Laserfiche WebLink
Plaaca mint nr h— 4:: r H—i—H f— i— n .]if. ti? nit,hl h--ritor 1 <br />Fnrm Annrnved OMR Nn- 905n.MgQ <br />EPA FoW VW22A (Rev. 345) Previous editions are obwlete. <br />B 12v3 CAL28a7MV <br />1 <br />DESIGNATED FACUTY TODESTINATION STATE (IF p- `, <br />UNIFORM HAZARDOUS WASTE MANIFEST 1 <br />(Continuation Sheet) <br />21 Generator ID Number <br />CAL000373074 <br />22. Page <br />2 of . 2 ` <br />23. Manifest Tracking Number <br />010685515FLE <br />24. Generator's Name <br />Dollar General #13632 <br />U.S. EPA ID Number <br />25. Transporter Company Name /`� <br />U.S EPA ID Number <br />26. Transporter Company Name <br />27a. <br />HM <br />271b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />and Packing Group (if any)) <br />28. Containers <br />29. Total <br />Quantity <br />30. Unit <br />Wt.Nol. <br />31. Waste Codes <br />No. <br />Type <br />5.Non RCRA hazardous waste, liquid (Consulter <br />Products), <br />1 <br />DF <br />00115 <br />P <br />331 <br />6.Nan RCRA hazardous waste, solid (Consulter <br />Products), <br />1 <br />DF <br />00088: <br />P <br />331 <br />x <br />0 <br />z <br />W <br />t� <br />32. Special HandlinglnstructDrisand AdditionalInformation 5.110524(Non-RCRA LigUid Waste (Cts Only) - Loosepaek) G: <br />-,'aa,id- Waste (CA Only) - Laoaepaek3 <br />t <br />33.Transoorter_AdkrwwledamentofReoeiplofMaterials <br />� <br />Alz <br />Prinfa&Typsd Name Signature Month Day Year <br />c" <br />34. Transoorter Acknowiedament of Receipt of Materials <br />Printed/TypedName Signature Month Day Year <br />it <br />,1 <br />ii <br />G <br />35. Mmoncy <br />`36. or h rdous waste treatment, disposal, and recycling systems) <br />, <br />I � I <br />EPA FoW VW22A (Rev. 345) Previous editions are obwlete. <br />B 12v3 CAL28a7MV <br />1 <br />DESIGNATED FACUTY TODESTINATION STATE (IF p- `, <br />