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Form Approved OMB No. 2050-00391
<br />ase dnt ort e. Form des! ned for use on elite 12 Generatorypr D Number
<br />22. Page 23. Manifest Tracking Number
<br />-7
<br />UNIFORM HAZARDOUS WASTE MANIFESTncn)
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<br />3 S
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<br />(Conlinuation Sheet)
<br />24, Generators Name
<br />SAN JOAQUIN HOUSEHOLD HAZARDOUS WASTE FACILITY
<br />25. Transporter Company Name } ^h� a/yl,.Tn-s ,11r� ®� 1 r�%% %G %
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<br />26. Transporter _ Company Name
<br />26.
<br />27a26.
<br />on (InGutling Proper Shipping Name, Hazard Class, ID Number,
<br />U.S. DOT Description
<br />Containers
<br />29. Total
<br />Duanthy
<br />30. Unit
<br />Wt.Nol.
<br />31. Waste Codes
<br />No
<br />Type
<br />HM
<br />HM
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<br />and Paddn9 Group (A any))
<br />and
<br />),CAUSTIC ALKALI LIQUIDS,
<br />N.O.S.,8,UN1719,PGII, (EP.G:159), (PF:7698851
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<br />,4771
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<br />N/k
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<br />CORROSIVE LIQUID ACIDIC INORGANIC
<br />(RG:154), (4:769884)
<br />N/R
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<br />N. O.S.,B,UN3264jGII,
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<br />AEROSOLS CONSUMER COMMODITY, ORM-D
<br />N/R
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<br />(AEROSOL§)(LIMITED QUANTITY), (ERG:),
<br />(PF:144528)
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<br />N140NI RATE PERT ILIZERS,9,UN2071,PGIII,
<br />N/R
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<br />LID698902j '5.1,UN1479,PGII,
<br />OXIDIZING SOLID
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<br />Q PESTICIDES SOLID
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<br />32. Sp clat Handling Immudons and Additional Information
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<br />5: 769885, (0 X 30 DF,6: 769884, X 30 DF,7:
<br />744528, G X MBCF,S:
<br />744493, '� X 30 DF,
<br />698402,„-7C-30 DF, 10: 744523, _R-MBCF
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<br />33. Transporter Admomedgment of Receipt of Mahmals
<br />PdntedlTyped Name Signature
<br />Month Day Year
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<br />34. Transporter Acknowledgment at Recel t of Materials
<br />Signature
<br />Month Day year
<br />PdntedRyped Name
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<br />35. Discrepancy
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<br />a36.
<br />Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and
<br />acy0ing systems)
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<br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)
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