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E. 41h St. Record ID# PR0514018 <br /> 9/2/2020 Program: HW <br /> Photo 31: The following uniform hazardous waste manifest(000247489DAT) observed lacking a signed copy from designated facility. <br /> �1atT��+m°°'�}eiorxaTteeeyv 1 }nsN <br /> l, Form Approaad.OMB N9.20510039 <br /> ✓'lease Pan!a 4,arnNae <br /> _ uHIFORN HNAROOU9 t.GeneMx l0NWrLar 2 Page i d a Eme�gen y NssPonss R�rn'a r 4 8 9 D AT <br /> WASTE MANIFEST CAD 982471888 3 80033-625-'1 00 <br /> a.r..�aralors Nam'scot ArawgAatlreaa ATIN Derswn gibwlro ceneamres�Redress 4n anB,em man nre"a ea'-1 <br /> Ourtdrt$Ltmmxmwn (aunUrrlB Llmmrrlawn <br /> 222 East 1=our81 91 <br /> R1POvnn.02 .G AB5368 O00�i� <br /> POalrth S1 r <br /> oB-0 <br /> '-r..- _ Gementera Pnw,ev 2H98131 ' <br /> L - - Rlpon.Cg95369 <br /> U.S.ePA1U Hu�Nsr <br /> a.TrenapaeRr 1 YNamB <br /> ingaenruV(VZ—roanvdX--EFUPHONE-Oust IDN8Yd&G004••••) CARg0a1T9747 (DO0307fD�2 <br /> T Tranypasr 2 Cera ll.S_EPA1a Numlbr <br /> 4.90-un,pae GAR000178747 -'1' <br /> (Kq,(NWPIera 1(""Cl PHO�JECuat DR 87ef5-0002•'" <br /> • ) uS.EPA1n Nvm9er ^O�� (70`L�T �j' <br /> 'r &ueas ted Kavatqy Nu,ne Ord ate Aadwaa 4i+ISt00Di27621 L <br /> LROaatna Em4ronmen�l 9Olaatlona LLC <br /> S82d5 Cld Porter Rd <br /> POTWl IN 46398 <br /> scar Ft— 26D-2402461 <br /> / 1o.Gvnrarcers li. 1 <br /> 9a, a6S. ex <br /> .0WTpAplbn(nGudinp Proper Shgplrg Nacre,HazaN Class,to Nurtiber, Trial 12.ur it 3-wash COdesTYP2 quan4T/ WtNol, V L <br /> HM erM PBdBig Group(d eiry)) No. <br /> rcr very of 1 Non-RCRA HMarrdaus Wasta Shcid(DIAIOKviC-COUS EAR TH f X52 <br /> CLLAhI UP) <br /> w <br /> nlr6ed rn flern W z_ <br /> red here,In r, <br /> 'lies or rhe <br /> C 3. <br /> mir <br /> aRan necessary <br /> /enoremrs or abler <br /> !'/tains'cedes,her 4, <br /> ,(s space to enter <br /> j�such as chemical <br /> 1r71yof wastes 0enri5ral <br /> 14.Spada)Handeng ins4ucdonsandAdditimal Infarmatmn p�747 1716DJ <br /> required In/omlalron for which <br /> rrg any alterl facility 1)1000175830 '7 l r <br /> .manikst for rejected wastes <br /> nereror abMerR n,eaMPnlq on IMtlel lrarrePorh=r to aCd rrcsuUnLLhTle additional t aneipmt-9 no gweralam Ill <br /> est and rhe specificalion of Contract relwlrTed by 6e oAe N <br /> .PCR Odr-0Fservfce dates required 15, GENEMTOR'aFOFFEROR'8 CER71fICATION:I hereby dada's mat the wheats of this wnsignmenl are fullyaM acomately dexn'bad above m Ns proper shippVng name,and ere UasslTtI.etl,packaged. <br /> bemquUed10enter inicrri ltpnIn marked and mbeledlplamrdsd,andareinallrespecmMproperconditionfornansponaccordingtoepd-bleinmmatlonalamnationalgmemmenhlraAutations.11expelsMp1S8"t kms" Primary <br /> Exporter,I certify Nal ere comm�ts of thla consigrtmeMconfortn Wthe mane W NB aVached EPAAcXnowtetlgmanlcif Cpn50n1, nerator v vue. <br /> Z I wrung that the warm minimfzeeon atatemenl kdenllfied 1"40 CFR 262 27(s)le I am a longe quantity ger—lad or(b) <br /> (ill am a smatl ntity ge } � ypa t <br /> a. G m(0 roYS Pri4redlryo�d Namefrin <br /> ]USSgpn;af=aaen statement.In 7 ' +IT f <br /> wse generators who have not r Jr! I [' <br /> mage a waste minimr7ati0n C 16.Irdamaeonat Shlpmenrs <br /> ❑ImpoR to U.S. ❑ExpoR from U.S. Pad of endylexit <br /> ityNg mar they have complied = z Transporter sigrtam2{For exports Dory(, tram laavkn U.S: <br /> 'S Cedi MUGn 0150 contains the <br /> !Opened and is in proper 0� a: 17,TrenspalerAdmowladgment of RecalPi ofMaledals 5 nature month 0ey Yea* <br /> content of the shippors Transporter 1 Prtnledfryped <br /> heconlentsoflhis a <br /> e Proper shipplrtg name,andSlgnaluro y _0���>5, <br /> I are in all respects P <br /> Is In Tranaporter2PdnmMyped Name <br /> 014428-t <br /> ndnaeonalgovammenfala! r <br /> ,1 corGly that the corral of r 1a.Discrepancy <br /> ~ ❑fullABkectlan Olt <br /> drnow7edgmenl of Consent." ❑Residue ❑Partial Reiecden 5 <br /> t9a.Discrepancy Indication Space ❑Ouanbl ❑TYPO 1$p . <br /> nor banspoda6dn,Phis parry a y <br /> rr oFlhe shrpmenl. <br /> halfoPin the Signal �- <br /> O Manifest RBlerence Number U,S,EPA IO Number 115 <br /> w <br /> for to stgri ng the ¢' r iah Alternate Farxldy(of Generator) 020 <br /> 8 4 <br /> s as rhe employee or _7K <br /> U01� <br /> tired in Item 15 may be O W Fa iii y s Phone Month pay Year <br /> i preparing andsigning 1&.Signature orAhamala Facility(or Genaralor} k <br /> Z <br /> S 19.Hazardous Waste Report Management Method Codes(i.e,codes for hazardous vraele Imalnea 1,d1spos6l,and recycling systems( N 2 <br /> - 1. 2, g 4. <br /> EPA <br /> r' 24 Oesignaled Facdily Gwneror Operator',Ce ikallon of iecelpl of hazardous mall covered by the manifest excel as nded In Item i Be <br /> Primed yped Name Signature Month Day Year <br /> EPA Farm 87CC-22(Rev.12.17) Previous editions are obsolete- J GENERATOR'S MMAL COPY <br /> ' l <br /> JASON GAITAN, EHS Page 31 of 38 <br />