Laserfiche WebLink
Please print or type.(Form de° ned for use on elite t2-pitch)ftewriter.) Form Approved OMB No 2050.0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21,Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (ConUnuationShoot) �A2S90D90002 3 OF 9 005870814 IN <br /> 24.Generator's Name <br /> Lswr'evc <br /> 25.Transporter Company Name U.S.EPA ID Number <br /> 26. Transporter Company Name US EPA ID Number <br /> 27a. 27b U S.DOT Description(including proper Shipping Name Hazard Class,ID Number, 2tl.Contalnefs 29.Total 30:Unit <br /> HM and Packing Group{d any)) No. T;pe Quantity WLNol' 31 Waste Codes <br /> 15. UN3262. Corrosive solid,basic,tnogantt,mo.s.Isodturn DM 705 <br /> irydro',ade mfxturelr S, 11 (ERG L541 1130FDO13-1 <br /> 141 <br /> ' 16. UN32W- Corrosive solid,baste,inorganic,n.a.s.(sodturn � ,-r' DM p <br /> trydrovde mmure),S. II [ERG L541 WPOO65A <br /> x 141 <br /> 17. UN35M, Waste,Mercury contained to manufactured artides,6 nl' P D005 <br /> ;6.1) (RCS[ERG 1721 DOP0071-LA <br /> 181 <br /> L& AlA3077, Fazardous waste,wild,rt.o.s-(DUOS), 9,111 [ERG 171) DM P DOflB <br /> �' GGFOg36A-Z <br /> LU <br /> Z <br /> CD 19. NA3092, Hazardous waste,hqutd,n.os.JOW6, 0011), 9 Hi(1;0 <br /> DOLL) [ERG 17L) E)OPOOL3-1 <br /> 20. NA3077. Hazardous waste,solid,In.o.s.(DODt3). 9.311 [ERG 1.711 �f78 <br /> DC1P0036-1 <br /> X1 <br /> 181 <br /> 1L. NA3M2., Hazardouswasta,liquid,rt.a.s.(17D09). 9, n1 [ERC- 171) OF ^�9 <br /> u <br /> P(aJL3-i <br /> 132 <br /> 22_ NA3082, HaxardOUE Waste,liquid,n.o.s.(f D021, 9,111 [ERG 17-1) DM CD02 <br /> DGPDO77-1 <br /> 341 723 <br /> 21 ftA3077, Hazardous waste.solid,mo.s..9, 111[i-ab pack)[ERG 171) OF P DOCS D011 <br /> 7CrPsO113-1 <br /> s31 <br /> 24. NA3092_ Hazardt;us waste,liquid,n.o.s.,9, fit(Lab pack)[ERG DF <br /> L711 DOPOL13-1 <br /> 741 <br /> 32.Special Handling instrum4r.s and AdditonM InfomaWn <br /> 33.Transporter AtkrKmied merit of Receipt of Materials <br /> PrintedlTyped Name Signature Month Day Year <br /> O <br /> a <br /> w 34.Transpofter Acknowledgment of Receipt of Materials <br /> z <br /> Pnnted,Typed Name Signalure Month Day Year <br /> H <br /> 35 Discrepancy <br /> a <br /> V <br /> a <br /> W <br /> O <br /> a36 Hazardous'P7aste Report Maragement Method Codes:i e codes br hazardous wa treatment,d sposal and regclir.9 systems <br /> Z <br /> O <br /> to <br /> N <br /> EPA Farm 8700.22A[Rev 3.05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />