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Please print or type.(Form designed for use on elite typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 1 21.Generator ID Number22.Pogo 23.Manifest Tracking Number <br /> (Continuation Sheet) CARODD °2 2 0$ 3 DES444598JJK <br /> 24.Generator's Name H J HELM CO <br /> 28M EL DC RADO ST <br /> STOCKTON,cA 9s2M <br /> 25. Transporter Company Name ry U.S.EPA ID Number <br /> 2.6. Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shippinp Namc,hazard r'a-�,III Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) 31.Waste Codes <br /> No. Type Quantity Wt.Nol. <br /> E UN3296.WASTE EO S-iv-uaLna, <br /> X N.c.&. n cif,rN� a�r� <br /> � c, 551 Dooa <br /> s, I <br /> ) <br /> j <br /> W <br /> C7 t <br /> {r <br /> I <br /> i <br /> ii <br /> ..-.s,_,...-�i..���..��L�..... <br /> 32.Special Handling Instructions and Additional Information <br /> 5. <br /> 712 �.� 71296 ERG M 172-2'b2 ,9=.4— <br /> I <br /> I33.Transporter Acknowledgment of Rerpipt of Materials!� _ <br /> LU Printed/TypedName � � Signature Month Day Year <br /> rZ 34.Transporter Acknowledgment of Receipt of Materials <br /> 4 Printed:?yped Name Signature Month Day Year <br /> 35.Disiprepancy <br /> J_ <br /> V <br /> Q ' <br /> LL <br /> W <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. e=61 MA72 .- ILi 7 f 73 ,Z)=8?iMA2 3 0 S 7A71 IF R EEC UI�3E.D'i <br />