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Please print or type. Form Approved.OMB No.205D-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 2 Generator 23. Traced <br /> (Continuation Sheet) <br /> 24.Generators Name <br /> Yto-is <br /> ter <br /> 25. Transporter ? Camparry Name U.S.EPA ID- 6,ob tz� <br /> U.S.EPA ID Number <br /> 26. Transporter Com ame I VM l <br /> 27a. 27b.U.S.DOT Description(indudirg Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group('d any)) No, Type Quantity W1Nol. M.Waste Codes <br /> O <br /> W <br /> z <br /> W <br /> C7 <br /> 32.Special Handling Inskudons and Additional tntio mabw <br /> 33.Trans AW ment of Rens Is <br /> H Prin"Typed Signature MonthDay Y r <br /> c116 Ile <br /> Z 34.Transporter Adsnowledgment of Receipt of Materials <br /> Pi gnature <br /> r <br /> 35.Discrepancy <br /> J <br /> U <br /> LL <br /> D <br /> a36.Hazardous Waste Report Management Methhazardous waste Codes(i.e.,codes for hazardowaste treatinent,disposal,and recyd'mg systems) <br /> z <br /> O <br /> LUW <br /> O <br /> EPA Form 870G-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />