIESEL <br /> O 3 BA 4425 F, -- - <br /> � 331 <br /> w <br /> z 2. <br /> w <br /> 0 <br /> 3 <br /> 4. <br /> 14.Special Handling Instructions and Additional Information <br /> PROFILE 2002198 <br /> WO#Y20985;Line 1: <br /> 15. GENERATOR'S/OFFEROR'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, <br /> 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 <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> 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 small quantity generator)is true. <br /> Generator Offeror's Printed/ryped Name bignature Month ga-y -Te-ar <br /> BRANDON ESPINOZA BRANDON ESPINOZA 10 02 1 2020 <br /> :-r 16.International Shipments <br /> t- 11 Import to U.S ❑Export from U.S. Port of entry/exit: <br /> Transporter signature for exports only): Date leaving U.S.: <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> t2 Transporter 1 Printedrryped Name Signature Month Day Year <br /> a BRANDON ESPINOZA I BRANDON ESPINOZA I 10 I 02 12020 <br /> N <br /> Z Transporter 2 Printed/Typed Name Signature Month Day Year <br /> W JUAN M.GOMEZ JUAN M.GOMEZ 10 02 2020 <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space Quantity ❑type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number. <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Facility's Phone: <br /> In 18c.Signature ofAltemate Facility(or Generator) Month Day Year <br /> Q <br /> Z <br /> N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 0 1. 2. 3. 4. <br /> H141 <br /> 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> Printed/Typed Name Signature Month Day Year <br /> BEATRIZ MOLINA BEATRIZ MOLINA 10 06 2020 <br /> EPA Form 8700-22(Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />