Laserfiche WebLink
6364 Lindbergh St, Stockton Record ID PR0521275 <br /> 6/28/2019 Hazardous Waste <br /> Photo 3: Manifest number 016010568JJK 5/15/2017 was found without a signed off copy from the destination facility. <br /> u�11 <br /> --A OHCCF__l)C. <br /> please print°rtype.(Form designed for use on elite(12-pitch}typewriter} <br /> UNIFORlN HA7JLRODUS I.Generamrip Numbs, 2,Page 1°I 3.Emerga"Y Response FN;ne 4.-chat Tr B 2pb0.0➢99 <br /> WASTE MANIFEST 0 4 6 ��, <br /> b-GaneraWSNameand Malpng Add� Geruatrs Srle address ra difrerenl Nan�ir�address iJ K <br /> plea:eprinitr AWB X r Generomrs Phane, <br /> UHfFI)RM deF s.transporter 1 Company Name US.FSAID Numner <br /> WNIP$T ASTF EST 3 - <br /> ies S MA7.T,—Podel2 Con—Y Name VS.EPAW Nurrepr <br /> �n�Narrp arttl Ma <br /> .-. S4 t;1.1q��1p B.OeSlgnatad Faulity Name and Site Adtlress U.S.EPA IO Number <br /> orJ�y� rgg <br /> 5 T Phana;977r- <br /> rartapwte,T Compmy Name <br /> F. <br /> N ilitys Phone: <br /> 2T ar2Ca,,2Cq 9a. 9b,US ppi OesuipLon linclutling Roper Sbippvng Name,HaurJ Clags,ip Nomter 10.Containers FI.Total 32.Unit <br /> HM and Fading Group la any)l No. Type 0_11, VAMI. 13.Waste Codes <br /> vUaeMrterad Fare <br /> ��,11 i�yN a CSi <br /> �$ Pe 0 <br /> 1 sa eixrT 3aL a <br /> 1 <br /> a <br /> 89 3382 w94 9b <br /> 2, <br /> Y ane'.$OJ7pmurpppn luN - . <br /> 3 QR <br /> d[r`'�GOUCIdin'vl7 �_ __� <br /> z <br /> 14.Special Haridfing InswcEons and AddA,.A In!arma§°n _ <br /> f' <br /> 5 <br /> 15 GENERAT0R'5iUFFERGR'S CERTIFICATIONS rre brddarr dw'.9ra_U,%cTo,mmgnnrvetare hely and aLW-a Yd—bed by the prover srx'ppmgTwne.and are[Las9fie0.pxYaged. -_f <br /> r4 sperm H mantes a:la E3beledrplarerde0.drtd aM in all respect-:n pnaPer�:-didpllerpaa5p[41aGmrGfig mappmble mrennoawand rmtianal go;e,wrer,lal requ�aCmu-neapndJtipmenlanm I am IM Pnmery <br /> 1) �G #r .riots aMMdrwr Eapader,l rR"Out d*wnb i%rr A-19-1 GN n to M kwg ditWYCftld 6NA lnvdadgnglrl W C—.,rL <br /> 128- IcedAy that dte waSk msranQaWI151alemeniidenEFM w MLFR-26ZITte]tdleTa�'g¢4�dh 9en9eamflw@I Gdlam s&rlaA Aaa�ldh 9®welu'IIs4ue- <br /> bt.11.tq * 7032 GermralorsrGReaals Pdnkd.7Yped Name 55namre MF m 1781' Y- <br /> 3�., <br /> rs. cq♦ER,tT�, '�P 295., � I6-Irdemation_ar sniprnnns <br /> maRea a'm FEROR'S LT7tt3q i ❑IWdm Us. ❑&poet fide us Pate as*Yh,2 <br /> FwaTx,I m'M.ane ae Trtaaspwter signaaire(fore,ywls GHY}, Data",Ku g. <br /> s'aere minim' 17.irsnspmler <br /> t0'd!F a1a[dra contents erVtisa w Arl�nneledglncidaFRrrapt MA7sarials <br /> GmY akralpeeiK5 P4nka/Try� BM.'Ma 0 TranspwFeri PdrNed/pyp gName _ <br /> sqHenT Gay Y 9 <br /> In.lnrena0:aa slVM1en15 r F �- ' 1 <br /> �,Trmrslioder2 PdntatllTYpaa Name e r V—,h Ga, Y- <br /> eipMa <br /> K i 7spam,.rignaa,re[rot on 11 on <br /> 7rc <br /> krrT 4ahaN l e(a9v Ie.Di--p-y r <br /> prmMa� -I <br /> `Y➢ee 1sa u�soepartcY lydlaEonSpace ❑ Y ❑7YPa ❑Residue ❑Parw Rwl— ❑Fa R23ectrn <br /> T �2 � <br /> }tr <br /> YPee Nsra < Lladest Rel era FF�d�.. <br /> Yr 18E.Ane;nap Fla Generamr! <br /> ra Usaesa,ry ater u.s.FPAtG ntmber <br /> Tae GhaapaT. <br /> i hr��a°"sPaa w Faliryas Pnme. <br /> ❑vwnE.y W 7$C.SignaNre ollnEenrale Fa lily for Genersbrj 3Nond, Oar 'tea <br /> 756 AIkoup Fya.4y,erG Z <br /> 6B <br /> 4 nlrap,� W 19.Harardous walk Repo?Ltalk'fgBmeN Methotl Coaes(i.e„mass kr aararaolu,ras�a[EneM-dr5prsal,arm^a Yd C sylt— <br /> i c ja�9's wpna. o v. <br /> a &wa°°° wm.rek aomy! <br /> = �� Gene.2 <br /> 4brJ 29.pPii9ratetl Falify Oracrd Operator.C.Obt N"'W o(hN dols nraU:rels cwaW by me m deaf pm nod n aepl lsa <br /> rr Oy 119 Nara N2sle AaodM Pnntad/Fyped Name s® Mont 6T, z <br /> ... � � m'a9amanr Nenoa CcderD r <br /> EPA Form 5700-22(Rev.3-05)PreviwsedAuns are ohkta- GENERATOR'S IYPW <br /> NiT1AL COPY <br /> - <br /> _ *11 <br /> John Alaniz, REHS Page 3 of 18 <br />