Laserfiche WebLink
800 W. Mossdale Rd. Record ID# PR0514467 <br /> 8/5/2020 Program: HW <br /> Photo 15: The following uniform hazardous waste manifest (018531147JJK) observed with no signed copy from designated facility. <br /> , i�J._.• r .._.. —tea. en.vn urrwsp ._ w n f• _ pSBufaY�yIRCtiNaaIFllRol aiFHVV'F�i aero E..+rr--- <br /> � I <br /> Pbaat.pnnra Gunn Farm <br /> oil 2V5 19 <br /> UNIFORM rUVwlpppra r Wrw.etrAre.rY� g ra ae�vRra�S.-M ae . <br /> wAaTi?IeAa1rFE.ST cwuoaazaa�os ¢ reoo!•1A-swo 018531147 JdK - <br /> `' , a�aas.„ ew�rr..srFeawla aaawa w.,eNote eenq <br /> s uiHgewlon 1,7@ <br /> SOF 3214ai6 U 953J(f 9DD'MOr-+SDALE RO <br /> 92" <br /> �fnr��.� {0533q <br /> 'nlnarorlMENtM SEFMCEa u i p e 7 i 7 tl 3 a 1 <br /> .ra,,,caea,z�.„F wn. arum N,.row �LiOES <br /> 6��'�7 Fao0Yit U 9.EPAIO Nm,9er , <br /> AS I6 SOUTH 5MLL Avi 11C <br /> rP3ANGE1E8 CA 900'sa r,AD 097 030993 i - <br /> Fe Phut (32311277 1 6(70 <br /> 9a 9D.11S.t70F 0.apipann llndtlhp Pmpar 9hlyµq Narlp.NaaaN CWe.IO MarMr. to CaxaNrn 11 Tinel IR.11na 11-V1aaLfMne 70TF`t- <br /> HM enQParhing GnArPllram'll No TYPa OuanOty wtNN. ', I � e� <br /> H ARpC111';WASP -R11 11)t.FPi ASFI 62 <br /> 4 e its - <br /> ' M P <br /> w <br /> 3 , <br /> 4. <br /> 14.SPaOel Handsng N Wctiens and Additional lntcrmason - =� <br /> } F'MERGENCY COWACT CHEMTREO 1-8o6424-9300 WOES TERMINALCERES CS 'PROFiLE M 981 5W)GE1 GREASE <br /> P500-006742.46 N APPROPI'll PPE EQUIPMENT <br /> ii. GENEkATOR'S/OFFEROR'S CERTIFICATfON:I hereby declare Mat the contents of MIs rnnsignmenl are fully and accurately descnuad above by ma pmpar shiptNngname,old are nassifad,packaged. <br /> marked and iabeled/plararded,..dam in all respacN In proper wr lion for hanspon aeearding to applicable intemalional and national governmental regulations.It enpan shipment aM t am the Pn—V <br /> Exporter,I remty that the nonlenis of MTs eansignmenteanterm to Ne terms of the shadlad EPAAck—ledgmenlal Consent <br /> 1 certify that Ilse waste min'rmizaton statement Identified in 40 CFR 262.27(a)(if I am a Iarga quaafily generator}or @I(II V am a small quantity generator)is We. <br /> fi <br /> MOM71 Day <br /> Generaloes0iferces Prinladliyped Name S1gnaWra <br /> Year <br /> `• I haYo <br /> 16. -S <br /> on8 <br /> lntema0al Shents araatan <br /> � ❑lmpori a l7 . xphn from U.S. Pan of enhyla>nt <br /> Trensportersrgnaluipmre(for exports only); Dale leaving U.S.: <br /> w 17,7ranspaderArkrlowledgment of Receipt MMaterials <br /> � Transporter i Prinlerlryped Name Signature Month DaY Ysar '8 nl ' <br /> t tL ! t 4 i <br /> 51 nature Year <br /> X Transporter2 RinledfTyped Name I g Month Day 11wpsta <br /> 79.Discrepancy <br /> � 79a.Discrepancy Indkaf]on Space 0 Quantlty ❑Type ❑Residua t—1 Partial Rejedian L�Fult Refection <br /> Manifest Reference Numpar'. <br /> U.S.EPA 16 NumLel 51C <br /> 196.AJtemale FaGlrfy(or Generator) <br /> ll abide <br /> J <br /> C.7 rnUon <br /> FaciliVs Phone; <br /> / ontR Day Peet <br /> L 18c Signalure ofAflorl Facility{ar GeneralM <br /> Q <br /> 7 <br /> 19.Hazardous Waste Report Management Method Codes ii e.,codes for hazardous waste treatment,disposal,and recyCling systems) <br /> en <br /> G 1, 2 4' <br /> �w <br /> 20.Deslgoaled Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as nded In Item ilia <br /> Pnnfed/TypedName nature nth am <br /> EPA Form 8700-22(Rev.3-05) Previous editions are Ddsofete. GENERMOIR'S 1N1�lAL CQR4 d--,.—s <br /> I� <br /> JASON GAITAN, EHS Page 15 of 21 <br />