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16 <br /> PI�Se print or type:{Form desgned,inr usaon elite(12-pitch typewriter.) Fo�Rt lkjttoved,OMB No.:2060-0039 . <br /> UNIFORM HAZARDOUS WASTE MANIFEST: 27 iG�en�etrator lO Numt�r 22..Pepe 43..ManrfestV:ackmg:Nun6�r <br /> (Continuation Sheet) G•W'' L rc' r "z— <br /> r <br /> 24.Generators Name.. _ <br /> 25.7ranspaler ComperryName U.S.EPAIDNumber <br /> 28.Transporter rfUYaMbar60C��X✓ <br /> 276. 27b.U.S.DOT Description(indudng Proper$Idpping Name,Hazard Class,ID Number, 28.Conlaiaem 28.TofeL 80.Unit <br /> HM and,Packing Grafi Pf _Y)) Type 4yaa. WL(w. `31.Waste Codes <br /> 4 <br /> o <br /> LLI <br /> J - <br /> _ r <br /> le <br /> '�. .. .. <br /> ., ewt�e <br /> }r <br /> k�. <br /> 32.4wal Handling Instructions and Additional Informatioe. <br /> 33,Tram <br /> port;;=AcknrowlsdgmenfTramof Rempt of Materials <br /> Prinled/Typed Name 0Si ure Month- Day ` Yea <br /> H 34.Transporter Acknowledgment of Recelpt of Materials <br /> .Pdntedfryped Name Signelue _ Y <br /> yl <br /> 35:Oistirepancy . <br /> Q36.H-ardpus Waste R000rt Management Method,Codes(Le fortiazordouswaste:treatment,disposal and rpyding systpms) <br /> .EPA ?FWUA{Rev.3-05) Previouseddtonsareots616te.• DESIGNATED FACILITY3O'.GENERATQR <br />