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EDO <br /> Form Approved,OMB No.2050-00 <br /> EwQ 201017 <br /> rare 4.Manifest Tracking NumberCi <br /> alfornia 01/ I 0035675 <br /> 35 JJK <br /> iiHeent than mailing address)HELH <br /> 0ERWISE"CES <br /> 2106 Adams Ave., San Leandro, CA 94577•(510) 633-2450• Fax(510) 633-2515 u.5.EPA ID Number <br /> Customer's Contact DateCAROODD09910 <br /> LLS.EPA ID Number <br /> Name <br /> f=AD028277036 <br /> Address Phone us.EPA lD Number <br /> CAD0970NOW <br /> Manifest Number �/ _ <br /> 00 \�Li 7 ` 7 \ s 11,Total 12,Unit 13.Waste Codes <br /> J J .J.J Type Quantity Wt.Nol, <br /> Ouan. Gal. Total Lbs. Description Price /} G 2�4 r 3 _ <br /> Aluminum Plates '/� / " Mone <br /> Scrap Film 7� G 134 <br /> Silver Flake r✓m <br /> Silver Recovery Cartridges G 3 <br /> Photo Chemical Waste <br /> Waste Ink/Ink Debris <br /> Waste Flammable Liquid <br /> DOT Empty Drums <br /> L Documentation Preparation ERGI7 <br /> II / fOLUQ <br /> nbed above by the proper shipping name,and are classified,parka ed, <br /> ral governmental regulations.If export shipment and I am the Primary <br /> CX�C/ quantity generator)is true. <br /> Month DayYe; <br /> 10312 1_ <br /> rlexit. <br /> U.S.: <br /> Month Day Ye <br /> Ot0?1 OTT <br /> Month Day Ye <br /> Customer ignature CEL Signature 1 1 1 <br /> ❑Padiial Refection ❑full Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> V <br /> LL Facility's Phone: <br /> w 18c.Signature of Alternate Facility(or Generator) Month Day V <br /> Q <br /> Z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codas for hazardous waste treatment,disposal,and recycling systems) <br /> w 1 4, <br /> D <br /> 20,Designated Facility Owner or Operator Cenification of receipt of hazardous materials covered by the manliest except as noted In Item 1 B <br /> Printedrryped Name Signature Month Day Yr <br /> EPA Form 8700.22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIR <br />