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3400 Auto Plaza Way. Record ID# PR0514278 <br /> 11/3/2020 Program: HW <br /> Photo 1: The following uniform hazardous waste manifest (0 1 6769412JJK) observed lacking signed copy. <br /> artwe rrdra - ir.r.aemm�el,z 1 a - . . ,rnpprovaa_t]N1aNn 2o,a.u.�;v <br /> t Cr,rmala4Nr4ar 2-Papattl ].Fmmxky gpyrnu Hro,rr 4.Mmnnsr TraceVng aumper {�/ <br /> P Y-- "NIF0.4MNALARDOU9 1 �r::nr 1,.}-� 'ire JJK <br /> f fh WASTE MANIFEST C A 1.f](1 n l 1 n 1:' <br /> r ' - S Gwwrelw'i nanr�tl Ml�rN AaeRM Gernamrl See 4dtlresa le dArlrenl WnmeiVnY ddaessl <br /> QAHDM nfVI TN1{CY CHtIrROLf-7 QA1i007 <br /> LL: J4O0 Alr1C,f'I AIA WAY <br /> d FOR SERVICE CA TRACY CA N!',3rdn <br /> _� DIXON OFFICE Gam ' r 206 938-46M r <br /> 2879 fi <br /> er` 1-606-727• s rrerraes�w 1 etaaanr N,me u.s.EPA ID Hamner <br /> TING CAL)' WORLD OIL t:WWaNMEI.`SERVICES ("ADO. H P 7 ,a., <br /> FOFIACCC)UN ,r,anapaty2CulgenyName, ll,S.EPA1DNumber <br /> 562-231-1550 <br /> S 0. real Facility Name and Site Addteas U5.EPAI9 Number <br /> us ECoti vCRNON INC <br /> 6975 401 BOYLE AVENiIE <br /> r LOS AWIELES CA 911O58 l:A f,n r, 10911 <br /> P Faa sPbwx: f123 277-1800 <br /> E ga. 9b.U.S DOT Desaipgen(induding Proper Shoping Name:Harold Claea.ID Pioneer, tO.Containers o TOWi 12.Um1 la.4falre code! <br /> O HM and I'vWirg Omup(I arry)l No Type on <br /> At%1, <br /> T <br /> Cr IN0N.ACRA HAZARDOUS WASTE.SMIO MAKE LATHE SHAVIN6S9 Lal <br /> Vill <br /> y CUSTOMER PUT <br /> M <br /> DAYS 181FOLITED <br /> 3 <br /> �M PART le 4 } ' <br /> all <br /> 14.Spe,,al Handling Instrucbons and Additional tnfamMeon <br /> EMERGENCY CONTACT:CHEMTREC 1.800424-9300 WOES TERMINAL•CERfS C9.-NALRG*RM- TZ PROPTLE 0 9['t <br /> 0L528 Wiser= <br /> —� <br /> s+ fiBRAKE LATHE 9HAV1NG5'P500�00095045"APPR(}PRIATE PPE EQUIPMENT � •�_V � � <br /> 1 15. GENERATOR'S)OFFERORS CERTIFICATION:I hereby declare that the wntems MConsignment nsignment ala folly and accuretely described above:by the.proper shlpping name,aid are dasslfied.packaged. <br /> marked and lairuJOplacerck.and are in all mspeds In proper Condition for trari l according to appllwble intamaf naVand natonal gmemmental regulations.If export shipment and I=Na Pnml <br /> 1 CASH FIEC D.� Sur trader r ceAk that the Contents olmis mnsignment c fam1 to the ones of the all EPAACknoWedgment of Conaem. f <br /> yMR� I car"trial the waste minimtraeon stalement idill in 40 CFR 262.27(a((if I am a large quantity generator)or(b)(01 am a small quanti <br /> _ i March 11 Da Year <br /> NON•RCRA1 Generabrsrodemrs PnntatllfyPad Name - - Signature y _ <br /> NON-RCRA �. -?ta--f r <br /> - r 16.Internal Shi ants ❑F. rt horn U.S. Port of en legit: - - <br /> OTHER:7E h p L1 el Io-Us. pa yr <br /> D@SIGMA i Transporter slgirril{for exports only): Dale leaning US.: <br /> ALTERNAT w 17 Transporter AcrmnwladgmentofReceiptofMarenals <br /> =Transporter I Printed Typed Name - Signature Mo-m11 Day Year <br /> pRUMSPfl 4 Transpoda12PnnledlfYPedPiame Signature Monty Day near <br /> Y7 16.Discrepancy <br /> glow I !v N <br /> ,17 <br /> By a r t Ing TBa.Discrepancy tndicellon Space ElQuantity ❑Type ElResell ❑PaNaV Relecllon ❑Full ieompUea arm m <br /> - Qadwe,in[t Mzndesl Re}erence Number: <br /> No Intorma,ion t F 18b.Allemate Fal(or Generator) U-5.EPA 16 Numeu <br /> J <br /> ell"-a nos V - <br /> _ nave Pro'ided S Farildyfs Phone, <br /> "rim-for Pine w 18c.Signature clAllemate Facility for Generator) Month Day Year I <br /> I-1 e3y Tnle we Z _ - <br /> knowledl-,1 w 19,Hazardous Waste Rawl Marral N Method Codas(I.a.cedes for hazardous waste treatment,disposal,and recycling systems) <br /> Irom alae . <br /> 0 r 2. 3- <br /> 4. <br /> I Carl"she, 20.Oesignaled Fadlily Owner oroperaWr:Certification of racelptet hazardous materials covered by the manifest except os noted in Item Ill <br /> r curable r AIdt11h Da Bar <br /> P e Printedlfyped Name Signature y <br /> This Indlurd <br /> and melerlr <br /> by the Star <br /> C,the Or <br /> EPA Form 8700-22(Rev.3.05)Previous editions are obsolete. GENER ATOR�S INITIAL COPY <br /> of the oMe <br /> JASON GAITAN, REHS Page 1 of 48 <br />