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I:... I. � ..:1a.1 r..,....,,.He.I <br />Farm Approved. OMB No. 2050-0039 <br />Please <br />rint or . rrorrn oesi Neu lul ubw VI1 ulikcj <br />U�tIFORM HAZARDOUS WASTE MANIFEST <br />1 1 <br />2t. nera <br />ID «,. <br />Number <br />nff -- <br />22. Page <br />23. Manliest Tracking;Nyumhe+ <br />O� <br />(Continuation Sheet) <br />6))tl/^ t1� <br />/244.. Ge�]neratofs Name f f' <br />25. Transporter Company Name <br />U.S. EPA ID Number <br />U.S. EPA ID Number <br />26. Transporter Company Name <br />279, <br />27b. US. DOT Description (irduding Proper Shipping Name, Hard Gass, ID Number, <br />28. Cantalr>en> <br />29. Total <br />30, Unit <br />WtAbl. <br />31. Wasto Codos <br />No. <br />Type <br />HM <br />and Packing Grouptlfany)) <br />Quantity <br />E NV <br />MENTAL <br />IrLU <br />liC�:A <br />Tt nF <br />�9TAACM1 <br />0 <br />z <br />ur <br />t� <br />32. Special Handling Instructions and Afflicnal Information <br />a <br />33. TransportEr Acknowl nt of Recela of Matedais <br />PrintedlTyped Nature <br />Signature <br />Month <br />Day Yo <br />rz: <br />O <br />0. <br />34.Transporter Acknow nt Receipt of Materials <br />nature <br />y ear <br />Printed/Typed N a <br />/ <br />35. Discrepancy <br />LL <br />0 <br />Q36. <br />Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />s <br />O <br />us <br />W <br />O <br />r.rrntlzl�rin�l e- nr ncAl11tlG11' <br />EPA Form 6700-22A (Rev. N5) Previous editions are obsolete. DESiGNAI to !`AI.11_1 r T r V LPLJ 4 rnnr'wim Q Im' 'N. wvll—y <br />Page 6 <br />