Laserfiche WebLink
.ype. (Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039. <br /> JRM HAZARDOUS 21.GI tor's US EPA ID No. Manifest Document N 2. Page Information in the shaded <br /> WASTE MANIFEST areas is not required by Federal <br /> (Continuation Sheet) C A D 83 6 0 $ o Z 3 6 Z 5 2 law. <br /> 23.Generator's Name <br /> E45T QAY nJvL) L.State Manifest Document Number <br /> ;Z2543625 <br /> M.State Generator's ID <br /> 24.Transporter Company Name 25.US EPA ID Number N.State Transporter's ID <br /> 0.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 Shipping Name,Hazard Class,and ID Number) 29.Containers 30. 31. R. <br /> Totl nit <br /> No. Type Quantit Wt/Vol Waste No. <br /> a nfUN- 1ZC�ZI� H/��rikDUl1� vJ�S-r t LI4�v.i� <br /> tPIJ <br /> 01A 0025ceb. Nc^l -iZCiZj ii��Ia200LJ`S 'W ,-jSj-6/ �C�JZD U 0 I Diet 0 0 05 5(or1.� solo001 PNt 0oy00 <br /> G d. <br /> E <br /> N <br /> E <br /> R <br /> A e. <br /> T <br /> O <br /> R <br /> f. <br /> 9• i <br /> I <br /> h. <br /> i. <br /> S. dditional Descriptions for Materials Listed Above . T.Har ling Code astes Listed Above <br /> �� LP23i13�'oZ (IxsS Site . <br /> 1bb, .337Go (1><55 Py►-dee Ctr <br /> 2vc� 3+377 (fx5's vC,(rey sPr,A35Gf� 95252 <br /> 32.Special Handling Instructions and Additional Information USE 4PPRCPRIRTE p69S 1)A!{L PROTECT-rVE EGOrPMEA1 <br /> 2y-HR, EMEREtENCY CWT#W'- <br /> FOSS ENVIkOtO rADJTA I. (5w 7 -I3Q® TO 13 : AP3001I PC ; VRO17-0It <br /> T 33. Transporter Acknowledgement of Receipt of Materials <br /> R Date <br /> N Printed/Typed Name SignatureMonth Day Year <br /> S <br /> P <br /> o 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 LABEAM ER®(800)621-5808 www.labelmaster.com EPA Form 8gp7a00-22A (��R99evv�g9-88��))Previous editions g areag obsolete <br /> ON . <br /> ®VRIMUSING SO UYBEAN INIl fl �vp��rrlNK. ���C�3, AL-' RETU_RN o r3ENEB"G9'41(1UR <br />