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3400 Auto Plaza Way. Record ID# PR0514278 <br /> 11/3/2020 Program: HW <br /> Photo 9: The following uniform hazardous waste manifest (0 1853 13 83JJK) observed lacking signed copy. <br /> Please lalype Fdm farun oh eRtl 12 ell Fdm rpradOM81w2656-0n09 <br /> P uNIFORN HAZARDWS 1-rmm 0 r"" a vape 1 d a Emerp.ncr suspm®vr� • n.c nq xwn <br /> 31 <br /> VMBTE K411111i CAL0003304,7,a rFCR IA:d-a�rxf <br /> 018538: s,] <br /> s �iE 1ii-QANOUl cer.r.mrssravww.�.la Aar nmle,e,nwuq susrna.l 'f Jj'g e <br /> s�oo Auro!LAZA weir r t i • <br /> TFACY CA eb3W i <br /> 200 83&4500 a k r t a t <br /> e 11AEfIwAL 9Errv1CFs <br /> j � <br /> T T�newwlr 2 rarrtlenY Nsnx 11.5 EPA Ip Number <br /> 1 P WY'HLV STFL�Irf4 U5 EPA IO Nwnum <br /> -'(W td ALA MErM 9TRE@T <br /> .'1-n\9F'TLlel CA 90222 <br /> sacslya Phoma_ (3201 - <br /> ya, 96.u 5.pOFPeau ptlon(Indudh p Shlppwg Nene,He a d C ass,to Number, 10 Cantaina 11 TAal 12.llnll 5.Wub Codes <br /> HM Arid PaduNGralPfdemYll No. TYPe Ouanaly WLNmi. <br /> ON FIAMMABLIL I N n; fllfo;nt INF fl1F'F11 9 .clot les a. <br /> F J PG 11 f <br /> SUMP/WAI SHWATE <br /> - WASTE" <br /> 4RT$/BRAKE saIIIIIIQIIIIIIIIIIIIIIi <br /> a '-SOL VENT _ <br /> x � <br /> a. <br /> la Spenal nan0iing Instructions and Addmonal lnPormaeon <br /> LMC.iLNCY G'ONTACT.CHEMiREC 1-800-424.9"WOES TFRMINAL.CERES Cs Nt.Li 9r:1 128-F•f'f7FILL a 0B1 <br /> 4293W GAR"E.01i' n'APPROPRIATE PPE EQUIPMENT <br /> -f�1L -'t 0 <br /> ,� <br /> 75. GENERATOR'SrOFFEROR'S CERTIFICATION:I hereby dedarc that the mntemts of this mnsignm 1i Eli ec .Iiiiyd—aa,d above No.proper shipping name,and are ckande4 parkagaid <br /> s� marked and labeleavpraramad,and are in all respects in proper condton for banepod according In applidaii international and national go rrmenlal Moislia I[aaporl SNpment and I sm rhe Pnma1y �— <br /> Espotcr.I oer*Thal me mnlems oNhis wnsignmentwnform tc line lennsol Ne aaachad EPAAr nowlsdgmenr of Consent <br /> 7 I certify Nal the waste mlmim Inn statement weenesed in 49 CFR 262.27(a)(if l am a Iarge quanbt generator)or(b((if l am a small quantity generator)is vue. _ <br /> GeneratarsWarai Pn'neYcll'yped Name Signature l Monty Day Year <br /> X F - X 17 M.InIorn nai Shipments import to U.S.❑ <br /> _ ❑Ewpan hewn US. Pon of antryliait <br /> ~ Trartsporlersignature(for exports enlyJ. __ <br /> _ Date leaving US.' <br /> � W }]-TransporterAcknowledgmeni ofReceiptofMalanaR /CON—L-A$Eti�-S, <br /> O Trar{spoRerlPdnladl7ypeName 8dgnature: Mari Day Year 5'17 AIAf <br /> I <br /> y f I: / n� /.� ! � <br /> KTransponer2 Pnmiedlfyped Name Signature Monn1 Day Year <br /> F <br /> 18.Discrepancy <br /> 180 Discrepanny Indication Space ❑Ouanul El <br /> y ❑Remduo ❑Partial R¢jec5on ❑FuA Rejection <br /> 18b.Afremate Fadiify{or GeneraWrJ Man91es1 Ratarence NumbeF <br /> J <br /> U.S.EPAI6 it <br /> 6aziPly'a Phpnew S8cSgnalurbofAllemalsFacii(orGaneralor) <br /> q Imam <br /> 2 <br /> W19.Hazardous Wadie Repod Management Method Codes{Le..codes for hazardous waste Irealmei disposal,and recydlng systems}Dwne(wr Operator;Certigcatlon ofreceipt ofhazardous Maledala wive by the mahilest Iii as hued in Item 18a <br /> PrinlecTryped NameSignature <br /> EPA Farm 8100-22(Rev.3-45)Previous editions are obsolete. <br /> GENERA'TOR'S INITIAL COPY <br /> JASON GAITAN, REHS Page 9 of 48 <br />