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' t or type.(Form designed for use on elite(12-pitcoypewriter.) • <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) CSL 6CID 7719-9 3 z O 1 r 913 2 3 DTIC <br /> 24.Generatoes Name <br /> ('CUrlrKV t••tAKetT PLACt DGA $A 01 Fr4rF ZPRI Se—'S <br /> 25, Transporter 3 _ Company Name KUi? sr r+5 U.S.EPA ID Number -• <br /> / . _ ="AK Ooot �7i2 <br /> 26. Transporter Company Name berr�/) _ 1rDz <br /> G <br /> 27a 27b.U.S.DOT Descriplion(induding PoaperShippingYJame,;HazaN-Vass,ID Number, ; 28.GOP are ..29r.TtV ''30rurdf -- > <br /> HM and Packing G=p(it any)) No. Type v Quantity Wt.Nol. 31.Aste Codes <br /> C) <br /> oillllll�r_ 1A <br /> I <br /> 32.Special Handling Instmcdons and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> LIUo Printed?yped Name Signatur /l _ Monj Dayi, Year <br /> z 34.Transporter of 'ptoFl�ate�ieh ; .,:. . <br /> Pdntedfryped Name Signa Month . Day Year <br /> 35.Discrepancy <br /> r <br /> J <br /> U <br /> Q <br /> LL <br /> 0 <br /> W <br /> Q 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste Vestment disposal,and recycling systems) <br /> z <br /> C7 <br /> fn <br /> W <br /> O <br /> EPA Farm 8100-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />