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1145 West Yosemite Avenue PR0527587 <br /> December 18, 2018 <br /> PHOTO 3: Uniform manifest 014057891 JJK found without a si nod off co from the designated facility. <br /> ip <br /> Appr..O.OMB No.2050-0094 <br /> p b« <br /> m— Goner„Inns aIle AtlUresg m d�nme�l Ihae maillno 14 0 5 7 8 911 JJ K <br /> :`09 ei_dll n •.� L.0. W 114"i Mill <br /> ',A ... <br /> ?TranWiW 2 CBmpany Name <br /> IU.S.EPA ID NumGar <br /> 2000 N AIAMEDA St RE E 1 �L <br /> CiAMPTCW 4,a a” U.S.EPA ID Rumba, <br /> 9tys Prune: f 310)33 7-72 W <br /> r;ATq sou, <br /> 96.U S DO7 DesnipWn/()'tlWiy Proper ShipPirg Name.Ha.'Class,ID Number, <br /> ntl Pach'rg Group l�.-))) <br /> 10.Ccmamers 1 Total 12.Una <br /> WATER),3,P©III No. Type Guanoty Wt NOL 1�.3�Was�teCotles <br /> 'a�InstnH�ons andtlddiponal Lnforma6on �—� <br /> ��47 GD'IMTAICT'CHEMTREC 1-8C*424-4 I <br /> `AI�RIATE PER3U 3 xi t1AE Rear;iC➢7 ]:f8'=F`ktIP11_t p;aE1 .',S*,04.1 ra <br /> NAL PRCirEC71HE F<JUiPMFlJr A:,tlLdtlE.pltSEl <br /> 170FFEROR's CER TIF IC all res 1 hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,arca are classified,packaged, <br /> led/placalyed,and are in all respects in proper condition for transport according to applicable.international and national governmental regulations.If export.shipment and am the Primary <br /> that the contents ofmis consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> este minimization statement identified <br /> in 40 <br /> CFR 2ti2 <br /> nted/TYped Name – .27(2)(it'am a large quantlN generator)or(b)(itI am a small quantity generator)is true. <br /> Signature <br /> is _ II Month Day Year <br /> Imlwrt to U.S. <br /> ex ❑Export from U.S. Port of ertry/exit <br /> �aterials Date leaving U.S.: <br /> Signature <br /> a _ nv Month Day Yea <br /> r; <br /> Signature <br /> Monlly Ye <br /> V <br /> 1111111 <br /> Resic'ue ❑partial Rejection <br /> ❑Full Rejection <br /> MM <br /> ManifestI <br /> VumberML 11 : <br /> `'" A1�Number <br /> i <br /> i <br /> Lydia Baker, EHS Page 3 of 5 <br />