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811 Zephyr St, Stockton, CA 95206 Record ID# PR0539941 <br /> Date of Inspection 09/12/2018 <br /> PHOTO 24: No TSDF Copy available for this manifest <br /> 09 <br /> .N,kI.rF.mO.twMlyywe.mIoRaD�O�U,5 sag�g1, <br /> ab�r suse on elite 11 2 pihh)typewdler) + s-eeeaes.rns� °2p1ovctlOMB No.205p03 <br /> wgsrWNIMSr P"e E �A "OR"84FLE <br /> 9 <br /> _ <br /> — <br /> B uc <br /> a�• �' cn eszos - <br /> 4dlenceA aemlfr iiansp.W.-(SV) u.s.EPA lO rvember - .. <br /> pon,r2 Pa�eNam� rum0007os.o - <br /> U S.EPAIO Number t <br /> ad BAd NC7fl 1-TRBn11N11 U.S.EPAID Number <br /> 3739 Edfh E NMD0�0862'/ <br /> s� , <br /> Y .US.DOTOeunpem lntludug PmperSM'pgng Name,Nazam Clens,IDNumber, IO.Cmbirers <br /> A Pactirg Gmup OfanYl) It.iobl 12.Unll 13.Wnb Lotlee <br /> NONRCRA RAZ7RDOUS WA "°' rypa Daanbn wl,vd. <br /> AND 00,) STE,SOLID(ABSORBENT F - <br /> " <br /> 3' Ii63, este amt Muted 3, 1 <br /> t OM P 0007 0095 <br /> � R —_a.�z.. HarAling lnswclionsantlAEtl'Oona lnlormaln,n p�,7Nmhy SW76 <br /> AC)Z06E1 NW Dxunwd N:D1017M <br /> A 2)EROY1314 AMig77-- 9)EROMtie; AC'f15o85 `j, h S V, <br /> GENERArOR'SIOFFEROR'SCERTIRCAi1DN:Inertey OetlarelM1aNlreconlerKs of mSwnsignmentarelullyantlawrately desaibNl above MlM1e pmpershippng name,antl are Wssified,pasMegeO, <br /> b laENeNryarzNed ane Grein all respesM in pyparwlpilbn tw l2nspp(a�ping to applipble in@mational and natiwal <br /> Exppneral¢rliN mewnlents of lhk wnsigmnmtmnlomlto me hurls MllreadacMd EPgAcklmMad govemmenlal reguleh'Ons.lf axpOd Mi—Mandl-rre Pdmaw <br /> icemNb kmin m¢a ion slalemem tlerNletlind0 CFR 2a2.2I(a)pflamela amentof Consent <br /> `reIN Ogamf pe leirryp¢p ma Nequanitygenerelor)w(b)(tll amasmall quanNy generebr)is flue. <br /> U� 9na <br /> { <br /> JI j Inle'n-aI511i nts ❑ � �, (ar <br /> 1 Impunrous ❑Export hour U.s. <br /> Pold <br /> ,1 Pt wpone.e nalare rp.e nsw enuyieuc <br /> i I��: iter{MerAWpaletlgmenlolRNZi'yWMateeak Date leevi US: <br /> i1 rlappNerl PenleMypsd Name <br /> ( lgnabre <br /> nspOdNgPrinletl?ypcN Name / /�-� Y ea <br /> i ignaW 1 7 s i z'(� - <br /> M'aDepanry <br /> I.Dav¢pancy lrxkabNt Sp3se ❑GuanMy o <br /> 1 I ❑Type ❑Resitlue ❑PaNal Re,—rr NO Rryecdon _ <br /> AgerwraFa"h(MGene-eror) Mani(esl Reference Number ` <br /> U.S.EPA ID Number <br /> =9gnaWmW `\ <br /> AlLvnate FagM1IY(or Igenereror) <br /> �r Jj <br /> ::;.:..� ' _ Waste Report Malragemenl McMotl Cotles(i.e.,wdesM MOnN DaY Year <br /> hazardous wash bea0nenl,disposal and resygin9 syalems) _ <br /> 1_ <br /> hd Faaq GNneror 4' - <br /> fypetl Nyne Gperalor Cerypcehgn o(receiplafhezatdous materials wvelPA by Ne Mani(est <br /> except as noled'n Item 1Ra <br /> SigneNre \ \ <br /> rR8700-22(Rev.3-05)Prev11111se IhOrlaara0bsolele. I Month Day Year <br /> DESIGNATED FACILITY TD DESTINATION STATE(IF REQUIRED) <br /> Tricia Dai, EHS Page 24 of 24 <br />