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Please print'or type.(dorm designed for use on elite(12 pitch)typewriter.) Form Approved..OMB No.2050-0039 <br /> JNir6RM HAZdRDOUS 1NASTE MANIFEST 21 r8e�°r ID Number t 22:Page a 23.Manifest Tracking Number r <br /> (Continuation Sheet) <br /> 24. <br /> : � t� ✓r - [ { ✓ f. 'y ' <br /> ..� �s- <br /> 24.Generator's Name <br /> 8.Transporter: Company Name <br /> F f + U.S EPA ID Number <br /> ' -t!' %rid '. rF,s+rrc' rMJcca : I <br /> U.S.EPA ID Number . <br /> 26. Ts rtes Co p ny Na <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,.ID.Number, 28.Containers 29.Total 30.Univ <br /> — HMT and°Paeki 'Grou'if an _Waste Codes <br /> � p( ' Y)) __._,_ �,._ �...._.._Nb.,: .._.. p — Qeantt Wt:fVol- — 31. _._*de . <br /> ypa" Y <br /> W <br /> W <br /> d, <br /> � I <br /> r` <br /> , t <br /> 32.$6cfal Handling instructions and,Additional Information <br /> 33.Transporter Ack owledgment of Recelp of Materials 1. D71 <br /> Pnnted7ypp Na ze Signature Month Day Year . <br /> 0 V9 <br /> �J <br /> w34:Transporter Acknowledgment,gf Receipt of Materials I <br /> Pr <br /> UMI. - <br /> e:Of1 nth D Ye <br /> r 35.. iscrepancYLL- <br /> , <br /> LLI <br /> i, <br /> 36,Hazardous Waste Repo t Management Method Codes(i.e.,c es for hazardous waste treatment dis sal,and$ecycling systems), <br /> Z - <br /> C7 <br /> EPAForm8700-22A(Rev.3-05) Previous editions are obsole DESIGNATED FACILITYTO GENERATOR <br />