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Please print or type. (Form designed for use on 2-pitch)typewriter.) Form Appmvetl OMB No,2050-0039.Expires 9-30-94 <br /> UNIFORM HAZARDOUS 121.Generator's US EPA ID No. Manifest Document No 22.Pa a Information in the shaded <br /> WASTE MANIFEST �1 �r areas is not required by Federal <br /> (Continuation Sheet) q v� (�7 ( Z law. <br /> 23.Generators Name / ,M L tate Man'fest Document Nibv' <br /> ' <br /> G� <br /> ti Y"' (\/� M.State Gene -tors ID C� <br /> -0. $$X $ CA • S33-0 <br /> 24.Transporter y Name 25.US�EEPPA I Num r N.State Transporter's ID <br /> (IIJV !JC bob O.Transporter's Phone r- <br /> 26.Transpotter Compan mem--- 27.US EPA ID Number P.State Transporter's I0. <br /> v"�t wUc1 7700 0.TransportersPhon :7 <br /> 29.Containers 30. 31. R. <br /> 28.US DOT Description(Including Proper Shipping Name,Hazard Class,and ID Number) Total Unit Waste No, <br /> 1707 No. Type Quantic Wt/Vol <br /> a. <br /> b. <br /> C. <br /> G d <br /> E <br /> N <br /> E <br /> R <br /> A a. <br /> T <br /> O <br /> R <br /> f. <br /> 9 <br /> h. <br /> i. <br /> S.Additional Descriptions for Materials Listed Above T.Handling Codes for Wastes Listed Above <br /> 32.Special Handling Instructions and Additional Information <br /> T 33. Transporter Acknowledgement of Receipt of Materials Date <br /> R <br /> Printed/Typed Name SignaW re o th Day Year <br /> 0 34. Transporter_ Acknowledgement of eipt of Materials Date <br /> R Printed/Typed Name Signature / o y Ye r_ <br /> E !� <br /> F 35. Discrepancy Indication Space <br /> A <br /> C <br /> L <br /> I <br /> T <br /> Y <br /> Style CF18-6 Labelmaster,An American Labelmark Co.,Chicago,IL 60646 (800)621-5808 EPA Form 8700-22A(Ree 9-88)Previous editions are obsolete. <br /> ORIGINAL-RETURN TO GENERATOR <br /> LSIH3 SOYEENIIN[ INN <br />