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I l &. V' L'1 d L_ L) <br />Please print or type (Form desioned for use on elite n 2 vnawrilor I <br />EPA Form 8700-22A (Rev. 3.05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />- ' — r-, <br />UNIFORM HAZARDOUS WASTE MANIFEST 21 =rabr ID Number <br />I I tW�Tp,�v9'�'ti3 No 2050-0039 <br />22 Page 25..- _..test Tracking Number <br />(Continuation Sheet) CA28900g-0002 <br />6 "6966488 .J <br />24 Generators Name Lftrenee lhremTore N1110nal Labor3Tory SRe 300 <br />VIRONIVIEN IAL NEA N <br />P.O. Box 806 t_-1135 <br />[DEPARTMENT <br />I.Itrermore CA 94551 <br />25 Transporter Company Name <br />U S. EPA ID Number <br />26 Transporter Company Name <br />US EPA ID Number <br />27a <br />27b US DOT Desrnphon (incWng Proper Shipping Name, Hazard Class, IDN be4 <br />28 Containers <br />29 Total <br />30 Un(t <br />HM <br />and Packing Group Cd �Y)) � - <br />Quantity <br />Wt1Vol <br />3t. Waste Caries <br />No <br />Type <br />45 Non RCRA hazardous waste, solid (debris contarrinaWd witf� <br />p-stroleiJm hydreca,tons) (DOP0144-1) <br />L26 <br />72 <br />-- <br />1 <br />DF <br />F' <br />46. Non-RCRA hazardous Waste, sofid (debris contamnated vriri <br />petroleum hydrocarbons) (00POW-1) <br />1 <br />M <br />129 <br />v <br />47 Non-RCRA hazardous waste, solid (debris conimmnatnd with <br />petroleum k; Jrocarbons) (DOP0044-1) <br />223 <br />.9 <br />DS <br />617 <br />U <br />o <br />a Nor*-RCRA hazardous waste, s3ohd (debris conta6ri ted avlth <br />nUffiu is acid) (DOP0044-1) <br />1a1 <br />1 <br />Dict <br />AA <br />r <br />w <br />Z <br />49 Non-RCRA hazardous waste, solid (empty drum) (DOP0046-1) <br />512 <br />2 <br />D3: <br />54 <br />P <br />60 Non-RCRA hazardous waste, solid (fretybdenum disulfide, <br />silicon carbide) (DOP0120-1) <br />331 <br />1 <br />DF <br />81 <br />P <br />51 Non -R -P,4 hazardousvrs-^ solid (non PCB canaat,)rl <br />0DOP002Ft-1 t <br />223 <br />- <br />-- <br />1 <br />52 Non-RC�,A hapj¢pur w ,,NPd jrion PCO ijoht ba11�) .. <br />- - <br />_ <br />(DOP0028-1 j <br />223 — <br />1 <br />Deft <br />960 <br />P <br />53. NarRCRA ha72dous Waste. solid (resin beads and plica <br />beads) (00POi2101-1) <br />i <br />DF <br />67 <br />P <br />331 <br />54 Nc-rRCRA hazardouswasce solid (resin beads) (DOP0104-1) <br />2 <br />Uhf <br />725 <br />F <br />I <br />32 Speaal HarAng Instructions and Adddional Information <br />33 TranWier__Ad=WedgrnentofRet,6ptafMatenals <br />Printedrryped Name Signature <br />Month Day Year <br />R <br />34 T r_ _ _ A ina ment of Recelpt of Materials <br />Printed/Typed Name Signature <br />Month Day Year <br />35 Dsaepancy <br />U <br />I <br />O <br />Q36 <br />Hazardous Waste Report Management Method Codes Q e, for hazardLus waste treatment, d spcsai. and wcydirg systems) <br />Lt <br />t7 <br />H <br />I <br />1 <br />EPA Form 8700-22A (Rev. 3.05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />