Laserfiche WebLink
Form Approved.OMB No.2050.0039 <br /> Please t nt or type. Form desi nod for use on elite 12-itch ewriter. 22 era peage z3. amfest Tracking Numgpa <br /> r ID Number <br /> UNIFORM HAZARDOUS WASTE MANIFEST , <br /> (Continuation Sheet) <br /> 24.Generators Name - <br /> U.S-EPAIDNumber <br /> 25.Transporter Company Name sry ► ,�-r ��(,t C � O f (�-� <br /> U.S.E A 1D Number <br /> 26,Transporter AS _Company Name <br /> 28.Containers 29.Total 30.Unit 31,Waste Codes <br /> 27a_ 27b.U.S.DOT Descriptien(including Proper Shipping Name,Hazard Class.ID Number, No Type Ouanfity Wt.Nol. <br /> HM and Packing Group(A any)) - <br /> 1 <br /> 0 \ <br /> W <br /> Z <br /> W <br /> C9 <br /> 32.special Handling Instructions and Additional Information <br /> i <br /> 33.Trans net ? Acknaxled nt of Recar t of Materials SignatureMonth Day Year PdntedlTypedName J ©�r � ,r,,�'. s5 /7 <br /> Lu / <br /> 0 <br /> a <br /> Z 34,Tru rter memoiRecei tofMaterials ont ay ear <br /> rgnalure � <br /> Pdnledlfyped Name <br /> H <br /> 35,Discrepancy <br /> J <br /> V <br /> Q <br /> LL <br /> D - <br /> LLJ 36.Hazardous ste Report Management Method Codes(i.e.,cedes for hazardous waste treatment,disposal,and recycling systems <br /> Z <br /> C9 <br /> V/ <br /> r�i <br /> DESIGNATED FACILVrY dGEN RATOR <br /> EPA Form 8700-22A(Rev.3.05)Previous editions are obsolete. <br />