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3460 Naglee Rd. Record ID# PR0527345 <br /> 11/20/2020 Program: HW <br /> Photo 33: The following uniform hazardous waste manifest (0 1 8530494JJK) lacking a designated facility copy. <br /> •� Porn Appre'+ed.OMB No.2050-0039 <br /> • Akase pfinl o'lyye tFprm desgned roruse Olr eti1el12d1ittlr <br /> —bet PaPala a. ireal-aaru <br /> D�earoIDN�oar � a(1 W p�8530491 JJK <br /> UNIFORM AN <br /> pranne <br /> M <br /> OAL 1 001a7�9300 <br /> •-y WASTE MANIFESTIFEST 000305005 (9— <br /> ���.s$ipa pddeas lNdNfnenl Na�maliiy atld+aeal <br /> 5 Gere+M•'a Name�M <br /> aAeO NA"LFERI <br /> OF TRACY VRE119 <br /> TRACY CA 95304 <br /> Genenlarr Plies <br /> � ,zp9 g2635S0 us ECPA IDDNO2 <br /> 8^7703 <br /> I Tw <br /> W `DO1LYENNm41roNMFNTN. x! <br /> 9E7NICE3 Us-PAtD numter <br /> 7 T-appder2Cp P—`— <br /> -PAID Nohh n <br /> a Despnamd Frciliby Namee�See AdvMeu <br /> YI IMA YEC.LLC <br /> 2730E 13TH 3T AZR00051692 4 <br /> YUMA 147 05385 <br /> Fn.lt,s PAme: (92"4-98213 <br /> 10.aeplainers 11 Total 12 0rN 17.Waste Codas <br /> sa o.uG DOT DesWptinn(nWudeg Repar SNPdr9 Name,HaxaM Class.ID Nulydtlr Typo Cianbly Y4 Not, <br /> H41 and Pacpi�g GmuP lNaryll <br /> 1 fA.:'m Pr RA HAZARDOUS WASTE.SOLID{OILY SOLIDI 352 <br /> o DM P ' <br /> z <br /> is <br /> 1{ <br /> 1 <br /> 14.Spedal Nentlrmg msuud�ms and Additional Irdormatrtn <br /> EME11'WICY CDM TACT:CHEMTREC 2-8004249300 WOES TERMINAL'CEIRES CS MAFRGM 9172 171'PROFILE.M 9P1 <br /> 36-A23PRE148 OXY 900D A m APPROPRIATE PPE EQUIPMEFFT <br /> 15. GfNERATOR'SIDFF5R01i CERTIFICATION:IhMb0 oms,that the contents of Nis—ignment aroNlly and—unrtaly descnbed above by the I-Per anipping name,and o''o <br /> re tlassfietl,paGWgetl, <br /> mah0d antl labered'p�rzNed,and are rn as respects in pmpM WfdleOM1 rprbansport acc Emg to applicable nlematienalantl nalwnal gwemmenWl rggUld4oNa.If eVod snipmenl and l am me Primary <br /> 'upider.r cemry Nal d,e contents of Nls conslgnmenl oanmrm 4 e,a mems o}NB Bdd[hatl EPAACLnpwledgmant of consent. <br /> I aMty It tme warm minimmube summent idMtiSetl in 41)CFR 252 27(a) I am atarge q—Ar generator)or@J(ifI am asman quart*genta.ull Is V11e. <br /> Gene+amrs+ORemfs Pnnledrryped Name squt— Monro Day Year <br /> '3.In�emde0ddl SNpmen[s <br /> ❑Import h US ❑Lapod rmm L!S. Portmenb I"t <br /> a 7ransporte',g-Wre por mxpoft a,Iyt Date 1myng LLs: <br /> �17 TransporterA HmvRedgmenl orReteiptor Mafenaffi <br /> iranspodari Pdnledfrypea Name Sig.Nre Month Day Year <br /> O <br /> a <br /> 7ransporter2 Pnnledfryped Nan,h - I Signature Month Day Year <br /> _ � 5 <br /> 18 ClscrepalNy <br /> f8a.Its-pancy Idduh,Spare ❑YPa ❑Residue <br /> OuanlNy T ❑pardal Releenan �I—li Fup Rete:ion <br /> Manliest Rerorenm Number: <br /> 19d.All-ale Facihly(a GenereWrl Us EPA 19 Number <br /> U <br /> LL Fapldy'sPhone.- <br /> w IBc.5igr,afu7a afAllamare Facrldy(o7Generatoq Month Day Ysnr <br /> 4 <br /> z <br /> 19 Hazardous Waste Repo <br /> I <br /> 'I Management Method Codes(i.a.,codes for haaelddua waste lreafmoni.disposal,and recyclllg systems} <br /> I 20.Oesrgnated Facilily Owner or Operator:Cedifrraeon of racerpl of hazardous materials covered by the mamlosl except as noted m 2Item 1So 1 PdntedfTyped Name <br /> Signature Month ay Year <br /> EPA Farm 870022(Rev.3"05)previous aditlons are obsolete. <br /> GENERATOR'S 1NRIAL COPY <br /> JASON GAITAN, REHS Page 33 of 51 <br />