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Please,onot or Form des <br /> i sed for use on elite 12. itch <br /> UNIFORM HAZARDOUS WASTE MANIFEST widler. <br /> (Continuation Sheet) 21 General,,ID Number <br /> General° ��— 7 22.Page 23,Manifest Tracki Form A roved.OMB No. <br /> a Iy Numtror. 2050.0 <br /> 25. Tmmposat company 3 L !} TY~} <br /> I j`1 P y Name <br /> P <br /> Co <br /> 26, Transposer r ` // i y UNum <br /> .S.EPA D 6cr <br /> mpany Name aC� Qr �Uti n` <br /> YS33�' <br /> t 27a. are.U.S.DOT Des 6"Von(mcludi Pm U.S.EPA ID Number <br /> HM add Packing GrouPdfanyl) Per ShiPPing Name.Ha m Class,ID Numbe, <br /> 29.Containers <br /> No. TYPe 29.Total 30.Unit <br /> Quantity Wr N°I 31.Waste Codes <br /> u <br /> ' <br /> K r f <br /> I. I <br /> 1 <br /> W i <br /> 2 <br /> W <br /> � I f <br /> F <br /> 1 ; <br /> j <br /> :jv <br /> i <br /> 32.SPenal Handling lnsWCGons antlAddls'wlal Information l ii <br /> ( <br /> 33,Tran ser <br /> ti PdnladR Name mast ofRecei of Mawrals. <br /> Z 30.Tran r - <br /> PdnlayrYPad Name Apknow7ed mast or Recei t Malenals r .r 2 ,� / Month Day Year <br /> gnawm <br /> 35 Diswepan4y <br /> _7 0°t ay ear rr <br /> U f;Fi <br /> LL <br /> W is <br /> R 36.Hazardous Waste Report Management Met <br /> hod Catles li.e.,codes for hazardous waste treatment. {{� <br /> disposal,and mcyGilg systems) I;.:.. <br /> A Form SI00. d <br /> 22A(Rev.3-05) Previous editions are obsolete. <br /> t <br /> DESIGNATED FACILITY <br /> iOGENERATna I` '" <br />