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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 Ofa 6. Department of Toxic Substances Contr <br />Please print or type. Form designed for use on elite (12 -pitch) Ater. AN r'..Itf...nt.. <br />O <br />LO <br />LO <br />N <br />LO <br />CP <br />O <br />OP <br />Q <br />V <br />Z <br />O <br />J <br />U <br />Lt') Z <br />O <br />00 <br />co <br />v <br />N <br />4 <br />O <br />00 <br />W <br />w <br />t— <br />Z <br />W <br />U <br />W <br />J <br />a <br />U <br />J <br />0- <br />V) lA <br />h <br />W <br />N <br />Q <br />U <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (4/97) Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812-0400 <br />UNIFORM HAZARDOUS�CIAIC10101211101518141012 <br />1. Generator's US EPA ID No. Manifest Document No. <br />2. Page 1 <br />Information in the shaded areas <br />WASTE MANIFEST <br />'";11 1111 19 <br />1 of 1 <br />is not required by Federal law. <br />3. Generator's Name and Mailing Address <br />CARDOZA ENTERPRISES <br />P.O. BOX 1022, MANTECA , CA 95'-J36 <br />B. State Generator's ID <br />4. Generator's Phone 1 2091 461-633-1/ <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />C. State Transporter's ID <br />AMOS 1NVIRO MEN;AL SPVI(.ES 5 5 6�i/�_, <br />D Transporter's Phone <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />Es, 3t6tp Trans tqr <br />9. Designated Facility Nome and Site Address 10. US EPA ID Number9 <br />4 1 sI z �rz g <br />RAMOS ENVIRON-MEN1TAL SERVICES <br />� � � � � � _ <br />�.t ' <br />1515 SCUTA RIVER ROAD, WEST SACPJ.MEN1T0, CA 95691 <br />h" <br />ItlT✓ <br />Phtan9 <br />g", <br />CA4003556�°' <br />0411111 <br />��.. <br />IF) <br />i l . US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) <br />12. Containers <br />13. Total <br />Unit :: <br />14. U <br />No. <br />Type <br />Quantity <br />a. NON—RCRA HAZARDOUS WASTE LIQUID <br />(OILY WATER) NAERG96#171 <br />G <br />Ebii <br />'Tr,, <br />, <br />N <br />b. <br />E <br />R <br />A <br />T <br />R <br />d. <br />Additional Descriptions for Materials Ufsted Abcyo' <br />f v <br />e <br />15. Special Handling Instructions and Additional Information a q SITE LOCATION: <br />•J 1 <br />HANDLERS BE 40 HOUR OSHA/SARA TRAINED SUPER STOP MARKET <br />AND USE NIOSH APPROVED PPE. 290 N. MAIN STREET <br />GENCY ACT; (916) 371-5747 MANTECA, CA 95336 <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 />marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and notional government regulations. <br />If 1 am a large quantity 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 hove selected the practicable 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 small quantity generator, I have made 0-90010 faith effort to minimize mX waste generation and select the best waste management method that is <br />available to me and that I can afford. <br />be <br />Print T ped Name <br />4VIU04 Ca ® <br />Month Day ar - <br />R7. <br />Transporter 1 Acknowled ement of Recei t of Materials <br />Ated/Typed <br />Name <br />Si re <br />Month Day Year <br />P-` <br />—Acknowledgement <br />L <br />1 <br />8 <br />18. Trans orter of Receipt of Materials <br />TPrinted/Typed <br />Nome <br />Signature <br />Month Day Year <br />E <br />R <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />L <br />1 <br />20. Facili Owner or Operator Certification of receipt of hazardous materials covered 6 this manifest except as noted in Item 19. <br />T <br />Printed/Typed Nome <br />Signature <br />Month Day Year <br />Y <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (4/97) Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812-0400 <br />