Laserfiche WebLink
Please Drint or Was. fForm desioned for use on elite 02 -Ditch) r.oewriter.) <br />X Form Approved. OMB No. 2050-0039 <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />V� <br />{ <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />21. Generator to Number_ <br />21,Page <br />23. Manifest Tracking Number <br />(Continuation Sheet) <br />24. Generators Name <br />SLaquII eC). <br />25. Transporter. Company Name _ EPA ID Number <br />I 1)3`13 <br />26. Transporter_ Company Name - <br />27a. <br />HM <br />27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />and Packing Group (if any)) <br />26. Containers <br />29. Total <br />Quantity <br />30. Unit <br />Wt.1vol. <br />31. Waste Codes <br />No. <br />Type <br />2-0fC05l,Vlt�- I QG--*-A4'Ci11�)CASIC, ,uIUrdQa /tj—C3. <br />1} <br />-1Q110 <br />1 <br />(S[X�tuln clr^'1�de rH�tasslwll NYd+�xiQB),g� <br />4arp, PG IT <br />o14 <br />D` <br />GI <br />LAYxStG Cor,l!:SrV6 Itu.d,G�c idii"lnur Oic'jmnuz <br />CNydr"hILrrt, AeldMcil U Ic A,G1�) &4r)3aleyr <br />cit Np <br />J r <br />iPrc�loj(p) �Cll�d4tr1v3�}r <br />OUs <br />o <br />AiY)y6t�n16.1(T) rYrt^,'Ca.�'G �er`�i�IZfV'5,5.7,JJA:i1O7 <br />�G7I� (er ;Iypj( (:CN2y314r� <br />P3 <br />w <br />z <br />1�Y1'�'411C1fG 3o1LcR rCY1S, 8,Ur) 17'�1,P6N <br />er : ICA, ()i: C' a�04934-Ijo <br />U•`u.,(f)1f Th rl raf 04 id"kib, <br />% <br />it licsI 11 <br />INlrfiilr,.UC N A t1J ln.l U,NG <br />`F01 <br />NIL <br />)( <br />:1a 6rtes 1Jr.�,cs�r11au1tnq pp�tt�s'uvtlhl�>r,oxrdC, <br />Solid 38,uGit► <br />,elecFrGrslc�'o��12ec.i71 ��T— <br />oo3 <br />G <br />u(} <br />�6uiter,f'":, coovairillyj Pctasslurtl ill rVAId <br />1 <br />Sokdl(fle(fylt 1 re: 1$,u,)3ca f,PGllt <br />1 <br />a <br />D rN. Iuz+�;awnl Pes.. v6Cj-4 <br />69 <br />1� <br />(d.zl <br />li loC 63I)G rdfx <br />3 <br />b Fy) <br />NIL <br />32. Special Handling Instructions and Additional Information <br />W x 30DF• 13K 3Cbr- 17.) 2-4, L4QP-Nil 3X Cy3 <br />8.)rI-1>g31Liq 34X3obF-� L1+ la3y 1x 3abF 10.) C1+ay0c�a3 Qxy34r; <br />I <br />K <br />33. Trans r I Acknowledgment of Receipt of Materials <br />w <br />Sigpatu� Month Day Year <br />Printecirryped Name�2 4141 <br />r -64uiie <br />z4e <br />a <br />34. Transporter AcknoWed ment of Receipt of Materials <br />Printecirryped Name signature crit Day ear <br />1-- <br />39. Discrepancy ' ' <br />5 Iir� + .Ii.a.rx`. \�v t� Ctrti\Ea'ft <br />LL <br />. <br />C <br />36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and regcAing systems) <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />V� <br />{ <br />