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601 Nestle Way. Record ID# PR0527272 <br /> 10/22/2020 Program: HW <br /> Photo 6: One uniform hazardous waste manifest(020403321JJK) observed with designated facility copy; corrected on site. <br /> J ��app,�„ea,6Ma No.Sa50Wa9 <br /> 2 Q 4 o--4 3 21 JJ K <br /> j � t wAaTE lnAxrpEar c .a�aa <br /> a e ,e„a„ c.rAr.wa.se nasmslamm,�law•e�v.am„e1 <br /> W 1 OPS .0 casv E W 96 en <br /> rnr,aMOP <br /> - n,eeoeaoo-a�s,ae vn 1p rw��ver <br /> mm,�r o comy�v rte. e e�Ymmeuula <br /> :eo.ye w Lsrwsy,rn �6.canto nw.•eei <br /> er c.t n t <br /> us_spafo Npmbar <br /> 16X E.BRUIMAOE(ll <br /> _ MAKERSPIELO.CA 9,W7 <br /> {'aou Fho MI-3224 M 1 <br /> • 9s aW V S WT jMtlutllrg Royer5ay01rg Name,Mymd CNsb.lp rNmber, Ie.[.p�veners I1.Yotal 15.!IML 5).Waalp Codes 1 <br /> eM aM Pau'npCaprtienYYl Type Ouentiry <br /> K t NDN MCRA HAZARDOUS WASTE SOLD(olly ahsomeM) OM v 1 pryer Z <br /> � v— <br /> Cwn — <br /> 3 <br /> j2 1a 3peder HemMng Msirvctians anJAatllaenal 1pyrmartln — <br /> 02 ERG tf 171 INVOICE# ��CC)6e(/ PROFILEN '7 T <br /> 01 •✓DEAR GLOVES U �n Gd-- T1- <br /> 02 I—05 15. GENERATOR'SIOFFEROR'S CERTfFICATION:I hereby tleclare Thal the mntenls orlhls epnsgnmenl are lolly antl accurale{y described above by Ne proper stilppirg name.arrl are iasslfiea.pac%agea. <br /> 1 +narked and fabelebrplacarded antl are In all respec3s in proper mlMltlml br Uanspod accoMing to applimhle intematimakaM national governmental regulations.11 expaishp—I aald 4 am de Primary ` <br /> Exports,I cetiry Mat rhe mntents o!Ihis consignman!mnbrm to the terms of the aaachetl EP++AckngwkEAment aI CansenL <br /> 1' trerUy!het the waste minimualion statement itlenUfied In 40 CFR 2a2.27(al(illam alalge quantity generator!or(b)(fl amasmal4 quanlity generator)is true. '- <br /> 1. Gene rarsr0eargh PriuMr7 d dame41 <br /> �1 Signalule tAenth Day Yeaz <br /> 0 161n ematiw alS omen <br /> ti ❑rmpw to U-5 ❑Expert hom U.S Pprtotantryrexit', <br /> ° ? 7 sooner vgIM-(for V—-1y) Oate leaairlg U.S.: <br /> 17 TragsporrerAduwefedgmenl orFewipl of Matwje <br /> O Tre3 � Name Signature Month Day Year <br /> ° a r <br /> ° = Try,n er4 Pn a yped Name Signature <br /> Muultthh} Day 'W <br /> 19.6ispreAancy - <br /> rax.Oisuepancy Md'c bon Space <br /> f ❑quantity ❑Type Rlnitlbe ❑Paroal Rejection ❑Full Rejection <br /> 01824gg87!!K <br /> ti lab.ANemale Facility(orGeneretorJ Manilast R-1-----Number: ' <br /> USEPA IDNumber 019676627!!K 4 <br /> i�Facihry's Phone: <br /> 02040332.1l3K <br /> L 18c.Signature ofAllamate Facrlily(wGenalaw) 021239x0 3 <br /> = Month Day Ye'aa 4 <br /> LL) 19.Hazardous Waste Repod Management Melhod Codes(I ebodes far hazardous waale IraettMent,disposal,and recycling systems) <br /> 7. g 4 <br /> 20.designated Facddy Owner w Operalor:Cerllficafj"of MCelpl of hasvdous rnalerlafs covered by Ne menilesl except as rwled in Item Ilse - <br /> PnntedRyped!Jame gnaw a <br /> Yew <br /> EFA Form 13700-22{Rev,12.17)Previous editions are obsolete. <br /> r <br /> f �4�UE�SIGNATMfACL - �I ] ),71 <br /> ^ AO <br /> R <br /> JASON GAITAN, EHS Page 6 of 6 <br />