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Please print or type. (Form designed for use on elite itch) typewriter.) <br />Form Approved.. OMB No. 2050-0039. <br />Style CF 18 WE(%1IAsttK8(e00)62i.sao8 wAw.hbehnesbrcan EPA Form 8700-22A (Rev. 9-88) Previous editions are obsolete. <br />®waxrtaa acratavucnr�;�.aar�uv� ORIGINAL -RETURN TO GENERATOR <br />uswc mveenv xw <br />UNIFORM HAZARDOUS <br />21. Gene,_.jrs US EPA ID No. Manifest Document No. <br />«. Page <br />Information in the shaded <br />WASTE MANIFEST <br />areas is not required by Federal <br />(Continuation Sheet) <br />C A N 1 1 1 0 0 1 0 4 4 9 9 6 2 6 <br />2 oS 2 <br />law. <br />2.3. GeNerator's Name <br />L. State Manifest Document Number <br />SAN J(tWIX 0WJKTT <br />AH -1499626 <br />1910 a HAIL, <br />M. State Generators ID <br />STOMTON, CA 95201 =111r; ALISOS HUDSOW <br />24. Transporter Company Name 25. US EPA ID Number <br />N. State Transporters ID <br />O. Transporter's Phone <br />26. Transporter Company Name 27. US EPA ID Number <br />P. State Transporter's ID <br />O. Transporter's 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 />HM 1 <br />No. Type <br />Quantity <br />WWol <br />., <br />a. <br />- <br />PLA2a1ABLa LIOUZDS, N.O.S_,.3., UN1993, PO II, (gasoline, <br />_ <br />thirmers).. (.g:. 129) . (P£: 689979) <br />i <br />„ b. <br />PAINT lU..L = MATERIAL, 3, UN1263, PO II, (DOT -a 111624), <br />(erg: 128), (pf: 744526) <br />cs� <br />5 <br />NF4 <br />C r <br />_ q,.. <br />.PAINT <br />E�[ATP9 HATPRIAL,. 3„tmT).263., lYi. IZ, (erg: 129) , (pf: <br />744527) _. <br />RA <br />D M <br />RA <br />0 <br />d. <br />E <br />N <br />E <br />R <br />A <br />a. <br />T <br />O <br />R <br />9- <br />h. <br />I. <br />S. Additional Descriptions for Materials Listgd Above (+ <br />* 28A: 699979(2-5%ACJS D1tt.I a. 280: 744526(�JX N1 \B Cr <br />T. Handling Codes for Wastes Listed Above <br />) <br />•• 28C;. 744527( 1-7'A 550M) <br />_1) <br />32. Special Handling Instructions and Additional Information <br />..,Wear appnapiate.PPE, when handling hazardous materials. Waste is RCRA exempt .per 40 CER 261.4(b).(1) <br />_ eio1.1on. was Peakedaaaorviing. t. 49 CTR 173.12b. 7850 5.RA aridga£oxK.St.. <br />StQktom: CA 95206 / MG OuLde 128 -... <br />T <br />33. Transporter Acknowledgement of Receipt of Materials <br />Date <br />R <br />A <br />Printed/Typed Name <br />Signature <br />Month Day Year <br />S <br />P <br />0 <br />R <br />34. Transporter _ Acknowledgement of Receipt of Materials <br />Date <br />T <br />Printed/Typed Name <br />Signature <br />Month Day Year <br />E <br />R <br />F <br />A <br />35. Discrepancy Indication Space <br />C <br />I <br />L <br />I <br />T <br />Y <br />Style CF 18 WE(%1IAsttK8(e00)62i.sao8 wAw.hbehnesbrcan EPA Form 8700-22A (Rev. 9-88) Previous editions are obsolete. <br />®waxrtaa acratavucnr�;�.aar�uv� ORIGINAL -RETURN TO GENERATOR <br />uswc mveenv xw <br />