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State of California—Environmental Protection Agency <br /> -Form Appro3ed OMB No.2050-0039lExpires 9-30-99) See Instructions on backOf age 6. Department of Toxic Substances Control <br /> "'Pleasikpriri'f of type. Fbnn designed-Vr use on elite(12-pitc rifer. Sacramento,California <br /> UNIFORM HAZARDOUS enerator's US EPA ID No. Manifest Document 2. Page 1 Information in the shcrded,areas <br /> WASTE MANIFEST ��ss isnot required by Feder''a1 law. <br /> 3. Generator's Name aTTnd Mailing Address A. State Manifest Document Number <br /> 7 <br /> 99836006 <br /> 2435 E. IJFPF'.,R AVENIT, STOC TON y 47A 2()5 B. State Generator's ID <br /> LO <br /> to A. Generator's Phone1463 CP <br /> N 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.] <br /> Ln <br /> ao <br /> � � D. Transporter's Phone <br /> RAHO <br /> 01fl) S71-5767 <br /> 00 Y <br /> p P 7. Transporter 2 Company Name 8, US EPA ID Number E. State Transporter's ID[Reserve .) <br /> { <br /> QF. Transporter's Phone <br /> CD V 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID <br /> to-le RAMOS EINTRONWRTAL SERVICES <br /> W 1!515 s 011 T[ RIVER ROAD, ;,JEST SACRAMENTO, CA 95691 H. Facility's Phone <br /> coo <br /> J 12. Containers 13. Total 14. Unit <br /> V 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. Type Quantity Wt/Vol I. Waste Number <br /> F?(�NId..F:CPA TWZA l OUS �4AS�`F �.,��)U state ��� <br /> 3 Ci w,{1LY t ATF ' 8,31 T_{?Cd7) NAEW96D�� ()171 EPA/Other 1 <br /> o N b' State <br /> coo E <br /> v R EPA/Other <br /> A C. State <br /> o T <br /> 0 c <br /> R EPA/Other. <br /> Wd. State <br /> Z <br /> w I EPA/Other <br /> V <br /> LU <br /> N J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above <br /> L A 7,Cf� pry A 11fjJ <br /> C. d. <br /> Q <br /> Q15. Special Handling Instructions and Additional Information 1701 <br /> Q PARD IT77' � t': 40 �j$?TR OSTM{!'%r/a'S R Af::f�..t:A.klIT <br /> Z w AND TJSF NUMB A PP I]I ! PFT <br /> . <br /> AM (916) 371-57,47 <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> Umarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> -�� If I am a large quantiy generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> practicable and that I have selected the practico6le method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a smalto l quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> available to me and that I can afford. <br /> O <br /> )- Printed/Typed Name Signature ,, ;"° ^' Month Day Year <br /> V <br /> ty R 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> W A Prin d/Typed Name Signature, <br /> f.', Month Day Year <br /> w P r c f " <br /> W 0 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> 0 R <br /> T Printed/Typed 9 ed Name Si nature' Month Day Year <br /> w E <br /> N R <br /> V 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> 1 <br /> L <br /> 1 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A(1/99) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />