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°ba se print o•type.(Form designed for use on elft•;:(12•pitch t• rsvr tec' Fonn:lRprrtved.U.v 4 No. <br /> Ol, <br /> F ) rR' ! r. »r )qo <br /> * ,UNIFORM HAZARDOUS 1.GeneerlD NumXN c.?age i oi 3.=mernency Response Phcxre A.Manifest Tracking Nut bar <br /> y20�jbI018144822 JJ <br /> + i }I <br /> WASTE MANIFEST I ..` + _' " 91tr371-5747 <br /> i.Gena fix's Name and ki rxsC rX,)-m rn rade &(rte tont Than mailing arfdmss) <br /> r"a,.-WOS OIL CG.-311 OCtz r10"N <br /> i PO KV 401 AT TN: IOY r:A=F€ALIOR IN 150 S)vJ4t!.'l�D�vp---�� <br /> VY-9STSA CR O S,%j TO,Cr". 05S tC.�7"�/.J�L rt t 7 c'7Gs�e-7Se• <br /> alor'Ph.rel',Gt}a71-9659 i <br /> o t:a,rs iurar I Company Name U.S.e"PA ID Bomber <br /> s RAMOS EMARONMENTAL S.wf•c`°wiCE3 INC. <br /> 7.Tr&rr*4rrer f k-otrg#iy Nomre <br /> U.S.EPAIU Numbar <br /> ff 8.Dey g rated FnItly Name and Site Address U.S.EPA Io NLmbsr <br /> i PACIFIC RESOURCE RECOVERY <br /> 3150 EAST P11CO ELVO, <br /> LOSANGELES,CA R= <br /> �•--T..., <br /> (f Facdif'sFhoma:800-d99.71dS <br /> ga, °b.U.S.DOT Desvip ion(irxdading Proper SNpping Name,Hazard Class.ID Numbar, iV.Containers <br /> it.Total 12.Unit <br /> Hid j and PacA g Gaup(f any)j No. Type Quantity l Val. 13.:Jas e Cedes <br /> i UN1203,WASTE GASOLINE,3,PGII G 331 DOD1 D018 <br /> 12. <br /> 14; <br /> I' <br /> A. <br /> id.SpecialHan'umg inshuctions arulAdd wal Infornal on <br /> 95.1)tPIR£F LE#«a°37 ERG#128 <br /> E.R. CQ#07tACTOFc RAMOS Ei�iFiPE d Fsrlr`+S <br /> HANDLERS SHOULD BE TRIAINE0 AND LtSE.f•,.P CAVE PPE _— <br /> 15. 6 # Tfi 'S'OPI Rpk a 4 11Y1EIGl4Tk!:I twoty dacfian ftift=t1witsoffis wuwnvv u€n fr* P OPV` 01V nsaw,and wn ci trilled;packaged. <br /> 4 miser.iml laboladloaccirded,weft are in air reep*—'s Ll f*cpr&coluaw fat Inca_yadrl a=rdfm to amit4ble,tvirartskmixtri llaforai gv rrmytts it morlarliun.U aapw iftiMiant and I am 14 Primary <br /> Cxfxml�,1 c ,r ftsai cart(+ of�tia cnnspnr: co°rlcm r4 ifie(ices cg ff� EFA d� e`Coraaes•.f <br /> t I r�r�*tr t�� n�assf«arz=•-�-mes� ai d(7 GF�i 2E�,Si7ta)(if t>nn a��st�rsl`+'�� ' !o`fh)(if,ane a g�;u,fy, ,neusort is u� <br /> Goner.xtrY nrf=,F l T signalu f Month <br /> Day Year <br /> UP <br /> —t i 18.Inierna(icmal Sh,rhmen°s � �.. , <br /> t—s ❑Import fo U.S LJ Export from U.S. nil of emryfexil: <br /> Z <br /> Transporter signature(`or exports only;: Dale loavBwj U.S.: <br /> LW V TrrspnnerAcknowtedgnrent of Receipt of Materials y r� <br /> ~ 1 r r.cr'Pnntrylff a <br /> Signal f ff 6funtr, Day year <br /> CL <br /> to 6,'Ls I l? I i Z G l/8' <br /> Q 'imrisporier L Prinr9-,Vr,,jwd name -sigantura Mnlh Day Year <br /> �}1 <br /> 18.Discrepant/ ' <br /> 18a Oiswepancy Indication Space Quamity ❑Type Residue El 70 Rejection <br /> I <br /> Manifest Reference Number: --d <br /> r F+ <br /> 18b.P.Iramme-aatry(or Generator) U.S EPA ID Number ( <br /> rj <br /> rd+ Facility's Pinna: <br /> � it„.Signature fitA ternate Facilit or Generator <br /> Lu Y( I (I fanth Day teat <br /> z <br /> c? <br /> as 17.HwLvlous`Haste Report Management Method Codes(i.e.,cedes for hazardous was(e treatment,dsposal ane racydhg systems) <br /> UJ A ' <br /> RV �2 I3. ,f <br /> 20 Ceeignated rarirty Owner or Operator:Certification of reripi of hazardous roateriars covered by the manifest except as noted in item 189 w <br /> nntad7lyp d Va!na Signahue 4`t f ?'Will Day Yr'r <br /> �1 l S � <br /> EPA Form 8700-22{Rev.3.95) Previous edilions are obsolete. t ES ert lig t `. ':0 DES 4I4A-iCx ST „. (I; <br />