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811 Zephyr St, Stockton, CA 95206 Record ID# PR0539941 <br /> Date of Inspection 09/12/2018 <br /> PHOTO 19: Manifest with unsigned LDR <br /> RODUb Generam:D Number 2.Page t of F—H11—cd OMB Nu.211V.3e <br /> WEST CAL0004MIn a.Em¢rsaa•R¢pee� �¢ .In.ae,.,Track�SNumm, FL _ <br /> ',... ., 1 7Z'ika t <br /> a-1011-1-1E <br /> 9anl)6 <br /> LLC c¢�era pre e>a aemesa l aner¢m mac ma Aa aae:ee. I. <br /> vv Nam <br /> vc ChdnW Trarrpgt AePA./D0A AC7EM7gtp us EDN�mber <br /> ayo 2C UROOOY%SAB <br /> O <br /> E—U—, <br /> Nano¢, <br /> T„/any, reeFaa�rorvamea�aSteAeer¢keusE. <br /> Ph DNumcer <br /> 9cq raw' B 578 ,1;M1es S am NVT33MOM <br /> aha <br /> Ub.0 D D�1 d9 miler <br /> d Class,bM1 ameazard ppnB N ,HIDNumber1q <br /> , .eonla hers „Tt ti.Un, 13.Wasm Codes <br /> aaPadh9 GmuplfanYll pa No <br /> � c P_p�ro.RF 'ItIr <br /> N2G12,tiViWL.lmmw>ra ur�k No. Type °pamty <br /> Nc.am,8,f G[6' <br /> °Sore tt"e ar,mJ?.�o r_�w„,�M"�rs <br /> b s hoa iz�0 o,a 2�Tt w4 hung 4 s� l(CJ <br /> rises /ate, °; x % <br /> ' 'TUy� J aen �{M,a es°yWe °poo„ y 3L/IJ J'(or-r u.,Y3417Z I�.Z2P1=uL.tS,.,v10r <br /> �'S <br /> 'a �ess'M,", t��rrPaiai hblrMs1�a % T - <br /> n hrs. nidM° <br /> oopev <br /> rya d'Ha "D uiul3maoaalelld�[�SzT ?}f �ooruF.,�ci���,: z){r3o <br /> Rrn ���H@°h�sq �fC9 a✓J r ri-�—_]5!C'JIi� / <br /> .n9nh �dn/{ {A"/er ryO w <br /> eJrr dyr dry I5. GEERATDRSIDFFERDRSCERTIFICATIDN IM1erebd IM1al M1e contents of Ns mos <br /> �(r�eiyd� ra °/!he° nC/(/yam °4U;�, maAed antl)bkd Dl tled, tlproper Gondton lorfanspoRattoNn gnmenlare(ully antl accuraleydescr bedabove by the procersli lfn.1me,aN are classfed packagetl _ <br /> �pxdr 9dii, n{ ' ExpoRer.l Nfymlh N IIh gto appl'wblenternal onalantl natonal govemmenlal regulal ons.If export Slipment antl)amthe Primary <br /> d� 9 t nlorm to Ne leans of the etlaMetl EPAAcknowletlgmaril at Canse I. <br /> ^Y �6 P�bgJmdnl�l_m2�{esld//ernd of., <br /> J,, IceNy mam re "'aM10 latemente-find 40 CFR 26221(a)pllamalaryequanfrygeneraron orfb)tflam small quantrygeneralor(-s Vue. <br /> ev, 7µ f�,BpU�/{y°, ,rp{eCr°Ga(y Generabls.OHerofs PnnfeRRyvetl Nam 5 n urs Mon\h Day Ye� <br /> D2.a,AH� amu. v/-J°nrcu'Pdronw s�,s <br /> km �U't aqe y4r° z nanappnersignalnil dDr exports Drily❑hNllcu.s _ -- <br /> `TDt ❑Export from U.S. POR f nlrylexit. <br /> Dal <br /> ving US'. <br /> B �00 fqT�d{wn <br /> OC 17 agmemor Rece�pf or Materials <br /> "M.r� also 7Yb/ e'9ene�lk�f°n Te,epoder l Prinledayped Name Signalure Month Day Year <br /> °ragyy,,ripao s�n9/hvih�e mom a 'a z lassoo T lervee ams _7ri !�/ " �j <br /> 6e."'�/� hyp ami/%SamrOn ¢ Signature Mon,h Day Year <br /> dy�O°nten o{°s Fav nran� ~la.orsoevancy <br /> JJs o f/5"P�J 1 Ina.Discrepancr Indiralron Spare D-4r, II�� <br /> p, I TYPe ❑Residue ❑Partial Rejection I_J F,11 Rejection ` \ <br /> "fiF.rand e�a/!e arhg narRr, � <br /> a `'fArq�A/A.E,nOnar9 ePC1J rnP �"16b.Mlemate Faaliry(or Genemlor Manifest Reference Number. <br /> m t <br /> ` ngf.cn°w/edlhdrr/Ip �/ V U.S.EPA ID Number <br /> fk+ °; 9me !sols <br /> ne <br /> oU 18c 1 9nRS10fafemale FaciO <br /> ^q°k aha/Id{^ Pint � Nfor Generamg <br /> yrsypnD{t°s,n�e J9nayr Month Day Year <br /> J <br /> as <br /> Ih n'ryf+e - 19 Hazardous Waste Recd Man <br /> 6'enp{yam«.. W agement Method zotles(:e..codes for hazartlous waste treatment,tlisposal,and rec clln <br /> y g systems) <br /> 13 3. 4- <br /> .n 10.Designarod F Lry Owneror Operator:Carl fcalion of receipt of hazartlous materials covered by the manifes(except as titled in Item 78a <br /> PMfM/Fjyptl Name <br /> Signalure <br /> EPA""8700-12(Rev.12-17)Previous editions are obsolete. Month Day Year <br /> GENERATOR'S INITIAL COPY <br /> �1 <br /> i. <br /> Tricia Dai, EHS Page 19 of 24 <br />