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Please print or tvoe. (Foran desionpri fnr ima nn arra 119-3,k% h <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />NT <br />UNIFORM HAZARDOUS WASTE MANIFEST 21• Generator ID Number <br />Form Approved. OMB No. 2050-0039 <br />22. Page 23. Manliest Tracking Number <br />(Continuation Sheet) CA2890090002 <br />4 405870331 J.1K <br />24. Genera'or's Name Lawrence evermore National Laboratory Stte 300 for NNSA <br />P.O. Box 808 / L -7a6 <br />k "' <br />Livermore CA 94551 <br />25. Transporter Company Name <br />U.S. EPA ID Number <br />JAN 14 2 <br />26. Transporter Company Name <br />U.S. EPA ID Number <br />ENT Al <br />NVIRON, <br />T27a.27b.PU,S. <br />DOT Desatp6cn (Including Proper Shipping Name, Hazard Claes, ID Number, <br />acking Group (if any)) <br />26. Containere <br />29. Total <br />30. Unit <br />, <br />HE W <br />No. <br />Type <br />Quantity <br />Wt 1Vol,� <br />was <br />25. Non-RCRA hazardous waste, liquid (photo replenisher) <br />(DOPO120-1) <br />saz <br />i <br />DF <br />70 <br />P <br />26. Non-RCRA hazardous waste, liquid (spent antifreeze) <br />(DOP0010-1) <br />3a3 <br />2 <br />Dt! <br />805 <br />P <br />27. Non-RCRA hazardous waste, liquid (spent antifreeze) <br />(DCPOQIO-1j <br />343 <br />1 <br />DF <br />41 <br />e <br />29. Non-RCRA hazardous waste, liquid (water contaminated with <br />diesel) (00130010-ij <br />133 <br />i <br />DF <br />45 <br />P <br />30. Non-RCRA hazardous waste, liquid (water contaminated with <br />ethyl acetate) (DOP0010-1) <br />134 <br />i <br />I7Ti <br />44 <br />P <br />31. Non-RCRA hazardous waste, liquid (water contaMnated with <br />petroleum hydrocarbons oil) (DOP0010-1) <br />1 <br />DM <br />451 <br />P <br />223 <br />32. Non-RCRA hazardous waste, liquid (water contaminated with <br />petroleum hydrocarbons) (00P001(-1) <br />i <br />0M <br />416 <br />P <br />223 <br />33. Non-RCRA hazardous waste, liquid (water contafrtinated with <br />sodium citrate)(DOP0010-1) <br />1 <br />DF <br />27 <br />e <br />134 <br />34. Non-RCRA hazardous waste, solid (adhesNe, sealant) <br />331 <br />(DOP0120-1) <br />1. <br />DF <br />11 <br />P <br />32. Special Handling Insbuct cuts and Additional Information <br />33. Transpo ter Acknowted ment of Receipt of Materials <br />kl <br />Printedrryped Name Signature <br />Month Day Year <br />O <br />a <br />z <br />34. Transporter Acknowledgment of Receipt of Materials <br />Printedrryped Name Signature <br />Month Day Year <br />H <br />35. Discrepancy <br />V <br />G <br />W <br />Q <br />36. Hazardous Waste Report Management Method Codes (1.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />C7 <br />N <br />w <br />O <br />- I- - <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />NT <br />