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Please Ant Ore. Farm designed for use on elite 12 itch t wr ter.) Form A roved.OMB No,2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) CAR0002317.12 of 2 009157,113FLE <br /> 24.Generators Name <br /> CVS #9830i�:i:r-r:.e; :,_i <br /> U.S.EPAID Number <br /> 25. Transporter Jj Company Name <br /> r• ^:. -21st-:Ce.nt.uryl'Env,ironuent-ti,'-of-,NevadaWLLe 1,NVD980895338 . <br /> U.S.EPA ID Number <br /> 26. 7ransooser ompany Name <br /> 27a, 27b.U.S.DOT Description(inducting Proper Shipping Name,Hazard Class,ID Numbe(, 28.Containers 29.Total 30.Unit 31.Wasto Codes <br /> HM and Packing Group(if any)) No. Type Quant ty WtNol, <br /> QO <br /> a <br /> w <br /> z <br /> w <br /> , <br /> 32.Special Handing Instructio s and Add.uonal Informat on <br /> I <br /> 33.Transpoqa,,1Ackncwl9dQmen1 of R 1 of Matenals <br /> r— Sgnature Month Day Year <br /> tePnnled[Type <br /> Z34.Transporter Acknowl d m t ofRecfjpt o'Materials <br /> Printed7Typed Nam Signature on Year <br /> Day <br /> f- rZ171ek <br /> i <br /> 35.Discrepancy <br /> V <br /> ti <br /> h <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and regcing systems) <br /> C7 <br /> h <br /> W <br /> 4 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(1F REQUIRED) <br /> •8700-22a-12v3 CAL20090641 - 540005857 040721204 M PD110316 SD110316 <br />