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Please print or type. Form designed for use on elite 2-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) CALOC)b ( `)q j_ C)I C,? � r4 G <br /> 24.Generators Name <br /> t 0-0y,t e e y <br /> 25. Transporter Company Name , <br /> U.S.EPA ID Number <br /> u S )r C IU <br /> 26. Transporter Company Name <br /> U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity Wt./Vol. <br /> O <br /> F <br /> LU <br /> Z <br /> V <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> LU PrintedlTyped Name Signature Month Day Year <br /> 0 , j <br /> a <br /> z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> H <br /> 35.Discrepancy <br /> J_ <br /> V <br /> Q <br /> LL <br /> G <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> C7 <br /> N <br /> LU <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />