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Pleaseprint ort e, Forn1 designed for use on elite 92• itch typewriter.typewriter.1 Form Approved.OMB No.2050-0039 f <br /> UNIFORM HAZARDOUS WASTE MANIFEST 1 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) CAD078790920 2 0110593d3FLE <br /> 24.Generator's Name Suffa r Tra#:y Coin m unity Hosspitsl <br /> 11420 N Tretv SIV4 <br /> Tracy,CA 95376 <br /> 8871 <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> 26.Transporter Company Name U.S.EPA ID Number <br /> 27a. 271b.U.S.DOT Description(Including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(If any) No. Type-1 Quantity Wt./Vol, 31.Waste Codes <br /> lion-MCRA,Hazardous rdous ste,Liquid(C osilursn) <br /> Non- CRA Hazardous Waste,Stolid(Lime Filters) / 352 <br /> DF <br /> UN3264,1Atsstae Ctarros Ke liquid,acidic,Inorganic,n.o.s. 791 D002 <br /> X (SULFURIC ilk),9,it ! DF <br /> ctc <br /> 0 <br /> w <br /> Z <br /> w <br /> cs <br /> NHandlin Instructions and Additional Information <br /> i) 30 1292 6)070,1274S&10599 7)070137708-8754 EIR15d <br /> l�l15 /VK tai <br /> 33.Transporter Acknowledment of Receipt of Materials <br /> L Printed/typed Name Signature Month bay Year <br /> 0 <br /> a <br /> cO 34.Trans orter,. Acknowledgment of Receipt of Materials <br /> 4 Printed/typed Name Signature Month Day Year <br /> H <br /> r 35.Discrepancy <br /> J <br /> rJ <br /> LL <br /> a36.Har m sf apart Management Method Co.os(E. codes for hazardous waste t(eatment, is o a t ding systems) <br /> Z <br /> co <br /> w <br /> 1:2 OL <br /> 0 <br /> EPA Fornt 0700-22A(Rev.3-05)Previous editions are obsolete. <br /> DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />