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A . � <br /> Please pont oCiype. Form Approved. OMB Nov 2050-0039 <br /> liN1FORM.HAZARDDUS 1 G Number - 2 Paf I i 3 Em ig yRespon Ph 4 Manifest racking Number <br /> WASTE MANIFEST Generator 20A 6 71 F47 1 3 <br /> AL %li7t"f' "�" <br /> 101 JJK <br /> 5:,Genstate ta Name and Mailing Addr r + Generalors Site Address (it different than mailing address) <br /> ST,OWON STEEL tSIV. OF i'HE HERRICK CORP. <br /> 3 P. HAMMER LP1.. . <br /> STOCKTON, CA 95212 USA <br /> -'. Generators Phd <br /> 6,3ransporter 1 Company Name U.S. EPA ID Number <br /> RAMOS ENOROPIMENTA>L SEF£VlCES INC. GAD0.4-'aYL-5' .A <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> ��..i lA t (�(.,..� S L/l�tJ � ✓(' (x--�. l? � v1 1=t ,� 'J Sia I. <br /> 8. Designated Facility Name and Site Address PACIFIC RESU.S. EPA ID Number <br /> 07U'RC`E RECOVERY '. <br /> GiaL d.Ei, a7 �i <br /> .91ED EAST PICO Pi1A' D. <br /> LOS ANGELES, CA 901f13 '....... <br /> Facility's PhwX&499-7145 '..,. <br /> go. 9b. U.S. DDT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers it. Total 12. Unit 13. Waste Codes <br /> HM . and Packing Group (if any)) No. Type Quantity Wf.Nol. <br /> z 2 J �{ (� <br /> K:..3s ) r DSI AM) <br /> 4. <br /> 14 Special Handling insbucgons and Additional Information r/� (j0cf IJ0nd - <br /> ' 981)PROFILLO �` � <br /> E.R. CONN'FRAACTOR: RAMOS ENVIRONMENTAL SERVICES <br /> HANDLERS TO BE TRAINED AND USE APPROVED PPE. ;:.. - Y rj L — _ <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION; I hereby declare that the contents of this consignment are fully and accurately describedaabboove by the p/ropper shipping name, and are classified, packaged, <br /> markedandlabeledlplacarded, and are in all respects in proper condition for transport according to applicable intemabonaiand national governmental regulations. If export shipment and l am the PrimaryExporter, I reality that the contents of this consignment conform to the terms of the attached EPAAcknowiedgmenl of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (RI am a small quantity generator) is We. <br /> GeneratorslOfieroes Printed/Typed Name Signature Month Day Year x <br /> STA SWc= x 3 J6 za o <br /> 16. International Shipments �1 <br /> i- LJ Impod to U.S. ❑ Export from 11 Port of entry/exit: <br /> ? Transporter signature (for exports only): Date leaving U.S.: <br /> 4' 17 TransporterAcknowiedgment of Receipt of Materials <br /> Transporter 1 Printed/Typed Name Signature Moat D y/' r <br /> C1. . , �o `VSJ Or (7 <br /> z Transporter 2 Pdmedrryped Name - Signature Month Day .Year <br /> 03 ` 2G 2c <br /> 18. Discrepancy <br /> � . 18a. Discrepancy Indication Space ❑ Quantity - ❑ Type pResidue ❑ Partial Rejection ❑ Full Rejection <br /> Manifest Reference Number. <br /> 181b. Alternate Facility (or Generator) . U.S. EPA ID Number <br /> - �. Facilitys Phone: - . ,. _ - .. .. . . . . . . . . . _ <br /> w 18c. SignatumotAltemate Facility (or Generator) - Month Day 'Year <br /> Q <br /> Z <br /> N19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardouswastetreatment, disposal, and recycling systems) - - <br /> I. 2. 3. 4. <br /> 20 Designated Facility Owner or Opertor. Certification of receipt of haf'ardous materiaiecovered by the manifest except asn din Item 1 B <br /> PnntedrTyped Name Signature M nth ay Ye <br /> TPA Form 8700-22 (Rev. 12- Previous editions are obsolet . DESIGNATED FACILITYTY GENERATOR <br />