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15453 N. Thornton Rd. Record ID COOESU50E <br /> 6/13/2018 <br /> PHOTO # 10 <br /> Manifest for the oil. <br /> par,hi lyp—,M, FIrIn APW^.red)MB Ne C;i`ir Sri <br /> _ ..UNif(NY I I A:ARI1M r,••�I„ > .I�llx-nNr r fue rP�..y.,Iw Nue a.Yan iruYhp mMr <br /> WA51[MANIrEtI 01.7 1 7 001 JJK <br /> �' `� •. � r n•nlnn.s.afrn..wxrta•.nasnq rMrevsi <br /> ---_-r " it li EPA ID NumMn • <br /> U.5.EPA ID Number <br /> . .i C r.4xhgr Prnp Iqemq Il.un�.ia:aM CUss.0 romax7 10.Cnmarers <br /> 11 TaW 12 U. <br /> NO Type 0,-wv YATN '.. . <br /> z <br /> c� <br /> w <br /> yr 4 <br /> 11 Sp"nial HaMfmg lnalnKlans and Additional Information - <br /> Ii. GENERATOR*WOFFEROR'S CERTIFICATION:I hereby declara that the conlen5 of this c fgnment are hdly aM—ready descrited above by the pope Shipp,name•aid are ckssr.ed,packaged, <br /> marked aM labekrlfpla-.arded.and are in aA respects in poper condition for transport acmrdirg W appAW tela Mtemaeonal and n.bonal -Nal,g,,W,.II a Wet shipment andI P <br /> I pwer I ce rly that the coolants of this consiam de mnary <br /> gnment dn <br /> cmn tc the"S of the attached EPA AckmMatlgmpnt of consent <br /> 94q,, c-fY eut the walk—rrk ten V.W,hara 0.nWd in 40 CFR 26227(.)(if I am a Jaye quantity generale)a(bl(,f am a small qumdty ganaramr)m true. <br /> xre WerOdeofs Pnnted'Typed Name Sgrotun, <br /> Day Ye r <br /> t c.Irua'natianal SlapmaMs r , f <br /> _ ❑Impnt to US. ❑Eapet hom U.8, Pan of anayreee- <br /> Tanaporer sgnature(tor espons o*; <br /> Gate kavag U.S.- <br /> �' 17 T nspanerAanowkdg ReaWlMMalelWs <br /> T. <br /> 7 Prmkd?yped j _ /_� <br /> z Transpunerl PnmeNTyped Name <br /> SgnaWre Alontb pay Year <br /> l16.Dnareparmy <br /> I86 Dluvepancy Indication Space ❑Ouanw ❑Type ❑Rukkre ❑Parted Rejection ❑Fug Rejection <br /> 18b.Mhemale Fadlily Ie Generator! MaMeal Rekrenca Number. <br /> U.S.EPA ID Number <br /> v <br /> tai F6cllityxa Phone- <br /> 18c.Sitir broof te.81e FacYity(or Ge nW) <br /> 4 <br /> Mo th Day a <br /> 19 Haaardtua Waste Report Management Method Codes(I,e.,cod.for hazardous at.Treatment-disposal,and recyding syele-) <br /> 1' 2 7. <br /> 4, <br /> 1 26 Oe9igna ed Fn dy Owner or Operator Cemfication of receipt of ha7aldous mmmra7s covered Dy Im mandest ea apt as Mad M I em 10a <br /> do yped Nam. <br /> Sigretu,a Mcnth—50y" <br /> EPA Form 8700-22(Rev.3-05)Previous aditlons are obsolete, <br /> GENERATOR'S INMAL COPY <br /> John Alaniz, EHS Page 10 of 13 <br />