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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No 2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21_Generator ID Number 22.Pa 23.Manifest Tracking Number <br /> (Continuation Sheet) Z,A2890090002 1305870814 114t <br /> 24 Generator's Name <br /> Lawrence Livermore Nationai LaboratorySi'Te 300 for NNSA P.0 Box SOS f L-7Bfi Livermore CA 94551 <br /> 25 Transporter Company Name U.S.EPA ID Number <br /> 26 Trensparter Company Name <br /> U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Sh;ppiag Name,Hazard Class,ID Number. 28,Containers 29.Total 30 Unit <br /> 31 Waste Codes <br /> HM and Packing Group(if any}) ; No Type Ouantity WWaI <br /> i UNIM3, Waste,G.asahne,3.If (ERG 1231 DOPOM41-1 3001 <br /> 331 <br /> 5_UN12658, Waste,Petroleum distiiiates,n.c_t.,3.111 JERG US) 3001 <br /> �t]PrX7a4-i <br /> I 331 <br /> 7.UN35M, Waste,Mercury contained in manufactured article:,a P 19009 <br /> 6.1) (RC�(ERG 021 DGPD071-1A <br /> 181 <br /> 0 3. UN326s, waste,corrosrve Itqutd.acidic,ar�'anic,n.o s.,5,11(Lax, R ©002 <br /> ~ pack)(gG 1531 DC3Po1L4-1 <br /> 731 <br /> ul U�. N32!66, Waste.Corrosive liquid.basic"inorganic,mo s.,6,If Lai P 00-;2 <br /> pa*-t)[ERG 154) DDP0114-1X1 <br /> *}yy <br /> jL <br /> is UN u76t];-Waste.Corrostve liquids,int-o s,8:It iub pack)[F-sk. F i; g00y <br /> xi <br /> L54J DOP0114-1 791 331 752 ) <br /> .L UN2967. Y`Jaste,5ulfamtcaad,8, 111 (Lab pack)(ERG 1.541 1 OF F 0130 <br /> a MPD114.1 <br /> 791 <br /> LL L'NZ735.Amines.liquid,corrosive.mo...-5,11 ILab pack)(EfTG CF P <br /> 153) DGPD1'sR-1 <br /> 331 <br /> B. UN3262-CtwMSrva solid.basic,tnerganic-n.o_s..S,if(Lab pack) <br /> ERG 1541 DOPOL14-1 <br /> lu <br /> i4. UN35%, Waste,PAercury contained in manufactured articles,8 .009 <br /> 6.1) (R4) (ERG 1721 DC1PM71.-1.A <br /> 181 <br /> 32 Special Handling Instructions and Additional Information <br /> a 33 Transporter Aclonled meet of Receipt of Materials <br /> H PrintedrTyped Name Signature Month Day Year <br /> t7 <br /> 4 <br /> Z 34,Transporter Acknawiedgment at Receipt of Materials <br /> PnntedfTyped Name Signature Month Day Year <br /> 35.Discrepancy `4 <br /> V <br /> a <br /> ui <br /> !- 36.Hazardous Waste Re n Management Method Codes i i.e,codes for hazardous waste treatment,disposal,and recycling systems} <br /> LU <br /> f , <br /> EPA Form 8700.22A(Rev.3-05) Previous editions are obsolete. f DESIGNATED FACILITY TO GENERATOR <br />