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Diamond Walnut Growers Inc Record ID# PR0513657 <br /> 1050 S Diamond St, Stockton, CA 95205 Program: HW <br /> July 10, 2019 <br /> PHOTO 5: Manifest 016654247 JJK missing signed off copy from the designated facility. <br /> xe mar HA Fwnr ao onNile 12-dlchl _ <br /> �VNIFORM Ng1tiAR000S I -^^r <br /> MWSTE MANIFEST c+m uhx lU urr <br /> JJK., <br /> crma,amn rn,,,, <br /> NIFEST V <br /> *maawrw z c.,mPmr N+rm. ru^r. <br /> EMMN„rm.r moo. <br /> Pnes4Naba Fa" Namaarq Sna aaaresa <br /> 11 <br /> r,M <br /> a^ru N„mor, n caauman n row <br /> o'-1 +rmracad a <br /> 0 <br /> z <br /> �:Speoal Hanapn.ln......ons ane Addli0,t,#lmrarmanm <br /> 1' GENERATOR'S]oFFEROR'G CERTIFICATION: hereby tleclare Ileal the mnlenla of this cwepmenl are 101,,ail atturatel tlescnhed above D Ne h <br /> ma..ane IaheleNplarareed.antl are m all respetts in proper Wrltlillon for Irons n a<mNin y an y Y proper s iplarq name,andbre daytifieA.P—gad. <br /> Exporter I certify)hal Ua mnrems orlais cons W 910 appM1caMe inlemational and nauanal govemmenlyl regulaLans.11 agrort shiDmem arq l am Ne Pmmary <br /> gnmenl conform to ale leans of the allaUee E iwleegmenl of Consent _ <br /> I cenity Mat the waste miza <br /> inimM1an statement ieenlified in 40 CFR 262.27(.11-111.a large quantityamtty genemtor7 <br /> Ganar MI(II I am a small quenWy genemton R bue. <br /> arato/s`Oflemfs Phn(ed/iypee Nama SignaWre MDnU Day Baa <br /> I6 Inlamalronal Shipments <br /> �' ❑Imnon to U's, ❑E.rpod from U.S. Port of entrylexit <br /> � iranspwrer signature(tor exports only); - — —.--- <br /> Date leaving U S. <br /> IY 1]T�ansponerACFnowledgment o/Receipt of Malenals <br /> w <br /> Transporter t Pnnled/Typad Name <br /> aSignature MpMh 0'r Year <br /> CTransponer2PrintadeTyped Name Signalule <br /> � Month Day Yea, <br /> ti <br /> ♦ 78.Disvepancy <br /> x1111 18a.Discrepancy Indoehim Space ElQuanhry EjType <br /> El Residue ❑Partial Releraon ❑Full RelacUon <br /> Manifest Reference NumMr <br /> 18b.Altemale Facdly(or Gene21or1 U S.EPA ID Number <br /> U <br /> if Facility's Phone' <br /> )� w 18c.Signature olAlfemate Facility for Generatoq Monty Day Yeae <br /> GE, = <br /> ir7C dF rn 19 Hazardous Waste Report Management Method Codes(i.e.,odes IV hazardous waste treatment disposal,and recycling systems) <br /> Ip .0IU f 2. 3 4 <br /> 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the merriest except as noted in Item 18a <br /> Pnnfed,Typed Name Signature Month Day feat <br /> T + <br /> Aryeyo EPA Form 8700-22(Rev.3.05)Previous editions are obsolete. <br /> Cpm GENERATON'S INVTIAI COPY <br /> d <br /> Tricia Dai, EHS Page 5 of 5 <br />