Laserfiche WebLink
940 N. Central Ave. Record ID# PR0513647 <br /> 11/10/2020 Program: HW <br /> Photo 19: The following uniform hazardous waste manifest (017695016JJK) observed with found designated facility copy <br /> • T �'R 4 Fa[m Appmpad.OMB No-2tl50-0639 � _ <br /> 1 wmso nm al ib.Farm des Had lar ties on Hole 1z.alrn -ler • .a-Y <br /> UNIFORM RAZA�10003 1Coneralw PNammr T-pYpele dElAerg.nc/Re�p.ns�Phone �.Moonset TracJr4np xumNr - - " <br /> WASTEIMANIFESi CAL 004370396 X 800]424-9300 95 016 SCK >.-• ' N• - ' <br /> S_ a, ' `l_' f r 3 -(s-: 5 Gme� s Nems end M'IMa Addmu Gemrelala 6Addre'a{If tllNennllhan maalna edtlneet ,: 94 '>b• `( e)" <br /> FIRESTONE 0366612 <br /> r .a - F.�x a• 940 A.CENTRAL AVE <br /> TRACY CA 35376 Ir <br /> 209 221.7164 <br /> j /a� -t - Genewlw's Phdre. U.S.EPAMN—, - <br /> t+rf •- 6.innypMer t cempeny Neme r f <br /> -� 'r *= • 'p <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD026277036 <br /> U.S.EPA IG N—m ' - <br /> "a`�. Transgvle.a CA'aOanY Name �rA <br /> v(, s.0esignand Fecillly Name and Soh Address EPAIU Number i a <br /> ae ;. ri, y f• y <br /> WOR <br /> t-0 OIL RECYCLING r' <br /> .iA'.# '.r 2000 N.ALAMEDA STREET <br /> r rjTJ '44 „j ► COMPTON CA 90222 CAT090013352 <br /> a ya'�, •� a a Fecll sMr0 r <br /> ya. <br /> 9h.U.S.DOTDsscrml.n,WAN P.N,Slippin9Name H-1d class ID Nwnher, 10.CenMlnem 11.To1W 12.Unll 43,Waste Lades ^'�'a►-1�f <br /> 1. •rr_ y- 'F _ i HM andPacMin9GmupGlarryll No, TYpe Duanlay <br /> r' �i 4 ` -,6 o f'NON-RCRA HAZARDOUS WA.9TE,LIQUID BRAKE FLUID) 343 <br /> D M 10 <br /> S <br /> f! �� • z <br /> 74 <br /> ' - w <br /> 16 <br /> 3 <br /> . 1 �'r t•� a v d �,. Ler <br /> 14Srryandling nUcpdAtlo <br /> a S Y <br /> * <br /> T'�c <br /> EMERGENCY CONTACT:CHEMTREC 1-8044249300 WOES TERMINAL:CERES CS NAERON 981'171 PROFILE M 981 <br /> N,J• -rr. _ - �� 12.r P4',V!E ff 1.10a ”Ap'i'RC°1?1,9TE PPE EQUIPMENT <br /> • <br /> V,-� - Y f 15. GENERATOWSIOFFERCR'S CERTIFICATION- <br /> ';' � <br /> Inerehy declare that itis contents ofthiscansgnmenlare NNy and apcufa161y desalhetl above by theymper shlppitg reme,arttie c7assiM1ad.packaged, �. _! M�1 <br /> 'w` '•ri- i markand IaheleNpawrdad.ond are In ea respects n proper eontlllion for Iranspon acmld ng to applrable Inlamaamaland national goremmantal regulations Ifexport sh'p�nlaM l am Ne Pnmary <br /> J e•-+ "S'.�� <br /> r� EkparmI cerory that the wnlenh of Nie corrslgnmenl wrtform WNe terms ol>ho annchetl EPAAcknowledgmenl of Consent .A. _f r <br /> .3 fY raAiyr,Nal the waste mn—ban statement ldendred in 40 CFR 262.21(a)(if I am a large quantity generatal ar lot l H am a small 4—bly genar&,w s true. ' <br /> G �. 1p.�'% 11_ GeneralprsN)Merors PnnledlTyped N.- 5y1/grtaNre Monk Day Year ' I <br /> rj,'f+ �t$1 Y` p�♦ I r�• I t /N — _ 7 l• <br /> �.`'• iY' }' y'r alder 16.In ones SNpmentf <br /> V" r['.'. :1•' .,1, - _ ❑Imppnlous ❑EeporthomU.S. Portonenlryreaib` ^ y, <br /> r ,M %i TranapaRersgnaWre{ror eapans only}: Detel:",a U.S.. Q <br /> 4i �", IY II.TranspollarAcd�wlsdgmamof Receipt ofMe[enals _ � •�- <br /> Tfaw er 1 PdnledlTyped Name Signature --— - Month Day Year e <br /> a lei r [ LI/�1�7��'I �-. Z 1 �.- <br /> Tmnsporter2PAnhd1TypadName Slgnatule Memh Day aar �Y" <br /> r <br /> r ' <br /> _ •• 11+} 1B.Discrepancy <br /> 1 !7r , faa.DI—pancy Indication Space ❑quanliry Typo ❑ ❑ <br /> _ -,..� C • � ❑ ❑Residua Partial Reyeroon PuN liepectlon <br /> Manilas)Rulurenr•o NumLer M1' e•a <br /> 4 - 1eb.Abemale FeOly for Gen emmq US,EPAIO Number <br /> W •� U <br /> Fadlily's Phona', <br /> 16c.SignalumofAllemale Family{or Generator) Manch Day year <br /> � 19.Hazardous Waste Repan Management Method Codes(Le.,codes for hazardous waste Ireamlenl.tllspoeel,and recyding systems} <br /> 'A ea. F` r;i o 1, 1 ..1 2, ], 4. <br /> a..r r+ 1A. ✓ J r <br /> - p•.!� " ;� I 20.Designated Facility Oemeror .Operalor Cadlh.gcn of reeelpt of hazardous maladals caveled by the manHeal adcepl ea nded In Item 168 <br /> 4 { I Pdntedliyped ems Ipnalure m ay I. <br /> 112 b <br /> EPA Form mo-22(Rev.3-05)PreYlovseditlonsare obsolete, DESIGNATED FACILITY TO GENERATOR <br /> JASON GAITAN, REHS Page 19 of 19 <br />