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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Man'dest Tracking Number <br /> (Continuation Sheet) CAL J000 44 Q Q0q, <br /> 24.Generator's Name '1 <br /> BAt4 <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> ._L, c�t EZS. (=C& . CARO ca 21 55 <br /> 26. Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers F29.Total FLnit <br /> HM and Packing Group(if any)) No. Type Quantity ol. 31.Waste Codes <br /> CC <br /> O <br /> Lu <br /> Z <br /> to <br /> t9 <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> Printedffyped Name <br /> ^;-(� S Month Day Year <br /> 'Transporter Ackriowled ment of Receipt of Materials <br /> Printed/typed Name A <br /> nature <br /> Month Day Year <br /> S Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> -05} Previous editions are obsolete. <br /> DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />