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Please¢print arType.(Farm designed for use an elite(12-pitch)typewriter.) Form Approved.OMB No.20500039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generalar ID Number 22 Page 23.Manifest Tracking Number <br /> (ContlnuaUon Sheet) CA2890090002 S rip 5 OOSS710091JK <br /> 24 Generatnes Name <br /> Lswrencla Litrerizlore National Laboratory She 300 for NNSA P Q Box BOB f L-785 Li"rmore CA 94551 <br /> 25.Transporter Company Name US EPA ID Number <br /> 26.Transporter _ . Company Name U S EPA ID Number <br /> 27a. 27b U.S,DOT Description(hduding Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29 Total 30.Unit <br /> HM and Packing Group(11 any)) No Type Quantity WLNoI. 31 Waste Codes <br /> 35_ Wn-RC-7A hazardous waste.solid(aiusm um and steel cuttings) I EIF <br /> 11Qptiif)4-1 <br /> 38_ felon-SMA hazardous waste,solid(absorbent and dirt 1 DM 129 <br /> t-ontarninatC-d with PetraleUm hydr*carb�,ris)DOPOL-33-t <br /> t�3 <br /> 37Won-RCM hazardous waste.liquid(ethylene glycol)DOPQM5-1 i Elm <br /> .-► 3d3 <br /> 38. Non-RCKA hazardous waste.solid(used fiM filters)WP- W4,i 1 Dr <br /> r— <br /> 352 <br /> Z <br /> CD 39. Ston-RC'RA hazardous waste,soled(!+rnpty drum iast coritaine*J l 0M s <br /> ghirrrane)4)CP t6-1 r <br /> 4. Non-aFtCRAhazardous wave.solid(debriscoritaminatedwith ,_ ON! 432 <br /> petroleum hydrocarbons)00 rOW4-1 <br /> 4L Ncn-KCRA hazardous waste.liqutd(diprcpyleneglycol 1 01M 363 <br /> moncroethyl ether)DOPC051-1 <br /> 331 <br /> 4Z Non-RCM hazardous waste,liquid(unused hydraulic fluid) 1 <br /> 273 <br /> 43 Non-[siesta Hazardous waste,liquid(unused curring oil) f 38 <br /> dGPe]4]8p5J-1 <br /> 223 <br /> 44 Non-RCRA hazardous waste,sclid(dcbris contarmnated ninth 1 ISM 21a <br /> ethylene glycol)DOP0044-1 <br /> 35� <br /> 32.Spedal Handling Instructions and Additional Information <br /> a rd3.Transporter meet of Receipt of Materials <br /> H PnntedlTyped Name Signature Month Day Year <br /> e3. <br /> en 34.Transporter Ackn mens of Receipt of Materials <br /> Z <br /> Pdnted)Typed Name Signature Month Day Year <br /> H <br /> 35.Discrepancy <br /> J <br /> U <br /> lei <br /> a <br /> a36,Hazardous Wa to a rfl Management Mefhod Codes e.,codes for hazardous waste treatment,dls;iosat,andrecyclingfrecyding systems) <br /> tz <br /> 7_ ! I . . Ii h 1LII 1e r- re <br /> i H101 1 HIL-) I 1 1' 11-1r �4I <br /> EPA Farm 8700-22A(Rev.3.05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />