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Please Print or Form designed for use on elite 12 itch writer. Form A roved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121,Generator ID Number 22.Page 23.Manlfest Tracking Number <br /> (Continuation Sheet) CAR000231712 12 of 2 010788942FLE <br /> 24.Generators Name <br /> CVS #9830 <br /> U.S.EPA ID Number <br /> 25 Transporter Company Name <br /> U.S.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 Packing Group(if any)) No. Type Quantity Wtivoi. <br /> 5.UN1993, Waste Flammable liquids, n.o. s. 1 DF 00125 P 214 D001 U002 <br /> (Alcohols, Acetone), 3, PG II, ERGI#128 <br /> 6.Non RCRA hazardous waste, liquid (Regulated 2 DF 00257 P 331 }' <br /> Liquids), <br /> 7.Non RCRA hazardous waste, solid (State 1 DF 00133 P 3311 s <br /> Regulated Products), -�" <br /> i <br /> O — --- <br /> y. <br /> W <br /> Z <br /> W I <br /> (.7 <br /> 1 <br /> 1 <br /> 1 <br /> S <br /> 32.Special Handling Instructions and Additional Information 5. 100198(Flammable Liquids) 6. 102979(State Regulated Liquids) <br /> 7. 102980(State Regulated Solids) <br /> 33.Transporter Ac$mowledgment of Receipt of Matenals <br /> Signature Month Day Year <br /> W Printed/Typed Name <br /> I-- <br /> of <br /> O <br /> a <br /> Z 34.Transporter Acknomed ment of Receipt of Materials <br /> Pnnted(Typed Name Signature Month ay ear <br /> H <br /> 35 Discrepancy <br /> J <br /> U <br /> Q <br /> LU <br /> LL <br /> 0 <br /> a 36,Hazardous Wase Report Xagement Method Codes(i.e.,codes for he rdous waste treatment,dis s I,and recycling systems) <br /> Z <br /> C7 <br /> rn <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 CAL20090641 940005857 041004222 M PD122217 9DI22217 <br />