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800 E. Pescadero Ave Record ID# PR0514340
<br /> 11/20/2020 Program: HW
<br /> Photo 20: The following uniform hazardous waste manifest (006285812SKS) with no signed_designated facility copy.
<br /> l,wparYd Typal - ,.malls w'.w ,war ..899-468-5769 L�nnl
<br /> I Iw^�°rs 101e°�west®end ma aPpropnte
<br /> aeabrewaa��m t a,I
<br /> "Perrraeter. I '.1K 8FI1 PlI 22419119")
<br /> 7AHLE IrPES OF C6NTA1NERs �
<br /> r ptesac stags. DT=DumP Wdr' PleasePontor From AP mved.OMB No.2US&OD39
<br /> A,paper" ,a.cases. OW=Woodendrums,baNata,�.. o type-(Form aaa rretl Farun an alae(12 eUl awdter. 3 me�gn Reaaaneq p� M.
<br /> arsmcktnP Number
<br /> boxes,ca duding HG=Kopper ler gobada can. UNIFORM HAZARDOUS r.a,nemto-lDNumbx x.va4arar i-StRa><rry4EH 3Ahb 2 r• SK�'
<br /> Sas.nedons,cases(1° WASTE MANIFEST CRL9991391'J5 - L
<br /> TG=Tank®MG. 5,GenMhfa Nem,grid Mealnp Rddmsa ['a!mmro-'s Slla Mdase III aAlerenl roan maNin9,damae}
<br /> bbaes Fy 0' cases- TP=Portable tanks. I Penske Truck Leasing
<br /> TT=Garso II(look ftks), au,n 800 E Pencndcro Avg
<br /> Ur plash[drums.barrNs.kegs. f TRQCY
<br /> ons.oehals,kegs. y CR 95:394-979.3
<br /> Gnlaratera Pllane: f'.09-83®-5059
<br /> rtlal Units to the nearest arts u.s.EPAro m,mhar 711R9011r981??r`
<br /> ry b Iwasfe,Round pe Paa g'SM.°. 1�- SYSTEMS INC
<br /> ed bnxea,the Wmf quan tY°
<br /> le raporl4uanlihes wkh predslU^. i.Tmnaponm2CampnnY Neme us.EPAID Number
<br /> r trot soar d-1111 ler tradions-To Ne eklenl Pracbral.report quantities
<br /> 001""
<br /> na d ntaa5llre mal call(saow You til acwrale .y
<br /> stared should be based un uOru'l measurements or aasobbfo s esumates- j t
<br /> ad apnlainer caPeaibes era oar accepts aOeslFnatetl Fanky Name arca 9naAaaresa as.t:FAto Number
<br /> algvabMles Shipp I'LF.AN HAROUR9 5AN FOSE
<br /> the unHd 1921 BERRYESSA RUAL
<br /> 'Sum PA^sMhdyDluma)le abbreviatlOn tram Table 11 lbelDw}fm $11I JflsE t Gtl 9x.1.3-i (:pL�Qt59484312
<br /> led bones,the apM°Pns a 408-441-9966
<br /> 'Wily"Phena'
<br /> TABLE n,UNITS 01 FlISIuz bis Meters. 9n, 9b.0.s.GoiDaScaptlpn prc>veieS Fmparsnlroins came.HaaareclaOa,IO Number. lo.cantamem n.Ttlal wwalt t3.wasracos.a
<br /> p=Pounds. HM ane necklra Cmap{a any(} No. Tsps
<br /> PIS only(- T=Tons(20110 PoundsY I OM P 223
<br /> Y=Cvbicverds. o NON RCRA HAZARDOUS WAST£ BULLUS
<br /> sonly},x1 rams} I.Df-:RMS, PETRCILC11/1 HYDROCARHONSI
<br /> (to, W td only be rapaded M
<br /> Gubic Malars.and Cubic Yards sttw Y barges.ens, nls,such as re0 tars,lank Lucks,a ,x, 2 Pdtj%% NON RLRA HAZARDI3118 WA S IF L TUI}i er=; F51'I U 343
<br /> ebulkshipme '^ , (n�ESEU, N!A
<br /> d slate waste mtles to describe e9dt waste soeem identified N Item
<br /> nlered here.in
<br /> I redundant with laderel codas must be of the s
<br /> fare no most repreeenraove or the Properties
<br /> codes which are
<br /> alioR Lor I
<br /> st'r Cions and Additional lnldrm infermabon rtecessaly a
<br /> ao°p° aaial handling or shipmOPhspaaific sor other ,
<br /> a ty sP Lying of ma matelots under the 9ntain cad,,bar cadet, +
<br /> � ste profile nu�ns P ce to enter addbdnat -
<br /> a such as vm nshtuenl t4.Special Hand1I InsNrcbwle ana AAditional InlmmaWn
<br /> ca' Also May use 1 1'fiD163 75h7tb527 ;'E2395!
