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asp 027- 1 $ 1111111111 IN 11111111111111111111 III 3403 4 -001 <br /> 002047466PSC <br /> Please print ort e. Form designed for use on elle 12• itch typewriter.) Folin A roved' 01613 No. 2050.0039 <br /> UNIF48MMAZARDOUS WASTE MANIFEST 21 . Generator ID Number 22, Page 23. Manifest Tracking Number <br /> (Continuation Sheet) CA L000390053 2o12 002047466 PSC <br /> 24. Generator's Name <br /> ORCHARD SUPPLY # 1570 <br /> 2650 N MAC ARTHUR DR. <br /> TRACY, CA 96376 (209) 662-0192 <br /> Number <br /> 25, Transporter _.. _ _ Company Name <br /> UIS* EPAID Number <br /> 26. Transporter Company Name <br /> 27a. 27b, U.S. DO T 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)) N0. Type Quantify Wtivoi. <br /> S. NON-RCRA HAZARDOUS WASTE LIQUID (WATER BASED PRODUCTS) 331 <br /> 6 CW 750 P ""-'-'- <br /> 6. NON-RCRA HAZARDOUS WASTE SOLIDS (EMPTY CONTAINERS, SPRAYERS) 181 <br /> 3 CF 020 P - -- _. <br /> - - <br /> tu <br /> Z <br /> ri! <br /> C7 <br /> C `'zf_ <br /> 4 rpt <br /> 32. Sppecial Handling Instructions and Additional information <br /> (5) OSHNONREG-07 - ERGO OSHNONREG•07 - NON•RCRAIDOT REGULATED MATERIALS (6) OSHNONREGSOL•05 - ERGO OSHNONREGSOL-05 • NON RCRAIDOT REGULATED WASTE <br /> PRODUCTS <br /> 33. Trans oder Acknowted meet of Receipt of Maleriais <br /> N Printed/Typed Name Signature Month Day Year <br /> tr <br /> O <br /> D. <br /> 34. Trans oder Acknowledgment of Receipt of Materials <br /> PriMedfTyped Name Signature Month Day Year <br /> W <br /> 35. Discrepancy <br /> U " <br /> LU <br /> IIQ <br /> O <br /> 36. Hazardous Waste Report Management Method Codes Otago codes for hazardous waste treatment, disposal, and recycling systems) <br /> (6) H141 (6) H141 <br /> EPA Form 8700.22A {Rev. 3-051 Previous editions are obsolete. <br /> GENERATOWS <br /> * ' <br />