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Please print or type. Form Approved. OMB No. 2050-0039 A GENERATOR 0. UNIFORM HAZARDOUS WASTE MANIFEST 1. Generator ID Number CAL000305222 2. Page 1 of 1 , 3. Emergency Response Phone 800-424-9300 4. Manifest Tracking Number 023160239JJK Generators Name and Mailing Address Generators Site Address (if different than mailing address) RAMOS OIL CO THORNTON 8925 W THORNTON RD PO BOX 401 THORNTON CA, 95686 WEST SACRAMENTO CA, 95691 Generators Phone: 916-371-2570 I Transporter 1 Company Name U.S. EPA ID Number FREMOUW ENVIRONMENTAL SERVICES INC 1CAR000171017 Transporter 2 Company Name U.S. EPA ID Number I Designated Facility Name and Site Address U.S. EPA ID Number RAMOS ENVIRONMENTAL SERVICES CAD044003556 1515 S RIVER RD. WEST SACRAMENTO CA, 95691-0000 Facility's Phone: 916-371-5747 I ga. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit HM and Packing Group (if any)) No. Type Quantity WINO. 13. Waste Codes NON rcra HAZARDOUS WASTE LIQUID (OILY WATER) 1 TT 830 G 223 -I H Special Handling Instructions and Additional Information Line 1: GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately descrtbed 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 Inapplicable international and national govemmental 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 EPA Acknowledgment 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. Generators/Offerors Printed/Typed Name Signature Month Day Year I 1 11 1 12 J2021 -I I- International Shipments . Import to U.S Export from U.S. Port of entry/exit: Transporter signature (for exports only): Date leaving U.S.: TRANSPORTER Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year I I 11 I 12 1 2021 Transporter 2 Printed/Typed Name Signature Month Day Year I I I I -0- DESIGNATED FACILITY -0- 18. Discrepancy Discrepancy Indication Space Quantity DrYPe Residue Partial Rejection Eli Full Rejection Manifest Reference Number: Alternate Facility (or Generator) U.S. EPA ID Number Facility's Phone: I Signature of Alternate Facility (or Generator) Month Day Year I I I 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) 1. H141 2. 3. 4. 20. Designated Facility Owner or Operator: Certifica on of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year john villanueva I john villanueva I 11 I 22 I 2021 EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM