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1000 S Aurora St, Stockton Record ID PR0514266 <br /> 7/6/2020 HW Inspection <br /> Photo 10: Designated facility signed copy of Uniform Hazardous Waste Manifest (UHWM) number 020421477JJK (dated 8/1/2019)was not found on site. <br /> ",- role—G¢iirorNa Environmernal Prelecnan ngenq Oepatlmenl eaTwac 6ebal9ec9��gralrnt <br /> I <br /> PfeaeP pria[0l NAB l <br /> Farm APPrnVedOMg No,2051)-K30 <br /> UNIFORM HAZARDOUS rEenermgr ID Nunder a.pagelo[ 3.Emerpervy RespenseP ne d,Mm Tmsking Number <br /> WASTE MANIFEST C q p f? 7'q 4 s1 5 0 7 4 1 n�-5c30D 020421477 JSK <br /> 5.Generators ryame ens Malling p dn— <br /> CAA 1 <br /> bane Msblag4 U8AClHpgpy� ca�a�mr9 s.t � rdallrerera can malllry aatlreae} <br /> 6006wRls g1 1 <br /> S1bcltfoTs 88206 Iwo.&.Aurors 81 <br /> ceaererersphor,e: 5 1 0 4 1 2 9epelrba CA 95M <br /> fi TmnsPnrrarl ec�mPenv Nema 8 3 0 4 <br /> ,iIW�pflF11Brl1R1�Dq�1�C9 uS EPA 0Number <br /> znarepener3 company Nema C A R D 0 0 2 1 7 6 1 3 <br /> US,EDA IO Namber <br /> 8.Oeal9na�tl Fxiley Name and Sita Atltlmse t1.5.FJW rD NurrOer <br /> P2w >3MYIc�s.Ir>i.Msaar17H10P� <br /> 180 ,. <br /> dOamYlpbrl <br /> CA'92316 <br /> ami'swane:50Es 421. 2 C A 6 9 8 2 4 4 4 4 8 1 <br /> 98, 40,H s nor nes,ap FWd Ug Ptoper�ipMrg nerve,Mazy J Gbss,IO Number, lo.Cpe�al 11.Trial 12.Unll <br /> HM -Pala G 13.Wash Coaes <br /> roup)Ir Brry}) <br /> �. TYPa /Ouattily WtNd, <br /> WBDACRA a wr.w sora lAbsorbam cox TM!oro 0 !2 352 <br /> w <br /> w a <br /> 3. <br /> a. <br /> 14 Specht HandrmpinsWagona artd Additirna'Infppne5on 7 Co1Y W/0Y•1 7206 7(S s �� <br /> 15. GENERATOR$(OFFEROR'SCERTIFfGATION; Nat the Wnlen6 ollhlswrdgnmedare lunyantl aquraWly tlO baa Shrne by the proper sMppingname,ani an;dassified,pardaged, <br /> ."daPd Iaheledlplsca,dd,and_Inag_N.m Prater forlransporF—dinj to epppf&hle IrdenA—I.and national govern I.1 iegdadms.It P,d shipment and 1 am 1,Pnmaty <br /> Exparler,I.a*jr at dm mnlertMhrsmnsigntrentmMOmyto Mm ostmsM tlu altadaM Idu.96,1 <br /> I renIFY dtat the_SM <br /> mininN2aepn s4leme,d ldenefied to qO GFR2U271a)Illi eros 1.7 quantity generalur}p(b) eros-5 qu."genesa Is true. <br /> G etap�l°"em's PnInladRY tl N SignaWm- McnN Vey Yeaz <br /> „t 16.Nlertta4pna SMpmente <br /> U <br /> Z— Transporipr SiAnahore(for export rnl❑1mpOrtA U.S. ❑FRwrthom U.S. PMNeMryfS <br /> YJ- pare basing U.S.: <br /> O:a 17 Tr Wod¢lAdarowedgnwydof Repefplal Maladats <br /> T:Tr I Pnnctl/Typea Namre� Sig IVM p0.y ear <br /> 51, <br /> Tranapormr2 Prrnled/Typad Name SlgnaNm Manth pay Year <br /> r <br /> ]8 Rtsaepancr <br /> raa.IhsaepancY indiradvn space ❑puanllty ❑T ❑Reeldue <br /> YPe ❑Pagel Refacdan ❑Full He]ectien <br /> Mandell Reference N-bO <br /> 1EU.Alternate FaciOly(o<Generebr) 0.EPA ID Number <br /> J <br /> V � <br /> Facgilys Phone' <br /> 4 18c.Srgnal"onAllemale FadXly(ar Ganerbr) IApnN gay Year <br /> Y <br /> H19.Hazardous X.M.Repm!Menagemenl Method Codes{I.e.,mics for hazedoW walla treatment,dispasal.and recycling systems) <br /> 2, <br /> 26.Designated Fadllry Owner IX Operator',CeNllcagon 0 recalpt ofhazard0ue msledals t Imd by the man AM except as need in Ilem 1Ea <br /> Prin y Nallle signatw Month Day Yea! <br /> EPA Form 8717422(Rev.12-17)P19VIOus edificns are Obsolete. GENERATOR'S INITIAL COPY <br /> 1� <br /> John Alaniz, REHS Page 10 of 23 <br />