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at or type. (Form designed for use one lite(12- typewriter.) Form Approved.OMB No.2050-0039. <br /> ,AIFORM HAZARDOUS 21.Generator's US EPA ID No. Manifest Document No. 22.Page Information in the shaded <br /> WASTE MANIFEST areas is not required by Federal <br /> (Continuation Sheet) C'�_ L ov 1 ZS 25`Z-%/ to 4 ?CS-7, law. <br /> 23.Generator's Name <br /> ,h! <br /> STD CK r© ateMat�ifesf�3oc4mentNm,mbe I <br /> State <br /> "Genera <br /> cKrv1-� - <br /> 24.Transporter Company Name <br /> p Y X25 i Number $ <br /> A- , ae , <br /> 1ranoportgr' Ph,oh,o CY �"�} "LF <br /> 26.Transporter Company Name 27.US EPA ID NumberF'._StteTransport@r°S�C� a•~ <br /> Q.Trans00er""s Poona" <br /> 29.Containers 30. <br /> 28.US DOT Description(Including Proper Shipping Name,Hazard Class,and ID Number) Total Unit We�ste No" <br /> "" A No. Type Quantity Wt/Vol <br /> a. <br /> i <br /> Ulf— <br /> b. <br /> i <br /> � r <br /> C. 1K I i <br /> t✓ <br /> G <br /> d. <br /> E <br /> N " <br /> I <br /> E <br /> R <br /> A e. ., ) <br /> O � <br /> R <br /> f. 1 Jti t At I <br /> C71'n <br /> FOR RELY( LING/TR ATM, NT Ar THE <br /> ,jiSVT L FAC CITY IN LOS A 4GEL <br /> 9• <br /> 0AJF0k:'ii%•THIS F01-11Y . <br /> PERMITS T RECEIVE YOUR WASTE STR AM. <br /> n. Is CAID <br /> P f <br /> e- <br /> J^ <br /> S Additf nai I?eser Otions for"Materials i.i;;t c Adaove T.Mandting odds forltU tps(tst d Above', <br /> `T <br /> 32.Special Handling Instructions and Additional Information <br /> i <br /> i <br /> i <br /> T 33. Transporter _• Acknowledgement of Receipt of Materials Date ! <br /> n Printed/Typ Signature !!! <br /> N _ 9 Month Da Year <br /> S 5� ( �f E <br /> 0 34. Transporter Acknowledgement of Receipt of Materials Date <br /> R Printed/Typed Name <br /> E Signature onth Day Year <br /> R <br /> A 35. Discrepancy Indication Space <br /> c <br /> I <br /> L <br /> I <br /> r <br /> v <br /> Style F76 LASELOIASTFR®(800)621-5808 ..labelmaster.com EPA Form 8700-22A (Rev.9-88)Previous editions are obsolete. I <br /> PRINTED ON RECYCLEO PAPER r1/TiEo wrtn Rga y pq ® �p yro y r,�, 3p <br /> USING SOYBEAN INK iii ISdY IN� ORIGINAL-IGI9 V" L-RIET@8d-N TO Yy'd�NERArOR <br />