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Please print or type. Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANI EST 21,Generator ID Number 22.Pace 23.Ma ifest�Tr`acking Number <br /> (Continuation Sheet) 3 �C�S� <br /> 24 Generator's Name <br /> U.S.EPA ID NumberQ C <br /> 25.Transporter Company Name ZjjjAJJ J <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name <br /> 27a. 27b,U.S.DOT Description(including Pro)er Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31,Waste Codes <br /> HM and Packing Group(if any)) Na Type Quantity Wt.Nol. <br /> O <br /> w <br /> Z <br /> W <br /> 1 tip15 I <br /> r <br /> NEP��N V _. <br /> 32.Special Handling Instructions and Additional nformation <br /> 33.Tmnsoorter Acknowledgment of Rao t of Materials <br /> H Printed ed Name Si Month Day Year <br /> 0 L Cl <br /> 0 <br /> a <br /> Z34,Transporter_Acknowledgment of Repipt of Materials <br /> Printed[Typed Name Signature ont ay ear <br /> 35.Discrepancy <br /> J <br /> U <br /> Q <br /> LL <br /> O <br /> LU <br /> 36.Hazardous Waste Report Management Meth d Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> r, <br /> w <br /> w <br /> a <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />