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--c)t ww geca r'iGv 79.,i41GOWJe7rrOC" .�J�30J". Lr'trp7TlJIC 1'0 "'t�Lnr-.L i i rz2vie 3 i i/ - - - <br /> Please print or type. Form de & ned for use on elite 12-ftch) ter. Form roved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest TrackUg Nunes <br /> (Continuation Sheet) CAR 01229732 2f 2 1 008629256ELE <br /> 24.Generator's Nam <br /> CVS #3908 <br /> U.S.EPA ID Number <br /> 25.Transporter Company Name <br /> U.S.EPA ID umber <br /> 26.Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Nam,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Pacldng Group(if any)) No. Type Quantity WLAAol. <br /> 5.UN1950, Waste Aerosols 2. 1, ER6#126 1 CF 00008 R 214 DOM <br /> ar <br /> a <br /> w <br /> z <br /> LtJ <br /> ca <br /> 32.Special HaruWkg Instructions and Additional ftnInstion <br /> 5-. 100201 (Aerosols, Flammable) <br /> 33.T of Receipt of Materials <br /> Uj Printedfryped Name Signage MmM Day Year <br /> 34.T meet ofamg of Materiala <br /> Printedffyped Name Signature 950 q-7ei—r <br /> 35.Discrepancy <br /> U.Q <br /> G <br /> 4 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste Vestment,disposal,and recycling systems) <br /> z 9/ <br /> C9 <br /> W <br /> D <br /> L-- <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> 8700-22a 12v3 CAL20090641 58876 040997974 M IDD121217 SD121217 <br />