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Form Approved.OMB No.2050-0039 <br /> 121.Genefaior ID Number 22.Page 23.Manifest Tracking Number <br /> AZARDOUS WASTE MANIFEST � � > 't 3 A 41 L <br /> (Continuafion Sheet) <br /> 24.Generator's Name <br /> t <br /> U.S.EPA ID Ncrn-r <br /> 25.Transporter Company Name 1' _ %' ` r;F <br /> U.S.EPA IDNumber <br /> 26.Transporter Company Name <br /> 27a, 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Grass,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> No Type Quantity Wt.Nol. <br /> HM and Packing Group(if any)) <br /> s <br /> r` <br /> U <br /> Uj <br /> w <br /> 32.Sgejtal Handling InsbucUons and Additional Information <br /> 33.Transporter Acknoededgment of Receipt of MaterialsS gnature 'j.3 Month Day Year <br /> w Printed(rypedName <br /> t <br /> a <br /> Z 34.Transporter Acknoerledgment of Receipt of Materials Signature Month Day Year <br /> Printed/Typed Name <br /> f - <br /> 35.Discrepancy <br /> J_ <br /> C> <br /> LL <br /> O <br /> a36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> ILD <br /> w <br /> LU <br /> 0 <br /> aGENERATOR'S NIT IAL COPY <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. <br />