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II NII I I II I I II II II I it 1111 li i l l 1111 111 <br /> 481027-18 _ 002047466PSC 3403945-001 <br /> Please print ort e. Form designed for use on elite 12 itch t ewriter. Form Approve UIGI�G 2050 0039 <br /> UNIFQR �DOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) CAL000390053 2 of 2 002047466 PSC <br /> 24,Generator's Name <br /> ORCHARD SUPPLY#1570 <br /> 2650 N MAC ARTHUR DR. <br /> TRACY,CA 95376(209)662-0192 <br /> 25. Transporter Company Name <br /> EPA ID Number <br /> 26. Transporter Company Name <br /> .S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No. Type Quantity wt./Vol. <br /> 31.Waste Codes <br /> 5.NON-RCRA HAZARDOUS WASTE LIQUID(WATER BASED PRODUCTS) <br /> 331 <br /> 5 CW 750 P <br /> 6.NON-RCRA HAZARDOUS WASTE SOLIDS(EMPTY CONTAINERS,SPRAYERS) <br /> 181 <br /> 3 CF 820 P -.•-_•-- -.. -..µ.�... <br /> O <br /> w f <br /> z t <br /> w <br /> C9 <br /> Ir <br /> 32.SppeciaLHandling Instructions and Additional Information <br /> (5)OSHNONREG-07-ERG()OSHNONREG-07-NON-RCRA/DOT REGULATED MATERIALS(6)OSHNONREGSOL-05-ERG()OSHNONREGSOL-05-NON RCRA/DOT REGULATED WASTE <br /> PRODUCTS _ <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> F Printed/Typed Name Signature Month Day Year <br /> O <br /> a <br /> Z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed[Typed Name Signature Month Day Year <br /> } 35.Discrepancy <br /> J_ - - <br /> U <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardouswasle treatment,disposal,and recycling systems) <br /> Z (5)H141 (6)-H141 <br /> 0 <br /> U11 <br /> o <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. <br /> OW <br /> 11 1 P <br />