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Please mw or too. Forrn designed for use on We 124tch writer. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Genaralor ID Number 22.Page 23,ManHeat Tracldny Number <br /> [CongnuetlonSheet) yy CAT+ +3 61t?943 C C1+�+�3D771 WA5 <br /> 24. . - WEST VA C�RROA —S[ PEREZ TIN, <br /> W S 'JA�P iaQRROAD—SITEPER Z <br /> TRACY, CA 95376 TRACY, CA 95375 <br /> Number <br /> 25.Transporter Company Name <br /> NUMDer <br /> 28.Transporter Company Name <br /> 27s, 27b.U.S.DOT Desraipw(including Proper Shipping Name,Hazard Class,ID dumber, 28.CoMakrers 29.Total 30.Unit 31.Waste Codas <br /> HM and Packing Group(it any)) No. Type OMW Wt Nd. <br /> 5. NON RCRA)HAZARDOUS WASTE SOLID (EMPTY � 512 <br /> METAL DAlORS� 4� -r1�, MerryAem <br /> t'1 01 <br /> i <br /> 32. mnlor�t Infarmalian r j_ 1� �f l <br /> 1 C,V' L�1 <br /> 33.T of RecW of Materials <br /> PrMedfTyped Name Signature Month Day Year <br /> 34.T erd of of Materials <br /> FwntedlTyped Name Signature Month Day Yew <br /> 35. <br /> mmwq <br /> 36.Hazgos Waste Rdpp#Iftagement Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> ul <br /> O <br /> EPA Form 87%22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY 1'0 DESTINATION STATE(IF REQUIRED) <br />