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<br />EPA Form 8700-22A (Rev. 3.05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)
<br />UNIFORM HAZARDOUS WASTE MANIFEST
<br />21• Generator ID Number
<br />22. Page
<br />„r,rr,V�VV. vi�,u ,\V. CVJWVJJ
<br />23. Manifest Tracking Number
<br />(Continuation Sheet)
<br />C890090002
<br />3
<br />005870331 JJK
<br />24. Generator's Name Lawrence Uverniore Natlonal Laboratory Site 300 for hIPISA a .o
<br />Q.O. Box 8W 1 L -7B6 Rr ��-'_-.
<br />r.n
<br />0ermore CA 94551 �- ""D
<br />25. Transporter Company Name U.S. EPA ID Number JAN 14 2016
<br />28, Transporter Company Mame U.S. EPA ID Nurn'tNVIRONMENTAL
<br />27a.
<br />27b. U.S. DOT Description Qnduding Proper Shipping Name, Hazard Class, iD Number,
<br />28. Containers
<br />29. Total
<br />30`Unfl
<br />Waste Codes
<br />No.
<br />Type
<br />HM
<br />and Paddng Group (d any))31.
<br />Quantity
<br />wuvd.
<br />15. NA3077, Hazardous waste, solid, n.o.s. (DO08), 9, III [ERG 17 1]
<br />(GtQPQ03B-1)
<br />181
<br />Doos
<br />2
<br />DM
<br />158
<br />P
<br />18. NA3077, Hazardous waste, solid, n.o.s. (0008), 9, III [ERG 17 11
<br />(DOP0036-1)
<br />i
<br />DF
<br />9
<br />P
<br />lsl
<br />Dooa
<br />17. NA3077, Hazardous waste, solid, n.o.s., 9, III (lab pada [ERG
<br />1711 (DOP0113-1)
<br />1
<br />DF
<br />7
<br />P
<br />331
<br />0035
<br />18. RQ, NA3077, Hazardous waste, solid, n.o.s. (DO 11), 9, III (RQ
<br />Xx
<br />DO 11) [ERG 17 11 (00PQO36-1)
<br />1
<br />DH
<br />185
<br />P
<br />191
<br />Doli
<br />w
<br />19. RQ, NA3082, Hazardous waste, liquid, n.o.s. (DO 10, DO 11). 9,
<br />III (RQ DO 11) [ERG 17 11 (DOP0013-1)
<br />2
<br />DM
<br />1022
<br />P
<br />541
<br />Dolo
<br />20. RQ, NA3082, Hazardous waste, liquid, n.o.s. (0011), 9,111 (RQ
<br />541
<br />DOI I) [ERG 171] (DOP0013-1)
<br />a
<br />DM
<br />2407
<br />P
<br />Doll
<br />21. RQ, NA3082, H azardous waste, liquid, n.o.s. (DO 11), 8,111 (RQ
<br />sal
<br />00 11) [ERG 171] (00POO13-1)
<br />1
<br />DM
<br />489
<br />P
<br />nolo
<br />gai RQ,
<br />ae .e nye• nni9=nrF) rcor 4eiX rao
<br />1
<br />. ,,
<br />2;. RQ,
<br />r•.at__ rron_ -r1, mnonn•�a ��
<br />2@45) I
<br />. Vice 84M802@4
<br />24. Nan-RCRA hazardous waste, liquid (dilute sulfarric acid
<br />134
<br />solution) (DOPOOO9-1)
<br />1
<br />DF
<br />100
<br />P
<br />32. Special Handling Instructions and Additional Information
<br />33. Tra AckroWWgment of Recelpt of Materials
<br />Pdntad/ryped Name Signature Month Day Year
<br />O
<br />CL
<br />N
<br />34. Transporter AcknaMed meet of Receipt of Materials
<br />PdrdadfTyped Name Signature Month Day Year
<br />F
<br />35. Discrepancy
<br />7
<br />v
<br />0
<br />36. Hazardous Waste Report Management Method Codes p.e., codes for hazardous waste treatment, disposal, and recyding systems)
<br />fn
<br />W
<br />O
<br />EPA Form 8700-22A (Rev. 3.05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)
<br />
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