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+';` <br /> Please rint or e. Form lest nmd for use an elite 12• itch [ ewriter. - <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number Form A roM,OM No.2050.IV39 <br /> (Continuation Sheet) CAL 0002-07 469 2 0174 77716JJK <br /> M.Gen©ralor's Name <br /> V*ST NW 41NE ft <br /> U.S EPA ID Number <br /> 25. Transporter Company Name <br /> U.S.EPA ID Number <br /> 26. Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 26.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing..Group Of any)) - r No. Type - Quantity Wt.Nol. - <br /> 06 Nonce , Won-RCM Haxae"m 0011 DM 00021 P 331 141 <br /> i <br /> 1 <br /> I <br /> w <br /> - p� dNfg gjwj��4~1 ona6IWmation <br /> hi <br /> 33 Trans rnrter AGvrawlad men[of Recei of lusalerials <br /> Pflnludfiyper}Name Slgrtelurfl Month Dny Year <br /> Cit <br /> O <br /> CL <br /> 34 Trantsportef Acknowk)dgmenl of Racelpi of Malufiala <br /> PrintedlTyved Name nature Huolh Day Year <br /> h <br /> Dl=epanny <br /> ti <br /> a <br /> Q36 and u Report Management Method Codes(Le.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 2 U, <br /> C7 <br /> w <br /> EPA Form 8700-22A(Rev.3-05) Provious..editions are obsolete. ' DESIGNATED-FACILITY TO GENERATOR <br />