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3400 Auto Plaza Way. Record ID# PR0514278 <br /> 11/3/2020 Program: HW <br /> Photo 19: The following uniform hazardous waste manifest (017696874JJK) observed lacking signed copy. <br /> Faun AKMvsd,DMB No,2650,0039 <br /> PlBase pnnl mlype.(Farm tles tied rOr ese on eIItO 12 Idrl near. 2.Page 5 0l 3.Emer9e1KT Respw�se Phono l Mwrast 1--Na—Numbr - <br /> t.Gmemtw Ig Nnmeer <br /> UNIFORM XATAROOU9 T 1t)�ru,•1.'•1-i'3Ufa 017 6 9 6 8 7 4 sJK <br /> WASTEMANIFEST GALd O493UA23 <br /> {,urbsm Ws Sin ganress Id tl,nemnt Vion maaag aedrn%al r <br /> 5 d -r&.Ntlne ure AtaanRMdrase <br /> I"C;y r,HE VWJL(:6 V 15 M INC <br /> JAU[rAUI L'PWA WAY CA 953v4 <br /> TBAr.Y - <br /> Gen—re Phone 2011 635-45W us_erA ID Number ""�.+�+ <br /> s TnnspcMr 1 Company Nemo C A 11 11 1 y 1 7 r 0 1 6 <br /> WUNLL+r?It ENNRUNMEHTAL SERVICliLS u.s.EPAW NumbN ���� <br /> r Tnnepoder x Comperry Name G A R O O rl 7 T S A 2 2 <br /> ,v Wii UWIOE Hf COYERY$YN!EM 1NG - — - <br /> 11.5.EPA IO Numhar <br /> B.neeignaled Fedfny NameaM&m Addn9a ..--_ -. <br /> YUMA YES LLC <br /> 2130U.13TH 9T AZR00061!592s - <br /> ".IJtAA A7 H.3G5 <br /> Fm ePhorm: 1'I-'t�t i,a4.rY--,;l <br /> 10.Gonlairrar5 51.Tocol 12.Unit 13.Waste Caries <br /> ga 9h.U.S.DOT""`PWpnduding Proper Shippru Name.Haaa.d Class.10 Number. Nu Type Q—Wy WI Nd <br /> HM sik PaN[Ing Gmup lH anYIJ <br /> 1,7_, ,ru!A IIAURWUS WABTt SO1.,10 i OILY 5UIJ0,PAPER HOW - <br /> �~� 0 4PIWASNWATER <br /> r <br /> WASTE <br /> a <br /> 14.special Handling Inspucoons and Add-W In i,—., <br /> c.MERClEpgOY W11lACi':CHEMTHEC 1-80U42ri-'.0.i0ti WOES i F:f+14•IYrr_ t.LFs.S;'.::r -PROFILE A 91`ail Vii <br /> .-al:1.3411!".el�AriCX)1 <br /> 012 Y SOUO.PAPER FILTERS" *AFPRf7PpIATE PERSUNAL PROTECTIVE Ei141{PAAE1vT 7(! ; Y <br /> 15. GEN ERATDRSIOFFERUX'S CERTIFICATION:I hembydaclareThat mecontanes of this croslgnmentam N11y and accu dOytlesmbed ahove by the p,epershippirg name,aN are dmOed.Pat aged. <br /> madod and laheteeij a—fled.and are in all...pecks in proper cordilion for Vangw according to appiiwbla inlamational and nasonai governmental regulaWns.if export shipmentand 1 am the 4nmary <br /> Exporter,l oerhly that lha contents el this rmosignment conform to the mrmsof the allc"i EPAAWe.ledgment d Consent. neraWrl is hue <br /> I certify Ina,the wean nim statement Idensfied In 40 GFR 26217(3)(if 1 am a large quaridy gpre to,)or(h7 lift am a smallquert+iy ge <br /> Gen iorsloffemrs Pntlmd.Ryped'NMF6 Signawre Month 5.1 Year <br /> 7s.IntemaaonaiShtpmenls ❑Import WUS, ❑Eapatfrom J.3:- Portoferikina il'. <br /> F <br /> cc <br /> - cc Trans <br /> rslgnaturelfwaxpreOfRlVl' Uamleaving US. <br /> : <br /> 37,TransporlerPcimmrtedgmenl of Receipt of Maianals <br /> wMonth 0a %W�Trans"1 PdnledlTyped Name Sgnature Y <br /> Yr Manlh Da Year <br /> Transpoder2 PnnledlTyped Nama fSlgnamra T <br /> S <br /> 414141 ia.Dlsorepanry <br /> lea.Discrepancy Indication Space ❑OuentltY ❑Type ❑Residue ❑Paniai Rejection ❑Full Rejection <br /> Manifest Reference Numbac <br /> ted-Mamale Facrllly(or Generator) U.S.EPA ID Number iyya�� <br /> J <br /> C] <br /> ua. FSSiPhone <br /> w 7& g.Signature ofAflemate Fatllily{or GtsnareMr) Monts Day Vaar <br /> a <br /> z <br /> 19.Hazardous Wasle Report Management Meewd Codes 0 e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 0 1. 2, 3. 4. <br /> 20.Dersignaled Facility Owner or Operator,Cedifiratlon of receVptaf hazardous materiels wvered 6y Iha mantlest eaCepl as tided in Item 18a <br /> PnntedlTyped Name Signature Monty 03y Year <br /> EPA Form 8700-22(Rev.3-05)Previous editions are obsolete. GENERATOR'S INITIAL COPY <br /> JASON GAITAN, REHS Page 19 of 48 <br />