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Please pn4 or typo. ,_ ; Form A roved.OMB No.2D50-0039 <br /> UNIFgM HA2;AIiDOUS WASTE MANIFEST Generator ID Number P a 23.ManBestTracking Number r <br /> (ConlfnuaUon Sheet} t,21 <br /> 89DO9=Z S ) 01W5M JJK <br /> 24 Generator's Name <br /> forme Lh eriydln m l+ uorial Lob SM$OD cm l>I@IW f P.O.Bon SA/L-M klV�e CA 94551 <br /> 25 Transporter Company Name U.S.EPA ID Number <br /> 26.Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S,DOT Description(mclutling Proper Shipping Now,Hazard Class,ID Number, 28.Containers 29.Total X Unit <br /> HM and Packing Group(d any)) No ITYpe Quantity Wt Nol., 31.Waste Codes <br /> 45.Wmn-. =hmr*w Wra@,nifid W!-PC8 balimb)DOP0029-1 1 Doi 174 P <br /> 7�3 <br /> 4L NW-11M h9ardims Waft,alm(burn P"frill)WS4554-1 1 DP 128 P <br /> 181 <br /> 47.NYoen-RCAA Ird=mob,R; (rldfa CW1br VnaW Vft 1 V Z3 P <br /> 133 343 <br /> 0 1 I hftW*"wr0. (fanny w ftd flan) 1 DF 16 P <br /> WPUMIUj 343 <br /> z <br /> LU 41 Non-140%hmindatrs rot , Inon•PCBb■fi>SW 1 i DM 254 P <br /> I <br /> 233 <br /> 5Bt N RMA fllttcr*W Waft sow(dam surd sud ) 1 DF . 20 P <br /> DOPMOS-1 <br /> -� 1n <br /> 5L WaSM Cammm"mrimdRy,ORM-D(wimmb)[ERG 1711 1 DF 47 P DOM W07 DO <br /> DDPM12-1 <br /> 331 <br /> a WSSM QftW1W MMMdity.ORM-D two )[ERG 1711 1 DF S4 P OM' 0019 003 <br /> OOP0112-1 <br /> 742 714 331 <br /> 32.Spewl Handkng Instructions and Additional Inlamrabm <br /> cyO 3.29 5 Y36 <br /> 'X 33.T arreparter nl of RecW of Materials <br /> r PrintedfTyped Name nature Month ay Year <br /> f <br /> i 34 Tra rent of Receipt of Materials <br /> Pnnted[Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> C� <br /> U <br /> O ` t:''11- <br /> 07'w �g Waste RepotJ.d/ anent 7 Cads(i.e.,codes /h p rs waste Al rspersal tems�� <br /> Uj <br /> LU <br /> EPA Form 87DD-22A(Rev.12-17) Previous editions are obsolete. - DESIGNATED FACILITY TO GENERATOR <br /> t <br />