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Please pint or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZAI .......pSTE MANIFEST or ID Number 1 22.Pf 23.Man T.rkInq Number <br /> (Continuation Sheet) 5(4 ! —� CIN <br /> uC� Lc <br /> 24,Generatys Name <br /> ( I j J <br /> 225. Transporter Comparry U.S.EPA ID Number <br /> tl <br /> TVa AJ <br /> 26 TranspoTransporterCompany Name U.S.EPA IDumbar <br /> 27a. '27b.-US:DOT Description(ineluding,Propar3hipping NxK-1Hazard'C1=,lD Number, x ''''�=` - � � '" 4'' "¢g,Toldt '30.Unit" ' <br /> HIJ and Packing Group(d any)) No. Type Quantity WIJVol 31 Aaste Codes <br /> O j <br /> w <br /> z <br /> W <br /> 32.Special Handling Instructions and Additional Information <br /> 33-Transporter=Acknow'ed mere of Receipt of Materials <br /> H Pnnt Ty Name ` Sgna a Month Day Year <br /> o /�`� l <br /> L <br /> rn <br /> Z TransporterAdrnoa! man;of Receipt of Materials <br /> < Printed/Typed Name Sgnaturr; ' Month Day Year <br /> 35.Discrepancy <br /> U <br /> UjLL <br /> O <br /> 36,Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,deposal,and recycling systems) <br /> z <br /> 0 <br /> rn <br /> W , <br /> O <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />