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State of California—Environmental Protection Agency
<br /> Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions on back of page 6. Department of Toxic Substances Control
<br /> Please print or type. Form designed for use on elite 172-pitch)typewriter. Sacramento,California
<br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No, Manifest Document No. 2. Page 1 Information in the shaded areas
<br /> WASTE MANIFEST ' s is not required by Federal law.
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<br /> 3. Generator's Name and Mailing Address
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<br /> COMM"(E''RCIAL SAL /f E GE
<br /> 245 Eo WEBER AVENUE, STOCKTON, CA 95205 � �
<br /> 7 4. Generator's Phone( 209) 463-990
<br /> V 5. om an Transporter 1 CName
<br /> P Company 6. US EPA ID Number >U
<br /> RAMS ENVIROM?NTAL SERVICL,'S ICIAIDIOL4L4101013151516 ��t�����l�err ����,i�G�f: , ; fi" . ,`; �'f � "
<br /> 7. om an NTransporter 2 Company P Yame 8. US EPA ID Number
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<br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number 6 gG{jq(y 9 x fi
<br />: RAMOS ENVIRMIENTAL SERVICES
<br />{ x.515 SOUTH RIVE
<br /> it ROAD, WEST SACRA��Ett"I'0, C,14 95691
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<br /> C A I7 0 4 4 0 '0 3 5 5 6Ii-,� �
<br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers 13. Total 14. Unit �I scut f µ 1 t
<br /> No. Type Quantity wt/vol i
<br /> a. NON--MCRA HAZARDOUS WASTE LIQUID
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<br /> (OILY SLUDGE WATER) NAE,Ru96#171
<br /> T17
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<br /> j 15 Special Handling Instructions and Additional Information
<br /> HANDLERS BE 40 HOUR OSRA/SADA 'TRAINED
<br /> ANIS USE NIOSH APPROVED PPE.
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<br /> ERG, Y CON'fAcr: (916) 371-5747
<br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by propershipping name and are classified,packed,
<br /> marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations.
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<br />! If I am a large quantify generator,I certify that I have a pro ram 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 practicable method o�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 small 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 /> Pd-®ted/Typed Name "``,, Signature �� �'-•`.,. Month Day Year
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<br /> T 17. Trans orter 1 owled ement of Receipt of Materials r
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<br /> A Pri d/Typed N Signature
<br /> R «. 9 ✓ Month Day Year
<br /> R 14tjTrq#ffp6rter 2 Acknowledgement of Receipt of Materials
<br /> ER int /T ed Name
<br /> YP Signature Month Day Year
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<br /> 19. Discrepancy Indication Space
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<br /> 20. Facih 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
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