Laserfiche WebLink
Please print ortype. (Form designed for use onelite (12 -itch• 't <br />GENERATOR'S INITIAL COPY <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />V ) typewn at.) <br />21. Generator ID Number <br />— Form Approved. OMB No. 2050-0039 <br />(Continuation Sheet) <br />r <br />22. Page <br />23. Manifest <br />Tracking Number <br />24. Generetofs Name <br />- <br />AWlied. AerosPaae Structure <br />P.U. box 6159 <br />tnn. CA 45236 <br />25. Transporter _ Company Name <br />U.S. EPA ID Number <br />26. Transporter _ Company Name <br />U.S. EPA ID Number <br />(including Proper Shipping Name, Hazard ClassID Number, <br />20. Total <br />Quantity <br />30. Unk <br />Wt.Nol. <br />31. Waste Codes <br />N <br />127a.EDOTon <br />52, tlazardtaus Warste,1f:1:a:id, <br />IZ ifzsxchlc-xrs�[eChllaraax, aal'1! lIXY3)?; <br />TContainemny)) <br />fi.. RQ, NA3077, Ra'LafidOra4 waste, solid, <br />9, 1113 {Obac-at-itun!(DO07! <br />( <br />�>M <br />Co <br />7. Non-RCRA hazardous, waste,waste,li. gaaid (t:oolar±t, <br />P <br />,rll! <br />O <br />S, NOD MC" hazardous Waste liquid <br />Q <br />(Watmr., Paint) <br />z <br />5 0 <br />a <br />4. R1on-RCR& hFazaZdOM-A, waste solid (P1.asi:i c, <br />adheMive) <br />2`// <br />10. NOD-RCRA hezardoor, wa:nte solid l,F1r_•RA <br />)'A! <br />P <br />Lq eorstalnaar! <br />`+l 1 <br />51.J <br />5:e.w <br />fit, <br />P <br />11. Non-RCRA..haeatdous waste. solid (A RA ty <br />,retainer ) <br />/ <br />511 <br />si7 <br />SL', <br />1.2. Non-RCRA hazardons waste solid (non-pch <br />light harll.aetn! <br />if11 <br />{p <br />OfA <br />32. Spedal Handling lnsWdions end Additlonal lnMnnatlan <br />,,, <br />MIR{321. ERG: 131. 9lR3258 ti . i1F <br />086735, ERKia 171. 10). <br />7)256989 1l), <br />33. Transporter_AcknoWedgment of Receipt of Materials <br />F <br />Printed/Typed Name Signature <br />0 <br />Month Day Year <br />a <br />i <br />34. Transpoder_Acknowtedgment of Receipt ofMatenais <br />Pnntedfryped Name <br />H <br />Signature <br />Month Day Year <br />35. Discrepancy <br />J <br />U <br />LL <br />C3 <br />W <br />36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />Z <br />r.7 <br />!A <br />W <br />O <br />EPA Form 8700-22A(Rev 3-n;) PmNnuc enni—.,.e ,.�.....i,.... <br />GENERATOR'S INITIAL COPY <br />