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212 Industrial Dr, Stockton Record ID PR0514288 <br /> 8/6/2020 HW Inspection <br /> Photo 8: The facility disposes of the consolidated TWW to Forward landfill on non-hazardous special waste and asbestos manifests. Several of the <br /> manifests on site had either the date or weight missing. Manifest 6146651 had an illegible date and total quantity. <br /> MANIFEST <br /> a o q RI <br /> t SPECIAL WASTE S ASBESTOS MAN <br /> REPUBLIC• NON-HAZARDOUS <br /> �� 9ERV1ca5 Ill and IV <br /> wasFe <br /> flsle,complete$atllons 1.ll• Il and 141 ' <br /> If waste is asbestos w mpleta Seetiens I, <br /> ki 14665'i is NOT asbestos wase,u <br /> • <br /> -_-_ I oena,a GENERATOR(Generator completes le-r) ber c.Page 7 of <br /> US EPA ID Number b_Neil OecumeM Num <br /> - E cenarator's1 e.Generators Melling Address' r <br /> Narne and Le-tlon. ' <br /> Phana', I <br /> oYrner of the 9aneYaang facility tlimers(ram the generator,pmuide', <br /> 0wgar•a Name i.Owners Phone No.: n.Trial o.unit • <br /> A'eale Profit _ m,Conuriners Quan WtNol ' <br /> s p k.Esp.Dare I. Oil <br /> Wast®Shipping Name antl No T a <br /> Descri inn <br /> r <br /> waste a.dl by 40 <br /> FR <br /> �N law hof,been RTIFICA710N: hereby certify that the above nametl mateerlconditlon for transportation according to appnceblesegulations;AND!t this • <br /> w ala is property tlescribed..dassmed and packaged,and Is in pmp <br /> a a treatment residue of a reviousl tdcted hazardous waste subject m the Land Dlapesal Restricagns.I certify and warrant that the waste has <br /> been treated In accordance with?Wil <br /> of 4o CFR M and is no w a hazardous waste as dil d h 40 CFR 251. <br /> generator Authorized ...Name Print r,pate <br /> si nature <br /> TRANSPORTER Generator completes Ila-le and Trans orter cor latae IIUe <br /> Tranppeners Name and Addrasa: ' <br /> h.Phone: ' <br /> c Driver Neme Print d.S'nature a-Data <br /> III• DESTINATION (Generator complete Illa-c and Destination Site completes Ilid-g) <br /> a.Llispmsal Facility and Site Address: c.us EPA Ncmber d.Discrepancy Indication Space: <br /> b. <br /> 1 hereb certi that the above named material has been accepted and to the best of m knowled a the for cin is true and accurate. <br /> e,Name of Authorized A ant Print f.Si nature .Date <br /> IV. ASBESTOS (Generator completes IVa-f and Operator complete IVg-i) <br /> a.Opemlers Name and Address', C.Responsible Agency Name and Address: <br /> b.Phone: d.Phone, <br /> e.Special Haadling Instructions and Additionak Information', <br /> f.Q Friable 0 Non-Friable 11 Both %Friable %Nan-Friable <br /> CpEfdATORS CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name <br /> and are eiassified,packaged,marked and bi beledlplacarded,and are in all(aspects In proper condition for transport ie=l ing to applicable international and <br /> national govemmenlai regLlatians. <br /> .0 orators Name and Title Print I h.Si nature i,Data <br /> •operator refers to the company which owns•leases,operates,controls,or supervises the lit lty being demolished or renovated-or the derro$bOn or <br /> renovaftln o e'lion or both t <br /> REyetrl4 GENERATOR RETAIN , <br /> n5-F 11A , <br /> John Alaniz, REHS Page 8 of 8 <br />