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F��rr i t <br /> `Pleprint or type,(Form designed for use on elite(12-pitch)typewriter) Form Approved.OMB No.2060.0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121 Generator ID Number 22�PageF 23.Manifest Tracking Number <br /> (Continuation Sheet) 289ONW02 005811088E AX <br /> 24 Generators Name , awrance Livermore National Labtara MShe 300 fur NNSA <br /> P $1 Anr StrM /I_7AA i ivarrnmra f-A QaCC1 <br /> 25,Transporter Company Name U.S.EPA ID Number <br /> 26 Transporter Company Name U,S EPA ID Number <br /> 27a, 27b U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> 31,Waste Codes <br /> HM and Packing Group(if any)) No Type Quantity WLAd <br /> l315�..Nflo�n1-� CRA hazardous waste,solid(adheirve,ascorbic a r Ci <br /> Wf r�t.[.rri <br /> 36. Non-R--tn hazardous waste,ltqusd{epaxq adtmewe)DClt'C?U0-1 <br /> 331 <br /> 37_ Non-k-RAhazardous waste.solididebriscarnammatedwith DM 203 <br /> p�tc�lauaZ�hydFu�afbol•is�G�Ft-: <br /> 223 <br /> 0 <br /> -M. Kon,KCRA hazardous waste_solid.empty drum last tontatr 75 a <br /> sodium phosphinate)DOP0047-1 513 <br /> W <br /> LU 39_ Han-SCRA hazardous waste.liquid�waterand sodium DF 179 p <br /> phos}lunate)00PI30091 <br /> 141 <br /> at]. Non-IRCRA hazardous waste.solid Inon-QCO taalias*s)DoPOOZ9-1 _ 0M 109 o <br /> 23 <br /> aj- Non LKA ti3zaraous waste.flgU10 laf rVreeze}i30P00&-j,-! A 130 ? <br /> 343 <br /> 92- tvon-RCIR R hazardous waiTe,solid 4non-Pcu:apacitorsl r)0PQ 29 IMF 6 <br /> i <br /> �r3 <br /> 43. Hon-Rom hazardous waste,solid I empty drum last contained b t. <br /> ra petrofeum hydroCarboni)DOP0047-1 <br /> 51Z <br /> 41. Non-RCRAhazarftus waste,liquid f.watermtxlure(ontaminated i DF <br /> with tn--sodium phosphate and beryllium)DOPODiO-1 <br /> 02 <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> F Prntedrryped Name Signature Month Day <br /> O <br /> a <br /> Z U.Transporter nt of Receipt of Materials <br /> Printedrryped Name Signature Month Day Y- <br /> M <br /> 35 Discrepancy <br /> LU <br /> C7 <br /> a <br /> Q <br /> { 3$Hazardous Report Management r>agement Method �s(i.e.,codes far hazardous waste to atmen� recycling systems) <br /> EPA Form 8700-22A{R6,'3.05) Previous editions are obsolete. bkSIGNATED FACILITY TO GENERATOR <br />