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i � plea.- 7e. Form Approved.OMB No.2050-0039 URIFQf2nAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 14.Manifest Tracking Number �+ WASTE MANIFEST _' u ),r j 1 800-535-5053-iNFOTRAC r;1 i�� ,7 7 0Aa7 5,Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) r Generators Phone: f i S.Transporter 1 Company Name U.S.EPA ID Number ; CLEANTECH ENVIRONMENTAL INC. _GAL-000368-1-36 7.Transporter 2 Company Name U-S,EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number CLEANTECH ENVIRONMENTAL INC. CAL000330453 5820 MARTIN ROAD IRWINDALE,CA 91706 USA Facilitys Phone: 626-812-7200 ga, 9b.U.S.DOT Desorption{includ ng Proper Shipping Name,Hazard Class,ID Number, 10.Containers it.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity WWDI. 1.a NON-RCRA HAZARDOUS WASTE SOLID (USED ABSORBENT) DM P 352 O w 2. NON-RCRA HAZARDOUS WASTE SOLID (ABSORBENT/PAPER f- DM J P 352 C7 FILTER MEDIA) 3. NON-RCRA HAZARDOUS WASTE SOLID (OILY SOLID WASTEIUSED DM ,t1 P 352 METAL OIL FILTERS) _ 4. 14,Special Handling Instructions and Additional Informatron 981)PROFILE# 9B2)PROFILE# USE GLOVES AND GOGGLES (ABSORBENT) (PAPER FILTER) 983) (METAL FILTERS) CALLER MUST IDENTIFY CLEANTECH ENVIRONMENTAL AS REGISTRANT, INFOTRAC 800-535-5053 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accuralely described above by the proper shipping name;and are classified,packaged, marked and labeledlplararded,and are in all respects in proper condition for transport according to applicable intematonal and national govenvaental regulations.If export shipment and tam 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 t am a large quantity generator)or(b)(if tam a small quantity generator)is true. Generator'slOPferor'sPrintedlTypedName Signature Month Day Year -j 16.International Shipments ❑Imp,l to U.S. ❑Export from U.S. Para of enirylexib Transporter signature{for exports only): Dale leaving U.S.: w 17.Transporter Acknowledgment of Receipt of Materials I-- Transporter 1 PrintedrTyped Name Signature Month Day Year a Z Transporter2 PnniedlTyped Name Signature Month Day Year t� 18.Discrepancy 18a.Discrepancy Indication Space ❑ quantity ❑Type ❑Residue ❑Padiat Rejection I ❑Full Re]action Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA IO Number J_ 0 I FaciJIly's Phone: w 1 Be,Signature of Alternate Faulity(or Generator) Month Day Year Q CO) 19.HazardCOLS Waste Report Management Method Codes(i.e.,codes for hazardous waste Irealment,disposal,and recycling systems) uuo 20,Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrintediTyped Name Signature Month Day Year EPA Form 8700-22(Rev.12-17) Previous Edifions are obsolete. GENERATOR'S INITIAL COPY