<br /> ler .Oenereto ed materials,such as chemical volume Imus in
<br /> r5 s°ts theIr spec he gravity 01 wastes Idenhhed wilt v c
<br /> ro� tiontorvmch _4 H.r ';e-1y6t8 (SK / Tfil}
<br /> ' s of federalfV required itdorma t.I n 1
<br /> .ani,..rrle'at' limited rope llesl inctuding"Y a- j pfadv,l sSIi and 15. GENERA70R'SlOFFEROR'S CERTIFICATION:Ih-trydedarawalore contents d ihismnsgn,no arab lYand KDYaalyde badabwehyttw proper shiPour9 name,and are ria ifien.pirngea.
<br /> {9a on the final man"for��n leg Waste markeaand la baledlpl—ded,ardaieh all neswa lIMPernern ntu eaneport rdogla appligdle intamaabnal and natiorrel govemrrrenral ragnavons.Il expos stnpmenl antltam the PrimaN
<br /> II�N,e number of the od9 DIP i EipMer.I xonly that he mnwnu of this can gmbent mnfonn wthe terms°t thx attached EPAArko-tauNmant M C.-ot
<br /> a a ifeCond matrI'.and he SIP 6i.7g7.Ganeralors, 1 Icartiry(hat the waste mmimiaalian stalamerrt identified in aO CFR 262 27(N pflam alarga Wanrily generaltlfla{b}Lal amesmall quaNiry gerN.+atorl ie true MbnN gay Year
<br /> �Trt•.aa.'.a�''tra , dales required unde �meel staleregulaM I GeneraNrslOpemrs Pnntedrtypad Name &Far—
<br /> On+mss 00k Ii% r infonmatlon in this spa0e -
<br /> �i r.r
<br /> arL In ill Wemationashpnents QImportIO U.S. DExpad Toro U.S. Pcdolenbylekle
<br /> Sas cartillcalion stalem F
<br /> nimiza �� haven z Transporter srgnatum(tor expona only}: Gale leawng U.a.:
<br /> N[a% to the waste mi �Snere whe °t
<br /> ;s ra4a,yroK' �,e r5 �n �ment,those Ke a waste minimi7abon lZ 17 TmnsporlerAckrwdodllmenlol RerelptorMftWdAsstam 9ev Year
<br /> A^ I.tiTtN� home e a so cerbia that thhey I on also contains
<br /> a Transporter r PanudlrYPad Nsme Signature
<br /> cpn ems Ih
<br /> "I The The Generators Ca ed and Ile to Pic
<br /> � a Signature Manm Ray Year
<br /> 11110 been propel Threpare nt of the shippers Tmnapaner z PMled yped Name
<br /> ,xaa riificabon}. nlents of this a
<br /> tis°11111" declafa Thal theca ler shipping name'and
<br /> ,f 4T'°' ed above by the prop Sds m proper ta.DisaePenry
<br /> .�� 110MPS and are in all resp tEa.Giwepancy lndipli^n Space ❑Type ❑Resltlue ❑Partial Re}ec0on ❑Full Rajacaon
<br /> ,e wt` }plaCaldod,1V and national govemm stents of ❑a liolity
<br /> .ywn' Interrati4partlhatihe as
<br /> "a a+ 'many Ea ITIR", iledgrnent of GOnsent' Mehlleat Rakrereal Number
<br /> F�aa l r.aa rTn ched EPA MICROs.dation,this partyU,S.EPA 1D Numhal
<br /> 'A 5 ppew` the ship"T't tot Iran p en(. 18b Allamale FadlitV Ile Ge+reraarl
<br /> ,t ie�a. _ I as the offeror of the Inthe signature I
<br /> =Un WWI oP
<br /> N' �s' dor to signing the Fadililye Phase',
<br /> yea t`a� Ie blocit p she emPioYae of
<br /> agent Month nay Yaat
<br /> ns as in
<br /> i6c.SIgPalure ofAhemele Faciilry for GenereWq
<br /> :ye,aph a�'T a�E�j wt�, ividual sig 151flaY
<br /> a slg'ture required in Ytem
<br /> 19.Hazardous Waste Report Management Method Solea{I,e,,codes ler he7srdous waste taaorreM,dlapceal,aMtecydlrq eyalems) A
<br /> 7.
<br /> a '
<br /> 20,Di slgneled faculty Orator orOpondoIr.GWOaLWnat receipt of harardous meledalsCUYerrad by the manifest eampt as noted In Ilam 16a
<br /> Month Oay Year
<br /> PrinMdlTYped Name
<br /> nature
<br /> Ei j j 8700-22
<br /> 70022(R119`3)Previous edIII
<br /> eiousedIII are Obsbb l.�835H GENERATOR'S IIN1TIIAL COPY
<br /> JASON GAITAN, REHS Page 20 of 34
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