Laserfiche WebLink
Please print or type,(Form designed for use on elite(12-pit,,q typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) 2 of r <br /> 24.Generator's Name R-1 I*_1IN, Cu <br /> S1 OC;i I EN.CA S`x?I)F, f <br /> 25.Transporter .Company Name <br /> U.S.EPA ID Number <br /> 26, Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 31.Waste Codes <br /> J fit;tV.14-RCKA f1+4.::.4&9y 'S <br /> ._..3{!";Ah#--f :l~:�I�$A1i`.,P'tF�()+°¢;.6>tC �;�';��:>,fi;f„�:iw�2,• �t�.xskt.l , <br /> I�pL,t'I rLt ;Ea ¢i _` �dlJi: i�vst 1~' `ar(- ,I()f44°;4: F1 6, t <br /> i A <br /> r <br /> Uj <br /> LU <br /> 14,1V f <br /> Z /,{/ yam//" orf .!�-' ✓� ✓ <br /> � y <br /> r^ <br /> 32.Special Handling Instructions and Additional Information <br /> b_p 14%0 11=10.6 0� Vi-2.11A 6.I' B-tG f l-kib''2' T) f4'-W4 Ekf? 171-27h3 <br /> 33.Transporter: Acknowledgment of Receipt of Materials <br /> LLJ Printedlrypen Name Signature Month Day Year <br /> 0 w� <br /> Z34,Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> J <br /> U <br /> LL <br /> G <br /> W <br /> Q 36,Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> (D <br /> coW <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br /> ,I <br />