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401 North San Jose Street PR0518011 <br /> May 20, 2020 Program: HW <br /> PHOTO 20: Manifest 020445105JJK found without a si ned off co from the desi Hated facility. <br /> I <br /> 0 <br /> j UxOW�bDl9.9a <br /> �. U.S.EPPI9 Numbx <br /> ncA.dirg Proper Shipping Name.Hasid Class.ID Number, 10.Comainers tt.ioerl 12.Uni\ 1].Waste CMes <br /> '2' <br /> No. TYpe Du VIl Wl Nol. <br /> W <br /> W <br /> C7 <br /> I <br /> 3 <br /> 4 <br /> I.Specof Handling Instructions and Additional Information �� < <br /> 58-7)PRt7FHJ_aF EIRGM71 �t e 5.0CV 9— •� ,. <br /> F,.R L'.OMRACTDR RAMOS ENVIROMbR'_WAL <br /> HAwL.Ep.s SHaAD BE TF'AAED AND LISE APPROVF-D PPE <br /> GENERATOR'S/OFFEROR's CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shlppmg name,ab are classdaed,packa4 <br /> marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and nafional governmental regulations.It enpon shIpmeM and 1 am the Pnma <br /> Exporter,I certify that the contents of this consignment oonban to the terms of the attached EPAAckii ledgmenl of Consent. <br /> certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(d lama small quantity generator)is true. Madh Da <br /> itor's/offerors Printed/Typed NameSig atge <br /> — ro <br /> national Shipments � ❑Export from U.S. Ponot entrylexit._ <br /> Import to U.S. Date leaving U.S.: <br /> iter signature(for exports only): <br /> porterAcknowledgment of Receipt of Materials _ <br /> Signature <br /> 71 Printed/typed'Name a r <br /> J: Signature <br /> r 2 Printed/Typed <br /> Hcy � ❑PafUalRejection <br /> ancy Indication Space Quantity <br /> ❑Type ❑Residue <br /> ManifestRefnber��PAIpN---� <br /> US <br /> Facility ra " <br /> --� <br /> (Altennate Faall4"' <br /> kcal an WWW So. <br /> Lydia Baker, REHS Page 20 of 21 <br />