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1022 E. Frontage Rd. Record ID# PR0519099
<br /> 8/24/2020 Program: ER
<br /> Photo 6: The following uniform hazardous waste manifest (018529249JJK) observed with no signed designated copy.
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<br /> I UNIFORM NAZAROOUS sF 1
<br /> Yam ioreem ss"sM er,a Ara app =4 MANIFEST
<br /> of mntoiner F_CGHTPINERs [r 5 f a1pYS NemeaN Mainyf ms �nr�Eore SM Addrs55 iR 3ee nb maiMgaEdreeal
<br /> 7AelF+_TYPES O DT,Dram wd: bprmis,eM -.! ,
<br /> or Plastic bags f7Lk=Wooden dn+ma. � ~
<br /> sN,paper. y cases. HG a Hp Peer ar 9¢ra¢la cos
<br /> Ire sd ra�pns allndudma 1
<br /> TG-T111 rs's nera�Y.Pn«m: d
<br /> dDns-WseS Tp,PnrWdk tent. 6.Trwppfa+l DprgaRYNeme U.S EPA 1D Nurthr
<br /> bones.ce y7=Loy°tanks lYnk WrYA) W.��•.r.�>•"II !r1Y'li-.��':`Rl r,l..l:.;l lr•. .I•.� 011 C11718.'� I ,
<br /> d or pmsu¢dmms.aa'r¢U.Y°� r.Tmmpndm2P rr,peny Name U.S.EPA ID Nwroer
<br /> anat.kegs I
<br /> mraryoth. mel anti 6a�e of B.pe.�na�tlF4I6Name erttlSllenddross IISFPAID Number
<br /> Iwesla.Rama Pa nMe YLIItirA L!f LLL
<br /> 7ap[e6-maIntal
<br /> mots or trallons.To10�de4wn°Iw' �pCr¢aa
<br /> „premar den 2Ta(7 111 STH 3Tr7EC I ' 1
<br /> °n reasoneoh'
<br /> nils clmeaserey ,d or BClualameasurmRen�a pma,85 esbr'netea YIIMH Ai
<br /> nem,snpultl Pa I'as�nraner ripetlbae¢ren (32844-BB[R
<br /> nor. eacm's Phone.
<br /> (Weg„wRwmei able 11 @slaw)la the conof 0contanes Dal 2URI1
<br /> ak edbrerioGpa fmnt ga abd P.*OTOasailraal(ndu9q PrWM5hlFPhr9 rdanM,Hazard pass-Ip NumL9r, 17 Waste codes
<br /> I boles.he apAmp^ 9/{ HM and PetdJrq(Pra,p dfarM}) i:o. TYPe Cuanbly WW¢I. •�
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<br /> II Tans r1aU0 2
<br /> renlYl. Y-Lahr[Ye�ds 2.
<br /> 11000 i<aogmms) Cluj
<br /> 1.d Cnaa red dem,NrrF WCka.m beGgas yf
<br /> runs.Cubit Meters.end Lub'w Yards should oNY Pe 1pp0�tl n•
<br /> large Bulk smpnlen
<br /> %Paam..I inPiro 1 4
<br /> desc6be ee[h Wasln lamd hen,h1 1
<br /> 31 end slate Vrdsle CetleS W m f NPraSe
<br /> derel p�dps must b0 en ae o1 die
<br /> ps Ilial are nal redundeh}WI nlatira Of me prep'
<br /> !I Wa51a codes WhlCn
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<br /> and AdOd^Phal lnbrmeBou .. ti
<br /> hg Insrnrl on r
<br /> r lradring al kla Materials a arms rimes.pv pydus,
<br /> eprocessas.soar ea Wa W"I "" so air aadrbanet 74.Special Handing insirvclione aMAddti¢n I lIVITIT on
<br /> mrmnem.paner¢lars d m.wRUG.earn as premrrd
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<br /> MweatestdedWWWit"y° xmi><i^ PEPS0INAL1090TECTIVEEQUIPMENT
<br /> r9un abhor Mair dly, - i
<br /> pl orale,m sPe� rrda rot wh�J• -
<br /> ed tp re0ard i!mlmd NPeS°f�eratly regrdred gy sh'11L Lname,and are dassR d.Pack
<br /> sand 15. GENERATOR'SIOFFERDR'S CERTIFICATION:Iheraby dadaremal e,a conten6Mlh'u m�ignmem are h,IN arts act rat desrpibed aCove by lha 4roperng aged• ,r e
<br /> ee pnsvrtleden the menllesl mandies!foriele - marked and IsbereNplaCarded,and are in an respects in proper condition Mr transport armrding to applic�Ge inlematnnalard national go%mmental regulah°ns.if export shipment ands am the Primary '* r
<br /> spa akin number ofV1e x691 ecification ofPG9.85� Foden rIoerery that the o°ntants ofthls cnnsrgnmenl wnPormt°ule Whersvfthe attached EPAAckrwvdedgmeat of Consent. r
<br /> ranges!Ga g vilest,and The sP 16S2E7 ape
<br /> shipped under a sewnd ma 4U pcq to r I Dandy that the waste minimization statement identified in 40 CFR 252.27(a)(if t am alarge quantity,generator)or @y lilt am a small quanbty generator) hue.
<br /> -8 Wlgd ull,i°e dares nt> rtlhirs spam to meat slate reg - Genamlor0ffen°fs P6hted,7yped Name Signature Month Uay Year H
<br /> required to errterlinfarmaUo
<br /> Izaflan�F4Cagon stidar,,L IT 16.International Shtpmenra
<br /> mfs C'+eYaffcnlpns r� ❑Import to U.S. ❑Frpa6fiom U.S. Dat aa"ing U.S..waste minim a orators wdld naYP = pale leaving 115
<br /> read.sign.and dateremenl.moss g a welts m`nrn'IZa
<br /> °n Transporter sgnamre Ifor eaports Doty):
<br /> ineTlUa4on gaNPca!ry@1 Ne duN Fp make complied. W 17.Transpo6 rAcknevAodgmenlof Receiptaf Materials
<br /> ;tarots or
<br /> reg'
<br /> to Ilial may ha+R rr7 SignaNre Month Uy Yeal
<br /> ,"bon 3 r reg'oI RCRA are also�fihh^q f c30onmn>zmslhe Transporter)Nriledryped Name
<br /> ants The GanarElors Ceri�'antl is In proper p
<br /> nizadon re"Imm prepared ire ship➢ars
<br /> ant has 4eeM1 prDPer1Y r1
<br /> R7atfhe shlpm ayy,;,anirleaaon),.711a conianl�rdthe Q Transporter 2 PrintedlTyped Name Signature Month pay Year
<br /> Idabun Itha Shipp derlare that the Drilla ams.and
<br /> nt isas follows:I h=rid ablaaA bV the proparshipP'ng° F,
<br /> Y and a 1u ately daec ed,and are ah as m5peets m PmPer I.gist agency
<br /> ne!and IT go'Ian"m^rel
<br /> Igen.marbled and labelatllpiecard
<br /> Intemaao that the vanignFa nt 16a.Discrepant Indication Spnce ❑FDP Re ecavn
<br /> ,rt a2rnda19{0 aPPbb l]IP°flet'I"ertiry _ Y ❑Type ❑Residue ❑Partial Reyection I
<br /> I am Ilia Prima y IENI ACknowledgmanl of Gareeni' ❑CuantiN
<br /> 1 shipment and Ration.Uds Pah)'
<br /> afaml tame terms or the edarh ._
<br /> dt�tits generator prepares 9he sflipment,of Me shipment Manifest Reference Number:
<br /> IlOpel's
<br /> Caton statemenl as the OHerD nature U.5.EPA1p Number
<br /> 'On behar of in the erg 18b.Nlamela Facility(ar Generator)
<br /> dol Ne wobs'bladi PhDr l0 50gainp
<br /> rpersonnel may PSP natun'- or ag = ly
<br /> dUB yatame fah,ma sti3 a
<br /> to that the indtNdUSI signs as rile e11t 'e eQi Fadllys Phone'
<br /> ti9�dan,to 1rtdlaa o Month pay Year
<br /> VI regUked in Ilam l5 maY � Idc.Signature ofAllemale FadlilY for Generalor7
<br /> al'I .- handwdpen sg H
<br /> mforfns4nn except tha _ ?
<br /> 19.Hazardous Waste Report Management Method Codes II.e,."Odea for hazardous waste treatment,disposal.and recycling systems)
<br /> Ind
<br /> mer 1, 2.
<br /> 20.Daslgnated Fadli{y Ownerer .Operaor..Certifliation of recalpl or haserdous morale Covered by the manifesl except as RUM in Hem f6a
<br /> Printedliyped Name Signature Month Dao Year
<br /> ' EPA Form 870022(Rev.3-05)Previous editions are obsolete. GENERATOR'S INITIAL COPY
<br /> JASON GAITAN, EHS Page 6 of 41
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