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Please print or Noe.(Form desioned for use on elite(12-Ditch)tvoewritec) Form Approved,OMB No.2050-0039 <br /> t UNIFORM HAZARDOUS WASTE MANIFEST( 22 jage 23,ma lleae rradi"Numb" <br /> (Continuation Sheet) I A �,���. �Q�j (y I `f'f�� .,',�•�1'� <br /> 24.Generator's Name?7 " <br /> 25. i .fi . <br /> 26. TransponerU <br /> Company Name : F A f� <br /> 273. 27b_U.S.Dor Description(including Proper Shipping liame,Hazard Class,ID Nnm,*, 28.Containers 29.Tola1 30.Unit <br /> HM and Packing Group(if am) No. Type Quantity WLNcl, 31.Waste Codes <br /> I <br /> LU <br /> W J <br /> W <br /> a <br /> f <br /> 1 <br /> r I <br /> i <br /> i <br /> 32.fipecial Handling Instructions and Additional Information <br /> pC 33.TransoodB Arknnwlndnmrnt of Receiot of Materials." _ <br /> w Prirdwyped Name I� r Signature Month Day Year <br /> Z 34 Transponer Ackwoledament of Receiut of Materials <br /> Printed/Typed Naml {- I c, Signature [ i Month Day Y- <br /> 35.Discrepancy <br /> v <br /> v <br /> a <br /> LL <br /> 0 <br /> Q36.Hazardous Wasle Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal and recycling systems) <br /> rn <br /> w <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. <br />