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Please print or type. (Form designed for use on elite (1: ,) typewrite.)
<br />Form Approved OMS No. 2050 W39.
<br />Style CF 18 EPA Form B700 22 A (Rev. 9 BBI Previous edi ,ons are Wsolele
<br />ORIGINAL -RETURN TO GENERATOR
<br />UNIFORM HAZARDOUS
<br />21. Generator's US EPA ID No. I Manifest Document No
<br />22 Page
<br />Information in the shaded
<br />WASTE MANIFEST
<br />areas is not required by Federal
<br />(Contindafion Sheet) ,
<br />,_.:A,,Jk e,1; 1-1,,,0 Da -1-0.1, 4 6 »9::2:.III
<br />,.,p.,ul, E I„law..
<br />< -,
<br />23. Generator's Name
<br />L. State Manifest Document Number
<br />am JOAQUIN OWNTY
<br />1i-1669266
<br />M. State Generators ID
<br />1810 E NALILTt=
<br />STaidevTOtr, CA 95201 ATT15: ALIsow ElUOSQ
<br />-
<br />24. Transporter ompany ame 25. US EPA ID Number
<br />N. State Transporter's ID
<br />0.. Transporlels Phone
<br />26. Transporter Company Name 27. US EPA ID Number
<br />P, State Transporter's 1D
<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 />Ru
<br />No. T pe
<br />Ouantit
<br />WWol
<br />a.
<br />CAUSTIC ALEALI LIQUIDS, K.O.S., a, 41X1719, pG 11,
<br />(lab-paak), (erg: 154), (pfe 744525)
<br />nA
<br />b.
<br />OXMI413f3 801 ID, TIMIC, N.O.S., 5.1, 0153087, pa II,
<br />-
<br />llob-IiIi , (acg: 141) , (pf: 744604)
<br />002_
<br />D r.()012_
<br />WL
<br />c.
<br />OD>(QtlSIYE LIQUID, ACIDIC, nMQMNIC, N.O.S., 8, U 3264, PO
<br />0
<br />AN
<br />G
<br />E
<br />d
<br />CNIDISING SOLID, N.O.S., 5.1, U01479, W II, (1ab-peak),
<br />N
<br />(aey: 140), 1 698402)
<br />001
<br />c 9 (0
<br />L
<br />R
<br />Am
<br />A
<br />e.
<br />CAUSTIC ALAALI LIQUIDS, N.O.S., a, [M1719, EG II,
<br />T
<br />(lab-Iaak), (axgl 154), (PEI 769865)
<br />A
<br />03
<br />0(),3qLj
<br />f.
<br />PE1i�IlAA[ allots, LI1JIB1?rD!DI 2.1, tMM075, (erg: 115), (pf:
<br />7445321,00(c VnIfS
<br />OO 1
<br />00 2
<br />f�
<br />1wew
<br />-on
<br />9
<br />OONSUMM OQ l® , OIl , (Aac Ia) (Limited
<br />(erg: 126), (p£: 744526)
<br />Sh15-
<br />p
<br />In,.
<br />IAD VESTICI S, SOLID, T 11i N.O.S., 6.1, 0152568, 12G TI,
<br />96aDias POLT.UTAarli (erg: 151), (pf: 744523)
<br />/,
<br />C ir
<br />V
<br />I NA
<br />i.
<br />S. Additional Descriptions for Materials Listed Above -. -
<br />T. Handling Codes for Wastes Listed Above
<br />28A¢ 7{1525( '(p Ss`DP ) •• 28B: 741604( 2.3c 30 15F
<br />:3 280:.769884( 7x30PP ) •x_.-288: 698/02( I Xao De
<br />.� *a 281 369885 ( 3x3� �� ) •+ 28r: 744532 (1 it 5” 5-0irl
<br />�a 280: 744528(Ik 1773 I'a• 288: 7{4523( I)(/h3
<br />.
<br />32. Special Handlino Instr�lcoons aql Additional Information
<br />Raac prapex EPE hen v�q Iia ��*.� Neteciala.lhate is BLAA PY'eup 40 CPR 261.4(b)(1)
<br />eaOlOalan.Job t 1493- .Siler 7850 8. VA Bcldgefard 8t, Stoolirton,aa."a peaked aOool'ding to 49
<br />CRR 173.12b. / PBG Guide 154 , 141 , 140 , 115 , 126 , 151
<br />Lye
<br />,iye
<br />T
<br />33. Transporter Acknowledgement of Receipt of Materials
<br />Date
<br />R
<br />A
<br />Printedrryped Name
<br />Signature
<br />Month Day Year
<br />N
<br />s
<br />P
<br />o
<br />34. Transporter Acknowledgement of Receipt of Materials
<br />Date
<br />R
<br />T
<br />Printed/Typed Name
<br />Signature
<br />Month Day Year
<br />E
<br />R
<br />F
<br />35, Discrepancy Indication Space
<br />A
<br />C
<br />I
<br />L
<br />i
<br />r
<br />Style CF 18 EPA Form B700 22 A (Rev. 9 BBI Previous edi ,ons are Wsolele
<br />ORIGINAL -RETURN TO GENERATOR
<br />
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