Laserfiche WebLink
f <br /> nt or type.(Form designed for use on elite(12-pittopewriter. <br /> Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> 25. Transporter�` Company Name U.S.EPA ID Number _- <br /> r . <br /> 26. Trans iter r U. €P ID Number <br /> po �_ Company Name � i,- �� �' , <br /> �-,i <br /> 7a"-27b;t!&DOTDes*bbn(irduft PIDMShippin#Namey Hanrdt)m,lDNumber, -- -'r - _r2p.Containers._, y, <br /> HM and Packing Group(dany)) 2gaTd�I 30'. -� � 31 Waste Codes <br /> No. Type Quantity Wt.Not. <br /> AY 2 Z <br /> - <br /> 2 <br /> W \ \ <br /> (D <br /> 32.Special Handling InsWctions and Addibonal Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> ti Printedrryped Name Signature Month Day. Year <br /> K <br /> O <br /> z 34.Transporter t j AcWpwfedgment of Receipt of Materials <br /> Printedrryped Name Signature Month Day Year <br /> 35.Discrepancy <br /> J <br /> U <br /> 6 <br /> LL <br /> 0 <br /> W <br /> 4 36.Hazardous Waste Report Management Method Codes(I e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> C7 <br /> N <br /> W <br /> EPA Form 8700-22A:(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br />