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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 MANIFEST CAL000456484 2 916-371-5747 022831455JJK 5.Generators Name and Mailing Address Generators Site Address(if different than mailing address) LODI USD Maintenance&Ops 880 NORTH GUILD AVENUE LODI CA,95240 Generator's Phone: 209-331-7186 6.Transporter 1 Company Name U.S,EPA ID Number RAMOS ENVIRONMENTAL CAD044003556 7,Transporter 2 Company Name U,S.EPA ID Number VEOLIA ES TECHNICAL SOLUTIONS CORP NJD080631369 8.Designated Facility Name and Site Address U.S,EPA ID Number VEOLIA ES TECHNICAL SOLUTIONS, CAT080014079 1125 L.L.C.,1125 HENSLEY STREET RICHMOND CA,94801 Facility's Phone: 626-485-2467 9a 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 Wt.Nol. 1.UN3139,WASTE OXIDIZING LIQUID N.O.S.(SILVER NITRATE)(CALCIUM D011 fD001 21CHLORIDE)5.1,II 1 DF 1 G - O 141 Z2.UN1760,WASTE CORROSIVE LIQUID N.O.S.(COPPER(II)CHLORIDE SOLUTION)8, D002 III 1 OF 1 G — n 791 3•UN3139,WASTE OXIDIZING LIQUID N.O.S.(POTASSIUM NITRATE,SODIUM Dool X ACETATE)5.1,II 1 DF 1 G - 331 4.UNI WASTE CAUSTIC ALKALI LIQUID N.O.S.(POTASSIUM HYDROXIDE, D002 X SODIUM AZIDE)8,II 1 DF 1 G - 141 14.Special Handlingg Instructions and Additional Information Line 1:1)AZURPK51;Line 2:2)AZURPK51;Line 3:3)U070175631-1 LOP;Line 4:4)AZURPK86;Line 5:5)AZURPK8IA;Line 6:6)AZURPK8IA;Line 7:7)U070175631- 1 LOP;Line 8:8)AZURPK9;Line 9:9)AZURPK9; 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 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)(if I am a small quantity generator)is true. Generator'slOfferors PhntedrFyped Name Signature on ay Year 03 23 2021 —J 116.International Shipments F Import to U.S Export from U.S. Port of entrylexit: Transporter signature for exports only): Dale leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials 1i Transporter 1 Printed/Typed Name Signature Montay ear O 03 23 2021 IL z Transporter 2 Prinled(fyped Name Signature Month Day Year Q � 03 26 2021 F 18.Discrepancy 18a.Discrepancy Indication Space ❑QuanlitY ❑type 1:1Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S,EPA ID Number J U LL Facility's Phone: UJ 18c.Signature of Allemate Facility(or Generator) Month Day Year Q Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LLI 1. 2, rH141 4.H141 H141 H141 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted In Item 18a Pnntedffyped Name Signature Month Day Year Marahco Marshall Marahco Marshall 04 09 2021 EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM