Laserfiche WebLink
Stout of Celilornia—Enfronm,ntsl Protection Agency <br /> Form Appcawd OMS No.2050-0039(Eapees 9-3694) SBC Instructions on bark of p'-'+@ 6. Department of Toxic Substances Cannot <br /> Sacramento,California <br /> print or type. Form designed for use on elite(12pfkh)Or. sr. <br /> 1. obi s US EPA ID No. Manned Document No. 2. Page 1. Information in the shaded cram <br /> UNIFORM HAZARDOUS D ts nor required by Federal law. <br /> WASTE MANIFEST Cl Al Cl 01 01IL01 014101 NI 818 1 0 7 8 of 1 ' <br /> 3. Generator's Name and Mailing Address <br /> RAMSEY REAL ESTATE DEVELOPMENT <br /> P. 0. BOX 4292, Stockton, CA 95204 <br /> ayNgj 4. Generator's phone (2091 466-8733 <br /> d 5. Transporter 1 Company Nome 6. US EPA ID Number <br /> °0 NOR CAL OIL iC,AD98241 7255 <br /> Q�Q 7, Transporter 2 Company Nome S. US EPA ID Number <br /> V <br /> 9. Designated Focm <br /> ilily Noe and Sim Address 10. US EPA ID Number <br /> b REFINERIES SERVICE <br /> S 13331 N. Hwy 33 <br /> �S <br /> Patterson, CA 95363 ICADIO1813111616 1 17121E 12. CentaInen Quantity 13. Total 14. Unit <br /> p Z 11. US DOT Description(Inclading Proper Shipping Name,Hazard Class,and ID Number) �. T Wt/Vol <br /> pV~ NON-RCRA HAZARDOUS WASTE LIQUID <br /> J),N E (WATER & OIL) 01 01 1 T T 0 0 0 G 7 <br /> m N b. <br /> E <br /> R <br /> °25P A <br /> T a <br /> O <br /> � R <br /> d. <br /> u <br /> W <br /> 2 <br /> C <br /> r <br /> Z <br /> Z <br /> O IS. Special Handling Instructions and Additional Information <br /> 1- APPROPRIATE PROTECTIVE CLOTHING <br /> Z "EMERGENCY CONTACT: (209) 667-669211 <br /> SEE E.R.G. PAGE 31l <br /> j 16. GENERATOR'S CERTIFICATION: I Mroby declare the the contents of the consignment are Fully and accurately described above by proper shipping name and aro classified, <br /> Q packed,marked,and labeled,and are in an respects in proper condition for trc mport by highway according to applicable federal,sic and'international laws. <br /> j11 I am a large quantity generator, 1 certify that I have a program in place to reduce the ,olume,and toxicity of waste generated to the degree I hero determined to be <br /> 6 economically practicable and the I haw selected the practicable method of heotment,storage,or disposal currently owilable to me which minimizes the present and future <br /> y threat to human health and the emirommenb OR, S I am a small quantity generator,1 how, mode a good faith effort to minimize my waste generation and select the best <br /> wade man meth method that is awilable to me and that I can afford. <br /> Q Printed/Typed Name ages Dr Sig _ 1 - +omit Dq� ear <br /> RAMSEY REAL ESTATE DEVELOPMENT 07 ` ' <br /> Z ` 17. Tr r 1 Acknwlecl ement of m ' tel rbh <br /> � w Printed . <br /> on <br /> sigrrotv�' ,� Mth Day rear <br /> _ u4� tay1 <br /> o I8. ram rter 2 Aeknowled n ment of It"of of Maleriah <br /> a , Prided/Typed Name Sig abro Monts Day Yam <br /> O . <br /> W 19. Discrepancy Indication Space <br /> IF <br /> V A <br /> Z C <br /> I <br /> L <br /> I "or rater Certification of.ecel t of hazardous mcrones covered b this manifM exe m noted in Item 19. <br /> T Sigmdura Month Day Year <br /> If <br /> DO NOT WRITE BELOW THIS LINE. <br /> DISC 8022A (7/92) <br /> EPA 117D 22 Yellaw: -GENERATOR RETAINS <br />