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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 1 916-371-5747 024625753JJK 5.Generator's Name and Mailing Address Generators 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 8,Designated Facility Name and Site Address U.S.EPA ID Number RAMOS ENVIRONMENTAL SERVICES CAD044003556 1515 S RIVER RD. WEST SACRAMENTO CA,95691-0000 Facility's Phone: 916-371-5747 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.non RCRA hazardous waste solid(oil,debris) O 1 DM 75 P Q 1352 W 2. i - I l i 3. 4. 14.Special Handling Instructions and Additional Information Line 1: 15. GENERATOR'S/OFFEROR'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/Offeror's Printed/Typed Name Signature Month Uay Year 02 02 2023 —r 16.International Shipments F Import to U.S ❑Export from U.S. Port of entry/exit: z Transporter signature for exports only): Dale leaving U.S.; Ll 17.Transporter Acknowledgment of Receipt of Materials Ll Transporter 1 Printedfryped Name Signature Month Day Year 02 02 2023 QTransporter 2 Printed/Typed Name 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 J U Q �- Facility's Phone: w18c.Signature of Alternate Facility(or Generator) Month Day Year ZZ N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LLI 1. 2. 3. 4. H141 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrinledlTyped Name Signature Month Day Year john villanueva john villanueva 02 03 2023 EPA Form 8700.22(Rev.12.17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA'8 e-MANIFEST SYSTEM