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<br />RECEIVED
<br />EPA Form 8700-22A (Rev 3-05) Previous edrb6ns are obsolete
<br />DESIGNATED FACILITY TO GENERATOR
<br />-
<br />UNIFORM HAZARDOUS WASTE MANIFEST 21 Generator ID Number
<br />22 Page
<br />r•orm APProvoo. UMB No. 2050-0035
<br />23. Manifest Tracking Number
<br />(Continuation Sheet) CM890090002
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<br />005�Q{�IE .�$� 2014
<br />24 Generator's Name I-Myrence Lkermore National trI!ratCry SRe 3r]0
<br />P.O. Box am L -71z< ENVIRONMENTAL HEALTH
<br />uv ertnore CA 9s +5t
<br />25 Transporter Company Name US EPA ID Number
<br />26 Transporter Company Name US EPA ID Number
<br />27a
<br />27b. US DOT Description (Including Proper Shipping Name, Hazard Class, ID Number,
<br />28. Containers
<br />30.,ti
<br />HM
<br />and Packing Group (d any)}A.No
<br />Quantl�tyl
<br />lit
<br />91 Waste codes
<br />Type
<br />15 UN3262, Corrosive solid, basic, inorgan;c n o s., 8,111 (Lab
<br />Pack) (ERG 1:t4] (DOPOi 14-1)
<br />41
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<br />16
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<br />16. UN3264, Waste, Corro-dve liquid, addi,; inorganic, n o.s . 8 H
<br />(Lab Pack) [ERG 154] (DOPO114-1)
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<br />1
<br />DP
<br />7
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<br />A002
<br />17 UN3264, Waste, Corrosive liquid, acidic, inorganic, n o s, 8. II
<br />(Lab Pack) [ERG 1541 (DOPOi 14-1)
<br />lam'
<br />15
<br />Y
<br />0002
<br />0
<br />18. UN3266, Waste, Corrosive liquid, acidic organic, n o s, 8, 11
<br />Pack) (PRG 153] (DOP0114-1)
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<br />C1(Lab
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<br />19. UN3265, Wast-, Corrosive liquid, acidic organic, n o s' 8,11
<br />(Lab Pack) [ERG 1531 (DOP0114-1)
<br />1
<br />DF
<br />8
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<br />Dar:
<br />20. UN3266, Waste, Corrosive liquid, basic, inorganic n.o.s. 8, II
<br />(Lab Pads) [ERG 154] (DOP0114.1)
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<br />1
<br />DF
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<br />D002
<br />21 UN3266, Waste. Corrosive liquid, basic Inorganic, n.o.s., 8,11
<br />(Lab Pack) [ERG 154] (DOPO114-1)
<br />1
<br />nF'-
<br />122
<br />D002
<br />22. UN3267, Corrosive�liquid Dasa orAanlc,,t.p.s.,
<br />(GiewrfleFletetrarnn 8 I! [ERCT 1531(DO�r'01 t4-?)s3i
<br />1
<br />D£
<br />16
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<br />23. NA3077, Hazardous waste solid, n.o.s (0005), 9.111("cl HE'
<br />[ERG 171] (DOP0036-1)
<br />1
<br />M1
<br />230
<br />P
<br />ia3
<br />Doos
<br />24. NA3077, Hazardous waste, solid, n.o s (DO08). 9, NI [ERG 17 11
<br />(DOP0036- i)
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<br />CF
<br />110
<br />PL�
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<br />080@
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<br />32 Special Handling Instructions and Additional Information
<br />33 Transporter _`_ AdmaWed meet of Receipt of Materials
<br />Pnnted/Typed Name Signature Month Day Year
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<br />34 Transporter _ Admowk4Vwt of Receipt of MateUls
<br />Printed/Typed Name Signature Month Day Year
<br />35 D screpancy
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<br />36 Hazxdeus td Report Management Metinod Codes' Q e doles for hazardous vraste treatment dapo;al, and leryc(44,ystems)
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<br />EPA Form 8700-22A (Rev 3-05) Previous edrb6ns are obsolete
<br />DESIGNATED FACILITY TO GENERATOR
<br />
|