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.,,type. (Form designed for use on elite ch)typewriter.) Form Approved.OMB No.2050-0039. <br /> -NIFORM HAZARDOUS 21.Generator's US EPA ID No. Manifest Document No. 22. Page Information in the shaded <br /> WASTE MANIFEST <br /> areas is not required by Federal <br /> (Continuation Sheet) CAD 9 8 3 6 0 8 0 g 2- 19 4 7 5 1 2 law. <br /> 23.Generator's Name <br /> L.State Manifest Document Number <br /> EIST 64Y mUD 23 78 Lf 751 <br /> M.State Generator's ID <br /> 24.Transporter_Company Name 25.US EPA ID Number N.State Transporter's ID <br /> O.Transporter's Phone <br /> 26.Transporter_Company Name 27. US EPA ID Number P.State Transporter's ID <br /> Q.Transporter's Phone <br /> 28. US DOT Description(Including Proper g 29.Containers 30. 31. R. <br /> P ( 9 p Shipping Name, Hazard Class,and ID Number) Total Unit Waste No. <br /> "M No. Type QuantityWt/Vol <br /> a. NON- 2C2fi Ng�gRDDvS ►N�ST� J_0t_r.D 223 <br /> (or Y Dt B2Zs) 0 0 2 DM 0 0 3 0 0 P a�A <br /> 1J0N- RCk4 1-Iq14VOL)S W11STE1 6-0Z-- <br /> (OrcY sole 35'Z <br /> ooh nM b2goc p A11q <br /> c. <br /> G d <br /> E <br /> N <br /> E <br /> R <br /> A e. <br /> T <br /> O <br /> R <br /> f. <br /> 9. <br /> h. <br /> i. <br /> S.Additional Descriptions for Materials Listed Above T.Handling Codes for Wastes Listed Above <br /> 28A9 33200 (2,K,5 <br /> 20) 47675 (q 955 6 <br /> 32. Special Handling Instructions and Additional Information <br /> uSE gPPfZ0F1Z.TgTE PE/2SOAlgL PRoTEC-IZVE EaarpA4FAIT <br /> 2q-NR E1nERCP CNCy CONTgCT: N/ZC CAi✓IRO^OMCn1TgL �Slo),7y9_ 1390 <br /> SITE: PARDEE CEAtTE2 .7-08 -1: gPS0o20 PO e: AP5002C-101 <br /> T 33. Transporter Acknowledgement of Receipt of Materials <br /> R Date <br /> N Printed/Typed Name Signature Month Day Year <br /> S <br /> P <br /> to 34. Transporter Acknowledgement of Receipt of Materials <br /> R Date <br /> T Printed/Typed Name Signature <br /> E Month Day Year <br /> R <br /> F 35. Discrepancy Indication Space <br /> A <br /> c <br /> L <br /> I <br /> T <br /> Y <br /> Style F16 LABEI.t�ASTER®(800)621-5808 www.labelmaster.com EPA Form 8700-22A (Rev.9-88)Previous editions are obsolete. <br /> PRINTED ON RECYCLED PAPERORIGINAL- RETURN TO GENERATOR <br /> ® o wi <br /> USING SOYBEAN INN �S(1Y INK1 <br />