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10878 North Highway 99 East PR0518084 <br /> April 6, 2022 Program: HW <br /> PHOTO 4: Manifest found without a designated facility signed Y. <br /> Please print or typo, <br /> UNIFORMHAZARDOUs 1.Gene.lerlDNu , Form Aplamved.OMS No.2050.0039 <br /> WASTE MANIFEST C A C 0 0 3 f 2 7 7 Pe9e t o 3.Emeger¢y Rmparse Pnug 4.xanrNn Tndln9 Numbs <br /> 5.(9Fenaerofspro - g , 810371-574! 028303 8 JJK <br /> tlrt ObtSie Adanss Geeartntya Sna �3� <br /> 5000 E.2nd$t.Ste 0 F asy ql laailrerem loan mainrq aaeressl <br /> 22-e..CA 84510 10878 N 11 <br /> e. S.rio Nt.q <br /> ed_PMne:T 4 Stockton CA 95412 <br /> e.TmnagMart nr rrame "' <br /> Ramos Erni'ronmental Servicrs Inc. <br /> U.S Eva ID—W, <br /> T TnnPpder z cnmPanr Nama <br /> C A D 0 4 4 0 0 3 5 15 8 <br /> u s EPAID rvemmr <br /> e, dcou oe sc., us.ePAio Nember <br /> 318500 0E E.Pico Ell,d <br /> LogAn9eles CA 98023 <br /> Fadabe Plana:800 4997445 5 <br /> 9a. 9b.USCAD 0 0 8 2 8 2 4 0.DOTOesaiptian(induding Pmper 3M1ippiy Name,HaraM Class,ID Numhr, le.Container <br /> HM nupe ding Gmup(u"yb 11.1 12.Dnn <br /> x !RO UN1203,Yto WasUrCWes <br /> No. TyPe Duanutp WINd. <br /> W�E(3asdme <br /> 3,POII(D001) 331 0.001 0.011; <br /> 2R4i U'N1325.UWSTE FlarmTabte solids,er9anio,n.os. <br /> X 4.1.P0111(9as0Nne,debns't(D001) 352 0001 Do" <br /> 14,S lr ons arta Mani <br /> T N I F-) sl °� r_ j° I,EI profikA ERCid133 E.R.Cormacta-Ramps ErKsonow,al ht t hmAd L <br /> mined and Mse approved 1. - <br /> 15. GENERATOR'SIOFFEROR'S CERTIFILAnON:l herby declare Nal the enlents of Nis mregn.nt 11,Ulyand a newly deemed above by lice proper shlWt,,me,artl are classified,pacMageb, <br /> &,bee and lafy 9,atffi ed,andareinallre;n entin DropermntliliDn(a banspMacmMing roappllcable inrorranonalard national govammenal regulatlore.11exportautteenlarta lam 111e Pnmery <br /> 6pMer,Icertify Nal Ne melena o1 Nis consgnmentconform to to terms of to adachN EPAAdn ,,bent D(Consent. <br /> 1certify Nattov25ro eunimirab'on sahmentidnrifiatl in 40 CFR n2.27(l)t Iamalarge qu ff genemtor)or(b)(it]amasmall quent"pedna )'a true. <br /> GenemtofLORerofs PnnNNTyDed Name Signature, hent Day Year <br /> 16.Inle"Ite"l Ship"'' <br /> ❑Import to U.S. ❑Eton from U.S. PoAolen1yle:d1 <br /> imnsponer signature(for eapods only)' Dale leaving U S.: <br /> W 17.Tr4nsponerAd,M,dgmentof Receiplof Matenals <br /> OTmnsponer 1 Pnnled/Typed Name Signature - Mont Day Y- <br /> T—Pend,2 Pnnted/Typed Name Signature I <br /> Mont Day Vear <br /> } <br /> "L <br /> 8Discrepancy <br /> I18a Discrepancy tdiwlbn spaea ❑Duantiry ❑Type Residue ❑PaNal Rejection El lull Rejectlon <br /> 1Sb.Allemale Faality(or Genemlor) Manifest Reference Number: <br /> U.S.EPAIO Number <br /> U <br /> LL Fecilive Phone' <br /> f18c.Signature ofAltemate Faolity(01 Generator) Mont Oa Yea,y <br /> N19,Harnedoe Waste RePen Management Meted Cades(i.a.,mdesforh1zard0uswasteteabnent disposal,and recycling systems) <br /> 2, 3. 4. <br /> p0,.,Vneted F.6b(y O.Yost or OpBlator:Cefif.b.n efreceiptoft,tardous malenals-,red by to manHeslex pl as need In Item l8a <br /> Pon ypad Nemo Signature Mort Day Year <br /> I <br /> EPA Form 8700-22(Rev.12-17)Previous eons are obsolete. GENERATOR'S INITIAL COPY <br /> Lydia Baker, SR. REHS Page 4 of 4 <br />