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Beare or i-alrtorma—tnvrronmeMal r"Weanon Agency <br /> Worm Apprcwed OMB No 2050-0039(Expires 9 30 991 See Instructions on back of @ G. <br /> lease �r or typage Farm designed for use on elite 112 prlchJ typewriyr Department of Toxic Substances aConrrol <br /> f �roCalifo <br /> ' UNIFORM HAZARDOUS I Generators US EPA 10 No Manifest Document No 2 Page I Information+n the shaded areas <br /> WASTE MANIFEST a in 4a 4 IS net required by Federal law <br /> OF <br /> 3 Generator s Name and Moiling Address X SWe Manifest Document Number <br /> SAN'CM'QUNC'TM°iX CEAVETERY 21296808 <br /> P-0-BOX 1737 STOCKTON s CA 9MMI B State Generotor's ID <br /> I Generator's Phone ( 2W]4j;&_(1 Agri AL VR> <br /> 5 Transporter 1 Company Name 6 US EPA ID Number C. State Transporter's IIT(Reserved f <br /> m <br /> Ramos ErwWVnmenfW Services CAP 9140joJ315fi D Transporter s Phone <br /> 7 Transporter 2 Company Name — <br /> 8 US EPA 10 Number E State Transporter s ID IReserved I <br /> r <br /> Q F Transporters phone <br /> 9 Designated Facility Nome and Site Address 10 US EPA 1@ Number G Stat*Fac lily s 1D <br /> Ramos En►rnonmentai Services 1 CJ L <br /> 1616 S. River Rd H Focihll/s Phone <br /> W. Sacramento, Ca. 9601 4j 0 0 3 5 j6,j6 916-371-5747 <br /> I I US DOT Description fineluding Proper Shipping Name Hazard Class and ID Number) 12 Conrmners 13 Total 11 !mr <br /> No Type I Quantity WI/Vol I Wasts Number <br /> a <br /> Stole <br /> r Non- RCRA Hazardous Waste Liquid � <br /> � _ � Q �-�-r �a �L � EPA/Other <br /> N b state <br /> m E <br /> EPA/Cther <br /> T [ i I State <br /> M O <br /> R EPA/Odsec _ <br /> d Stare <br /> J EPA/Other <br /> L3 <br /> J Additional Desmphons For Matenals Listed Above r;ti=t <br /> " K Flandhngr Codes for Wastes Clshd Above— -$' <br /> 15 Special Handling Instructions and Additional Intormaimn <br /> HANDLERS TOBE TRAIN® <br /> 2d HR EL*UE GD CY CONTACT 916-371-6747 ,lob# Pro&# <br /> FIARDING WAY&CEWETERYLANE:STOCKTON. <br /> 16 GENERATOR'S CERTIFICATION I hereby declare that the contents of this consignment are Fully and accurarel described above by proper ship mg Home and era dassihed pocked <br /> marked and labeled,and are to all respects in proper condition for trans highway 1 PK p Pe - par} g way ac[ordmg to applicable international and nohanal government ragularrans <br /> IF I am a large quantaiy generator I certify that I have a program in place to reduce the volume and Iox)c%of waste generated to the degree I have determined to be economically <br /> practicable and that have selected the prachcoble method at treatment storage,or disposal currently ova ilab]e to me which minimizes the present and future threat to human heap <br /> and the environment OR tF I am a small quantity generator�l have madsm good Faith efforzlo minimize my waste generation and select the best waste management method that is <br /> available to me and that 1 can afford ��**"-�� <br /> Pr ted/Typed S+ afore loth V Year <br /> P� - . - <br /> Tram r I Acknowl ement of Receipt or Materials <br /> AT 17 <br /> 1l Prm d yped ane ar r` a <br /> IJ on Ye <br /> s (��j I <br /> P <br /> 0 IS Trans rt*r 2 Ackno�otleclamen!of Rece t of Materials ° <br /> TPanureted/Typed Name Signature� Month pay Year <br /> R <br /> 19 D screpa-ry 1.,drra+ia-Space _ <br /> F <br /> A <br /> C <br /> I <br /> 20 Focihty Owner or Operator Certihcahon of receipt of hazardous materials covered 6y this manifest excr t as noted rn Itera 6 <br /> mted/;ypedName SignatuAITEIBELOW <br /> Month bay Year <br /> �1a r <br /> DO NOT W THIS LINE <br /> SC 8022A(1/99) White TSDF SENDS THIS COPY TO DTSC `VI-r•i+ J DAYS <br /> 8700--22 To P O Box 3000 Sacramento CA 95812 <br /> ; <br />