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q <br /> Please print or type. Form designed for use on elite 12 itch typewriter. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> 25. Transporter, Company Name 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 /> O <br /> LU <br /> Z <br /> W <br /> 32.Special Handling Instructions and Additional Information <br /> r. <br /> cc 33.Transporter-Acknowledgment of Receipt of Materials <br /> W Printed/T peo Name <br /> Signature N g Month Day Year <br /> CL <br /> Z 34.Transporter Acknowledgment of Receipt of Materials <br /> 4 Printed/Typed Name Signature Month Day Year <br /> F <br /> 35.Discrepancy <br /> i <br /> C3 <br /> W <br /> a 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal and recycling systems) <br /> Z <br /> N <br /> W <br /> D <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. <br /> DESIGNATED FACILITY TO GENERATOR <br />