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d _ _ _ZZ -- - - Form A roved.OMB No.2050-0039 <br /> M,nIeC,,. Form deal ned for use on elite 12- it; writer. - - 22,Pae 23.Manifest Tracking Number <br /> ZARDOUS WASTE MANIFEST 21.Generator ID Number 9 y <br /> ontinuation Sheet) <br /> Name <br /> ver: PAID Number <br /> _ Company Name <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name <br /> 28.Containers 29,Total 30.Unit 31.Waste Codes <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, No. Type Quantity Wt Vol. <br /> HM and Packing Group(if any)) <br /> K <br /> O <br /> Q <br /> K <br /> W ' <br /> Z <br /> E <br /> 32,Special Handling InslnmHons and Additional Information <br /> 53 <br /> 33.Trans chat Acknowled ment Gf Rei of Materials Signature Month Day Year <br /> W Printed/Typed Name <br /> K <br /> O <br /> CL <br /> Z 34,Trans otter Acknowled mant of P.eceipt of Materiels --Signature <br /> Month Day Year <br /> Printed/Typed Name <br /> H <br /> } 35.Discrepancy <br /> Zi <br /> J <br /> U <br /> LL <br /> Q36.Hazardous Waste Report Management Method Codes u-,codes for hazardous waste treatment,disposal,and recycling systems) <br /> S2 <br /> y <br /> W <br /> D <br /> EPA Form 8700-22A(Rev 3-115) Previous editions are obsolsie <br /> ii r'iap+r r C':"TQ OCeTlNATIOo,�. <br />