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• Form Approved..OMB No.2050-0039.Expires 9-30-99 <br /> UNIFORM HAZARDOUS 21. Generator's US EPA ID No. Manifest Document No. 22, Page Information in the shaded <br /> WASTE MANIFEST 7 / .•1 - areas is not required by Federal <br /> (Continuation Sheet) r' law. <br /> 23.Generator's Name / L. State Manifestpo ent Dumber <br /> /I V '- <br /> M.State Generator's ID <br /> 24.Transporter Company Name 25. US EPA ID Number N. State Transportees ID <br /> O.Transporter's Phone <br /> 26.Transporter Company Name 27, US EPA ID Number P.State Transporter's ID <br /> q,Transporter's Phone <br /> 29. Containers 30. 31. R. <br /> 28 US DOT Description (Including Proper Shipping Name, Hazard Class,and ID Number) Total Unit Waste No. <br /> No. Type QuantityWWoI <br /> a. .+•Iij, t+ , s.. b/Ji' t,r: `r i�. ; 11", i (r•7 A/��iifr7L. ri .-' <br /> ti/' J�,c1S I_ Cr(�(rs'1 IVdl�r ytri I Ll7/ 32ft6 11 <br /> r <br /> b. !/tom It�flSdt.F i rlbNbrn4akll�f A �,.., . <br /> "J rsr,-t l1,1! Gel ?S G N <br /> c. DtJ' h.. !""i ,)1.1 des _/ 'l/: /I 1' i 10 i l r r p G <br /> �(°P�MQi`3V•�5, rQ !v�>,t rrsT h(�r� ''v`r �rt t, } �. ✓ // p + <br /> a d, <br /> E <br /> N <br /> E <br /> R <br /> A e. <br /> T <br /> O <br /> R <br /> f. <br /> 9 <br /> h. <br /> 1 <br /> S Handlinpl 4�es fw Wastes Ltstsd Aoove <br /> a.= f b.• 4 c. d. e. f. 9. <br /> 32. Special Handling lnsquction§a g.AjdrtwnayInfogn4tion, V I I i a:%t <br /> T <br /> 33. Transporter—Acknowledgement of Receipt of Materials Date <br /> A PdntedlTyped Name Signature Month Day Year <br /> N <br /> s <br /> 0 34.Transporter_Acknowledgement of Receipt of Materials Data <br /> R Month Da Year <br /> r Printed/Typed Name Signature Y <br /> E <br /> R <br /> QqP 35. Discrepancy Indication Space <br /> if t <br /> T <br /> Y <br /> EPA Form e700-22A(Rev.9-88)Previous sakons are obsolete. <br /> GENERATOR COPY <br />