Laserfiche WebLink
Please prF ff 153 12* Form Approved.OMB No.205M39 <br /> UNIFOY HAZARDOUS WASTE MANIFEST 121.Generalnr ID Number 23,Manhst Tracldng Number <br /> (Continuation Shaat) CQ89009=2 4 01944MZ JJK <br /> 24 Generatat+s Hama <br /> Lawwpce Uverim Ntationed Lab 9fte 3W an behW of U5 NMA P.O.Banc WS/L 786 uvermo re CA 9M1 <br /> 25 Transporter_.._. Company Name U.S.EPA ID Number <br /> 26 Transporter Company Name U.S EPA ID Number <br /> 27a. 27b.U.S.DOT Description(Ir eluding Proper Shipping Name,Hazard Class,ID Number, 2B.Containers 29.Total 30.Unit <br /> yy HM and Packing Group(d any)) 1+0, Type Quan�ly l, 31 Waste Codes <br /> 25.NbrAIM houirdass waste,scud(debris corttWrtinatt d vtdth 1 DM 44 P <br /> 1l m. wiry me dbomrwte)DDPOD44,1 <br /> 332 <br /> 21L Nat-MMA has+ ftk=waster.WN{n=dMd with PWG�wm 1 DM 241 P <br /> hydnxarbats)DDPia*11�-I <br /> 223 <br /> 27.NWF4=hUV*W ft Wfid(absorbatt with Ptrira!€tum DM 1W P <br /> hy�d;rocarbares)i'J�M'030�1 <br /> #` 2n <br /> c 78 Ntm-MA h=r*=Waft 9M Mk==RWMNdVd with 1 DP 14 P <br /> eat*1111rea I DGPOMzA-i <br /> W 3521 <br /> LU <br /> 2&Nlo ACRA hanfdars WWW,acfid(may CO drum)DOP0047--2 1 DM 51 P <br /> 512 <br /> X Nofl-RCRA haaftn WEft.CON( W"dM.W with 4.. DM 654 P <br /> item h0mcmitlam)DOP0,044-1 <br /> 223 <br /> 3L!Mast-RCPAhaVdM waft SON(UMPty dntm iist tined 1 DM 52 P <br /> d1 mrtn)DOP0047-3 <br /> 512 <br /> 3L Non-RCRA h=f* is waste,SdId 4tW&W 91W ponlydar) g OF 111 P <br /> 141 <br /> A Non-F RA hmmirck a wrote,ilgWd(adheSIVM)DOPOM-1 1 DF 5 P <br /> 331 <br /> 34.Mart-RORA hm m'dma waste."(pahtt seed nd mzl oUj 1 OF 170 P <br /> DOP0120.2 <br /> 331 <br /> 32.Special Handling Instructions and Additional Information <br /> vi <br /> 33.ran4+ -r A t of Rawipt of Materials <br /> w PrintedlTyped Name Signature Month y Year <br /> a <br /> R <br /> i X Trampnrvr l,c w ment of Receip,of Materials <br /> Printedffyped Name Signature Month Day Year <br /> w <br /> 35.Discrepancy <br /> v <br /> w <br /> Waste Repirt n I�tfro� p.e.,cod � j tr)M7tems)�CJ V/ � /W <br /> LU <br /> EPA Form 8 22A(Rev.12.17)'Previous edilians are obsolete. �/ GESIGNATEp F Ci TY T GENERATOR <br />