Laserfiche WebLink
795 E Roth Rd, French Camp Record ID PR0546244 <br /> 10/15/2020 HW Inspection <br /> Photo 4: Facility did not have a TSDF signed copy of uniform manifest 006239883GBF. Facility also did not file an exce tion re ort. <br /> '1 Please prim or type. <br /> Fwm Apwovee.OMB No.215D13079 <br /> � UNIFORM HAZARDOUS I.Gonerew lD Numem iPa9etd 1.Emery�p RaPace PnwK a.u,Mrest Trxtln9 Nvm6er GBF <br /> WASTE MANIFEST 2 3 9 8 8 3 <br /> 5.Generalofs Name aid Miary Address Gennatofs Site Addess lY Mlerent ban nwNg address) <br /> AS SMAR ITECH DIESEL REPAIR <br /> • B E RUTH RD <br /> GerwatarsPho FRENCH EMAP,CA WU31 aS_EPAIDN <br /> 6.Trernporter 1 <br /> T U S.EPA to Nem6ar <br /> 7.Trarrspon.2 Company Nano <br /> US,EPA ID Numoer <br /> 8.Deslpra4d Faefty Name and SMAcdress <br /> YIIMA YES 1.WAS E I IlAKSF ER FAtiILITY <br /> AZR00x2114n <br /> 65M LIS HtCA WAY 05 <br /> .w&AZ a&3ai5 <br /> FaaTays Phone:.. 10 Conbhrers ,t.Tool 12.UMt .1.Wane Cafes <br /> 9a. 9trUS.DOT DesaipYca(Ydtsf:n9 Pmpx Sl/lq^911ame.Irazerd c—.ID O�"Y <br /> Na. Pe <br /> HM anE P:w4irg Group Cd amyl) <br /> ti <br /> 1. � f1M tAO P <br /> oWNJ-Rr.RA HA7ARMtJS WASTE 9('A It),A9f4'>RPFMFS.PAPER nil <br /> FII TFRS R DF.R RIS <br /> Z 2 ' <br /> IDD <br /> T <br /> G <br /> 1G.Spaa:J Ma�dfin9lnsln2Uons and Addaonal In!ormaaen <br /> PROFILG71 PAPER FILTERS EN130 I11 <br /> EMERGENCY C O LACI'AMAFY nr,and are dazidted,padca9ed. <br /> above W u,e prccer snrovl^9 nT <br /> ccoM 1 agplzaNe'ntemaeonal and reeonal 9ovemmenW""Aaeon%It eYpxt s�.wnentaMlam dre Rimary <br /> 15, GENERATOR'SIOFFEROR'S CERTIFICATION:I barely detlare�ae s men)are N:ty'an0 aaufalQlY de <br /> madree and IabeledyDlearded,ane-rein as respads in wooer t a conaenL <br /> .Exporter. rerti/y Nil the mnterRs of Nu mnsgnmem w'Yorm to the tome the atladced EPAAduw.Ne�d Qan YI am a smeA WanCty 9anerolor)Is true. fin, Day Year <br /> I certify bat Pre waste minimlratian aWemenl IdentiM1ed in d0 CFR 262.27(a")CA I am a large pmnaey 9 e-�°r Cell O <br /> GerrefalofslOM(ols P`nnteG/IyPed Name — •, <br /> �aJCt' - SIF.)GY Pan enrtyl-L <br /> J nlaWnal$bjpment9 ❑Expod Iron U.S. <br /> 16.Inle <br /> Impel to t1.5. Date leaving U.S.: <br /> Tronspcnersgnaturelb e>Pons only _- Monty gay Yaal <br /> W 17.Transpom.AcknovAedgM I of RK ipt Of Matenels 11SgnaN <br /> Transporter yped <br /> ea <br /> 0 Signa u2 <br /> W= Tran r2P yped Hama <br /> 18.DwafancY Ll Residua ❑Pathe)Rejection L�Fu6 Rejececn <br /> 18a.Dlscrepan.y Indication Space ❑Ouanlity ❑Type <br /> / MaMW Rejwen Number. <br /> U.S.EPA ID Numeer <br /> 18b.Alfemale Faa6C/(a Generator) <br /> J <br /> U Menti Day Year <br /> 1¢i Facili S Plane: <br /> 0 180.SgnaluM ofAttemate Facility(a Generator) <br /> LU <br /> a <br /> z <br /> dng systems 19.Hazardous Waste Report Management Naffed Cpdes(.e.,codes for hazardous waste Ueatment,dfspo=.el,old recyUIreS <br /> V5 1 z. Notice:State of Californl and all to <br /> generator to photocopy <br /> 20.Dasyreled Fadfdy gmer a Opera Cerfifiafion of reaipl of hazardous materials covered by the mmddass`eecePI as nded in item 18a p75C With 30 days: <br /> PlinleaRYPea Name p.o BOX 400 <br /> Sacramento,CA'—,581 --i II IrkL cUPY <br /> L <br /> Form 8700-22(Rev.12-17)Previous editions are obsolete. <br /> John Alaniz, REHS Page 4 of 10 <br />