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Please print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST 1 209-234-7700 013483037FLE 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) GOLDEN STATE LUMBER INC 3033 S AIRPORT WAY STOCKTON CA,95206 Generator's Phone: 209-234-7700 6.Transporter 1 Company Name U.S.EPA ID Number BIG SKY ENVIRONMENTAL SOLUTIONS CAL000346010 7.Transporter 2 Company Name U.S.EPA ID Number EQ INDUSTRIAL SERVICES INC MIK435642742 8.Designated Facility Name and Site Address U.S.EPA ID Number US ECOLOGY NEVADA,INC NVT330010000 HWY 95 11 MI S OF BEATTY BEATTY NV,89003 Facility's Phone: 800-239-3943 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt./Vol. 1.OILY DEBRIS O 1 DM 160 P 352 w w2. C7 3. 4. 14.Special Handling Instructions and Additional Information 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. Generator's/Offeror's PrintedlTyped Name Signature Month Day Year RANDY SNIDER RANDY SNIDER 07 09 2019 -J 16.International Shipments Export from U.S. Port of entry/exit: /exit: Import to U.S ❑ p ry z Trans orter signature for exports only): Date leaving U.S.: w17.Transporter Acknoviledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year CO JOE RILEY I JOE RILEY I 07 I 09 12019 W QTransporter 2 Printed/Typed Name Signature Month Day Year CHRIS SONS CHRIS SONS 07 15 2019 F 18.Discrepancy 18a.Discrepancy Indication Space Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J_ V Q LL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year a z H19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LU G 1. 2. 3. 4. H132 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year APARK APARK 07 31 1 2019 EPA Form 8700-22(Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM