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Form Approved.OMB No.2050-0039 Please print or type. UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST LAL+983606Y30 1 zt) -»31-&Xx < 024.183871 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) ASSOCIATED TRACTOR SERVICE, INC;. 1323 W CHARTER WAY 8 16CICT UN,CA 85205 Generator's Phone:"09-466.3003-105 r U. . A ID Number 6.Transporter 1 Company Name A�MF:RICAN VALLF�WASTE OIL, INC:. G'ARtK10212&Q U.S.EPA ID Number 7.Traosporter 2 Company Name dVORLDVWDE RECOVERY SYSTEMS INC CARU001754.. . 8,Designated Facility Name and Site Address - U.S.EPA ID Number YUMA YL6�e V4AS i L I HANSI F<Iv VA(A u l A71R000521148 6500 US HIGHWAY 95 Yt W,A:2 t393p5 Facility's Phone: 9a. 91b.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. 1. IVCN-RC;RAHAZARMIS WA;STF SOLID,ALiSORREFffS PAPFR tail �M ..lACI` �' 352 of Flt TF.RS b DEBRIS ; Z 2. w _,. 3. 4. 14.Special Handling Instructions and Additional Information NiiOHLEM 113 1 'kill _ SAM 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 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 quantity generator)is true. Generator's/Offeror's Printed lType me Signature Mogth Day Year 16.International Shi ents ❑Import to U.S. ❑Export fro"U'S. Port of entry/exit: F- ? Transporter signature(for exports only): Date leaving U.S.:. a 17.Transporter Acknowledgment of Receipt of Materials h Y air O TM 1 Printed/Typr. e Sig e My IL Mo h D Year Z Transporter 2 rinted/Typed Name ignatu UY + do 00Z 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 V rai Facility's Phone: Month Day Year w 18c.Signature of Alternate Facility(or Generator) a Z U) 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) L 1. 2. 3. 4. FI fl 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as nded in,ltem 18a Month Day Year Signature Printed/Typed Name EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR