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3460 Naglee Rd. Record ID# PR0527345 <br /> 11/20/2020 Program: HW <br /> Photo 24: The following uniform hazardous waste manifest(017468840JJK) lacking a designated facility copy. <br /> Please pnnl or type,(Form desgnetl fm use on¢life(72-pikh)typewriter I Fonn Approved.OMB No.205MO39 / <br /> I7til <br /> HAZARDOUS I Ge�nmmr Ip Number 2,vaae r d 3 1"111 ResparoeMma 1,MaeMeat TVIa q Number <br /> MANIFEST f.At OU O 3 a 5005 Ilii"1i 3.'I-i-'.['r� 01j JJK <br /> /a kerne W MnargMIER HYUNDAI IX F18Ae;Y-PRE]48 wall RtyAuYPlnrra: :09 fl'�+4kr 7 Compmy Name U5 EPA ID mamlaaNLU UIL tNYIHONNRENIg119EHYn.2 CampanyNemepnamber <br /> RI.L�WIL'k FrtGUNENY <br /> f.A Rrr0017r.A"" <br /> R.Qesgretetl FaoiN Name Graf SIIe Atldrys u.5.EPAlo Nemhm <br /> fLIMA Tl LLI; <br /> 27.10 L 1:11 H Sr <br /> PUMA, AZ e�jjfa7 <br /> (anti al'nwq: A 7 F7 Fr S l fi.5i 1. i'iA _ <br /> ga 4b.u5.DD7 Qesrnpownlmdudlig proper Shipping Name.Na7ard Class.r0 ftumber. 10,Ccnpiners 11 Tops 12.Une 13.walla Cafes <br /> �w aM Parona Grarp Drany)I <br /> Nn Type Qaanety AdNol- <br /> o ,NuN-RCRA K4ZARIYWS WASTE.SWU I WLe SOLID.PAPER FlL1 t?t <br /> z <br /> A� <br /> I <br /> 7 <br /> 4. <br /> t4-Spenal Handl-ng lnSWCdena andAtldiaonaf l,kmr to <br /> EMEfMENCY CIINTACT'GHEMf l 1.800-424,93W vlVES IERMINAL f;l e1S 'Pill 118811b2623HfW41I 4ti <br /> OILY WUD PAPER FA TF R.S API'l U PPE EQu1HMF_NT <br /> i <br /> IS GENERATOR'SIQFFEROR'SCERTIHCATION:Thereby declare that the mnlenls dihls sonsignmeM are Nlly and aewrelelydescnbetl above by Vre proper shippng name.andareNassAed,pariaged- <br /> mdrkaf and IabeletlfplaCartle0.and azo m all m5pool5 in proper Londltion kf L-dnspal aC[bd'mg b applicable inlamadmaiand naAorraf gouemmen W mgulafions-If esyod sh3pmenl and 1..t.Primary <br /> Eappdar.l certify Nat[he wntents of this wnsignmenl wnbnn to ltw termsd Ne ahachetl EPAI knrnrledgmenlof Coneenl. <br /> rerdfy drat the waste milslatement dl 4n CFR 262211a)le I oma large anendrygeneratmta Tb}{f emasmall quamdy generdlar)Es one. <br /> Generamis101 PMtedRyped Name ,Sirplature 4MonthD-�y <br /> 1G.Intemaaonel shrpal ' <br /> H ❑Import to US- ❑Expod r+om U.S. Pprl0l endylepF. <br /> z 7ranapoAer signalu.e pr eapals only), Date leaving 11.5: <br /> 1772spoderAft ledgmenlof Reapt of Maledals <br /> Transporter i PnnledTypetl Name Signature Transparler2 Pnnledrrycetl Nama Grenalure <br /> F <br /> ♦ 16 Dlsuep,oy <br /> 1 Igo.Discrepancy lydkaNm Spare Quantity I]Type ❑Residue ❑Partial Rejection Ll Full Releclior <br /> Mamlest Rnfxrenre Number <br /> I6b.Altema(e Fedfly(or Generator) II.S.EPA 10 Namder <br /> 1 <br /> u FoOVs Phone: <br /> lec.Signature oFAlremam Fal ly)or Generator) Month Oay Year <br /> 6 <br /> z <br /> y19.aazmdous Waste Report Management Meshed Codes(I e.,codas lorhazardnus warm treatmoM disposal and recycling sgstams) <br /> I 20.Oesignaletl Fadliry Owner or Operator.Cartigralionol receiptolhaaardoba malerlala covered by Ino mendasl except as n0.ed 1n Item 1Ba <br /> 1111 PnnlaNTytaw Name 9gnature Month Day Year <br /> EPA Form 8706-22(Rev3.175}Previous editions are obsolete. GENERATOR'S INITIAL COPY 7c <br /> M <br /> — •.rrre namef �_ <br /> JASON GAITAN, REHS Page 24 of 51 <br />