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1000 S Aurora St, Stockton Record ID PR0514266 <br /> 7/6/2020 HW Inspection <br /> Photo 9: Designated facility signed copy of Uniform Hazardous Waste Manifest (UHWM number 016467187JJK (dated 9/7/2017) was not found on site. <br /> ' f r <br /> Fon Appwod-OMB N.2010-00]8 <br /> Please print.,type.(Famt designed Wr u11164,'I'll 112-pitch)IypewNpar) d,Nanlfsst 7—kI-a Number y <br /> UNIFORM RA7JIf[OGU5 I-Cer�eabrY7 Nurber 2,Page 1 m 7.Emergency Response Phone K <br /> VMSTE MANIFE"Rj C A 0 0 2 8 4 1) g p 7 4 reds <br /> 5.��rs��Maung AdtlreSg cnnammrs Sita Adtlmss f f diRamnt Nan m illrrg <br /> 600 39M II1Y 9f �'�'C4N'ppra�pal 9YYrr 1121111 MalwgaR+�M <br /> low B.Awwa Sn <br /> 91 CWft CA 9&-M Stiman CA 96206 <br /> cerrerabre Phone: 6 1 0 4 us EPA IO Number <br /> 9.Transporter)CerrW YName <br /> EY1�YnaMtaeMal l C A R 0 0 0 2 1 7 5 1 3 <br /> I.Trampormr2 Cm,N_ yJ.s.EPA 6 Number <br /> B.Oesymamd FadlYy Notre and Sesl�Uren US.EPA Itl Number 'I <br /> ISO W l4wYY�iva.svk s.k e. <br /> MKW*VhnCA92318 CADS 6 244449 1 <br /> one <br /> F.ay.Ph408 171-2012 <br /> %.1 11,1!5.1117 Oesodaon ynI Propa'r Srygarg Name,Haag Class,In Number. 10-Cella-oars 11.ToFal MUM i3.'Naste C,odea <br /> NM mrd Padaq Gmup laa�Yll Nn TyPe Oianaly WLPkI. <br /> 1NOo11CRA Fy,p1I UIMIa ftW 1AGoo tII C*M 1Yf CM 3W <br /> O <br /> Wz <br /> � JI . <br /> a 1 <br /> 4. <br /> 14.Sp-af Nrir.I ln5W49ons and Addigonal lnrannaloM1 wl 1 YWR 17BPt - <br /> [11, GENERA7IR'SfOFFEROR'S CERTIFICATION:Ihamby declare Nrtbo mnlenlgdYda epnalgnment are fogy and aowralery deealbetl above by are proper shipping nems.ab are classiMa,pacaaged, <br /> marked and label llplacarded anE are N aY rayecla In pmperopndit'pn for 6anspon eccorcYng b eppllr�le inlematlma'am ratlorlal gwernmenW regulauuns.If expos ehipmarrt and I am tlra Primary <br /> EaWrfer I p9rGly Ihe[the canlenle dtlde Oonsfgnment Clhfoml m Iha rarrile dlha af�rJred FyAAdmpwladgmenl dcanaenl. <br /> I-MN trot era N,asls minimins.ala�t Identlhpd'm 40 CPR 26L27(a)PI f am a large qu.dry gagarw)or @1(d3 am a sural q—My gars-I Is 4ue_ <br /> Ganerabr); Eervfs PdMled7Typow Name 1 5lgnetu'e Month Oay Yeer <br /> r IQ lnlamatlonai Snpmanla fff <br /> ❑trgpod bU.S, ❑Fxpa@fmm U.S. Poddenbyama; <br /> TranapoMralgnalma(fa expoRsalJYY OaMf or"U.S., <br /> 17.TrdneporterAcfvmdedgmanlarRecelplclMaI <br /> Tran 1 PdnleMypad Hemp I Slg <br /> `f f/. Manlh Day Year <br /> raneporter2 Pdnled?yglad Name <br /> +a Month Day Year <br /> id-Discrepancy <br /> 18a,Olsuapancylndration Spapa I,J Ouantlly ❑Tp. ❑Resilue ❑Partlal Re on <br /> � �Flill RSJecUon <br /> Idb.Altemela Faullty{or Ganeramr) M-f-M Reverence Number. <br /> U S.EPA IO Number <br /> 'acUit�a Phone: II <br /> dc.SICn Dim pfAltemate Fedlfry(or Goroo ) IL { <br /> Month Day Year <br /> I.Hazardous Rasta Repot Moormanl ageMedbd Codas p,e..CDM IV I'MWOUs waste MMent,drsposal,and racycLlxl sys7ems) <br /> 2. 7. 4. <br /> Designdad FadIU er or Openlor.Cerdbcatbn of reeeipl Of[I materials coveted by Iha manifastepoapt EAdW ,192 <br /> 1 Name Signature <br /> FAonlh !clay Year <br /> 7h 8700-22[Rw 3-05)Previous 261!1/ns are b6s01e1e. <br /> GENERATOR'S INITIAL COPY <br /> ±irr <br /> John Alaniz, REHS Page 9 of 23 <br />