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3400 Auto Plaza Way. Record ID# PR0514278 <br /> 11/3/2020 Program: HW <br /> Photo 5: The following uniform hazardous waste manifest (0 1 8237273JJK) observed lacking signed copy. <br /> 'lease Print of type.(Farm designed foruse on elite(12-pitch)typewriter. Form Approved.OMB Nc 2050-00:79 y <br /> 1-Generarnr IU Namfier 2.Page 10 g.EmergenPy proper- Phme l ll� 'i�T M 1�map. }7 r ' Q ,? S� a fi G R art.�q <br /> UNIFORM HAZARDOUS LJ r f r'L ! JJ K <br /> WASTE MANIFEST A!-U<;0 3 3 0 4?3 f 90014'.'4 9304 (� <br /> s.censsa� OWTOMHEVI'l T-QYNiORI Generelora sae Aldrins(rdafelarrr manmeilhg address} fib. ,41 'Ali <br /> j - <br /> UW AUTO PU4ZA WAY $ II <br /> TRACY CA 95:104 s <br /> 209 els-na0o - - <br /> Ge�rerpe'phnne' - -. <br /> 6.Trans der 1 Company Name U.S.EPA 16 aheMM <br /> -, riiVlRprrM E Ni SER%nCE3 CATy0:R27T03F I t <br /> r Transpon,=r 2 Company Name U.S.EPAID Number <br /> B Desi nates FaolirY U.S.EPA IU Number <br /> �I;f 14Lfat1�% <br /> ."T6 54LITH BME AVENUE <br /> L00 ANTE LES (,,A 940.58 ( AT)0 9 7 0 3 0 9 9 3 _ — -- <br /> Fed) Phone: 13.^3}?771.ri00 _ <br /> V <br /> OOT D-Apeon lmdidiig Proper Shipping Name,Haaard Class.ID�Aanber, te.Comainers 17.Tmal 12,Unir 13.Warta Codes <br /> ang Group 0 amy)) No TYPO Orrantty WtNd, <br /> KORA HAZARDOUS WASTE,SOLI)(EIRi LATHE SHAVill 181 .. <br /> W <br /> w- <br /> SUMP/[NRSHWA 7ER <br /> ✓E7RRKE <br /> 1� <br /> �1 <br /> g Insllhn inns and AddieMal InfIXmalionCY CONTACT GHFtATi 1�t3(lf}+1.y.9-9,?i00 WOES IERMIl CERE3 G_- hEAEFt;p:�$} 11S FFRCrF{LL.K°.'-'7 iRN<E LATHE SHAVINGS a P!504-000794&9`APPROPf21ATE PPE EQUIPMETIT -- <br /> 15 GENE RATOA 510FFEROR'S CERTIFICATION:Iherehy declare tai to contents afthis wmsgnment are holy arrd aCCuf8tely 6esailmd aoove M to pager shipping name,and are dassi6M.the RPh maryart' <br /> marked and I.hefetljA—zded,and are in all respects in proper ,eordi6on fortrenspon according bplirable apintemationalard naliond g—mmirtal regulators.If a,pnl sMprnel and Inam lm <br /> Esprrter,I puefAThal <br /> in.wnlents 0f this wnsignment conform to dre terms of to atkd1ad EPAA kr.Wedgm mt of fpnsent <br /> f oars l!yhlLreMaste minimlraGan slalemen"Wied In 40 CFR ffi2.27(e7 Ill am a large qua"generator)or(b)(41 am a small quant generator)is hue, _ <br /> C,enorafprViCi mes'+rniteEflVPe'd Naime Signature i Day Year <br /> r 16.InteaMWMl Snipmenls ❑li to U.s. ❑Export lmm U.S. PortolenhylaxR <br /> ? Transporter signature(for exports only): Dale leaving U.S.: 'ONTAINER Tn <br /> 17.'x—sporlerApi—dedBrnent of R-1pldMaledaLs <br /> Transporter 1 PrinteMyped Name' ! Signature i Day Year h.M� <br /> QTransporter 2 Pnwinirryped Name Signature Month Day Year <br /> _ Yar <br /> ♦ 19.DrscrePanry f`'1 <br /> 1 1Ba Orsaepanry Indi ahon Space Quenu y ❑Typo LJ Res due ❑Partial Relectwn ❑Fu4 Rejector <br /> Manlfast Reference Number. <br /> Job.AltemaM Facility for Generator} U,s.EPA 10 Nuni <br /> J <br /> U <br /> LL Faatlyra Phone- <br /> 1i Signature orAtemate Featly for Generator) Monty Day Year <br /> 4 <br /> Z <br /> 0 19.Hazardous Wesle Report Management Method Codes(te,,codes for haiartlous waste Uealment,disposal,and recycling systems) <br /> 4a 1 2, 3 4- <br /> 20.Desgnated Facihy O-er or Operator Cedihcatan of recelpl of ta2aMous matelots covered by to manlfesleaoapt as noted in 11 188 <br /> Pnnled7yped Name slgnalure onm ay Year <br /> EPA Form 6700-22(Rev,M5)Previous editions are obsolete, GENERATOR'S INITIAL CO <br /> t <br /> JASON GAITAN, REHS Page 5 of 48 <br />