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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 2 916-375-5747 022995607JJK 5,Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) LODI UNIFIED SCHOOL DISTRICT MAINTENANCE&OPERATIONS 880 N GUILD AVE LODI CA,95240 Generator's Phone: 209-331-7186 6.Transporter 1 Company Name U.S.EPA ID Number RAMOS ENVIRONMENTAL SERVICES CAD044003556 7.Transporter 2 Company Name U.S.EPA ID Number ECOTRANS LLC CAR000245050 8,Designated Facility Name and Site Address U.S.EPA ID Number PACIFIC RESOURCE RECOVERY SERVICES INC CAD008252405 3150 EAST PICO BLVD LOS ANGELES CA,90023-0000 Facility's Phone: 800-499-7145 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 WUVol. 1.RQ UN1203,WASTE GASOLINE 3,PGII(D001) [)018 ID001 I p 0, \ DM 5 G — --- S—- 1 1 331 I] z 2, f W U' - -- 3. 1 4. 14.Special Handling Instructions and Additional Information Line 1: 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's/Offerors Printe/Typed Name Signature on ay ear PETE LILIENSTEIN PETE LILIENSTEIN 08 04 1 2022 -1 116.International Shipments H ❑Import to U.S Export from U.S. Port of entry/exit: z Transporter signature for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Uay Year O JULIO PEREZ JULIO PEREZ 08 04 2022 a QTransporter 2 Printed/Typed Name Signature Month Day Year JAVIER CRUZ JAVIER CRUZ 08 08 2022 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 J_ V LL Facility's Phone: w 18c.Signature of Allemate Facility(or Generator) Month Day Year Q Z 19,Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. H061 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year ALMA VACIO ALMA VACIO 08 17 2022 EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM