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940 N. Central Ave. Record ID# PR0513647 <br /> 11/10/2020 Program: HW <br /> Photo 14: The following uniform hazardous waste manifest (017696596JJK) with found designated copy. <br /> F4L- Form Approved.OM8 No.200.0639 <br /> 3NOTZ3RI4 . <br /> ,-;1 OP@ araa r'rwase paATm ryva.fFnmr designed ror nse an ellle 7apltah atar.l a.xanmaslTransTng xambsr , <br /> 'A JASTTN30 N I , 1.Genemax IO Number 2 Page r of ;.f narger�cY Raspomu Fine a 17 6 9 6b 9 6 SJK :'�". <br /> VOAAT r' I UNIFORAINAZAROOIA 1 (aW)424.9300 1f� <br /> eus Wa TEMAWFEST CA10D03703915 <br /> s.GenaraWra Name ane xareaAder.a+ Oeneamrs snaA4aresa Sa dsleranludn melbg aeeresss � �F <br /> ANOHIVN3 Yfl U82A FIRESTONE•35fi612 <br /> r^ 940 N.GENr RAL AVE 45375 "y r.gf ,Fs- <br /> RACY CA <br /> lfil aen.m ewes 209221-7154 us EPAIONemmr <br /> aPonerrcamnn�r Name CA0028277036 <br /> yy_2AO✓FIAm pfA3JO WORLD UIL ENVIRONMENTALSERVICE9 n a <br /> uS.EPA 16 Number <br /> 33FIT2 INN30 7E T1 r.Trenepwber xc�axnr Name '.•. <br /> NOTDwIMJ PN u.s,EPAIONamnar �_. 7 �: <br /> 8.naagnetetl FxitrNaaM sed Si@ Obsess <br /> US ECOLOGY VERNON INC <br /> 637590UTH BOYLE AVENUE "Y <br /> r CADO97030993 <br /> LOS ANGELES CA 90058 •` <br /> 12043A.Oa'BtNU Fe Wy Phme: (3231277-16M <br /> 17 <br /> td.csnT <br /> .AWJA2R3VIHU7 sa sb.as.ocTOes�Paon6nGudn9PmpersnlPP�,gName.naraNGass,IONambec pinars .o1sl 72.una 73-waste cases - <br /> Hx dnd Pxaing C+eep(ranyll No, TYPe Gaandry WI Md. ' ! <br /> r r o 0 'NAZ <br /> ON-RCRA HAZARDOUS WASTE.SOLID(OIL AND ABSORBENT) <br /> P 2 n+ <br /> ,I rryM d4 DM <br /> V � <br /> r 3 I <br /> '.A <br /> r =�T <br /> �A. <br /> T h 7a sPaaal H"11"lnswceons end AGtlmdrar lrrtvmamn <br /> EMERGENCY CONTACT:CHEMTREC 1-800.424.9300 WOES TERMINAL:CERES CS NAERGM 981:171'PROFILE M 98.1 <br /> ` AY104487 OIL AND ABSORBENT`P500-000688M"APPROPRIATE PERSONAL PROTECTPIE EQUiPMENT�! 7- <br /> ? c /x <br /> _ 'S. GENfRAToR'a1GFFEAOR'S CEATIFICATIGN�,Thereby derrare mat the eonl¢nk of dns wnsi9nmenlarefWly and aaw7yatetle4Gnbed ab­by the proper snipping name,�artl avw dassfiad,parlaged, <br /> '1931.4� marked andlabeladplarartlegand are in dil r¢Sp¢[t5le titter Nndifion(a IransPod accoNing to applrcable iMemational and naaanal govaimenlal regulations.If export shipmertl eM l are the Pnmary <br /> f �,a 1020s1�6 Espoder,lr,¢rbfa that Ne mnten[sol+nis consignment wnrormb melerms mrhe aaar>t�Ep0.Arkrpwledgmenl of Gansent. <br /> 'T'�-' - Irenity mal the waste minimvanon sUlbment ken5fied in 40 GFR 362.211a]lillamalarge paanory geiceremf]ar]b(Ria sural qu hkygneratorliextla- <br /> �T�. Gensraiorsr uorsar;ntad7ryped me Si�awre M.On Day Year <br /> �� 76.Irmema[ana 5 ipmenls <br /> _ _ ImportbU.S. ❑Expattfrom U.S PPa olamrylenr <br /> T 7^sPwler egnaNre(lsreapods anlyl, Data le awro9 U.S. <br /> 7 de17 Tran9poRerAuknowkdpment orRepelpl WMatmab <br /> w <br /> r Q h Tref r 1 Prfn! ype Name Sig.Wre Manlh Day Year <br /> 4 7, ¢Trdnspuler2P \ Nama Signature <br /> TMonbs Day Year <br /> I JJ�� E 1a.Discrepanry <br /> [r 7C 19a.Oisnapanrylntlira6on Spapa O.'aty ❑Typo <br /> 1 I ❑Residue ❑Partial Re7eclwn ❑Full Refection <br /> II Manlfpsi Refarerrrs <br /> 18 � tab.AlTemafe FacNiy(or Generator) NumberuS.EPAIC Namfaar � <br /> U <br /> I Fa LL Facwivs Phone: <br /> w tB IBc-Sr9nalure dAllamate Facilgy(ar Ganaralar} NuntN gay Year <br /> 1 ? 4 <br /> 2 <br /> ►� I m Ig y fB Hazardous Waste Report Mana99"111 MathM Codas p,e.,codes for ha doua weals aeatment.Disposal,end mcydlnp syslemsl <br /> W ., w <br /> 4. <br /> 20 2g.Deslgnaled Facillly or or Operator:CarAcdaWn of Nmpl of 119aerdwA melerlels COW10d by the manilesl easaptae noted in llam lRa <br /> L Pd FPno0ped arae iSOR <br /> ��! I Slgmlum Tr ay Year <br /> EPAFo �" �� I! <br /> EPA FDmI 8700.22(Rev.3-DS)Previous edlOns are obsolete, r <br /> OE NATES FACILITY TO GENERATOR <br /> JASON GAITAN, REHS Page 14 of 19 <br />