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<br />UNIFORM HAZARDOUS
<br />WASTE MANIFEST
<br />I G"wItlifi IU It Y"'°'
<br />CA1_000327765
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<br />016411206 FLE „1,„,,,,or„ MIMI awl 1,',, ',, q Afl,/,059 - '• - • Wal9relems #1013.31 V/Al• 'qv% all'.e.i,' 147d0 Harlan Road - -, 147 ,-,r) Ha4ar Poll
<br />1-athroP, CA 95330 I athrup. CA 554;";t5
<br />Genrratia's Phone
<br />6 Transporter 1 Company Name
<br />All En4ronmental Sergoes LI_C FAL7.1.0421
<br />7Tianspodor 2 Company Name .• .. Atlas En4ronmental Solutions FArairiAL120
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<br />Tecate,
<br />Facility's
<br />&De‘covardiplill,irno sett and SitaAddii.Ls US EPA 0 0..rtAr M6041CD. S.A..C19 C.V. Bd #2 Mex-Tij .Krn 121. San Pablo M130619001 Baja Califeniia. MX CP21530
<br />Phone
<br />Oa 9b US DOT Description (Including Proper Shipping flame, Hazard Class. ID Number l'., r.r.r•a•,:••-, '1 ToU/ 12 Unii 13. tum car HM and Packing Group (II any)) ..,, r- :,..anfty ''
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<br />x WAS1E FLAM1c1A-BLETICOTIIS, N.O.S. (151FSEL.). 3.
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<br />Non-RCR4 Hazardous Waste, Solid TASSORBENT. DIESSU -,52 P
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<br />14. Special Handling Instructions and Additional Information th1Tu1t,
<br />1 1 ) TR.216232 ER(141128 2) TR216233
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<br />Primary Exporter Temarry Recycling. kr.. 02E074/9E/20:
<br />15 GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately descnted. atiom by Te pope shipc•rg name art are dassifed. Oacfraget
<br />marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations If expert sniornern and i arni the Pnrnary
<br />Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment 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) (Al am a smelt Quantity gen. erator) a Mie.
<br />G- nerators/Offeror's PrintediTyped Name D It *t 10 Signature . A Mc47•11 /
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<br />16 International Shipments
<br />Import to U.S. a Export from U.S. Port of entry!exit ...i
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<br />. Transporter signature (for exports only): Date leaving U S •
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<br />Transporter Acknowledgment of Receipt of Matenals
<br />Tran r',:i 1 Pnn, d 'Typed me Signature Month !.-. a f 'ea-
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<br />Transporter 2g7dTyped2.,...4::-.0.- - Signature Mor Cs
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<br />i Discrepancy/'
<br />Discrepancy Indicaton Space Partial Reiection Full Repacton Ouantrty Type Residue
<br />Manifest Reference Number.
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<br /> Alternate Facility (or Generator) U S. EPA ID N....trnt.-s
<br />Facility's Phone: 2 18c.
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<br />Signature of Alternate Favl.ty (Cr Genera:or i I.:-:"
<br />Ce.) 19. Hazardous Waste Report Management Method Codes (re., codes for hazardous waste treatment, disposal, and recycling systems)
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<br />Designated Facility Owner or Operator. Certification of receipt of hazardous materials covered by the manifest except as nrted in Item 180
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<br />PrintedTyped Name
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<br />EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
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