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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 MANIFESTg�� rk - _ . . a��:.) „ 5.Generator's Name and Mailing Address' JJ K- w F.Generitor's SIWAddress(if different than mailing address) RAMIi lS ENVIROINIMEI<TA1.rjEFkkr'N;P-S INC. P.G. ;9CY 461 1515&RA1ER RO. qty �r S"i:i3 o:�:W,MEirr,D t�;a, s.1i ''WES"!~la.0�d�Ar�il;f ;CA SM91 Generator's Phony:. t( a r/k 6.Transporter 1 Company Namidii,"P- U.S.EPA ID Number 7.Transporter 2 Company Name U.S.EPA ID Number ' 8.Designated Facility Name and Site Address U.S.EPA ID Number �.t?Pvltys cUttRf��ArlEidTgi.;�E�i'.'3iac��Ihfi. >.t�tr�hC��.� 1515 SOUTH F/ER. RD. Facility's Phone:_,,, . 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 VVt.Nol. L p Ir31q I4 CRA.IiAZ161.4Rrir:.us volk-sTE z 2. L o 3. 4. 14.Special Handling Instructions and Additional Information 9-tit) USED OIL,rSWEsl OIL I�AhDLERS TO HE TRAINED AND t_t.SE PPE. t. i;r,`tlri^?d;E'Ki�:t7: "s+.N:l�iryrs "!�,%i;'<:lf•!ttFril'r 3. ;:I .',i3i;" �' / -' 7 1im''J e� t 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,aryl 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 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)(ifI am a small quantity generator)is true. Generator's/Offeror's Printed/Typed Name i"` Signature �- Month Day Year i- 16.International Shipments F ❑Import to U.S. ❑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 LLJ f- Transporter 1 Printed/Typed Name Signature ' E',�' 1^ 9 J Month Day Year O ,^ r' Z Transporter 2 Printed(ryped Name a' Signature Month Day Year F. 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 Zi U LL Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z 0, 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as poled in Item 18a Printed/Typed Name ; Signature "e. Month Day Year /1 rt;','�'T,;:P r,% d EPA Farm 0700-22(Rev.12-17) Previous editiogs are obsolete. DESIGNATED FACILITY COPY IF YOU RECEIVED THIS MANIFEST,YOU HAVE RESPONSIBILITIES UNDER THE e-MANIFEST ACT.SEE INSTRUCTIONS ON REVERSE SIDE.