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Please print or type. Form desig2ed for use on elite 12-pitch typewriter.) Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121.GeneratorID Number 22.Page 23.Manhat Traddn®Number <br /> (Continuation Sheet) �: : t ;, • t i 1,t �" t ; <br /> .GeneraWs Nerve ! P <br /> . <br /> U.S.EPA lD Number <br /> 25.Transporter Company Name <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name <br /> 27a. 27b.U.S.DOfDescripfion(nclkdtkg Proper Shipplrg Name,Hazard Class,ID Number, 28.Conus 29.Total 30.Unit <br /> 31.Waste Codes <br /> HM and Packing Group(if any)) No Type Quantity Md <br /> Q <br /> W <br /> X <br /> W <br /> 32.Special Handing Instructions and Additional lnfomrabon <br /> fj <br /> 33.Transporter-Acknowtedgment of Receipt of Materials <br /> pi Pdrdedfryped Name Slgneture Month Day year <br /> E2 <br /> O <br /> O. <br /> 10 Z 34.Tran end of Receipt of Maris <br /> Prinledrryped Name r Signature Mauls Day Year <br /> H <br /> 35.Discrepancy <br /> v <br /> Q <br /> 4 36. 'atdou Waste Repot Management Method Codes(l.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> CD (1- <br /> u°3 <br /> 0 <br /> EPA Form 8700-22A(Rey.3-05) Previous editions are obsolete. f..._... . T DESIGNATED FACILITY TO GENERATOR <br />