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e <br /> Please prAr " Form A,-proved.OMB No.205G'0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 3Pac�e_ Y3�Manifest Tracking Number <br /> i (Continuation Shoot) CAZ$�QQ(DZ DFF / OL94456321JK <br /> 24,Generator's Name <br /> Lawrefbce LivmrrWe irrational Lab Site 300 on bdWf of LOS NN A P.O.Box 808/L-786 Lhwnwm CA 9051 <br /> 25 Transporter Company Name U.S.EPA ID Number <br /> 26.Transporter Company Nama <br /> U.S.EPA ID Number <br /> 21a. 27b.U.S.DOT Description(indyding Proper Shipping Name,Hazard Class,ID Number, 28•Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wt1Vd.X- 31 Waste Codes <br /> 1S.Rq NA221%Waft moors,9,qi(ERG 1711 WFM1-1 3 DM 298 P <br /> 151 <br /> 16.N0077,Kann�ma Waft tom,MALL(110918L 9,Hi(ERG 1711 3 DM 597 P om <br /> DOPO03&1 181 <br /> 17.NA3W,Hmrdous waft eaN,n."(DM 9,01(EW 1711 3 DM M P D13M <br /> 181 <br /> I.MM",Fla""%%ft gild,nA.L(DOM DM%91 IERG 2 DM 298 P DOOR DDO <br /> 1721 DDPM3&1 lei <br /> z <br /> 19.Rq 103WR,HUWftW r s. ,n.t3ts,(D011),%fil(R4 1 DM 226 P 0031 <br /> D 1)(EPA 1711 DoPaa 1 <br /> 181 <br /> 2Q NA3077. M wum,sand,n.cs,([lC1X 9,Di(gM 1711 1 CF 1325 P Dim <br /> DOP003MPI <br /> 181 <br /> 2L Non-MMA haZardimin WM tQ,tend{fast ootrttained Ove al n) 1 DM 48 P <br /> Zd mpa���j 512 <br /> 2L Non-RCAA h=WdOW amid(Wn PCB tiara}DMIM2 DF 48 P <br /> 1 <br /> 223 <br /> 23.MCn-R€:itA hazardous to M te,saUd(igrrl V*M iaat conW rflrfa 2 DM 86 P <br /> Ipcloroi M hyt 0=b0M)DOPW47.1 <br /> 512 <br /> .Non-RCRA hazardous Vas to,KNd efopty dntrn last t rkadato Pig 1 DF 14 P <br /> n 44?—! I L 512 <br /> 32 Special Handling Instructions and Additional Information <br /> 1Z 33.Ta r ment of Receipt o(Malerials <br /> H PnntedfTyped Name Signature Month Day Year <br /> 34.Transporter mentol R,-mi t of Materials <br /> Prinled(Typed Name Sgnature Month Day Year <br /> r 35.Discrepancy <br /> J <br /> LL <br /> O <br /> LU <br /> 36.Hazardous Waste e�pClement/ (i.e., / waste t�tment dis a systems)) ` ��� / / / <br /> t7 S /{ 1 <br /> EPA Form-000.22A(Rev.12-17) Previous editions are obsolete. / DESIGNATED FA ITY TO GENERATOR <br />