Laserfiche WebLink
3460 Naglee Rd. Record ID# PR0527345 <br /> 11/20/2020 Program: HW <br /> Photo 31: The following uniform hazardous waste manifest(018531276JJK) Observed with signed designated facility copy. <br /> Phase Prins q tyre(Porn dealgn }or use on el'ile(72-Pilch)"Ole, <br /> Tin Appmaad.OMB No.2050-0079 <br /> UNlFQRM HAZARDOUS i.GenmbrlO Numbm - 2Pag01 of 3Emeryera,T RnlAnea%,me a.Mmlleal Tr+ch4rq qJJK <br /> SIFEST01 5 316.Tnne-W1C—i Name. US,EPA IDNumber <br /> WONLDOILFr, DNMENTAI1 �.. CM1D028^'7e end Sas Add— U8.FPA iD Number <br /> YES MMM EMEM.BIC.660014M10NWAYB6rami 'Phmq:YUMA CA $ AZR000621 <br /> 9a �U.S DOT Deecnplian)mduangPmper Shippina Name,HaiaN Class,[O Numller, m0 CanM— 11.Total 12.UnA 13,W8ale Godes <br /> HM dM Pecklrg Cvn Vany)) Na. TP. Quantity YAW <br /> ea- tNOF'LltCFEA 41"ZODOUS WA5TESOLID 404LY 34110,PAPER FMEFZ4) p - <br /> w <br /> z <br /> PEP <br /> ,4 Gpe HandlinglneWcbon. Adomerallnlomlauon ' S')15C�4- <br /> EAEEwvwcONTACT:CNEMTREC 1-BOD424-9900 WOES TE11MINAL PROFILE tR 9E1.O rPF CERES `ADDITIONAL EPA <br /> ODCd__�:r fills!"AKRO/�INTI PER90NIIL PN[+tECf11f��QUIP1k[HT ' <br /> IS GENERATQR'eA7FFER0R'S C11TIMIATIDN:Thereby deUare that Ne mnt6n<B al lh4—aignment are rally anda¢uratety aescla MCGoue by the yral>Br shipplrig nmre,aN ere classified,package7, <br /> markedandlabelediPlarardai and are inau wipols in preper eonaiaen fIX t,anapod acwrtlingmapparahle'mkemadoralend naacinal goremmenade deaone.H enad,r pmeM end Ism the Pmnary <br /> E.pwter.r cemry Nat fie OonlenLS of mid Wnsynmam mrdorm b the terms of me artarhed EPA ACMncwledgmeM d Consent <br /> I salty <br /> "he waste minimization stdtament identified in 40 CFR 262.27(e)(it I am a large quan4ly Senator)or(b)(P I am a small quantity genemlor)is 1nle. <br /> GensretoYslOflemis PnntadRyped Name SgrlaeAe Month Day Year <br /> 10-h1ar nonal Shiymmla <br /> ❑Impartm U.S. ❑ExpptRom U.lit Pwtol enlryle+ik <br /> Transporter signature Ifo,"Pons only): Date leermg U.S.: <br /> w 17.TrarrepwtarAcknoMadgmentof Receipt of MatariaLs <br /> O Trani 1 Plmiedlyped Name Synaatre n <br /> Moltlh Day Ye/as <br /> tl V I <br /> Za T,au�porlar3 NaeRe SgnaNre Month Day Yi ar <br /> Of <br /> te.nec eparey <br /> 1ba.fNaaepancy lrMicaOon Space ❑Ouanllly ❑Type ❑Residue ❑PaNaI Ra)apion ❑Fualre actio, <br /> Mandast Refalance Number <br /> 18b.AllemeM Facility for Generatoq US.EPAIDNumber <br /> J <br /> V <br /> LL FadlfNs Attune: <br /> w }&Slpnalura OtAIlemate Facility(or Generelop <br /> a _ Manlh DayCD <br /> vent <br /> z <br /> 19.Hazardous Waste ReportManagement MMhed Codes p.e.rode,Nr hazOrdpue waste Irealmenl,disposal,and recycling systema) <br /> t 2 3 4. <br /> 1 I>> <br /> 1 20 Designated Farillry fMnercr Operator Cartfrcatwn of racelptol haz9rt0usmaledalsc a ad by 0,e mari except re nada in Item ME <br /> ills Pnnledlfyped Name <br /> Signature Mmlh pay Ycir <br /> I � e <br /> EPy;F0RR 8700-22(Rev 3.05)Previous edlUOTTS are 6bSi GEST NATEO FACILITY T6 GENERATOR <br /> JASON GAITAN, REHS Page 31 of 51 <br />