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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST Generator Nu be gin <br /> 2 a t Trac g Number <br /> (Continuation Sheet) <br /> 24.Generators Name <br /> LLS 34h n a]� �2 . LEf ieL (6 P--> <br /> -� <br /> 25. Transporter Company Name -/Q_I _ At00 r {a'�5 r U.S.EPA 10 Number <br /> d � <br /> `TL ^ U. E/PSA'I`D`{NJumber <br /> Ck <br /> 26. Transporter Company Name '} �7^ <br /> a IA22 <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28-Containers 29.Total 30.Unit31.Waste Codes <br /> HM and Packing Group(if any)} No. Type Quantity Wt.Nol. <br /> tr <br /> O <br /> W <br /> 2 <br /> W <br /> C7 <br /> i <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter ment of Receipt of Materials <br /> LIJI.— <br /> PrintedlT Signature Month Day Year <br /> Ix <br /> 0 r4Z4 <br /> Z 34.Transporter t of Receipt qf Materials <br /> PriMedlTyped Na Signature f h1�ih Da Ye <br /> F <br /> 35.Discrepancy <br /> J <br /> U <br /> a <br /> 0 <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> C7 <br /> W <br /> D <br /> EPA Form 87DO-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />