Laserfiche WebLink
1022 E. Frontage Rd. Record ID# PR0519099 <br /> 8/24/2020 Program: ER <br /> Photo 7: The following uniform hazardous waste manifest(017468981 observed with no signed designated copy. <br /> Ii Pon' �Fora a nedfnaadde Mltell2-ilchllYPewdler) Form ADProveo,OMH No.205"039 <br /> ..µ.•• r UNRORMHA7ARDOUS ro. nrna -0—r z.Fay 1 0 a.111".1 rr77 V ._ <br /> . WASTE MANIFEST t.A L O U O'.:'J U1"465989 1 . <br /> 5 G�nereld0.Nm!aM Maaln9 A21rm Genernofs Ste oeareas IA aifrerenl an rwmry sddesai <br /> •^ iuYt FHVi 10• <br /> WHim CA <br /> rainy Ph— :69 fi9'f}G6G2 <br /> 6.Tmneperhr 1 Cmrgany Name U.S.EPA r9 Renter T <br /> Witti CML Tfj%NWjNMFNfAL 91,WGE2i <br /> T.Tmnspodw2 Cunlarry Mlle U$-EPAW Nemher <br /> f WU14LUWIUL NlcUlrr_Rv SYJIi tiic A I' <br /> ` I 9.OeslprvEetl Ferm'fy Name end Six ADtlmee U.s.EPAIC i <br /> ..730 E 13TN 911 <br /> YUMA AZ %SK38i <br /> Fapt Phone: lx 'it5'Sg44 '1R <br /> rt� 9h.0,s.007 Oeaalplion{IndWlnp Prop�rStripp'Ig Name.NaaanlGass,lO Nemhor, In.Conlainere 11.Toil 12 Urn T3.waste codes <br /> J NM and Packnp Group(A any(} No, Type 0uanary 1M AYi. <br /> 1 h 1n-,i FIAGARDOUS WASIE soi l OILY Si PAPER Flo.IF RSa <br /> 2 <br /> , <br /> w <br /> q � <br /> .. 14.Spacial Nanning In,ir ione and Additional Inforni 1 <br /> _ tB1tHuENGr wr.I�r r ::rflMfrEc s-erxtszas�woesuRnslr�Al. �.. <br /> - - CHI.Y WU[).PAPFft FILIEN'S' `APPROPRIATE PPE EQUIPFAENf _ n <br /> 15. OENERATOR'SICTFEROR'S CERTIFICATION, hereby deGare Ihat the mntan6 of Nis CAnshgnmenlare wAyaM accuralety descn6ed above dy the propel sRrpping name,artl are ctassae4 paceaged. . <br /> marked antl iabelediplacartled.and are in all respects in pmper contlrhon ter transport aconrtling w applicab¢intemadonal aM nafional govemmanW regutadans.pespad shipment and I am the Primary <br /> Eepoder,I carfiN Nal the mnlents of this consignmeni stat n to the(eons of the adaGhed EPAMR—Iedgmant of Consent- <br /> I certify that the waste minim o ije,statemenk dentiRad in 40 CFR 262 2T{a)(t I am a large quanliry genemi or(e)441 am a smztl Wei generator)5 wa, Month Day Year t <br /> GenerdtMS10*r es PnnledlTyped Name Siqnawre <br /> Y <br /> 1 16,inonal Shipments <br /> It— wmaa ❑Impad to U.S. ❑Fxpod hon U.S. Porto}antryiexi4: <br /> Transporter Signal-(for exports only}: Data"nig <br /> w <br /> 77 TmnsporWAcknowsOgmentof Raoaiptai Materials Signature Manor Day Year <br /> a Transporter I PrlMedlTypetl Name., / <br /> d <br /> GTransposer 2 Pnnledrfypad Name Signawre Month Day Year <br /> a <br /> 98.Discrepancy <br /> laa.Discrepanry Indication Space I]quantity ❑Type ❑Residue ❑Prift,Rated on ❑Tull Releclion <br /> Manifest Reararea Nareper. <br /> 18b.Ntemate Facility(or Generator) U.S.EPA IDNumher f <br /> J <br /> V <br /> w Factlie Phone <br /> 18c.SiggalurI'Alternate Fadlity(or Generator) Month Day Year <br /> Z <br /> 2 <br /> t, 19.Hazardous Waste Report Management Matwd Codes(ie,codas for hazardous waste Ireakment,disposal,and recycling systems( :+ <br /> a 1 2 g 4. <br /> 20.Designated Facility Oryner or Operalor CeNifiwlion of reeelplgi hazardous materials covered by the manifest except as ntted in Item 71 111n <br /> Frinlaff7ped Name Signature Month Oay Year <br /> e <br /> EPA Form 8700.22(Rev.3-05)Previous editions are obsolete, GENERATOR'S INITIAL i <br /> JASON GAITAN, EHS Page 7 of 41 <br />