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E. 41h St. Record ID# PR0514018
<br /> 9/2/2020 Program: HW
<br /> Photo 29: The following uniform hazardous waste manifest (007093709SKS) observed lacking a signed copy from designated facility.
<br /> and the-Altr ate aeerevi-kan nom taole�i --- o� _�•�� «o=�+=»
<br /> Pieria Prim Or type. Fenn Appre°ed.OMB No.205"n39
<br /> 1_TyP SOF oN1ZwIN uNffgRM HAZA 3 onndaemmNumbw 3_Peg ra a n-Nanan,tTnckln xumbnr
<br /> _ DT=pump wdl, RnouS CAD91324718S6 q m�9YA F;;F Yw 9"�G f107t1 3�Af] SKS
<br /> a�sbn ha95 oW a Wooden drums,h—ls,kegs. WAaTE M0.NIFEnSpT U f L 0 9
<br /> �(In'to groll- AG=Hooper or gondola cars, s f1 E�ar�O°a L1Wlm ran const Div
<br /> uem.amrs site Aatl�==rd aArereminsn mint,u addreul 2�ZQ. O(]Q
<br /> TC=Tank cars. RIPON 4th 6t l
<br /> cases. CA 9$366-2761
<br /> TA-Portable ranks. Gr,>wakrn P�—, 209-599-6131
<br /> rs,panels.kegs TT-Cargo tanks(tank trucks). 6.Tg r n U.S.EPAIPNumber r131?r.r
<br /> '�°9H.E�lT SYD7'EM$ dNC TY.RGDO)
<br /> s,
<br /> 7 T'��Oet�z C'uri Name U.S.FFA to Nvmlaf
<br /> al tti of waste,Round partial units to the nearest
<br /> 315 w rrervions.To the extent prociipl,report quantilles s.oesiar�a=ab Fddliry Name e�elleA,lOfeau d
<br /> NJ win allow yon to report quantities with precislon. - U.S.EPA 0 Number
<br /> hased on actual measurements or reasonably accurate 6060 88TH STREET'
<br /> .Canlainer oepaollies are not acceptable as esbmetes. SACRAMENTO CA 9°x626
<br /> 916�3H6-4yt3 ra0oo00tr4:»
<br /> 'ra61 Fscin Ph—.
<br /> opdafe abbreviation from Table If(below)for the unit of ga, Ia a
<br /> ab.N,S.Dor NwWk n till ing ProW Shi
<br /> 10.CmtW�nBrs 11.TOWI 1g.Urrmt
<br /> HMW
<br /> Packing Group n '�Noma,Harsco Class,l0 Nurriher. 13.tussle c ea
<br /> s.-UNITS OF MEASURE _ r)) No. Ty Qi wt.tvm-
<br /> r. _
<br /> N=Cubic Meters. o tAQUEOUS PARTS BASHER soLUTFON)
<br /> P=Pounds- c)( �}1" f+
<br /> T=Tons(2000 POUpda}, ua
<br /> Y=Cubic Yardsx a.
<br /> s,and Cubic Yards should only be reported for very
<br /> ED
<br /> tank trucks,or barges.
<br /> 3.
<br /> codes to describe each waste stream identified in Item
<br /> mda aost with federal eimered hem.in
<br /> properties of the
<br /> it are mreplesenmkve of the
<br /> 4
<br /> ydrionai Information
<br /> ndling or shtpmenPspeaUc tnfcirm n necessary
<br /> g of the materials under the generators or artier 16.Sperdal hadnng InstrucliOns.0Addition*Intamiavon _ .L1
<br /> J;waste profile numbers,container codes,bar
<br /> enerstors also may use this space to enter -
<br /> ittheirshippedmaterals,surh asChemiCei i 24H EMERraEi4cYp800-4619-1760-GH/SK/TFI-Contract retained by generator ronFers agency au'tt,rr'•.
<br /> raistate,orsped5cgaviryofwastes idenufled on initial transpc)rter to add or sur=stitute additional. tran=porters an generatOr's huh,
<br /> 75. GENERATOR'SIOPFEROR'S CERRFICAT)ON:I herebydeGare Net the contents of aril consignment ere fvlyarttl accuraONy desrnbad above by+ha proper shaping name,antl are dassiked,packaged,
<br /> d
<br /> types of fedi requifed information for which markedandlabsk lacarded,and are in all res as in
<br /> Ie manifest,including any aitemale facility �P ➢e Proper catheters o the atl according to Acknowledgment
<br /> ant of anal and national govemmeMal regNaUons.H capon shlpmenland I am the Pixnary
<br /> Exporter,I cattily that the mnteras d ms wrrsignment nonlonn to the terms of the aaadied EPAAcknmNedgmenl of Consent.
<br /> bar of the dnginal manifest for rejected w351ea I cei gal Jr.waste minimization statement identified in tip CFR252 27(1)(11 am a 111,1 g111 generator)or(b)-2.a small poen" ptstator)is Ince
<br /> I second rl1 Infix st;and the Specification of Genersk"a Qtfers"Pdnkd/ryped Nard /� I aignllure Math Day jYjear
<br /> srfiptions and FC6 our-0f-service dates required Z
<br /> Byer,Canna[be required to enter infOrmi In /A15.Inlemakonel shipnrenN �Im rt k U.S.
<br /> errors. z i ❑Export tram U.S. Port of enlryfewl:
<br /> Trmnsparm,signature(for expods only), Date leaving U.S
<br /> he waste minlmi7aden codification statement.In 17.7r"f ods,Acknvnddgmenl of Receipt of Materials
<br /> n Stalement.those generators who have not Train 1 led
<br /> Prilyr yped vine sign Month D Year
<br /> Nn the duty minimiz�t on
<br /> O `^U
<br /> A are also certifying that they have comp
<br /> I make a waste w n -�
<br /> The Generaboi Cerap sliOn also o0nlai/15 the &I Transporter 2 Fdntedlfyped Name 'signature Month Day Year
<br /> teen property prepared and Is in proper
<br /> 3r toicin).The contenl of the shipper's 1 I&Discrepancy _
<br /> y,declare Thal Ute contents of tid fill 01
<br /> 3ed above by the props name,and ise.Discrepancy indication Space
<br /> Shipp n9 I ❑QUam ily ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection
<br /> dlplararded,and are in ail respects in proper I 0;Ile oternatonal and nalionaf goVemmental Manilas)Reference Number: 1
<br /> prey Exporter,I certify that the contents of 16bAltaiFaCilih(or Generator U.5_EPA ID Number 4T
<br /> attached EPA Acknnwledgmanl of Consent"
<br /> res the shipment far transportation,this party
<br /> Hent as the offeror of the shipment. ai Faciiill s Phone:
<br /> the words, on behalf or in the signature w ter.Sgnatu a ofAUemafe FaC911ry{or Generatd J Month Day Yom
<br /> signature block prior to signing the
<br /> the irsim al signs as the employee or z
<br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes ler hazardous waste deatmeM,disposal,and reading systems)
<br /> itter,signature required in Ilam 15 may he Li f N Z
<br /> le if the generator is preparing and signing
<br /> t) 20 Pesignaled Facility Owner or Operator Cediftcali of receipt of hazardous materials covered by the manifest except as noted in Item 18a
<br /> 1 PrialedAypedName Signature Month Day Year
<br /> EPff9r t� 3}Previous editions are obsolete. GENERATOR'S INITIAL COPY
<br /> JASON GAITAN, EHS Page 29 of 38
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