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Please Drint or Form designed for use on elite 12 itch ter. Form Approved,OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121.Generator ID Number 22.Page 23.Manliest Tracking Number <br /> {Continuation Sheet) CALOODC375M 006193MSKS <br /> 24.Generator's Name <br /> P- I an rat inn P 1-n AMP <br /> 25.Transporter r Company Name �� U.S.EPA ID Number <br /> "&,0 a?5,0 4 S� <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 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity W11vol. <br /> tr <br /> TPO <br /> O <br /> w <br /> Z <br /> w <br /> t9 <br /> 1 <br /> t <br /> 32.Special Handling Instructions and Additional Information <br /> 33.T rent of R. of Materials <br /> LU Printed/Typed Name Signature Month Day Year <br /> 0 5c v 3 <br /> a <br /> Z 34.Tran rent of Receipt of Materials <br /> Phntedrryped Name Signature on ear <br /> ay <br /> F <br /> 35.Discrepancy <br /> J_ <br /> C.7 <br /> a <br /> 0 <br /> a36,Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> t7 <br /> H <br /> W <br /> D <br /> EPA Fort 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />