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Y � � <br /> Please Ddrd or Form designed for use on elle 12 Form roved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21 ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) CA 229732 o f 2 9 1 1434192FLE <br /> 24.Generatoes Name <br /> CVS #3908 <br /> 25.T Company Nemo 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 Nam,Hazard toss,ID Number, 26.Contadners 29.Total 30.Unit 31.Waste Codes <br /> HM and Pecking Croup Il any)) No. Type Quantity MJW. <br /> 9, Waste Oxidizing liquid, n.o.s. 1 CF 00012 P 141 DON <br /> (Hydrogen Peroxide), 5. 1, PG II, ERG#140 <br /> X 6._UN2811, Wa-ste. Toxic .solids, . organic, n.o. s. 1 CF emi P 311 DIN17 D610 <br /> (Chromium, Selenium), 6. 1, PG II, ER6#154 <br /> . X 7.UN3249, Waste Residue Last Contained, 1 CF @M1 . P 311 P001 <br /> Medicine, solid, toxic, n.o.s. (Warfarin), <br /> 0X B..UN2810, Waste Toxic, liquids, organic, n.o. 1 CF W002 P 311 D007 D024 <br /> s (N—Cresol, Thimerosal), 6. 1, PG II, ERG# <br /> uJz <br /> 9.Non RCRA hazardous waste, liquid (State 4 DF 00595 P 331 <br /> Regulated Water Based Consumer Products), <br /> 32.SpecialHandling instrucand Additional k6aration 5.1 197(Oxidizing Liquids) .. 6. 100196(RX Toxic Solids } 7. <br /> 101079(Residue weight does not exceed 0.0436 lbs) CNT:8 8.1 7(RX Toxic Liquids) 9. <br /> 1 9(State _Regulated Liquids) , <br /> 33.Transporter Acknowledwivurt of Reoelptd Materials <br /> aril Printedfryped Name Signature Month Day Year <br /> sac <br /> 34.Lqffg2LW Acknowledgment of Receipt of Materials <br /> Printedayped Name Signature Month Day Year <br /> 35 <br /> V <br /> O <br /> X.Hazardous=ent Method Codes(i. .,codes for hazardous waste treatment disposal,and cycling systems) <br /> Uj <br /> W <br /> D <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRE11 <br /> 8700-22a 12y,3. CALM96641 S8876 041149430 M PD079518 SD070518 <br />