Laserfiche WebLink
3927 East Clark Drive PR0514138 <br /> October 10, 2019 Program: HW <br /> PHOTO 15:Waste water dis osed of as non-hazardous waste with an incom tete hazardous waste determination. <br /> •arE ralleY' - swap IMw - <br /> ,nim mNumbn --.. <br /> NONNAiAP00U5 } r4 7"a-9,fry0 QfN4N T <br /> WASTE MANIFEST _ -�--- Gan s5lle Apd,au 111 all n nmeiura atld,esal <br /> C�v,yx N o US.EPA IDNumbar <br /> l utm.:�.1w cwn.___,_•1; _ >.tnn. c r _ I o '1 —�. <br /> :mmwne,:CompnY Name <br /> U.9.EPA ID Numpa, <br /> g paYpxlea FenbryNm aM SIre AtlGmss U.S.EPA ID Number <br /> Yl)LV GWN 1 Y N'I <br /> 440X(,'C)L1N1Y RC)AL, <br /> ,,0,A'I ANC it 9''li <br /> inch'e Phaw: I 10.Containers 1I,Total 13.Una <br /> 9 Waste SAlppoV Name end O-110ba Nn. Typa 0a 1ny WTNM. <br /> 1.N1 1AI..i-IAZANI.Y)l1:WA:>:F L 1Ul IIUu('NAG TL:NAI cF< <br /> Up <br /> i <br /> 2 <br /> 3. <br /> J. <br /> 13.Spacial HeMeng InslmclbnsAddlllonal Inlolmalbn <br /> 1)L01 wr11 F-V4RSt"YH 4Y/Nl4sl Anet,rYCal WAS FTOVIOAA 01p.dAp` <br /> 11.GENERATOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the WMenls o1 Ihls mnsignmenl are lolly end atturetely tlescnpetl ap0ve by IAe D,apel snippinA name,and are<las,�M1eO,pacFaged. <br /> madled end IabeleWPI-aIed,end are m all respects In propel condition 10r Irenapoa ecco d a9 m epPbceple inremelipnel eM nelimel gavemmenlel regWepons. <br /> W. Oay Yeal <br /> Gane,alar's1011oror's PnnleMyped Name <br /> SlgnaWre <br /> j� 15.Int6mplmnal SAlpmanls 0 Impact to U S. ❑Export Irom U.S. Pon of enlrylexil. <br /> TrenS dors nature br ex ods Onl: Dela pevi U.S.: <br /> W 16.11anepader AeelwW109men101 Receipt of Wades Signature Mnnm Day Yee, <br /> Tmnspodel l Panted typed Name <br /> Month DV Yee, <br /> a: Tmnapada12 PlmledffyPeS Name SignaWre <br /> F!J ""'"Pancy ❑Penial Rated,- ❑Full Relecpon <br /> 1)n.Dlscrepanp In nWn Space OUandry TYOe El Read.. <br /> MenAesl Relaremre Numper. U.S.EPA 10 Number <br /> Uy I Ib Alpmele FecIMY I.,O—br) <br /> r 5LL FaaYl�e PhOM: �_�� Month Day YW <br /> 11 1%srohMUM d Afiia eFeGXN(Of OW-al <br /> u <br /> N <br /> O <br /> 1 Il��r Io1 maI1111.,Is��,xeled Uy lne mBM <br /> Iq t>.,,.Igrlxl irarmre Pn,n„a�gta. ��,bb,,nml,.d n.�np - spnawla <br /> 1.,1rm-Nmpo <br /> GENERATOR'SISHIPPER'S INITIAL COPY <br /> 169-BLC-0 5 11977(Rev.9/09) <br /> .ate <br /> Lydia Baker, REHS Page 15 of 54 <br />