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GENERATOR .s I i . Form Approved. OMB No. 2050-0039 <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />21 Giein'eratcr ID Number <br />CAL 000327765 <br />22 ,.=• age <br />2 <br />23. Manifest Tracking Number <br />01 64 11 20FLE Num.! liValgretiDS #1 0i3 1 <br />147E0 Harlan Road <br />Lathrop; CA 95330 <br />5. Transporter 3 Company Name U.S EPA ID Number cil gar° /G3ta Et? —1,--e —j "•—i"191 i _ - cYuilig. me- LA Sc us', ,14 c... 1 ...,smetrrrs4.21-7 <br />26 Transporter Company Name U S EPA ID Number <br />I <br />27a 27b. U.S. DOT Description (including Proper Shipping Name. Hazard Class, ID Number, L'• ::::nt] '..-r,, <br />44 and Packtng Group (if any)) hi:i <br />i <br />, <br />?.2 Special Handling Instructions and Additional Information TRANSPORTER :....: 'ranspotter 1 Acknowledgment of Receipt of Materials <br />Printet Typed Name Signature <br />I CAi" Ari lir, I ( It/ <br />34 Transpor,er Acknowledgment of Receipt of Materials <br />PnntecIfTyped Name Month Day <br />I I <br />Ye:.ir <br />I IDESIGNATED FACILITY it Discrepancy <br />'36 Hazardous Waste Report Management Method Codes lie, codes for hazardous waste treatment, disposal. and recycling syst,::--, <br />I I I I <br />I I I I <br />EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM