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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.Manifest Tracking Number WASTE MANIFEST C A I, 0 0 0 0 4 3 3 3 8 I (800) 424-9300 1015004645 FLE 5.Generitors Name and Making Address Generators Site Address(if different than mailing address) Quik Stop Markets, Inc. Qik Stop Markets, Inc. #120 9u 165 Flanders Road Stockton, CA 9d. Westborough, MA 01581 5209 Generators ftna 6.Transporter 1 Company Name U.5 EPA ID Number BELSHIRE CAR 0 0 01. 8 3 9 13 7.Transporter 2 Company Name U.S.EPA ID Numbw 6.Designated Facility Name and Site Aldi�s; U.S.EPA ID Number U S. Ecolgy Neyy da Operations N V T 3 3 0 0 1 0 0 0 0 RHigh}way 99, �1 mifes S. of Beatty F. i}sY oyes NV 89003 (775) 553-2203 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 Non-RCRA Hazardous Waste, Solid (ERG #171) P 352 *DO18 of (Rags, absorbent, & debris impacted with petroleum hydrocarbons) Z 2. LU c9 3 4. 14,Speclal Handling Instructions and Additional Information t fOLD LABEL AT 0OTTE8 Generator is a RCRA V$QG as defined in WEAR ALL APPROPRIATE BESI : 32 6232 LINE. AFFIX TO RIGRI 4Q CFR 260.10. 0018 COd6 represents PERSONAL PROTECTIVE QUIRSTOP CCN; 659237 SIDE OF HAZARDOUS p CLOTHING. OTERIAL BILLS 50 THAT waste that is RCRA identified but not TAB STICKS OUT. RCIRA regulated. PROFILE # 070214257-0 1�rJ'S TIM 011rrrAAiPL W• 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, 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 EPA Acknowledgment 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 small quantity generator)is true. Gmeralor'slOtfer s Pnntedrryped Name Signature Month Day Year Q ` ' � 16 International hlpnents F Import to U.S. ❑Export from U.S. Port of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials w Tran:portar 1 Prince ped Name Signature Month Day Year U) Transporter 2 Printedrryped Name Signature Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantityyp j j ❑T e Residue Ll Rejection El Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z N19.H za dous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2. 3. 4. 20.Designated Facility Owner qr qperator:Certificilition of rejeipt of hazardous materials covered by the manifest except as noted in Item 18a Prin93�, Signature fef t ,l EPA Form 8700- (Rev.12-17) Wevious editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM