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Please print or type. 8e MA"1"am F6 Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21. e <br /> ne at�ID N b 22.Page 23 ife � <br /> (Continuation Sheet) g 1 <br /> 24.Generators Name <br /> 25.Transporter Company NameSbED O NumbNu deo$S s s 8 <br /> 26.Transporter Company Name <br /> 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(d any)) 31.Waste Codes <br /> No. Type Ouantityty Wt.Nol. <br /> LY <br /> O <br /> W <br /> z <br /> W <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> I PrintedlTyped Signature Month DDaayy Year <br /> a it / i f <br /> to 34.Transporter <br /> Z Acknowledgment of Receipt of Materials <br /> PrintedlTyped Name Signature Month Day Year <br /> H <br /> > 35.Discrepancy <br /> J <br /> U <br /> a <br /> 0 <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 /> c7 <br /> Fn <br /> 0 <br /> EPA Form 8700-22A(Rev.12.17)Previous editions are obsolete. DESIGNATED FACILITYTOEPA'se-MANIFESTSYSTEM <br /> r'Ww woor ft a Iwo uwa wAwwwr1laaa wawwtaa wARA.w rwwa awi rmr.aw.ANKA"w r <br /> Page 2 <br />