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RECEIVED 2/14/2019 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 CAL000411324 2 408-31 015886817 J J K 5-Generator's Name and Mailing Address Generator's Site Address i different than mailing address) SALLY BEAUTY SUPPLIES#744 5756 PACIFIC AVE.,STE H-1 STOCKTON,CA 95207 Generator's Phone-209-952-70134 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HAZARDOUS WASTE REMOVAL INC. CAD982492399 7 Transporter 2 Company Name U.S.EPA ID Number TEMARRY RECYLING,INC. CAR000194217 S.Designated Facility Name and Site Address U-S.EPA ID Number RECICLADORA TEMARRY DE MEXICQ FficC:30619001 CARRETERA FEDERAL NO. 2 1 SAN PABLO, TECATE 15C Facility's Phone: 619-2709453 ga 9h.US.DOT Description(including Proper Shipping Name,Hazard Class,ID Number 10.Containers 11.Total 12,Unit 93.Waste Codes HM and Packing Group Iif any)) No. Type Quantity Wt Nol. X 1 UNI 950,WASTE AEROSOLS(Each No Exceeclli 1 L Cali 331 D001 j 0035 o FLAMMABLE,N.O.S..2.1 l .� u� X UN1993,WASTE FLAMMRBLE LIQUIDS,N.Q.S.,(ACETCiNE, 331 1 D035 ISOPROPANOL),3,PG 11 �OQ3 NON RCRA HAZARDOUS WASTE LIQUIDS,(DETERGENTS, 561 GLYCOLS) 14.Special Handling Instructions and Additonai Information q 1) R091613 ! c t'Y-5 9l (Aerosol) PRIMARY EXPORTER: TEMARRY RECYLING INC PC* 1099 2)R ! F t (Flam i - e) 4)R / LW t`r SV (NRL-CP) 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 labeledfplacarded,and ate 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 Acknowtedgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if€am a large quantity generator)or b)(if I am a small quantity generator)is true. GerALators/OffeWs Pr intiyped Na Signature Month Day Year J 16.Intematianal Shipments ❑Impo U.S- Export from U t: C.J-S- Part of entrylexiJ �]'I A`,�CA - z Transporter signature(for exports only): i Date leaving U.S.: W17.Transporter Acknowledgment of Receipt of Materiais Transport 1 Pdnte ped Name 1 Signature Month a Year 0. � 1 . Q Transporter 2 PrintedfTyped Name Signature Month Day I y r 16.Discrepancy 18a.Discrepancy Indication Space Quantity F-1 Type Residue Partial Rejection U Full Rejection Manifest Reference Number: F 18b.Altemate Facility Ior Generator) U-S.EPA ID Number J C3 LL Facility's Phone, w 18c.Signature of Allemate Facility(or Generator) Month Day Year a z 22 19.Hazardous Waste Report Management Method Codes(i.e„codes for hazardous waste treatment,disposal,and recycling systems} LLI 1. 4 1 2 Des nated Facifity Owner or Operator:Certification of receipt of hazardous matenals covered by the manifest except as noted in Item 18 P'nte yped Name Slgnatum Month Day ear EPAFo 8700 22(Rev. -0 ) Previous editions are obsolete. DESIGNATED ?ILITY TO DESTINATION STATE (IF REQUIRED)