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<br /> Please print or type (Form designed for use one ife(12-pitch)typewriter,) Form Approved OMBNo 2050.0039
<br /> UNEFORM HAZARDOUS WASTE MANIFEST 21,Generator ID Number 22..PapeF 23.Manifest Tracking Number
<br /> (Continuation Sheet) :A2-890090002. I[ 005870814 UK
<br /> za Generators Name Livartrtore National LahomorySite 300 for NNSA P.O. Box 808/L-786 Livermore CA 94SSI
<br /> 25.Transporter... ._- Company Name U.S.EPA ID Number
<br /> 26.Transporter .- Company Name
<br /> U.S.EPA ID Number
<br /> 27a. 27b.U.S.DOT Descnptian ndudi g Proper Sh Aping Name Hazard Class,Ip Number. 26 Containers 29.Total 30.Unit
<br /> HM and Packing Group{if any}) No Type Quantity Wt Not 31 Waste Codes
<br /> 75. NA3071, Hazardous waste,solid,n.a.s.(DUX), 9,lil [ERG 1711 DUOS
<br /> „7�E)G36-1
<br /> 181
<br /> 26. NA22 U Atbest4s,9,ill 4RW JERG 171) D0170131-1
<br /> Z7- NA3017, HZZaTdOttswaSte,solid,n.o,s-(pM7. DOM), 9,Flt jEftG D! D006 +0007 D008
<br /> 171) D0170104A-1
<br /> 181
<br /> M. NA3077, hazardous waste,solid,n.o.s-(ChW51, 9, 111 JEWS 1711 G005
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<br /> Z
<br /> 29. NA31S2, HaZardous waste,ltqutd,n-o.s.(Cr(M. G421), 9, 111 JFIQ ( M 391 L7006 pC11
<br /> 0011) [ERG 1711 00FDO313-1.
<br /> SG1
<br /> 30- NA22U,Asb=estos,9,of(RQ) (ERG 1711 DOP0131-1 , DM 414
<br /> 151
<br /> sL NA3077, Hazardous waste,solid,ri.e.s.113011), 9,111 (MQ DO1II) D' D011
<br /> 9HG 1711 130POGMA-1
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<br /> X31 NASM2 1-iazatdeusw3ste,ltqutd,n.c.s-JEKM, 0011). 9,111(RQ QC111 DOO6
<br /> 00 1) [ERG 1711 00PID013-1
<br /> 5d1
<br /> 11 NA3077, l4azar3culs waste,solid,n.o.s.(4011), 9,ill (SCI DOW >DO11
<br /> ERG 1711 DOPOM&A
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<br /> 181 k
<br /> 34.14otZ-MGiRa hazardous waste,liquid[water Contaminated with Z- OF �C
<br /> ]uTAxrrt:;1t3not)DGP0�1
<br /> 331
<br /> 32.Special Handling instructions and Additional Information
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<br /> a 33.Transporter Acknowledgment of Receipt of Matenals
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<br /> PnntedlTyped Name Signature Month Day Year
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<br /> = 34 Transporter—Ackiowledgment of Receipt of Materials
<br /> PnntedfTyped Name Signature Month Day Year
<br /> 35.Discrepancy
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<br /> 4 36-Hazardous Waste Report Management Method Codes(e.,codes for hazardous waste treatment disposal,and recycling systems) "
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<br /> EPA Form 870d-22A(Rev.3.05) Previous editions are obsolete. f DESIGNATED FXbIL--ITY TO GENERATOR
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