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I <br /> Pleasa print`or type. (Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No,2000-0404.Expires 7-31-66 <br /> UNIFORM HAZARDOUS 21.Generator's US EPA ID No. Manifest Document No 22. Page Information in the shaded <br /> WASTE MANIFEST C A D 9 8 1 1 7 0 3 4 3 6 0 7 0 1 areas is not required by Federal <br /> (Continuation Sheet) law. <br /> 23.Generator ��y Printed Circuit Board c/o N. Sarnevesht L.State Manifest Docum ber <br /> rr <br /> 27902 S. MacArthur 8 5 0 2 4 <br /> Tracy, CA 95376 M.State Generator's ID <br /> 24.Transporter Company Name 25. US EPA ID Number N.State Transporter's ID <br /> S lT O.Transporter's P h o!f <br /> 26.Transporter Company Name 27.US EPA ID Number P.State Transporter's <br /> Q.Transporter's Phone <br /> 29.Containers 30. 31. R. <br /> 28.US DOT Description(Including Proper Shipping Name,Hazard Class, and/D Number) Total Unit Waste No. <br /> HM No. Type Quantity Wt/Vol <br /> 0-6 ul'u%D v A—/ '7 /� t 2 <br /> b. w pS-E ��.� r_-.t �D u U 11 Co O v <br /> Go�2 RaS1 L)G �� <br /> c. as-re AC`Iib LvuGS vu -1 -7 <br /> C6 RQC>SI UE PA h-t 6R t I&,-- <br /> G d <br /> &,--Gd. U; sS-Z-E ,A <br /> E a6v- 2osruE <br /> iA e. W IaE5r6-1 4 f_f c*t L1 k}V. LI .D La GS .� � ✓ <br /> 7-� <br /> x ( o ruzo5i u 8 -Rt�L VJA -1'? 1 9 <br /> R RV <br /> Wce_a a�os ruE�AS('- <br /> 2tz t C) <br /> g R R15 P tst µ 1 J4 (r u <br /> h. ILL) �(—T I'D L <br /> 00 9-12GSr 06 d-1 l e S, I t <br /> RU u 1 -'L <br /> i. p STre 9E L O f.t 4%U O 1JC3S v u -/ <br /> @0 n.vz�is <br /> ►w u <br /> S.Additional Descriptions for Materials Listed Above T.Handling Codes for Wastes Listed Above <br /> 4�' t s -`t'uS a-P eco o 0 0. r )G <br /> e FLUQ11s00.t� AIG-% o teXuITWa3 k <br /> �g0(Q <br /> jj � ( 0 a ,E. twk�ivk � r!6, 1 <br /> _t c-G'tG 4 C <br /> 32.Special Handling Instructions and Additional Information 1�" u IZ <br /> fiLt{O�C3R� A�tQ 'rad w ,� ,ops <br /> Z� �LCJo 60 RtC, �A�t,� �G 6 <br /> T 33. Tr sporter Acknowledgement of Receipt of Materi Date <br /> R Month Da Year <br /> A Printed/Typed Name p�� Sign re <br /> W �� L? L� <br /> S <br /> ci 34. Transporter Acknowledgement of Receipt of Materials Date <br /> T Printed/Typed Name Sig ture onth Day Year <br /> E <br /> R <br /> F 35, Discrepancy Indication Space <br /> A <br /> C <br /> 1 <br /> L <br /> 1 <br /> T <br /> Y <br /> Style F16-6 Labelmaster.Chicago,IL 60646EPA Form 8700-22A(3-84) <br /> --.� '�-`*'f•t�af 411 �-���•••, �-...,-� <br />