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Form Ag roved,OMB No.20500036 I <br /> 22.Pee 23 anifest n9Hu bor <br /> Please tint or 1 e. Form des ned for use on elite 121.6enerator 1D Number <br /> UNIFORM HAZARDOUS WASTE MANIFEST O 1 r <br /> (Cownuatlon Sheat) IBJ <br /> 24.Generalcrs Name //u� <br /> V `/V U,S_EP ID Nu/mJlber <br /> Company Name <br /> 25.Transporter Cly U,S.EPA ID Number <br /> 263-Transporter- CompenyNamo.. t i <br /> 2B.Containers 29.Total 30,UPR 31.Waate Codes j <br /> 27a. <br /> 27b.U.9.DOT Deso tion Qmduding Propor Shipping Name,Hazard Class,IG Number, No. Type QUonUty WtNol. <br /> HM and Packing Group V any)) T <br /> i <br /> I. <br /> I <br /> I <br /> I <br /> a <br /> 0 <br /> z <br /> w <br /> i o <br /> I. <br /> I <br /> i <br /> ; <br /> 1 <br /> r <br /> { <br /> I. 'I <br /> r <br /> i <br /> 32.9pedal Han'ung in6lruoUono and Add tional{donnatbn <br /> i <br /> i <br /> h onlh Day Year <br /> 93.Trans der AcknuMe d Rece t d Materials Sign to <br /> Printed pe me <br /> oon ay ear <br /> Z 34,rrar r Acknowwoment of R,,-"At of Matadals na ure <br /> Printedllyped Name <br /> 35.Cisorepancy i <br /> J , <br /> Q <br /> LL <br /> 38,Hazard rls Was a Report Managernont Meltwd Codes(i.e.,codon for hazardous waste treaUnont,disposal,and recycling systems) <br /> � I <br /> uU <br /> LU <br /> a <br /> ILITY <br /> EPA Form 8700-22A(Rev.3.06) Prevlous eddlons are obsolete, <br /> DESIGNATED FACTO DESTINAT{ON STATE(IF REQUIRE <br /> I <br /> I <br />