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vironmentol Protection Agency <br />99) See Instructions on back ge 6. Department of Toxic Substances Control <br />No. 2050-0039 (Expires 9.30. <br />Form designed For use on elite 99) pitch writer. Sacramento, California <br />UNIFORM HAZARDOUS 1 • Gener6or's US EPA ID No. Manifest Document No. 2. Page 1 !s not aqui a the shaded areas <br />is not required by Federal law. <br />WASTE MANIFEST O ' 01 71of <br />3. Generato�r'ys,Na`�e d Mailing dress s v+ <br />_�lOc3K CVs . rf•s��TraK c7�1����1 fAlt ,-I\j '�. <br />}� <br />X. <br />4. Generatots Thohs l �� v'► �, 7�" : y c <br />DO NOT WRITE BELOW THIS LINE. <br />White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />DTSC 8022A (4/97) To: P.O. Box 3000, Sacramento, CA 95812 <br />EPA 8700-22 <br />S. Transporter 1 Company Name 6. US EPA ID Number <br />RAMOS ENVI NAL SERVICES ICIAIDIO1414101013151516 <br />7. Transporter 2 Company Name 8. US EPA ID Number+ <br />9. Designated Facility Name and Site Address 10. US EPA ID Number <br />RAMOS ENVIRONMENTAL SERVICES <br />1515 SOUTH RIVER ROAD, WEST SACRAMENTO, CA 95691 <br />CAD 0 4 4 0 0 3 51516 <br />13. Total 14. Unit <br />Tye Quantity wt/vol <br />;. <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number( <br />12. Containers <br />No. <br />A <br />t. <br />G <br />N oNYl <br />W A <br />` R 0 <br />E' <br />b" <br />a, <br />N <br />R� <br />. <br />T <br />C. ., <br />O�, <br />R <br />d. <br />15. Special Handling Instructions and Additional Information <br />�J <br />HANDLERS BE 40 HOUR OSHA/SARA TRAINED <br />AND USE NIOSH APPROVED PPE. <br />EMERGENCY CONTACT: (916) 371-5747 <br />16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are Fully and accurately described above by proper shipping nome and are classified, packed, <br />For by highway to applicable international and national government regulations. <br />marked, and labeled, and are in all respects in proper condition transport according <br />t <br />If I 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 economical[ y <br />that I have the method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health <br />practicable and selected practicable <br />and the environment; OR, if I am a small quantity generator, I hove made a good faith effort to minimi my waste generation and select the best waste management <br />method that is <br />available to me and that I can afford. <br />Printad`j /A IF LWN CCSignatur <br />I Ail C..._ontir�► <br />y� (par <br />T <br />17. Transporter 1 Acknowledgement of Receipt of Materials <br />Month <br />Da Ye <br />I <br />A <br />Signature <br />Printed/Typed Name �. <br />I. <br />I <br />0 <br />18. Transporter 2 Acknowled ement of Recei t of Materials <br />Month <br />Day Year <br />T <br />Printed/Typed Name Signature <br />T <br />7— <br />E <br />R <br />19. Discrepancy lndication Space - <br />F <br />A <br />C <br />I <br />L <br />20. Facili Owner or Operator Certification of receipt of hazardous materials covered b this manifest except as noted in Item 19. <br />I <br />T <br />Printed/Typed Nams Signature Month <br />Day Year <br />Y <br />DO NOT WRITE BELOW THIS LINE. <br />White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />DTSC 8022A (4/97) To: P.O. Box 3000, Sacramento, CA 95812 <br />EPA 8700-22 <br />