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3400 Auto Plaza Way. Record ID# PR0514278 <br /> 11/3/2020 Program: HW <br /> Photo 14: The following uniform hazardous waste manifest (0 1 6769412JJK) observed with signed copy; corrected on site. _ <br /> 1« Fonn Appoaed.OMB CIo.1950-0039 1� <br /> Please Pnm or 11 fFrnm dnlpMOlor use on elke 12-dlcN wtlter. x NntT y[u]mly�� [� 1 1 7 <br /> Pleaee P� l3NIFORM HA RIOUe ,Ga^ brin Hvmtxr x ' ` 1` b 9'G'54Sy4JK } _� <br /> WASTE MANIFEST ;AL QO h330977 <br /> UNI mAeam N,Nn melena adernal <br /> {�icl-st�rMI- <br /> 1 s.c TRACY CA <br /> PLA2:A WAY CA 9i <br /> X00 BS44500 <br /> Genmrdf�OrK= M��,puaenNmy <br /> Gn °rm � NMENTAL SERVICES x StB V[9=7 7 0 3 8 <br /> a.1 <br /> _ US fPA1�N�rMer <br /> y imnsponcr 1 Company Name <br /> -� ]. <br /> T 5578 SOUTH BOVI.£AVENUE <br /> Los ANGELES CA T0058 CAD097030993 <br /> I' F.G Pn.- {3239277-1500 13,wedes <br /> waste C <br /> F 9e, 9e US.iblia,,paanpnciad"Proem Shi M—,Mi Cease,to Number, t0.Lonrainen 1ck—1 'WiNd. <br /> I IiM ad PeaWrg Getup fa enYll No. Type . <br /> NON-RCRA 1 DO—US WASTE.SOLID(BRANS LATHE SHAVINGS) <br /> _ w Z 2. <br /> w <br /> 4. — <br /> 1: 14$WWI Handling lneWctions and Uraumrai lnfonnaaM - <br /> _ cMEFIGEll CONTACT:CHEMI'REG IL-&)0-424-9300 Wl TERMINAL CERES 4 NAEFtlilftJBS•11k"PRUFILEIi ��� �� - ■ <br /> BRANS LATHE SHAVINGS ,P500-0005&720'APPROPRIATE PERSONAL PROTERVE �U MENT� <br /> Y I J y reme,and are dass4ad,pal <br /> 15 15 GENERATCR'SppFFeR00.'S CERTIRCATtONi Thereby tledare Nat Ne rpirsanlsef Nis oonsgmnentare Nhyaiefaocura r desarl Agovemeb the prWar sh4pn9 and lam Na prim � <br /> markedaM labeledlpla�arded,and are In all ra Was in proper win ition for transport acrAraing Neppllcahle mlerralianaland natirnyd ggvemnreraet regWaaona-hmroatsh4merd <br /> I Frpeder,lce�ah'fhat Ne panlenis of Nis 4onsignmemcanlorm to thaternls Mthe adauhad EPAAcklrewledgment of Cgnsenl. alis Gua. <br /> I certifp Nal the waste mi- nslatemeMiderl h 40 OR 262.2T(a){it l oma large quantity genemter}or{b}[dl setae quantity pay Year <br /> Ge � Slgr�ature - <br /> Gepeldlof9<Cfle <br /> 1fi. Eypert <br /> J 16.Inlama9unal SnlpmenN ❑ rtof anbyledk - — — __ <br /> F ©Impart m U-5. Dela leaving U.S. <br /> pmler : <br /> Tr, z Tonaii,paium&r eapmb 00) <br /> w 17 � 17.TransporterA.dTowfedgnleM of Rebi l01Malanets <br /> R Trar K TranppLrt 1 A�nnaed wed <br /> sgruimm M14outh Oav 'tear <br /> a a C •1l kVonln G:vy at <br /> CTrar 4 Tmnsporter2 PonredR eine 8lgnature <br /> cc <br /> r <br /> _ III}}} 18.- 18.Gisaepanq <br /> f 1�� 19s.Discrepancy IMiratlon Space ❑Nesldue ❑Partial Nelaceon ❑Full Reteclmn <br /> t ❑ antrty ❑TY� <br /> Manliest Relerente Number. <br /> U.B.EPA 10 Number <br /> 1Eo � 186 Wtemale Fanhly{or Generetoq FVS <br /> V V <br /> ti Fahr LL Feolitfs Phone, Month Dap Yowl <br /> Wi8c w 18c.Sgnature RAftemata Faril,ry(or Generalorl <br /> a a <br /> Z Z <br /> rn 19.F 49 19.Hazardous Waste Rapod Management Madmd Codes(i.e.,codes for hruerdque waste heaimenl,drspoW and recycling systems) 4 <br /> -y J 10 p 1 I 20.Cesgri latl Facility Umar ar Operalor.CeNfilatlon of r,00ipl olhaxardous maMrials covered by the orantlest ercept as nded in Item 180 _Rotr SlgnaWra I y Y�r <br /> Pnotedriyped Name _7 U <br /> I <br /> EPA Form EPA Forrn87o{}22(Rev.M5)Prevlodseditions are obsolete, DESIGNAT£OFACILITY TOGENERATOR <br /> JASON GAITAN, REHS Page 14 of 48 <br />