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Please orint or type. Form designed for use on elite 12- itch ewriter.I Form Approved.OMB No.2650-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21,Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) CAR000231712 of 2 008675487FLE <br /> 24.Generator's Name <br /> CV5#09830 <br /> U.S.EPA lD Number <br /> 25. Transporter Company Name <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name <br /> Z 2Ta. 2Tb.U.S.OOT Descr#iGn(xndudng Proper Shipping�.Hazard Class,0 Number. 28.Containers 29.TOW 36,Unit 3t.Waste Codes <br /> HM and Paddng Group('l any)) No. Type Ouanhty W N . <br /> 5. on RNA hazardous waste, solid 3 <br /> 6.Batteries, dry, sea-led <br /> x <br /> 0 <br /> w <br /> Z <br /> w <br /> 32.Special Handling Instructions and Additional Inlormation ace e g u ateD l s n l v e r s a a c n e <br /> NiCad Batterie_) <br /> fe 33.Trane e< A of Receipt of Malefiats <br /> �u Ptinted/Typed Name Sint re Month Day Year <br /> a <br /> O <br /> d <br /> z 34.Transporter AdmovAedgmentofReoeiptolMaterOls <br /> Printed/Typed Nam Signature Month Day ear <br /> 35.Discrepancy <br /> Zi <br /> U <br /> Q <br /> aL <br /> O <br /> a36.Hazardous Waste R rt Management Method C410(ce. es tot hazardous waste treatment,disposal,and recydirg systems) <br /> z <br /> c� <br /> w <br /> 0 <br /> EPA Form 8700.22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> 8700-22a 12v3 CRL20090641 540005857 040547157 M PD120715 SD120715 <br />