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1022 E. Frontage Rd. Record ID# PR0519099 <br /> 8/24/2020 Program: ER <br /> Photo 4: The following uniform hazardous waste manifest (0 1 8529257JJK) observed with no signed designated copy. <br /> PI"a er prnl Ior teem aW 1}plMr Fum Appraeld,OMB W-20SOMM <br /> OMIFORY N42J us r Goman IO MrnOn Z �JJ <br /> 1 1 - <br /> WASTEMANIFEST S.1 .8 23`G,J! K <br /> s arw.v,x„,e,e M.rrweae... cre.aw.s�cm2„Ia mn,am m.,.m.a�,a am...r P <br /> pn�. Iw <br /> ' - - B T ��aa[[ ��r�E�1y��� 115.EPAID.NwpGei <br /> t us Eml Numem y^a <br /> 6.Dear AfNT"8'N AdMaN US EPA ION—, <br /> y E1JrIM 4MEE7 <br /> F— phew <br /> 9e Ob.ll.s.oGT Dee.+wtlpa[abr�'q Preps Shbprrq Nana.»uaA t]re,iDNraribw, ,a.Genrenen n.inrel 5z.unn 1]NYsb fable V <br /> HM -a Patldng GmuP(4AMll No Type oeay Yn�Vnl <br /> „,. rr1VT4rR:1CA/41LAhtUIaU�:ww as FE.WUU MLY 5000.PAPER FILTtiCJ! <br /> O _ P <br /> uw.r.. <br /> IN <br /> a C <br /> s. <br /> 9r <br /> a <br /> niw(waaq.erd.e�i�yar� - t<.Srad Handfilrg nshvclpns enaPAeltlortarlMorrrNtloll <br /> rso-Addr tir�til ai pashf. LMtkfaEWGr f,4JM1AGT GjLI14M:C 1-80D,424iJj,A;ww Il.timli4AL -11kL,l LLL.e:'.d,1 U,i, L!'i 1rr..N1t1AIL <br /> PROTECRA EQUIPMENT <br /> u❑ 15 GEN fRATOR'SIOFFEROR'5 CERTIFICATION:Ihemby declare that rhe mneerds orlhis wnsignmenl aro%Iy and a avrately tlesaihad—by"proper ahlppug nems,and are tlassifietl,wctlaged. �� <br /> .u.,, ,,, marked antl labeled!plaraked,and are in ell respects'm proper coMaan fa Vanspataxonlingm eppli�ble intemetional and national govemmenWl rogaWdme 11 aspalshign-A. errs rhe Primary <br /> Zmrer,raidI Nat the xrter,I—cgnmentrAnfoan W the terms tithe atlaohed EPAArk Iedgmenl oreataeel. .. <br /> r porpry dratthe M.rrxnimixallon srarement id� ed in M7 CFR 262 27(a)(fl em a ec9equantity generatar)or(b)(llama small quantity genessWrl 1s Wa.' <br /> 3eneralorW0remtla PnnledlTyped Name Signature MI Day Year <br /> J <br /> 'Tae <br /> 6.Inlemahonaf Shipments <br /> i ❑Import to U.S. ❑F.'4on from u.s, pod M Bnayrexit <br /> Transpoper sgrtaWra(for expels onry) Date leaVing U.S.: <br /> W17.Transporter Achnowlatlgmenl of ReaeaFor Materials <br /> Transporter 1 Pnn a rrypad No 8ignaWm MOmh gay Year <br /> r] <br /> " a <br /> - - Q Tmnspater 2 PrinledlTypad Name Sgnature Mash Day Year <br /> 18.Dlscrepenrry ' <br /> 19x.Qiscrepanay mdlcalmr,Space ❑Duanaly 1-1 Type ❑R-doo ❑Panic!Rete d an ❑Fua R.Ie Jwn <br /> Pu <br /> blandest Foder mos Number.P. - <br /> - --r- nr-::S•—;-+,;,r r��ll%F'_r_?ed� I 11 qa rma,.' 18b.Altemals FadM*(wGaneralar) U,s.LPA ID Number <br /> C] <br /> LL FacliiVs Phone. r' <br /> Ida.SignalursofAllemale Facillly(or Generator) h4onrh Day Year ' <br /> r.dr.:��,o w,Pyuasvcu a— <br /> Wha�mN.i! . Q <br /> Z <br /> 19.Hazardous Neste Report Management Me81ad Codes(ha.,codes for hazardouswaste IreeI disposal,and mayclIng systems) n <br /> . r0.. r I 20.Desgnaled Faality Ower or Operator:CeMcatzn of racelpt of hezerdoua materials covered by the mandesl except as ntled In Item 18a <br /> J !FI Pdnledrryped Name Signalure Month Day Year <br /> (� EPA Form 8700-22(Rev.3-05)Previous edilions are obsolete, GENERATOR'S HTML COPY F <br /> JASON GAITAN, EHS Page 4 of 41 <br />