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Please print or type. Form designed for use on elite 12 itchtypewriter.) Form Approved.OMB No.205.0-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 1 21.Generator ID Number 22.Page u 23.Manifest Tracking Number <br /> (Continuation Sheet) L;A 3 t 00610949 of c C-1003077121WAS <br /> 24-G?hfWs404C. (o2O--TRACY) % DAN PEREZ TIN, INC (#02('.!-TRACY) i ��� PEREZ <br /> 400 (WEST VAE_PICO ROAD-SITE 4o0 WEST VALPICCt7 RQAD_SI <br /> TRACY, CA 95376 TRACY, CIS 95370 <br /> .EPA 10 Number <br /> 25.Transporter.,� Company Name <br /> 28,Transporter Company Name Number <br /> 27a. 21b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity Wt.lvol, <br /> 5. NON RCRA HAZARDOUS WASTE SOLID (EMPTY 51`' I <br /> METAL DRUMS) <br /> up 0 i° <br /> ( r A/43D"7- r H A Amax-s k1 -t t sow o, <br /> "011 'Illr U41'41 ) ,(0008moi 41$4,11 � � �T' 7 <br /> r ` <br /> � I <br /> 0 <br /> i <br /> LU <br /> ud <br /> C7 <br /> l <br /> i <br /> I <br /> i <br /> 32.�ge1i�/�H n82nd itfonat Information ( �� <br /> CS+Y 1p1 ,4 <br /> Vw <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> LUPdntecITTyped Name Signature Month Day year <br /> 0 <br /> a <br /> Z 34.Transporter Acknowled mart of Recer t of Materials <br /> Pnntedffyped Name Signature Month Day Year <br /> 35.Discrepancy <br /> 1 <br /> U <br /> 36 Haz*pus Waste R*"F4apagement Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> 0 <br /> u7 <br /> W <br /> G <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. OF:SIGNAl EU F tACILt i Y FO DESTPJAT1Cj',4 STATE.-(6F REQUiRFID) <br />