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Please print or type. (Form designed for use on elite itch) typewriter.) <br />Form Approved OMB No. 20500039. <br />All <br />UNIFORM HAZARDOUS <br />21. Generator's US EPA ID No. Manifest Document No. <br />22. Page <br />Information in the shaded <br />WASTE MANIFEST <br />areas is not required by Federal <br />(Continuation Sheet) <br />C A H 1 1 1 0 0 1 0 4 4 1 2 0 8 3 <br />3 of 3 <br />law. <br />I <br />23. Generators Name <br />L. State Manifest Document Number <br />SAH JOAQUIN COUNTY <br />AH 1375223 <br />1810 E HAZIETON <br />M. State Generator's ID <br />STOCKTON, CA 95201 ATTN: ALISON MMSON <br />24. Transporter Company Name KIM EPA ID Number <br />N. State Transporters ID <br />O. Transporters Phone <br />26. Transporter Company Name 27. US EPA ID Number <br />P. State Transporters ID <br />Q. Transporters Phone <br />29. Containers <br />30. <br />31. <br />R. <br />28. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) <br />Total <br />Unit <br />Waste No. <br />R <br />No. Type <br />Quantic <br />Wt/Vol <br />.. <br />a. <br />CORROSIVE LIQUID, ACIDIC, INORC-IANIC,..N.0.5., a, UN3264, PO <br />_ <br />.11,..(lob-pack), (arg: 154), .(pf: 769884) <br />b. <br />C. <br />0 <br />d. <br />E <br />N <br />E <br />R <br />A <br />e. <br />T <br />O <br />R <br />f. <br />9. <br />h. <br />i. <br />S. Additional Descriptions for Materials Listed Above <br />T. Handling Codes for Wastes Listed Above <br />,-,38A , 769894( 14k-A,30OFZ ) <br />32. Special Handling Instructions and Additional Information <br />_..,.Weer- appropriate,VFS When handling hazardous ma* rials. Jab# 1483- 05212q <br />Waste i5.%353A.asompt.pac. 40 _CPA.261.4(b)(1) exclusion. Site: 7850 S. FA, HnidgeEord St.., Stockton,.. CA.. , <br />. -,. vas .packed according to 49 CL'i.A 173.12b (PBO euidc 154 <br />T <br />33. Transporter Acknowledgement of Receipt of Materials <br />Date <br />R <br />APin <br />rryped Name <br />Sig ture <br />Month Day Year <br />P <br />uJ� �ir�C(. <br />r�,dS <br />�6 <br />o <br />34. Tr n porter Acknowledgement of Receipt of Materials <br />Date <br />R <br />T <br />PrintedTyped Name <br />Signature <br />Month Day Year <br />E <br />R <br />A <br />35. Discrepancy Indication Space <br />c <br />I <br />L <br />I <br />T <br />r <br />Style CF 19 IAWARASM O (WO) W1fBOB www.1abelmutsi EPA Form 8700-22A (Rev, 9-88) Previous editions are obsolete. <br />�euTmaxge[cmmwem��.��,°"1 ORIGINAL -RETURN TO GENERATOR <br />