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Please print or type.(Form designed for use on etite(12-pitchy typewriter.) Form Approved.OMB No.205HO39 <br /> UNIFORM HAZARDOUS I.C-,-d-,ID Number Z Page 1 of3.Ememancy Resporw Phone a.Manifest TTraddN Nomba !�/ <br /> WASTE MANIFEST Cf1 aaa©55I-CL&371-57A7 017145623 JJ K <br /> 5.Genem&sNameand MaEng Address <br /> ban4f77J: <br /> 6.Trarmponcr 1 Company Nam U.S.EPA ID Number <br /> RAMS EMIIIROWEWAL SMMCES INC. CA00440035M <br /> 7.Transporter 2 Company Nems U.S.EPA ID Number <br /> a.Designated Fac>tyName and Ue'e' UA ES TECWCAL SOWTONS 11.5.EPA If)Number <br /> 1125 HENSLEY STREET CA'It1BO AU9 <br /> RICMdOND,CA 948U1 <br /> FacWs Phonpo-�= <br /> 9a. 9b.U.S.DOT De-"m(6xduding Propel'34ping Name,Hazard Class,ID Nundaer, 10.con 11.Total 1 12.LW 13.ti&%W[.odes <br /> HM "Padd9 GW(f any)),, W. Type Quantity W NoL <br /> } <br /> 0 CPC-6tZ.S, ,,.s,+1I PJA41SrS5-Q0P,Wim, 1 (P 7 <br /> 3 P <br /> 3,4joI11 I7�' 1Q�GL S 4a#S* <br /> DrY7 15 <br /> fi�4z,.4�Dox.c.b <br /> scor <br /> 14. Handb%;In*udons and Additiad tnferr mbm <br /> 901 PROFA" ERc#)'+l Pliez,�CV *-20�y23 I/�s55�ra�/sG 22 <br /> ER CONTRACTOR: RAMOS ENVtRONMEWALSEmncEs 483) P FCF l tai LKLH—y4 <br /> 11ANDLERS SHOULD]6E TRAHM AM USE APPROVED PPE <br /> 98.t P� !fr'�a IIS � 9 sy}p ' � 4 <br /> 15. GENERATOT'SfOFTrEROR'S CEVWICATION:I hereby dedara that the contents of this consignment aro fully and accuraLely described above by the proper shipping name,and are dassated,pacto ed, <br /> marked and fabeh df*carded,and aero In all r aq"In proper=4 0m IN transport w000dng to a*=W intema al and national governmental regulations.H mpyt shipment and I em the Primary <br /> Exporter,I ce"that the contents of this nortsignmant=ftm to the tems of the attached EPA AdmowWgmeM d Consent <br /> I eerW that the waste mhuhntzatim etalamervt kientifted in 40 CFR 262.27(a)pf I am a take quantity generator)or(b)(if I am a amal quarldy generator)is We <br /> Geraerala a Pra,tedrT Signa Month Day Year <br /> 4G19 12T 1 19' <br /> _n 16.IntotrsTronal5tdpmanLa <br /> 7~-. ❑f mpod to U.S. ❑FxpaR from U.S.. Poll of enbyle>dt <br /> Transporter sutura(for exports only): Date leaving U.S.: <br /> LW 17.TransporterArfuiowledgnteht d Receipt d Maherfais <br /> Transporter 1 Prnt"Typed Name Signa Month Day Year <br /> ILW <br /> d 2 PoMedlfyped Name Month Day Year <br /> a <br /> 14,DBaepancy <br /> 18a.Dls r ancy Iradratim Spam ❑ omtty ❑Typo ❑Residue 0 PVW Re(6 W ❑Full Rej.don <br /> Manifest Reference Number <br /> 18b.Allrsnmle Pack(or Generator) U.S.EPA,D Number <br /> .a <br /> U <br /> 1Qi. Far;�ls Plwne: <br /> LU18c.S4uitvreofAttemateFacifly(crGenerato� NkmOa Day Maar <br /> a <br /> Vj19.Hazardous Waste Report Maragement Method Codes(Le,codes for hazardous waste natmK disposal.and mcydmg systems) <br /> d 1. I,- <br /> 3 4. <br /> 20.Designated FacTty QwW or Operator CeriffiCarion d n>oeipt of t azardous mafarlals covvaed by the maNtest except as noted In Ilam 1 as <br /> PmSedlTyped Name Signa4ae Month DayYear <br /> EPA Form 8700.22(Rev.3.45) Previous editiatls are obsdete, DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />