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i <br /> Form Approved.OMB No.2050-0039 <br /> Please p or type. <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.IMnNaet7recking Number J K <br /> WASTE MANIFEST ��DLAK—,A3B� `� 918'3715+47 <br /> 5.Generators Name and Mailing Address Genereofs Site Address lR dlflere8t than marling aeeresal <br /> TERESI TRUCKNJG INC. <br /> 900'OCTOR RD. <br /> LODI,CA 95240 <br /> General Phan U.S.EPA ID Number <br /> 6.TransportM -n <br /> RAMOS EW1RONMENT4L SERVICES INC. CAD0410035M <br /> U.S.EPA ID Number <br /> 7.Tr spoiler 2 Company Name <br /> ee/ger -5 <� 5 ,-f n n 31 <br /> 8,Designated Facility Name and She Address U.S.EPA ID Nu <br /> VEDLUs ES TECHNICAL.SOLUTIONS CAT090013079 <br /> 1125 HENSLEY STREET <br /> RICHMOND,CA 94801 <br /> Fadi' 's Phone:`I00'243-2382 <br /> 9,. 9b.U.S.DOT Description including Proper Shipping Name,Hazard Gass,ID Number, 10.Containers 11.Tocol 12.Unit 13.Waste Codes <br /> HM am Packing Group(it any)) No. Type Ouantity Wt.NoI. <br /> 1. NON RCRA K42ARDOUS WASTE SOLD jSTEEL SKAVINGS) <br /> /D <br /> z 2. <br /> w <br /> 3 <br /> 4. <br /> 14.Spedal Handling Instructions and Additional Information � <br /> 98-I)PROFILEK ERG*71 <br /> E.R.-CONTRACTOR: RAM09 ENVIRONMENTAL <br /> J4"4"°.r° "fir <br /> Ii 5F TRAINED AND USE APPROVED PPE <br /> 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,am are classified,packaged, <br /> marked and IabelecIplacardi and are in all respects in proper condition for transport according to applicable intemabonatand national governmental regulations.R export shipment and t am the Primary <br /> Exporter.I certify that the contents of this consignment conlorn to the terns of the attached EPAAcknowledgi of Consent . <br /> ceNty Nat the waste rent izetion statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(dl am a small quantity generator)is true. Year <br /> SignaNre Monty Day <br /> - GeneratWslORenoes PnnteWlyped Name ., <br /> J6.I-,mmational Shipments Import to USS ❑ExpoNrom U S. Port of entrylexit: <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> K 17.Transporter Acknowledgment of Receipt of Materials <br /> l- Transporter 1 Printed/Typed Name Sgnature Mo Day Year <br /> a /Ap,d Dey ear <br /> zTransporter 2 PnntedlT Name Sgnature <br /> Q r <br /> C <br /> 1 e.Discrepancy <br /> 1 18a,Discrepancy Indication Space (-10.,_. D7ype - - OResIdue ' ❑Partial Re)ecBon - - ❑FUR Rejection <br /> Mani Reference Number. <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> V <br /> LL Facility's Phone: Month Day Year <br /> W 18c.Signature of Alternate Facility(or Generator) <br /> a <br /> z <br /> y 19.Hazardous Waste Repon Management Method Cedes(i.e.,cedes for hazardous waste treatment.disposal,and recycling systems) <br /> 4. <br /> D ' <br /> 20.Dq@ignated FadRy Owner or Operator Cetkauon of receipt of hazardmm materials covered by th manliest except as ncLd in Item tea klonth ay ear <br /> Pnn ed.Tylted Name 1 _ <br /> EPA Form 8700-22(Rev.12-1 Previous editions are obsolete. DESIGNATED FACILITYTO GENERATOR <br />