Laserfiche WebLink
Please print or type[,I _ <br /> UNIFORM NAZARDWS WASTE MANIFE5T 21.Generator ID Number 22.Page 23.1fanifestTracking Number Form Approved.O�1B No,2050-0039 <br /> (Continuation Sheet) CAL 000 379 505 2 020202871 JJK <br /> 24.Generators Name <br /> v &FINAL W3 <br /> 25. Transpo ter Company!Name U.S.EPA ID Number <br /> 26. Transporter Company Name U.S EPAlDNumber <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 26.Containers <br /> HM and Paddng Group cif any)) 2R Total 30.Unit 31.Waste Codes <br /> on No. Type Quantity Wt.Nol. <br /> Q <br /> W <br /> W <br /> C7 <br /> tPIM� <br /> po ter Acknowledgment of Receipt of Materials <br /> ped(NameSignature <br /> DMordhDay Year <br /> 2orter Acknowledgment of Receipt of Materials <br /> Pnntedayped Name <br /> f- Signature Month Day Year <br /> } 35 Discrepant' <br /> C <br /> J <br /> fl <br /> LaL <br /> fa <br /> W <br /> d 36- 1141 Report Management Method Codes{i.e.,codes for hazardous waste treatment,disposal,and nsryghng systems) <br /> 0 <br /> h <br /> W <br /> O <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIIFEST SYSTEM <br />