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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 I CAL0003 333 877-577-2669 013658223 FLE 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) O' Reilly Auto Part s#3810 4178747257 151 WEST MAIN STREET 1551 WEST MAIN STREET Generator's Phone: RIPON, CA 95366-3012 RIPON, CA 95366-3012 6.Transporter 1 Company Name U.S.EPA ID Number Steric cle Specialty Waste Solutions Inc IMNS000110924 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address 21st Century EMN, LLC U.S.EPA ID Number 2095+ Newlands Dr. East Fernley, NV 89408Facility's Phone:77!=,975P7r,91 KIIJnr4A WLA1Q--Z ga 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt.Nol. o X UN1993, Waste Flammable liquids, n. o. s. 1 CF 00001 P 214 D001 (Acetone, Methanol), 3, PS II, ECRU#128 z 2. L C7 3. v 4. 14.Special Handling Instructions and Additional Information 1. l 006 70(F l a lli 1R a b l e Liquids) 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,l 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 sma uantity generator)is true. Generator's/Offeror's Printed/Typed Name ` Signature Month Day Year 011 1 081 23 "01 16.International Shipments . . � ❑Im port to USEl 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 UJ Transporter 1 Printed/Typed Name Signature t Month Day Year a Jared Marciel 08 1 23 •`01 Transporter 2 Printed/Typed Name � /^ � Signature Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ResidueRejection Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J_ 0 LL Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year Q11 , Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) U 1 2. 3• 4. N�A)i 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in It )8a Printe ped Name ^ k Signature M nth Da Year 1 EPA Form 8700-22(Rev.12- ) Previous editions are obsolete. DESIGNATED 0 EPA's e-MANIFEST SYSTEM 1