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795 E Roth Rd, French Camp Record ID PRO546244 <br /> 10/15/2020 HW Inspection <br /> Photo 2: Facility did not have a TSDF signed copy of uniform manifest 006453809GBF. Facility also did not file an exception report. <br /> ,,c'ID Number •• -- -�-E`^ <br /> � ZPagalq .r., <br /> dq � r innenearess z a. Ryba pqa„ , Anprv+ed ol,�tcnx�.pg� ` �J <br /> 795 E DIESEL <br /> FRENCH C r e1°""�°"s•owl `lu <br /> MAP,CA U%Mt <br /> AAAERICM,g\ .,.fir yNana 4RLLEY W"ST$OIL <br /> •�f. YGM-� WOFt n'lS••. LLS.EPA 40 N�mha <br /> Q�"ityN eand ShAdd{aar�R£COVSRYS'YSTLMS p� U.SepPlLLrwrwer lTa� <br /> itVUMA Yea. <br /> GtR9005T1sA72 <br /> FY\ '�dM ♦ ''3y,� �y yUk%. H%C Y6jP'tW@RFACIU7`f Us.epmou,uneer <br /> Yom'AZ 8`s3os AZROWS21146 <br /> and Packing Gbmespcn(pilianY)) <br /> Wer ahipplrooNme, L <br /> Haxartl _ <br /> �,�� `�'� \ '4.♦.'A9��\ a.N?'1N-FkCRA .IONw�her, 1o, v,�ar*eaeaa <br /> camlr.ars It.rmn 1z.u�u ,s. <br /> \ 'S ��tl W57f1R Na. Type NrenmY wVrcl. =' <br /> y fFILTERSBD�13RI WASTE SOLID, <br /> FNT-5,RW(^R Ott, } OIJI Ay p <br /> 4. <br /> 14.SP-dal Handling lnstrudian.and Additional lnforma€ion <br /> PROFILE@jg1'B434WRS PAPCHFILTER5 FRG#171 ... <br /> EMERGENCY CONTACT:AMAN I <br /> 15. GENERATOR'Siurrc OR:SCERTIFICATION:I hereby declare that the wnlents dth.mnsg—ntare blyand arr must d..bed a4ave by lha pmperehipplrrgnama.and are das kd,packaged, <br /> marked and la beledlplacarded,and are in aHreniec in proper condition for nan4crt cording W appllcahlelntemationd and n Wnal govemme�l rtgalallens.li expmistnpmenl arrdlam the t'nman 1 <br /> Exporter,I certify drat the contents orchis cnnsignmen€canformtota,terms oflhe egached EPAAC—tadgme (Consent. <br /> lcertilythOlbe Wes€eminlmlaalionstalementidentpedln4e CFR262.27(a)(dlamalargequanlhygenemlor) 4b)4iFlam asmall quantity ganamlogNwe. <br /> Generotors0fferors Printetl/iypad a Signa <br /> f <br /> -j 16.1 Import to U.S. ❑Export U.S. Podaf enbyb"t <br /> Transporter signature(forexperts only): Ua%wauiog U.a: r <br /> a 17.TwsporterA&rmWedgmentof Remlptof Maledals <br /> Transporter 1 Printed d Name ,/ signature - M'&' Qay� Novo C/ r.. <br /> ch <br /> g a re V <br /> 7m ortera <br /> F / f <br /> 18,Discrepancy <br /> ❑ <br /> 18a,Discrepancy Indication Space �quantity �1YAa Residue ❑Partial Rejection ❑PulV Rejecucn <br /> r <br /> Manif Reference Number <br /> U.S.EPAII)Number <br /> _. f8b.Alternats Facility(or Generator) <br /> U <br /> FadlVs Phone; gay Vear <br /> 13 18c Signature of Alternate Facility(or Generalor) <br /> 2 <br /> S2 19.Wazartldus Waste Report Management Method Codes(1.8.1 codes for haaardouswastedeatn:ent,dlspasal,and racyding 50ams7 Notiee:State of California requires <br /> 1. z. 3. generator to photocopy and mall to <br /> DISC with 30 days: <br /> 21).Designated Facility Owner or Ope,eloc Certification of recelptof hazardous mateddis covered by the manifest sxcWils Poled in Item 18a P Q BOX h 3 <br /> Signature <br /> PdntedlTyped Nama Sacramento,[A 95812-t)4Op <br /> EPA Form 8700-22(Rev......j Previous editions are obsolete. <br /> John Alaniz, REHS ~� Page 2 of 10 <br />