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Please print or Form designed for use on elite 12 ewriter. Form yed.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST Tt.Genrrawr lD Number 22.Page -1 23.Manliest Tracking Number <br /> (Continuation Sheeq 55 oF'oZ Dl 'f'�iTs623 <br /> 24.Generators Name�,p-�� �D % h4;4'w S,cg-uD <br /> 3 s. Pae.�� .4-��✓� <br /> 25.Tnnspory Company Name U.S.EPA ID Number <br /> 25. TrartspoMr_ Canpany Name U,S.EPA ID Number <br /> 27a. 276.U.S.DDT Desalptlon tndutfiy Proper Shipping Name.Hazard Cass,lD Number, 29.Conainers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group Tday)) No. Type Quantity WINoI. <br /> n10n1 12CP�] ht ZA4ZDC7'c <br /> �so 4p,b64Ar�s„r7-) <br /> IA14rrJ Rcle4q h4z*Aba�6 61_wS-i`v <br /> ap >Q <br /> 32 Specal Handrng Instructions and Addlfidral infermadaq <br /> gJ-PLtI�-z/oa [R 361t4�t�1 �xs5 s,�Bs_P�+> ZsX/��/oa cP_Lff-ss <br /> 1.}$1-pRa <br /> F^7+ "t/-7slDa. LP—L}F-62 6EK 'ri <br /> 84-Pry / l X02 t P1/ -60 594�17Y »cSSGi <br /> ¢ 33.T td of MAIUWs <br /> W FiotadiTyped Name Slgrawre Month Day year <br /> O <br /> a <br /> z 34.T mntorR dMaterels <br /> PnnLVTyped Name Signawhe Month Day Yew <br /> r <br /> 35.Discrepancy <br /> J <br /> v' <br /> a <br /> W <br /> O <br /> 36.Haadous Waste Report"emend Method Codes(i.e.,odea for hazardac waste treatment disposal,and recydYg system) <br /> z <br /> no <br /> no <br /> w <br /> 0 <br /> EPA Form 87*22A(Reu.3-05) Previous ed Wns are obsdele. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />