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936 Performance Dr, Stockton Record ID PR0514506 <br /> 6/8/2020 HW Inspection <br /> Photo 1: Designated facility signed copies of Uniform Hazardous Waste Manifest (UHWM) numbers 018791035JJK (7/17/2018) and 017144762JJK <br /> 10/5/2017 were not found on-site. <br /> F—a. w m.,e,z.gM I a �AFom ea aaa wo msaaraa <br /> �eni.r to Numex m,.l }Yxp t m } �.ckvMe4+w•tri <br /> 0 8793-035 JiK <br /> aae W1MVElr Grinul,de eae Pemw M exWal awnLLvq eae,eae} <br /> pe MMrcaaem+ <br /> FERAE�Y POM SIEEL SERVICE <br /> DSG�PF�14FrnA+JCS DaQ..L6 <br /> srocRrdal,cA asaoe <br /> ,cwapam Name us. w,ae.r <br /> RAa,pS EWRONMENf .SERVICES WC. G1E044ODBM <br /> myenei 2 CaMe^v rW�K VS.EPA iA faurod <br /> � ia�aNyp,.}µme c0`e" 09°PAC IFIC RES[]IJFrCE RECgIERY U,6.EPAro wurLa <br /> 3,Se FAST PILO SA <br /> GPO @a05 <br /> LOS AIaGELEB,CA Sa023 <br /> 9ppCig71L5 <br /> aa.�.sompesrdPeNeC wa Type nVaash rvva. <br /> 9r and raa�gG rq{neaall <br /> GIII P 3S2 8 <br /> O'CIVE CME,MINERAL SPIRIM 00 f <br /> VJ <br /> O�a�a <br /> D <br /> N <br /> i4.S➢eciar Haatlling InsW cPeas and Mtlilional Information <br /> 9BJjPR0f%LW ERG#133 <br /> HANDLERS TO BE TRAINED AND USE APPROVED PPE, <br /> ER.CONTRACTOR:RAMOS EMARONMENFAL SERVICES ` <br /> s <br /> 15. GENE9ATOR'910FFFR0R'sCEanFICAm0N:Thereby declare that the conisnts oflhlsmnsignmeglare 41Y 41d accurately desrn6ea aEwehy the proper sldppingname,and are tlsssiEed,petlagae, <br /> nmmad and le6eledhplawPoed,aMere in adrespects In properwndilfon lortrarupodarmrdingaapptica6le Inlematimal and nasanal goYom ntal iegutadons,If P.Vp hfpmemand I am the PMaa,y <br /> ExPm ,,I ca18"dl Ne anterrm VIN-mnsl9n 4-1n Io Ne kmas oI the attached EPAkkmMMU..rd N Conaenc O <br /> J cerbly Mal me male minim' on statement idKlifl din 40 CFR 26221(2)(If l ama large quantity gene c'(d}(rf Il quantity genemlon is hue_ <br /> N1 - amaSigr 9 �A <br /> Y <br /> :.r,a.In}emational Shipmenh <br /> i 117 1 <br /> Impmt fa U.S. ❑Expml from U.S. Pmt d snbyfesit: <br /> TrahspmtersignaWre(lwespads only): <br /> w 17.TrarRpwdmAdnowletlgmentofReeiptMMatens& Date"*9U.5.: ^' <br /> r aaparrertP,MrearryPadName ' V <br /> 0 Signature Yeas <br /> °> <br /> C 7aruporter PhnledlTypee Name St nature mo D le O <br /> F g Mand, Day <br /> Yea, <br /> 18 D' `1 <br /> 182.DMMPancp Indication Space ❑ V <br /> (]au�rary ❑TYPe ❑Rasitlue ❑PartialRelection FugRejection <br /> tae.AUmale Fadlity(w Generalw) Manifest ReFe[ence Numher. <br /> ,r U.S.EPAID Number <br /> U' <br /> Facilivs phone: <br /> FS8c.SlgneNre afAgemafe Facifily(cr Genamlar) <br /> i Muth Day Year <br /> 74.Hazardous Waste Repan Maragemenl Method Cutler(Le.,codes fwhalafdeas waste headnent,disposal,and recycling systems) <br /> LU 4 1. 2 <br /> 3. 4 <br /> 20.9ignaletFadlfy Oyrneror Opem*:Ceftification oFreceipl of hazardous materials wvered by the manifest except as need in Item lea <br /> Printed/Typed Name <br /> 5ignamre M""t' gay Y.' <br /> EPA 87170.22{Rev.3-05)Previous edifians are obsolete. p� <br /> DESIGNATED FACOLATY To DESTINATIOPI STATE(IF REQUIRED) <br /> John Alaniz, REHS Page 1 of 2 <br />