Laserfiche WebLink
940 N. Central Ave. Record ID# PR0513647 <br /> 11/10/2020 Program: HW <br /> Photo 18: The following uniform hazardous waste manifest (018170416JJK) observed with found designated facility copy <br /> 4r_1 # ?+ Fym,AMp .OMB No.2050-063' ` _ _ it *, •- <br /> 4.MaQa�Tga170416 JJK <br /> �. (Form designed far use on afite 12-Ikh) a Page,of a.Emeraenq R�eOn6e rneu <br /> ti` 6 .t •- •l Please Pnnl or type. J 96 1 (BDO)424-9300 r <br /> BNIFOPM HATAROOUS nefle:emman mating aaaess} r � ♦ <br /> t'i - ; �'F:.; a WASTE MANIFEST CrA-9'0'� �-a Gererabfs silaAddressl 'VC- Lr... <br /> +!T �, � � � • .�_y A � S.GeneraW�s NameOM AIaIMBAtldies6 �6�[n•�y ryC-S�ro <br /> law,-sxNriS-EERYeA <br /> k'. +� !( T ZZ /�/�4/ U.s EPAID Ngo 4, <br /> 1k A•+' 1^ I! ' .�', r je �. Geaemoors I=Mne; - CAD 0 2 0 2 7 7 0 3 6 <br /> ' 3 a ..+ r-•.�"•. 6.TranWOOR GIX OIL Name U.s.EPAID N:0iber `�•�' f <br /> ; WORLD OIL ENVIRONMENTAL SERVICES -I`(at <br /> 4• - :. ` A CAA 000175422 .1 „ •,_x, <br /> y, M T rnnePaaarzcngygTEM INC. <br /> WORLDWIDYEFFY uS.EPAID Number <br /> wiD RE <br /> E REC4 <br /> B.oesigneted Faciliq Name and Sea Addles - <br /> J� EMENT.INC, <br /> Y�US GHWAY95 AZR00052k146 <br /> YUMA AZ 85365 <br /> 12 Una C <br /> '• Fa[ih sPno',a: - 10.Ganlalnars 11.TOW1 17.Yd85N CMes <br /> T-sl}s } ♦ t v �' ti.' US DOT 0—npWn(imludirng Proper ShIM19 Noma Hazard Glass,IO Nombre, No. Type Raandty Wt.NaI. • a r <br /> ./ J' `f HM t andPa&rQG-p(dany)) -CONFORMING FILTERS) <br /> HAZARDOUSWATE.SOLID.(NDN <br /> SDN-fCiA /ten �3 l a •��,� . <br /> } <br /> ' )} ,>•.-�! �. �+ . s a � DM <br /> i <br /> y 3' eC <br /> � ♦a- �yY '.!rye' '• a. � ti 1� -� <br /> 1a.5pecial HdMling lnSeaations and Atld�aonal lnfom,adan ~••4a <br /> ',Ir <br /> EMERGENCY CONTACT:CHENITREG 1-500.4248300 WOES TERMINRL:21525��L PPiRATOFlL�PERSONAL PROTECTIVE a <br /> *TRUCKM <br /> EQUIPMENT*EMERSENL'Y CONTACT CHEMTREC 800 424 8390 roma.arm aleclassaiea,pacxagaa, '- <br /> y • dascnhed atlmae h'1 tree Propershprymg <br /> 5111 <br /> and <br /> ll,O Primary <br /> ,y,4.t!; Is. GENERATO!"&.1FFEROR'SCERTIFICATION:Inerebyderdaronarnfoo natsailnlsrdiflgtaappl�MFuan n�,ea�IMdyreaonalgovemn,entalreguVations.Vlexpos Pm'a'nt } =N <br /> madeed and laael.oplace,ded,andamina9 rear <br /> acle npmper caMdlon for¢anspon acrDmin9roaPPi <br /> enar dr Icery(y that tree contents a}7�is aans5nmenl wnrdrm N>he leans of iFe attad,ed EPAACNnrnvledgmant Pi Coltsent.— roto[is 4ue. *. <br /> 67 T ;. W that Un;wade minnntation statement ldamliriad Vn 40 CFR 262271a)(r I am alarge quantity gene=0 a(b)(itI am asman va"ty gene ) M 3ay Year <br /> Gempol40Merofs Pnnle6Rype�_Na� . <br /> r ••a,� 6 Y `n S ❑Dred Irom U.5- Port of sn7ryfarit. <br /> •as. ,y _ 161 aoaal SClpnwnls ❑Importlo U.s. 9ateleaving ll.s: <br /> .bi �����-i� � � Trenspaterslgnawre iter exports only): t <br /> 17 TmnsParterAd6nmvladgmant or Receipt of Maiedals Month gayq Year <br /> &gnatum..� 7 Q/ ► <br /> Ts r 1 pdn <br /> ranledlfyped Name <br /> aL,�,�(' ��(•�J �' lAon4h Day Year - <br /> s _ signahve <br /> z Tranpd rN 2 FffnWlypad Na�me/ l ( L,y. 4 •' <br /> I/' t fiLr"Ve <br /> r .. <br /> •r tg,ihsuapenuy ❑ <br /> I� ❑Residua ❑Paruai Repadon Futl Relactron <br /> 1a O <br /> . Vscrepancy indlrallon So- ❑Quantity L 1 Tyga <br /> Menitesl Relerence Number, w M <br /> U.S.EPAID Number <br /> 15d.Allemale Faulity(or Generator) � <br /> Alpnth Day 'sear <br /> FacifiNs Phone. <br /> w 1Bo Sgnalure of Altemate Facility(of Gosarmor) <br /> zstems <br /> L9 Ig.Hanrcous Waste Repoli Management Method Codes¢.a.,codes for haxardvuswaete treatment,dlaposal.and mCyding s0ems) 4 <br /> e j 29.Oesgnated Fagbty Owner or Operator:Garhgcation of mcelpl of hazardous maledals waerad 6y Ne mandast escepl M nded in Aem 1@a Mot11d <br /> Signature 1 (t *- '- <br /> Prig Nam <br /> Name { <br /> DE51G ED FACILITY TO ENERATOR <br /> EPA Form 8700-22(Rev.3-P5)Previous edipons ora 0b 60le <br /> /TG <br /> JASON GAITAN, REHS Page 18 of 19 <br />