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711 W. Grant Line Rd. Record ID# PR0514334
<br /> 3/30/2021 Program: HW
<br /> Photo 6: One signed uniform hazardous waste manifest (0 1852926 1 JJK) observed on site.
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<br /> PERSOWLL FROTFCTNE EQUIPMER(
<br /> 15. GENERATURs1OFFEROR'S CERTIFICATION:A he,eny deFldrB Ilial Ina mntente of Nis consignment are frilly aM aauralelY deunbetl above 4y the preper shippi,q name,and are ciastiaetl,pachagee,
<br /> —a and IabefedlpacardeQ.and ar—all—pe h In pmpar mndiir for aanspwl acmren,g tJ dpp,b.,a_honal and national go�emmenFal reguVatlona If erpoR shlpmeM any 1 em g,e Pmnary -
<br /> Expener,lreroy mat the wnrenls of Nis consignment oust mNe terms of me aeachea EPAACNnmrdedgment of consent.
<br /> I®Nfy NBt ale wesla mirnmizahan&Wr,,a rW,,ehad in 40CFR 252.27(a)(if I am a large quantity generator)alb)(IR oma small gbartnty ge v-1mr)Ia Wa.
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<br /> rY }7.T+ansporterAdurowledgmenl ofFecelpl of Materials
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<br /> 19.Hazardous Waste Reporl Management Method Codes(I e.,codes for hazardous waste Irealnlent,disposal,and 1egdIng systems)
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<br /> 20.Designaled Facility Owner orOperaroc C&,McaWn of rawlAl of hazardous rnalenels covered by the manifest accept as ntle in ilem tea
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<br /> EPA Form 8700-22(Rev 9.03)Previous edllfons are obsoio. @SVGVrED FACILITY TO GI_,< R
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<br /> Print Name do Print urnver Name
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<br /> JASON GAITAN, REHS Page 6 of 6
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