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Please print or pe.(Form designed for use on elite(12 itchtypewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) G' l,,.oFjD:q Q 1 �U{�q <br /> 24.Generator's Name <br /> U.S <br /> 25.Transporter Company Name <br /> EPA ID Number <br /> ,;t g. >. „•rt ;., ° .x`=:,r„ �CARfMfl�87622::,. <br /> 26.Transporter Company Name Y-1-t/i - 1J _Ti v. /l i�1/1 j�y��0./1 U.$�P D u b ZY <br /> 27a. 27b.U.S.DCT Description(including Proper Shipping Name,`Hazard Class,10 Number,�, +28..Containers 29.Total 30,Unit <br /> HM and Packing Group(if any) No. Type Quantity Wtivol. 31.Waste Codes <br /> I <br /> i I <br /> � I <br /> i <br /> I <br /> i <br /> i <br /> tr <br /> a I I <br /> W iW <br /> I <br /> i I <br /> l <br /> i <br /> i <br /> I <br /> I i <br /> I I <br /> I <br /> I <br /> i <br /> i l <br /> i I <br /> I <br /> i <br /> i I <br /> i <br /> i <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter_Acknowledgment of Receipt of Materials <br /> H Printe d Name ` Signal Month Day Year <br /> a ✓r ,��c L .�, ?� <br /> Z 34.Tr s iter Acknowled ment of Receipt of Materials <br /> � <br /> Printed/typed Name ,,-^-� Signature „Qay r <br /> 35.Discrepancy <br /> U <br /> LL <br /> O <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal and recycling systems) <br /> Z <br /> rn <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. <br /> DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />