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795 E Roth Rd, French Camp Record ID PR0546244 <br /> 10/15/2020 HW Inspection <br /> Photo 2: Facilit did not have a TSDF si ed copy of uniform manifest 006453809GBF. Facility also did not file an exception report. <br /> mW r1d Nrm,ber <br /> ✓ e ALIA"W )914n ale l <br /> f ,.dereu 1 " ) it"s�p Pomn h000r�—UMe,, p <br /> o'1--SEL REPAIR Ge^e'abr�s� <br /> 5 E DI <br /> S7j V U C Y J O O9 GL�F <br /> 7J5 E RUTH RID.CA <br /> FRENCH= zit �"^Wa9 aurinnl <br /> Na�+re <br /> AMERICAN VALLFY WASTE OIL.ItvC. <br /> y Name <br /> US EPAq MmMr <br /> >t�� wOR,. IoE RECOVERYCMHX701777@ <br /> n 'tK,ary Name e.w Sife AMreas SYSI EM8 p.)C U S EPA ID Mawe. <br /> s5W US H2 WASTL•11tlyrSFER FACILITY <br /> E <br /> us.PArD wewa.CAROMI 754'22 <br /> I%ftAY 95 <br /> a PrwnefYlB-34A-H818 Y` ,N_8:s3f15 AZROW521146 <br /> - ` e` - 9b.U.S.DOT pesppyon I�dum <br /> - •.T end Packing Group(tl a Y)1 fop'Snipping Name.Hazard Clas.,ID <br /> IkrtrAer IO.Cmhkyry <br /> t' lt.TOMI 1Z.Ura ta.Waere Godn `\ <br /> g ,NCNV-RCRA I"7,gzgRQC1lJS WASTE. "O. typ orwmh WLNOL <br /> FILTFR5 k(.pEBRIS SOLID,AR.SORFIC"S,PAPER OR <br /> �j P <br /> r rw s <br /> kh, 'oe N <br /> a U7hber3j�962 <br /> 071 <br /> > 14.Specht Handling Inshutapns and Additional Inlormatim <br /> • PROFILES!1913434 RS <br /> Wd FAF'f:Ti FILTERS ERG ff171 <br /> EMERGENCY CONTACT:AMAN <br /> 18. GENERATOR'SIOFFEROR'S CERTIFICATION:I hereby dedam that he contents of his mnsynmenl are fully and awxwely deatdbed above by to groper shfppkg name,and are classfied,par aged, <br /> i marked and labeled/plamrded,and are in all mspeds in proper eonddion for .Wert amadtrg to applic ble ntemationai and na 1 govemmenlal Mutetions.11 eaporl siriprtent and I am al Pnmaly <br /> Exporter,I certify that the mnlents of this mns'gnment confann to the terms of he atUched EPAAcknowiedgmen Cant. <br /> I terrify that the Wade minimlracon statement identified in 40 CFR 262 27(e)(it I em a large quantitygenerator) (b)(il I am a small quantity genenlwlle hue. <br /> Genereor"Offerots Pmted/Typed a Sgretu _-. <br /> 161 a <br /> j F Transporter <br /> m e <br /> Import to U.S. ❑E+port k U.S. Port of entrylout <br /> ? Transporter signeNre(far exponsonly)-. Data leaves U S.: <br /> j. 11.Tnmspb111Ackrawledgment of Receipt of Materials <br /> Transporter 1 Printedl3yped Name Sq_naUue Mmtn Oay Peer <br /> M h uay iew <br /> ¢z <br /> 7ransponer7Pnnted/l d <br /> ~ Nam- <br /> 8.Discrepancy _ <br /> 18a.Discrepancylndimbon Space ❑Quantity ❑Type ❑Residue ❑PaNal Reier6m FA Regotion <br /> / Mamf(jsIjRatemem Number. " <br /> U.S.F3AID Number <br /> 18b.A)temate Fadlily(or Generator) <br /> :3S.4\� 0 <br /> / v <br /> tai Fadllty�s Phone: Day Year <br /> 18c.Signature otNtemate Faality,(or Generator) <br /> LU <br /> = Notice:State of California requires <br /> � 19.Hazardous Waste Report Management Methpd Godes(i.e.,codes for trazardous waste treatment,disposal,and recydh+9 systems) <br /> Z, generator to photocopy and mail to <br /> 1. <br /> DTSC with 30 days: <br /> 20.Designated Facility Qwner or operator.GertMca of receipt of hazardous materials covered ay SlgnatumMff6StWcepl as nded in ttem 18a P O BOX 400 <br /> Pdnted/ryped Name - A <br /> Sacramento,CA 95812-0400 <br /> GENERP�TUFC�mITan�..r=- j <br /> EPA Form 8700.22(Rev.12-17)Prev bus eons are obsolete. <br /> John Alaniz, REHS Page 2 of 10 <br />