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1515 Hoff Dr. Record ID# PR0538579
<br /> 8/28/2020 Program: HW
<br /> Photo 2: Uniform hazardous waste manifest(021388235JJK) observed with no designated signed copy.
<br /> Pieaze pnnl M type .,
<br /> UNTORMNAIARUOUS t In ia,m , Fpm Approved.CUB No,70560039
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<br /> WASTEMANIFEST .--J7f^(]l�L�"a,0A�.% 7 �P�°1d 3.E"QsezY Rw+wreePmw ax,�ulen Tro.0
<br /> 318235
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<br /> �' S 318 2 3 5 1
<br /> � -.!-.. 'f� r�,R,amre SJR Mheu M d�aertnt coil myErq eadres.I
<br /> nunaaRaus la.d.+.abd rxgulwrioaa may apply ro / �!J 11"t�1 Aj lrrl p
<br /> 'AMkIi 13 of Chapter 6S Of Div—on I Of dtc c're'— •bn �fs]` /j?G6
<br /> fdirision aS elle 2222�r'rhe Cahri ip Csxlm,rf s rran.wnm r eaewanr Nm 7 —
<br /> nsibihry rn rd—r;fy and—r4y with nary such
<br /> ,rner's wades ClcanTnh in no—1yn., 'Tranapo�xxcernpa,m Name
<br /> u.s.IPAtoi
<br /> Pendant rherrtu..4ny advirc or gurdnm+e i -
<br /> r't gene,0 urrderstarralinc of upplirable lows a_IlasgnaNe t=apoON--ss,naae.e — .. us ewww..m.
<br /> wisaact,should nor be stied upon by eus- -
<br /> OfCleaPTn-h. C'usromershoulddirectrcg- j w) 7 -r.c /I JJ - • �'r J' 'ODOf'�/'9�I—
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<br /> 9x 96 VS.nOT n¢;mP +llrK'FMmp Proper Shgpxg Name,r�aA Ctrn,Ip Nurr4ar. ,O fgnU,iners 15.Tda1 17Vna
<br /> 'ations regarding ore sencnlrinn.handling. � xrd a�a Pxrx�na Groupilr xnrl) uwxea cores
<br /> Na Type euanury mNoi
<br /> hAr aft u'asre rendered to CleanTech rrrcru �
<br /> &CCR proirrly ch. !!CrILL'd por3VaR[rd
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<br /> than I,Op(1 ppm halogens.7ass than 5
<br /> :grecs Fnhrcnheir. Customer has made J z.
<br /> I{Rea or by applying knowler!¢e of the _
<br /> Wh's hurdling,manifesting.transport.
<br /> usramer'.c rompl ori with rhrse Iaws 3
<br /> Peer's used oil Jilin a vuluable prod- '(( G
<br /> Ser generators In Iransporr trlleics
<br /> 7f facilliating this EWYCJ ng actin-
<br /> g,without limitarron,the cost of w spedxr Ma,kr,g matmahons and Addiuonalinformaeen
<br /> Zmer s waste(including•with-
<br /> far recycling,whether or not
<br /> t5. GEN'ERATOR'S10FFEftOR'SCERTIFICATfON:Iheraby Declare thatfhe contents of this mnsignmeM are lvnpaM auerePely tlesrnhed shove 6y the proper sNpping name,and are tlav,Eed,Packaged,
<br /> icen,directors,shareholder. 1' markae ane lade,ed.rplacaMed.and a+e in all respects in proper cantlitan for panspon acmitllrgmappicahle lnbmaeonal and nalimalgrnemmental,egulatlons.Nespon sNiprnem antlVam the Fim,ary
<br /> 'osi.and eSpeu..%m(including, r Eaponer.1 w"real the wnfenh of this mnsigmned wnfwm to ftie terms of the attached EPAArI rne1,,i of consent.
<br /> ' Icerefy that Ne waste minimuatlon sWiemeM identlsed In 4o CER 262.27(a1{il Eam a la,ge goantiry ge,xaatorl a(al till am asmat geaOlay generalon n We.
<br /> al Costs,penalties,li and ( 1 f nt Irs./OVemra Pnn[edCrypetl Name Sgnalure Monty Cay Year
<br /> Pi damage,demi and ! . ,
<br /> etamer's breach of rep- I J fa.fntemaAonaf Shipments
<br /> r ❑ImpwfM U.S. ❑Erpwtfram U.S. Portol entrye.it:
<br /> ich liabilities
<br /> Storage,beat- ? Transporter sgnanre(for exports onfyl', WN leaving O S-
<br /> 'ren liabilities were Caused � n.Tranapndara�w,nedg,nemotRe«�PcofMsledais
<br /> of any breach or alleged Trnsporter f PnnleaTyped Name signature Monet Day ear
<br /> entitled to rr[orer jr-a- ao
<br /> Z Transponer2 Pnnted/Typed Name Signature Month pay Yea,
<br /> )1,.srandby tees coir!be
<br /> I} 18.Discrepanry
<br /> 1 180,Aisuepancy Indic ii Spate ❑puantly ❑Type ❑Residue ❑Pw iak Reieah ❑Full Ralectwn
<br /> prtovision ofthe work 1 ManlestRefer n eNumner.
<br /> to any other relief 1.o h fab Nfemafe Facility(or Gene tutor) U.S.EPA I➢Numher
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<br /> LL Facility's Phone.
<br /> 18c.Sgnature DrAllemafe Facility(or Generator) Month Day War
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<br /> I.sill d.{fliiil N 19.Hazardous Wei Report Management Method Cedes(i.e.,oed�es for hazardous waste treatment,disposal,and raeyciing systems} .4
<br /> C 1.
<br /> 26.Designaled Facility Owrreror Operator Certifind6n of recelptel hazardous malndals wvered by Ne manifest except as Wed in Item t6a
<br /> Printedlryped NaMe Spnature Mi L1ay Year
<br /> EPA Farm 870a22 LRev.12-17)Previous edarobsolete. GENERMORS INMAIICOPY Y'
<br /> JASON GAITAN, EHS Page 2 of 28
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