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E. 41h St. Record ID# PR0514018 <br /> 9/2/2020 Program: HW <br /> Photo 30: The following uniform hazardous waste manifest (007093709SKS) observed with a signed copy from designated facility. <br /> CAD9G2471G g91 ut a Em �.MenlmxlT-kw number <br /> yG'„ �� sy - .TE MANIFEST 56 1—�$9F�'-�8�f"I`�0 § �I <br /> �� o, 'f 1C op 1� sName an C Malting Adtlress 007083709 SKS <br /> uQ ° rA un ert 8 Zi noerntan Const Div r neraIsrtradera rdmaera rNanmaln gaaare 1 �� OUT,� <br /> ''� 9- 9- E 4th .S$ �d <br /> q� o w l <br /> e„aawroPnona 209-594--fr131 CA 95366-2761 <br /> 7YCROPOOfli2ra5 <br /> s%ill �$ '���r�i��rs 7rrans rterzCumpanyNama u.sEPalOnember <br /> N s , dPI%o-, <br /> ! � <br /> �S <br /> s� /° V.S.EPAII)number <br /> V y� /�/ Po ryg4��a, a,Designalad Faciiily Name and Site address AFE Y—kLEEN SYS TEMSr IHC. <br /> o 'C" G,P /a6 d6 0 .� 6000 GOTH STREET <br /> y C T yc If, SACRAMENTO CA 95828 CA0000084517 <br /> A p '- �s� °�jf ses� 91G-386—+4413 <br /> s o/,5 Faolr's Phone. - <br /> iV / 5o-Containers 11,To181 17,Unit 13wasl,Godes <br /> � g 4 a A G� ga. 9b.U s-DOTfleecnptlon(iliduding Proper Stnpping Name,HazadCtess,l0 Number, Nn rye Quantity <br /> �S s wl.r�al <br /> �9y�3f HM and Pacltirg Grwpgt enyll .. G 134 <br /> HON—RCRA. HAZA QU WAS LIQUID <br /> 16%. pl (AQUEOUS PAI WASHER SOLUTION) C) (♦jM a� <br /> 4 l <br /> !, A POP a�. 2 i? <br /> `t4 9y ' 14.Spec <br /> � %'-6 � <br /> qr ds P s°o/h ay 15. GEA <br /> 1 <br /> of % a Exp 4 <br /> �n�i rye iwn <br /> 14-speualhandling inswcuonaand aadltmnall_nfnmwson D:SCA G0584567 'GUI2272 2571932 Ill <br /> \�1 <br /> ,a Interna h a`utthori <br /> /Ps n z YanspertE 24H EJ7ERGEMCY114gU0 468-1760—CH/S{( TF1—Contract stained }dy generator anfer9 a envy <br /> +Torre an initial trans Grt2r to add or sulygtitute additional trans artery on Exnera 01 S taehalP. <br /> 15, GENE RATOR'SIOFFEROR'S CERTIFICATION!I hereby declare lh9ithe ppntenis of Ibis consignmsnl are fully and VnAarely described above by'n gulatas R ex name,anti aria I mthi 9a kaged• <br /> C T2ns�rler marketl and wimledlpla.earded,and are in all modecEs in proper w1diaon for transport according to apPGcable intemalionatartd naVonal govemmenEl regNallats-tt export sh�ment aria I am the nmary <br /> as lLmi L In a , Exporter,I certity that the canfemsot Nis cansignmenl confomnto the lenrrs tithe attached EPAAcknowledgnleni of Consem a small guan' starer,is hue �67j63o7S <br /> o have not a 7 nsyoder I cediN that the waste minimizaton stalement old. <br /> in FO 1262 271a)(if I am a large quanbty gene*ator)or(b1 MOI Day Year � <br /> minimiiell0n GeneratorsfOMerols Prinreol Name Signature- Q, 015��28 <br /> .-k <br /> y have cornplied a— i t1 <br /> r18.aISO Wntain5 the Discrepz <br /> sl ed and i1 in proper 16.International shipments ❑ImporttoU.s. ❑ port ImreU.S- PdsMentrylext 578F� <br /> stent of She shipper'5 18a.Ds ep Transposer signature(tor all only),. Baa leasing U 5'. <br /> contents of this t rr - �6a529 <br /> C 17 T <br /> ,roper Shipping name,and . ponerArlmowledgmem of Receipt OrMatedals Month Day Year Sky <br /> Tra net 1 Pdnledlryped Nps Sgnalu <br /> ire in all respects in proper feb.ANsmart �. <br /> national govemmentai _Zi o,o `i Mo 4 % <br /> D Year <br /> celGtythat the conlentsof � c) zPri ed Name 0IT17 <br /> nowleidgmenl of Consent-" Fal Phi o i.y Vt MAl m3 to <br /> w }Bc,Signalurr <br /> m franspoAaVon,this Party02p3 <br /> Of ft Shipment. 1 S.Discrepanry �Yppe ❑Rpsiduo ❑PeyaReyachpn ❑FulReaclion � 2! <br /> hal!Orin the Slgnahzfe r2j i 18a,Discrepancy Indication Space El puan6l, <br /> T rn 79.Hardrdous IJ <br /> or to signing the <br /> a as the employee or Q Mlande5l Reference Fil <br /> US EPA I➢Number <br /> ulred in item 15 may be I 18h.Allernale III(or GeneralorJ <br /> illlf 20.Designafec � <br /> IS preparing and signing Pnnmdf[yped r 10 <br /> I Fall Phoria: Month Day Maar <br /> EPA Form 8700.2; <br /> w 18c Signal of Alternate Facility(or Generator) <br /> Z <br /> 0 19.HaZarder s Waste Repos Management Method Codes(I,e„cedes for hazardous waste Ireatmell.disposal,and recycling systems) <br /> _ 3 4. <br /> 2n.Designated Fal Owner or Operator CanificaUon of receiplof hazardous malenals covered bythe manttast except I noted in Ilam 1 Man pay Y ar <br /> PnnledliypedName Signalu - <br /> Previous editions are obsolete. D� IGNATED FACILITY TO GENERATOR <br /> JASON GAITAN, EHS Page 30 of 38 <br />