Laserfiche WebLink
Please print or type. (Form desioned for use on elite (19-ndchl Nnawraar t <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />--I <br />UNIFORM HAZARDOUS WASTE MANIFEST 21. Generator ID Number <br />22. Page <br />ruin mppruveu. Villi No. ZULU-UUJ9 <br />23. Manifest Tracking Number <br />(ContinuatlonSheet) CA2890090002 12c: <br />PRIEn <br />005870331 <br />JJK <br />24. Generator's Name LalivrenCe Livermore N30)1-131 L30ar3tory Site 300 fatirrtfW*d <br />P.O. 13ox 808 / L-786 <br />Uvemtore CA.24s51 JAN 14 2016 <br />25. Transporter Company Name <br />U.S. EPA ID Number <br />ENVIRONMENTAL <br />26. Transporter Company Name HEALTH DEPARTIVItINI <br />I U.S. EPA ID Number <br />27a. <br />27b. U.S. OOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />28. Conlainers29. <br />Total <br />30. Unit <br />HM <br />and Packing Group (if any)) <br />Quantity <br />'NLNoI. <br />31. Waste Codes <br />No. <br />Type <br />35. Non-RCP.A hazardous waste, solid (bum pit ash) (SJ95-2554) <br />181 <br />i <br />DF <br />105 <br />P <br />38. Non-RCRA hazardous waste, :solid (debris contarnnated with <br />petroleum hydrocarbons) (DCP0044-1) <br />zza <br />i <br />DM <br />80 <br />P <br />37. Non-RCRA hazardous waste, solid (debris contaminated with <br />petroleum hydrocarbons)(DOP0044-1) <br />223 <br />3 <br />DH <br />559 <br />P <br />0 <br />38. Non-RCRA hazardous waste, solid (dried paint) (DOP0t20 1) <br />zsl <br />6 <br />DF <br />943 <br />P <br />w <br />LU <br />39. Non-RCRA hazardous waste, solid (empty drum last contain <br />petroleum h;rdreca hDns) (DOP004?-1) <br />slz <br />i <br />DH <br />40 <br />e <br />40. Non-RCRA hazardous waste, solid (empty drum last contained <br />petroleum hydrocarbons) (DOP0047-1) <br />1 <br />Dpi <br />40 <br />P <br />sit <br />41. Non-RCRA hazardous waste, solid (errpty drum last contained <br />petroleum hydrocarbons) (DOP0047-1) <br />7 <br />DM <br />333 <br />P <br />slz <br />42. Non-RCRA hazardous waste, solid (empty drum) (DOP0047-1) <br />513 <br />1 <br />DM <br />16 <br />P <br />43. Non-RCRA hazardous waste, solid (empty drums last contained <br />petroleum hydrocarbons) (DOP0047-1) <br />2 <br />DIES <br />so <br />P <br />512 <br />44. Non-RCRA hazardousYmste, solid (grease) (DOP0087-1) <br />2,1 <br />I <br />D11. <br />173 <br />P <br />32. Special Handling Instructions and Additional Information <br />33. Transporter Acknowledgment of Receipt of Materials <br />F <br />Prinledrryped Name Signature <br />Month Day Year <br />O <br />CL <br />Z <br />34. Transporter . Acknowledgment of Receipt of Materials <br />PrintedrTyped Name Signature <br />Month Day Year <br />F <br />35. Discrepancy <br />J <br />U <br />a <br />LL <br />O <br />W <br />Q <br />36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />Z <br />0 <br />co <br />W <br />0 <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />