Laserfiche WebLink
PI prird or Form de3ignied for use on eft f 2 Form Amrcvved.OMB No.20500035 <br /> UW-ORM HAZARDOUS WASTE MANIFEST 21.Canerebr ID Number 22.Peps 23.AINW*t Traddnp Number <br /> (Continuadort Sh"# CAL000018659 of 2 000182556WAS <br /> 2" rpCgRP. ! DAWN JESS qTY* � P�S C ,CLERK <br /> AT S,A IL 60179 KbN, CA 95205 <br /> 25.Transpoft Company Name ^ <br /> U.S.FA C Number 141 <br /> U.6.tM lU Number <br /> 28.Transporter Campmry Nemo <br /> 27a. 27b.U.S.DOT Des pow Mdudlnp Proper SNppkN Name,Hazard Class.ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> tlra arid Paaarww n any)) No. Type 4+ h W!M. <br /> X 5. RQ UN2929,WRSTE TOXIC LIQUIDS, FLAMMABLE, D001 D016 D <br /> GRN�C N.0.S.,6.,(2, PGI I, Z CF n <br /> 5. DICHLOROPHENOXYACETIC ACID), (D037 D001), XXX XX XXX X XXXX XXXX XXXX <br /> ERG#131 <br /> xxxx xxxx xxx <br /> x 6 Re <br /> IT (AIMPI <br /> D, ks 71 1 -714 <br /> d' <br /> t <br /> X 7 <br /> 0 1;'R <br /> . ,STf36-I-E;{9�tt11yHf1`�TR�3f-ISE , <br /> innnn� c�u•cf. <br /> 7 <br /> W <br /> W 8 Qh uN 1494 t, V-rs µypoc►�wa�zE Sowtfa+✓s $ <br /> eV%-0ls,q Ian 6o I �F 4 <br /> 9 UN togb I iA4cuum 2.2 t='R(q 4412j <br /> 331 <br /> a�ot e� 4Ma <br /> ?ox a —S ►xs5Df x 55a� <br /> w 33.Tre of of Me*dab 42 <br /> W Pr Nemo MOmb Day Yea <br /> O d <br /> 2 <br /> z 34.T AclvroV mem of R of Matettale <br /> PnntFNVTYped Name Signature WonT Day ear <br /> 35.Discrepancy <br /> J_ <br /> V <br /> Q <br /> LL <br /> D <br /> Q36.Hgardous Waste tTi �IanagemeM".C.6.9(i.e.off( hezardoua waste�eatrnent,6spc rocydn0 sYsfems) (q I <br /> 2S2 <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 />