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Please printo Form desow ror use on elite(12-pitchl lyirewriter. 6I iM98412&M SC PP1Ar 5/30,&2017 Form AAbproved.ONS No.?050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.GeneratrlDNun, r 22.Pape23.Nan8est TraTr,ldng Number <br /> )Continual on She 9 8 3 5 0 0 5 9 4 Ol0907223FLE <br /> 24,General&.Name - <br /> Kaiser Perfmaneme <br /> 25.TramPMer Company Name UL EPA ID Number <br /> A, 3��z27 <br /> US.EPA ID Number <br /> 2a Transwer Comfy Name <br /> 27a. 27b.U.S.DOT Des'iplon(ndudng Raps SNppnp Name,Hamid Class.ID Nrmbcr, 28.CmW,xr. 21.Total 30.Unit 31.Wasle Code. <br /> HM and Pac"Group(darry)) No. Type Ow wy WINo. <br /> 5.UNi85L WASTE MEDICINE:LIOUID.TOXIC.N.OS_CWR(;U D009 141 331 <br /> X 64,PG UI 0 0 i D F 00005 P <br /> 6.UN3266,WASTE CORROSIYELIQUID.MSIC,INORGANIC, 8002 551 <br /> X <br /> 111.0.5,M DIUM HYPOCHLORITE),S.PQ II 001 D F 01 006 P <br /> T.14ONi1CRA HAZARDOUS WASTE,LIQUIDS,flIORMALIN.TISSUE 311 <br /> 001 C F 0-"63 P <br /> 0 <br /> i <br /> 32.Specal Nand6p autr�cednsand Addfinwl Infamadon <br /> S.CH538288 ER"151 1X10 <br /> 6.LCCRB ERC-.0154 1X5 <br /> 7.CH1218596 1X20 <br /> I>< 33.Tran a aMativals <br /> .w-- Rn[edRypM Name � 5lpreare M1ImN Day Year <br /> 2 34.Trans r mead Rec*a[Marlerals <br /> PrededFry*Name : re4re Iii ey ea <br /> ~ I <br /> } 35.DsaePawy <br /> CJ <br /> Q <br /> LL <br /> L] <br /> Q35.N ardws waste Report Mmagemnt Method Codes(i.e..mdes for hamarnus waste Reabnent.degosal.aid recydig s)stems) <br /> I � unan I I <br /> N <br /> W <br /> O I I I <br /> EPA Form 8700-224(Rev.3.05) PrWous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED( <br /> Clean Harbors has the appropriate pemlits for and emill accept thewaste the generator is shipping. <br />