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Please pfint or type (Form designed for use on elite(12-pitch)typewriter.) Farm Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 2t.Generator tD Number 22.Page 21.Manifetl Tracking Number <br /> (Continuation Sheet) :AZ$9QD90002 of 9 0058708141A <br /> 24 Genaretor's Name <br /> Lawrence LiVermore National LaboraiorySirte 300#or IN NSA P.G. Bax ME f L-786 Livermore CA 54551 <br /> 25 Transporter Company Name V.S.EPA l0 Number <br /> U.S EPAIDNumber <br /> 26 Transporter, Company Name <br /> 27a 27b U S DOT Description(including Proper Shipping Name Hazard Class,lD Number, 28.Containers 22.Total 30 Unit 31 Waste Codes <br /> HM and Packing Group if any No Type Quantity Wt Vol. <br /> 75. Waste-Consumer commodity,ORF-1-D faerosots)jERC 1711 7010 <br /> mpu m-1 <br /> 331 <br /> 76- 1Naste-Consurrar r:omrnodrrr,ORM-0 faerasofs)[ERG 171.) <br /> ;ru FOl ii-i <br /> 122 <br /> It Waste,Consumer ctrnmodtty,C)""'-D 13e")SCIS)IEFtr 1711 7001 D0 <br /> 35 <br /> - <br /> UPfl311-1 724 331 <br /> oc <br /> 0 <br /> w <br /> a <br /> LU <br /> r.9 <br /> 1 � <br /> 32.Special Handling inmructions and Additional Information <br /> 33,Transoortr--Acknowledgment of Reeeiol of Materials <br /> PmtedfTyped Name Signature Month Day Year <br /> O <br /> a <br /> cO 34.Transpater Ackn meat of Receipt of Materials <br /> x <br /> PWxdfTyped Name Signature Month Day Year <br /> 35.Dismpancy <br /> Z:i <br /> C? <br /> UE <br /> a <br /> Q36.Hazardous Waste Report Management Method Codes(is,codes for hazardous waste treatment,disposal,and recycling systems) <br /> M <br /> U3 <br /> w <br /> v <br /> EPA Form 8700.22A(Rev.3-05) Previous editions are obsolete DESIGNATED FACILITY TO GENERATOR <br />