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Please nnl or l e. Form des' ned far use on elite 12- itch t ewriter. <br /> UNIFORM HAZARDOUS WASTE MANIFEST 2i Generator ID Number Form All OMB No,205f]-Uf739 <br /> C A L060"133 LI�1 27,Page 23.NlanifestTracicing Number <br /> (Continuation Sheet L�1`k �/cx1 ®�2— ® 2Z [�27 -/ 7 772114 <br /> � /4 <br /> 2A.Generator's Name / <br /> AM EA 647V ivl4fT44e-T46CAl .5G/Jill tif-C <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> 26. Transporter Company Name U-5.EPAIp Number <br /> 27a, 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, <br /> HM and Packing Group(if any)) 28•Conlainers 29.Total 30.Unit <br /> �d R C-04 <br /> ;4 'OilS No. Type Quantity Wt./Vol. 31.Waste Codes <br /> CF-4"pry <br /> A-10AI ICC <br /> � �rE, DPIl INC Z Yo SZ <br /> Lu <br /> 32. clal Handling InslrucllonSandAdditional Informat• <br /> ep) A.-,ALJ � ^-� s tri® S-6 <br /> M 33.Tra kknowledgmm of Recsi i of Malerials <br /> H i ledlTyped Nama <br /> aSignature Month Day Year <br /> 34.Trarrs ortar A dnovrle meat of Recel l of Materials <br /> Printed/Typed Name <br /> h- rgnaturs om ay ear <br /> 35.Discrepancy <br /> .a <br /> U <br /> D <br /> w <br /> Q 36,Hazardous Waste fiepori 1111anagamerJt h691hod-GodesHIS for hazardous waste lrealmenl,disposal,and recycling syslams) <br /> C7 <br /> w <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />