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SC <br /> Please -tint or M. Form des' ed for u�on elite 1.2 itch' ewritor. P Sf6.�20.3 FormAgpruved.OiriB r4+r.2050 0439` <br /> U100ARM HAZARDOUS WASTE MANIFEST 21.Generator ID Number. 22.Page I 23.hSanifestTraelring Number <br /> (Continuation Sheet) CAD-079799408 2 tri 2 09675 F.E' <br /> 24.Generator's RFD <br /> St Joseph's Mediu Center - <br /> U.S.EPA ID Number <br /> M.Transporter Company Name <br /> U.&EPA ID Number <br /> 26.Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Paddng Group(f any)) No. Type Quantity WtNol. <br /> X755. AMTE..- B -�wDSULi1TIO .9.PS it 00i €# W9 P 551 jD002 007 <br /> g <br /> 6.NON RCRA HAZARDOUS WASTE LIDS.(GELATIN-SODIUM 551 <br /> CITRATE) 001 O F 99909 P <br /> 7.NON RCRA HAZARDOUS W&STE L(QU(DS:JMiNE tOIt) � <br /> 00i D E 99096 P <br /> Cr <br /> O <br /> z <br /> I <br /> J ` <br /> 32 Special Handling Instructions and Additional Information <br /> 6.LrCCRN 1X5 <br /> 7.LrCC� 3.X5 <br /> 33.Tran of Receipt of Materials <br /> uj Prfnteffyped Name Si nature Month Day Year <br /> O <br /> ra. <br /> 34.Trans porlor Aetutowl tot Rete' of fAatedals <br /> PrintedlTypedName Month Day Year <br /> 36.Discrepancy - <br /> a <br /> B36.Hazardous Waste Report Management Method Codes(.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> c�a 5.14049 13:14040 7.H9 <br /> o <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are absotete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> Clean Fiarbare has the appre0ate perrrtitn far and will _vt the wee the Aerteratftr if elispire, <br />