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Wool 111111111111111 <br /> IWARMIUSt.Generedr fD Number 2. i of WMEVANFEST 3.Enrergertcy Phone 4 MiMslfest ragtpfg NuttYjer Form ved.OMS No.2050-0039 <br /> Name and M"l (877) 577-669 FLE <br /> Generata"a s+ar Address(sa�erx roan malting ad�ess) <br /> Marshalls # O381 t a1^shalls#M0381 <br /> ( 9i 5-0'392 2429 nest Kettlemen Lang <br /> General phom { 2429 Rest Kettlemen Late <br /> T 1 E4 <br /> r U.S.EPR t0!!umber <br /> t r <br /> z T 2 5000110924 <br /> U.S.EPA(p Number <br /> F ver S stems G R 001 4 <br /> Name Yuma Yes LLC <br /> Yes, U.S.EPA 10 Nurr <br /> 2-730 E. 13th Street <br /> Yuma, AZ 85365 <br /> F s Ptxx,e;r{ <br /> 9 9b.U.S.DOT t9ndudirtg pmW Stopping Nares,Hazard Class,fl) <br /> Number. <br /> HIM art Packorog GroW{'d any)) 10.Congers 11.Toth 12.UrR i3.W Codes <br /> No. Type Quantity Wt Nd. <br /> o !Non P hazardous waste, llgUl f (COnSumer i DF 00115 � 32 <br /> 0F <br /> rdtS), <br /> UjjUj <br /> s <br /> 4. <br /> 4 <br /> g1prre arxt Rrw+conal itlonttanon 1. f 338 t GBS State Regulated <br /> Liquids) <br /> I& GENERATORWIFFEROfySCBRT ICATION:1 �e <br /> marked and declare!fret of poptems of the a=d <br /> g o ap are <br /> acct are kr al resp�s in proper rWrdittat transport acewdkg to and above P�Pa< PP�q name,and are classified,pacxageo, <br /> Exporter,t Gerdy that Ore MnWts of this cx r"rom®nt conform to the terms of the attadted EPA ACIcwmadgment of Aahl �nrgtrtations.8 export shipment and i am the Primary <br /> I certify#w the wxGe mitwnirafion staienl Identified in 40 CFR 262.27(a)(d I am a large quantity generahar)or 1 a <br /> genarater)is true, <br /> t �Br>ebxa MMO Day Year <br /> 16.Intel �—t 0e 07 202' <br /> I_1 Import to U.S. El�trap U.S, � <br /> Transporter signature(tor expels ortfyr}; <br /> 17.TranSPOMAOuvootedgmard of Racal of Materials <br /> Transporter i PretWyped <br /> Month <br /> Day Yea <br /> z Transporpr PdnWyped arae 02 07 Oa <br /> Mirth Day Year <br /> 18.Discrepancy <br /> 18a.!Discrepancy kWK3b n Space ❑Quantity Q T (� (— <br /> s —R.6. Q Partial Rejection ❑Fug Rejertinn <br /> tab.Ajtemate Facft(or Generator) Mar si Refererx a Nunteer <br /> U <br /> U.S.EPA tO Number <br /> Fadfity's Phare: <br /> uj 18c.SO tune of Attemate Facey(a Generator} <br /> 2 Month pay Year <br /> H 1. Hazardous West- <br /> LU <br /> aste Report Marragemerrt Metlad Codes(i.a.,codes for hazardous wade treatment,disposal, <br /> p i. 2 recyd'im syswoml . <br /> 3. <br /> 4. <br /> PrsrDes rated Facility O+ww or Operator.Certification reoetltt of hazardous malerift covered by ft ntan i-o e <br /> xcept as noted in Item 18a <br /> Signature <br /> Motdt Day Year <br /> EPA Foran 87M22( ov,12-17) S editions are obsofebe. /+ <br /> DE 1 HATED F ILITY TO EPA's e-MANIFEST SYSTEM <br />