E. 41h St. Record ID# PR0514018
<br /> 9/2/2020 Program: HW
<br /> Photo 23: The following uniform hazardous waste manifest(000306122DAT) observed lacking a signed copy from designated facility.
<br /> OrnQ_ /kM PMaae Pnnl o,
<br /> ryG,= I1
<br /> WASTE r1 pp<oved pMe�205r`.pp39
<br /> WnSTE
<br /> C✓OsJB7471am e^••u�crn��no. ' �{ �g,y�
<br /> '`O^'m ' lt8i �s r n T�'¢ea "W"6 k r.x,ntma v�m.,. aTTN I?en.n Rmerm O�JU 1.10122 DAT
<br /> w w.arw� Tfn 'aTab � Gm % Lmm+rmen
<br /> �� /e .,ALL La�IrOVr�I SI
<br /> @�g ua�w''crq 'toe+ren��Svan. � r/. eiynnrumRIPen,GA453E6 ,y}/,I, 45�}C-M,�7,
<br /> J ra,_ bn cy klo a T.a,.ao,r rs ry MMR'.'ERI cMOME-c.:ue11Dr187�D003-...f
<br /> ar GaF;000179747
<br /> fgB�F/�� rBa s�"wa°�a �q��a W�q eo^'vn+ma P.ql fMrpr`s,y•••,ERI F7iOME�raI lOR L768-I]002.••• us.caAlolaw�
<br /> UA.jT /4bry� c1O„q'fey Trate _ In+1.m.aae srteAaan,ee 1 CARD00179747
<br /> s 'rr >Bd�arh r-�wnrn tnuro-untyrlla Saraewea UL_e u.s.saAlow.�ba
<br /> °cMEys a°iir ern ' �`S uld F^nrler HA
<br /> 'Y'c URF OE,), ar a. FemiYs -9n JN 4- 1HRMG127"
<br /> po-p ,ya 652 PhOaa- 2- 2240-2451
<br /> ysanarIT'T ergd, tars r""!w 98 sou.s-aoTo.eeplmU„wa,pPraparsmpn�w.,,a.nemda„a,luNempsr.
<br /> /�� -� Y,C X19 NM and PagagrGpep fe nYll 1o.cur{,yi�9
<br /> /Zr Yobs `�krY a11.Tdsl v,UAA la wum twee:
<br /> y�� °62 k1�y �Osl i
<br /> CLEAN
<br /> E Nup}lamrtarsWeYeeSold{UTAr{7µecFUUSLing
<br /> o 41
<br /> 1 W
<br /> s s6a
<br /> /ij d Nye /kMaa,� 4 la TRPp00' ,,&CAba2,Ir&Y
<br /> yepW'p.11111 B Y 6rl n'snr! T rn 3 �i la 11U-050015111e.Wee2rtlaas Y Qj
<br /> wrrbg3, 9&,;s "Q7 - a 1011 Gi?A00sleSSl CJ,�e2ailKe Y
<br /> m57�,spdpOtRST Crv]iC2f111X Y
<br /> �k9e s suet a Ifo M o
<br /> ��'Ofn,Semi 6r 14$pfYiai Hantllllg f�Wclpns aiW AddieOflal lnromulien 2alE CAFMiTBM tic-MgiGIo Y
<br /> f as�si tai y 098359 SO 180147
<br /> R7rrira'orn D 11 1000175830 , raDi, /. llf/I�� 2117 unaoonsar CA0!@a11a5a Y
<br /> en e�fo � 2 ,�SCx7/4
<br /> VA V t a-,d a/rn "*5 L onu-ad re1inetl Ry daneralw canlero a0ency aumorily o/n fnrGsl vanspw4l to add of su6sdluu atlrseanal bans l;orers an generainls behaN
<br /> ' f�Y y15. GENERATOR'SIDFFEROR'SCERTIFICATION:1 hereby deplane Viet Jte rgntenls of Nis GPnSignmeM are ivlty arM accuratety dasuthe8 above by Ne gaper sMpq�name,airi are dMLf�1,Pa 1ra3e0.
<br /> 6rCd/b Y/dyyBS maned aiy labeieNplawNeo,eM are in aV respects In proper—d b.kr pans rtarmrdln tP applKaale ln[emaliPnaland natioM10lgovemmeMaln!gulatlaahp efpat sMpmeiYi allolam Ne Pumary
<br /> p g
<br /> > dd! Of Esporfen,lwNly Nal the s!-Mc of its consignment mr f— fhe lama Of me aMe Ohed EPR Ackn led
<br /> gmenl of Consent.
<br /> P
<br /> rerill/b Sye'Q4j�. Icerdy Nal the
<br /> _w'l inimizadon shdfemenE idelrlifietl in 90 CFR 26227(al Gffamalarga gnannly gerceratarl Pr(h}{irl amssmaN quanvn generalar}'s hue.
<br /> Tla/fir Ceneralor'srOfterers Prinledliypad Name S+gnatam Idonth Uay Yeaz
<br /> S/d� - J Ie.rnlemadonal5hipmenLe ❑Erpod lrom U.S. 1Pml of enhyfeait. 2�2d oOo^Znl /
<br /> Valk")�O(Ary ? 7ransPorfer siHnalu2 ffor exportsonly❑Import to U.S. L JCC)
<br /> data leaving V.S..
<br /> � 'o' i7.Transporter Aclrnowletlgmenl afReceipE of Materials
<br /> std Transporter 1 Pnnled1Typflp�dn�1/2� p �/ $IBnatule Rghaf Day 'f
<br /> r�0■ ✓17 f1/f J ` '�x &s LJ 7 V
<br /> P r 7ranspprler2 Prrnfedfryped Name Sigoatule eAorM Day Year'c
<br /> r
<br /> I&.Discrepancy
<br /> -� 189.Discrepancy IrtdlC3don Space
<br /> ❑Guandly ❑Typo ❑Residue ❑Panlial Rejection ❑FuB Relettian
<br /> ,er y
<br /> of l 1 } Manifest Relaience Numhel:
<br /> 186.Akiamale Faalily{ar Genars lor) U.S.EPA ID
<br /> 161M. Namher
<br /> "
<br /> Psrly ¢ - - - -
<br /> 7 LL FacrMy's Phone
<br /> Age bo w 18c.SlgnatumofAlfemete Fac$ly(or Generalorl Month Day Year R203�45.U1c
<br /> jinn) 4
<br /> j qr z
<br /> 2 i9.Hazardous Wasle feat Managemenl Melhod Codes{I.e.,codes for hazardous wasle treatment.dlspdsaL and recyding systema} 017T�fi9p111(
<br /> maybe3. 4_
<br /> 1LUX
<br /> ArV I&
<br /> 1�� T
<br /> ' 1d.Oasgnaled Facrliry Owner orpperater:GeNfcaGon of reralpt of hazardous malenlals covered by the maNresl except as nded in Ilam 18a
<br /> PrintedffyMName Ignalure Month tray Year
<br /> EPA Form 8700-22(Rev.12-17}Previous editions are obsolete. GENERATOR'S 1NUML COPY
<br /> JASON GAITAN, EHS Page 23 of 38
<br />
|