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Please print or,type- Form Approved.0i No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121,GeneratorlD Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) PA0980814800 2 of 2 016503864FLE <br /> 24.Generator's Name ,JR Sim olot Co. <br /> 16777 Howland Rd <br /> Lathrop,CA 9.5330 <br /> 25. Ti ransper+er 5 Company Name US EPA ID Number <br /> Advnneed Chemical Transporttnc./DBAN--Ten 0 <br /> 26. Transporter_ Company Name U 5.EPA ID Number <br /> 27a. 27b-U-5-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 w0voi 31.Waste Caries <br /> i <br /> I <br /> a <br /> a <br /> W <br /> 2 <br /> w I <br /> th <br /> I <br /> I <br /> E <br /> i <br /> I <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporler Ackno0edgment of Receipt of Materials <br /> H Printed,'Typed Name Sig at Month Day Year <br /> a S ZZ <br /> N 34.Transporter Acknowledgment of Receipt of Materials <br /> 4[Y Printed/Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> 'r <br /> H <br /> J <br /> U <br /> a <br /> 0 <br /> LU <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> w <br /> 0 <br /> EPA Foxe 8700-22A(Rev 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />