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Please prA Ar type (Form designed for use on elite(12-p,.,,./typewriter.) Farm Approved.OMB No.2050-0039„/ <br /> 21:Generator ID Number” 22.Page `1' 23.Manifest Tracking Number <br /> UNIFORM Hi�ARDOUS WASTE MANIFEST a c.� <br /> (Continuation Sheet) d, _ d` <br /> i r <br /> 24.Generator's Name <br /> I <br /> ` <br /> ' , n <br /> 1��.� !),. � ��/ �,.�.�,? 1��� ~,��,,•� �• <br /> U.S.EPA ID Number <br /> 25. Transporter Company Name T' ,t 7 k- <br /> V <br /> 'r <br /> ,l. ?'7 '/ /f !.�k••'�.{ �5 .I'(.:e•^�� lT�,.f. C: .''frr"1 A ,y".:.•, J S <br /> U.S EPA ID Number <br />{ 26. Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class;ID Number, .. 28.Containers 29.Total,_: 30.Unit 31.Waste Codes <br /> HM and Packing Group(it any)) No. Type Quantity Wt./Vol. <br /> l <br /> I <br /> I <br /> ;,r CEI E i <br /> z <br /> w5 Zola <br /> g <br /> I \11E <br /> 1' � til l tL1�l <br /> 32.Special Handling Instructions and Additional Information;. . <br /> 1 ,. <br /> 33.Transporter .^' Acknowledgment of Receipt of Materials Month Day Year <br /> w PrintedlType Name Signature, ! 1 <br /> 0- A <br /> -10 <br /> porter •- <br /> r �. <br /> Z 34.Transr Acknowledgment of Receipt of Materials Month Day Year <br /> e <br /> Signature <br /> Printedrryped NamJ <br /> i. /'Y <br /> Y <br /> } 35.Discrepancy <br /> Q <br /> LL <br /> 0 <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />