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' CZ <br /> Please print or type' Form Approved.OMB No.2050-0039 <br /> VIP AZARDOUS WASTE MANIFEST 21.Generator ID Number '22.Page 23.Manifest Tracking Number <br /> Continuation Sheet) 17,AR000180844 2 of 2 013304635FLE <br /> 24.Generators Name Piste Electronics Inc <br /> 199 Frank West <br /> Stockton,CA95206 <br /> 25. Transporter Company Name U.S.EPA ID Number <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, 28.Containers 29.Total 30:Unit <br /> HM' and Packing Group(if any)) - "" No. Type Quantity Wt.Nof. 31 ._Waste.Codes. <br /> 5):Noo-RC.RA Hazardous Waste Liquid(Silica.,Aa)ilate 0119omerI) 4/b343 <br /> 6)Non-RCRA►Hazardous Waste Liquid(Phenol,Water) 343 <br /> 0 <br /> W <br /> Z <br /> W <br /> 32.Special Handling Instructions and Additional Information � D ��/ <br /> ER ©70i31670•Zt077ANJ SIX C?�T S)ERGO 070131 70-20721 ARl- ¢ <br /> 33.Transporter ment of Receipt of Materials <br /> _ LU Printed ped Name Signature Month, Day__Year, <br /> .- <br /> O <br /> CL <br /> Z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printedrryped Name Signature Month Day Year <br /> 35.Discrepancy <br /> J <br /> U <br /> Q <br /> u. <br /> O. <br /> W .36. z ou to Irt Management Met Codeod01)r hazardous waste.treatment,disposal,and recycling systems) <br /> Z <br /> Co 1"�jca <br /> ,1 <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />