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4600 East Fremont Street PR0513600 <br /> October 2, 2019 Program: HW <br /> PHOTO 1: Manifest 017549094JJK with an incorrect generator ID number. <br /> usN PAtD 0 8 .� 6 y 6 v <br /> oiPAIDNumbe <br /> P1tl66pow or Form 1e. 2 pitch)1 water. Form Approved OMB No.2050-0039 <br /> Emergency Respon7i; <br /> test Track'ng Number JJK <br /> .."meRDOl15 <br /> tlYllTE FEST <br /> 5 ia+aatrt Nene aa`Maang Arfuro.� Genenbr s Sib aAdiassGMMM Debone6Trenrame f G�mres NemsA ID Number <br /> A ID Number <br /> ADeaFaae l Faaaty Ne ee al Se Addm A ID Number <br /> F 's Priare. <br /> y W U.S DCT Ownpion(nrbdig Proper Shipping Name,N anl Class.ID Number10,Conlaineis 11,Total 12.Unit t J,Waste Cortes <br /> NM adold-Coup ie any)) No. Type Cuantity wt NoI. <br /> K <br /> QO <br /> K <br /> Z <br /> f7 <br /> S—Manclet,rmtrrcbons aid Odd"mlonmatipn <br /> GENERAT0R80F7E`bW$CERT91CATON:I hereby declare gat the contents of this consignment are fully and accurately described above by the proper shipping name,and are desmied,packaged, <br /> 'narvsc as hbaleopia-ded,and ars n are respects in para condbon for transport axadirg to applicata—temational and national governmental regulators.It export shipment and I am the Primary <br /> E"W fm*"Ne IM mrbai dawmmgnwd m9onnb Cre hams d Rre avached EPAAclulowledgment of Consent. <br /> r 4reN es Ce rwi rreer®6pn alaletRrt dea6ed in 40 CFR 262.Ve)(if l am a lege quantity geneatorl or(b)(if I am a Small quantity generator)a true. <br /> Gew°ratolsplfacls prrMNrypee Na+re Signature Monts Day Year <br /> J i6.na-eget green" _— <br /> z instiatb U.S. ❑Export ft—us. Pon of entry/ent <br /> — T'arspnnersq�✓e;tor exlxan only). Date kavirg U.S: <br /> W1?. asporp AwgMepgrert at Recent of MMn* <br /> S re <br /> Month, Day Year <br /> m <br /> 3rmcxee i prated?yced Name <br /> SgnaNre 44x!n Cray Yeas <br /> 1 ,e Decompler"of <br /> •>ia Deomperp k,&*.Sp_ <br /> ❑Residue ❑Partial RepUhn L Full Re(No1 <br /> 18b.Nernee Facility(ar Gmr� Relerwge Nunber: <br /> U <br /> U S.EPA ID Number -- <br /> Iti Fewi,pi— <br /> IM !& drAelaype a3ey far <br /> F< <br /> ogZ <br /> yr�yaeleRepi I-V,men Marta Cadm{�e..�das br narudwk twee traevnrrl. <br /> redid-W end regaling ayseenel <br /> Z 3 4 <br /> 1Ype<1 Pater <br /> a Operal Ceperauordrererq of rNigpgyrrwner paused by b`nom ae+eP!Y n*6 n NNn i8a <br /> Fj <br /> Lydia Baker, REHS Page 1 of 6 <br />