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ase print or type. Form Approves.OMB No. 50 9 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID NuMber 22.Page 23.Manifest Tracking Number <br /> (C tiriu tio%Shaet) 000078204 of 2 01280120BRE <br /> 24.Generators'Calftnia Nature) RvduCtS <br /> 1250 E.Lain tied ash1pn.am#nl ;corn <br /> 25. hansporter ComMMny Name } 15.EPA ID Number <br /> 26. Transporter Company Name U.S.EPA ID Number <br /> 27a. 2 .S.DOT Description(irtr.OV Proper Shipping Name, Class,ID Number, 28.Containers 29.Total 30�Unit <br /> 31.Waste Codes <br /> HM and Packing Group(if any)) No, Type Quantity wt./Vol. <br /> 5 UN1219,Wthslie Isopropand,3,PGi1 '51 001 <br /> DF P <br /> 8 UN2014,Whsle Hydrogen per>ide,aqueous sdttons,5.1 (8)311 P, DF 1 p L <br /> kUN3082,Ernironmentallyhaziindous substanoss,Ilgyid,�l:o.s' l <br /> ( pec Mate,Sodium Carbonate),9,P(III OF P <br /> o t8 UN2025,Whsle Marowycompounds,solid,n.o.s.(Mercuric <br /> de Red, MMy M OMWC A W te),6.1 ,PC11 DF P <br /> W _ + <br /> Z <br /> W <br /> f9 <br /> 77 <br /> 32.Specht Hardfirg Instructions and Additional Information <br /> ERdixf 24; AiCTW71 <br /> CM4 �0 f 8)ERG014D; ACT0714 CAIS r �� 7).ERW 71; ,ACM714 C W 116"`,�53 ERGO 151 <br /> T9saf70 Com ^. <br /> 33.Trans Acknowledgment of Receipt of Materials J. <br /> W Printed ame <br /> Signature �/ �- Month ]ay Year <br /> 34.Transporter Acknowledgment of Receipt of Materials <br /> PrinkKirryped Name Signature Month Z--,ay---Ylar <br /> F <br /> 35.Discrepancy <br /> J_ <br /> C.1 <br /> a <br /> 36.Hte Report Management Method(aS1i.Q,codes fa hazardous waste treatrrterr\�spo<a�arRl mqaing systems) >j <br /> IU, <br /> O I <br /> EPA Form 8704-22A(Rev,12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENI:RATO R III <br />