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6SiL SI{ ;HIP# 227811972 �III��I�II��I�II��II��II��I�IIIII�I� Please print or type. Form Approved.OMB No.2050-0039 Afl — 1:-Ge n6 ato�IDNumber — 1-2.-W -1fme,,[[ggre� RQQs-pps�e 1p-- — 4:Mani es Tr6X,ng umer UNIFORM HAZARDOUS CAL000393232 _tSYlttl_zt�°t1_1 i WASTE MANIFEST 006953071 SKS 5.Generator's Name and M ilio Address----- __ Gen erator'�Site Address(if different than mailing address) O' Reilly # 3460 ---_-__ 1210 N Tracy Blvd TRACY _ CA 95376-3435 Generator's Phone: 972- 555-1554 6.TrafffCom�..nyEg SYSTEMS INC U.S.EPA ID Number Y- TXR000081205 7.Transporter 2 Company Name U.S.EPA ID Number CLEAN HARBORS ENVIRONMENTAL_ SVC INC. MAD039322;.-_5Q1 8.Designated Facility Name and Site Address CLEAN HARBORS ARAGON I FE, I...L..C U.S.EPA ID Number 11600 NORTH APTIJS 'ROAD ARAGONITE LIT 841129 Facility's Phone: 4:;5-884-E!iQt4'1 ' UTD981552177 ga 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) No. Type Quantity Wt./Vol. 13.Waste Codes X 1 UN 1993, WASTE FLAMMABLE LIQUIDS � P D�++�1 D@05 D007o N.0.S. (ACETONE, ISOPROPYL ALC�IHOL), 3, PC I p4� DOIE D027 343 w Z 2. � NT RELATED . _ 3. 4. 14.Special Handling Instructions and Additional Information TSD e AG 79432868 OR 14348 CSG- --f VCCZ 03 1 24H EMERG�N6Y#B66-4�8-1764—CH/SK/TFI—Contract retained by generator, confers agenvy authori y on initial transporter to add or substitute additional transporters on enerator' s behalf. 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 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 small quantic enerator)is true. �'s nnted/Ty� Signature Month Day gYear J 16.International Shipments r Z ❑Import to U.S. ❑Expod from U.S. Port of entry/exit: Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials LLJ� Tp 1 Printed4Typed a rre),, Month Day Year N Z9 rinfedQm ype Na ae Month Day Ye9r F �� l f 18.Discrepancy 18a.Discrepancy Indication Space ❑ quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: � 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U U- Facility's Phone: Lo 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) U.1 2. —.� 3. Av) 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by themn'rfest except as noted in 18a Pri d Name Si t re - n Day Year EPA Form 8700-22 Rev.12-17 revious editions are obsolete. I)7457159/4+ 485731 DESIG ATED FACILITY TO EPA's a-MANIFEST SYSTEM