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Please print or e. Form desicined for use on elite 12- itch ewriter. Form Approved . OMB No. 2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121 , Generator ID Number 22, Page 23. Manifest Tracking Number <br /> (Continuation Sheet) L 0 F 3 O Z 6 V Z4 P" �YP5tL <br /> 24, Generator's Name <br /> �L <br /> U.S. EPA ID Number <br /> 25. Transporter Company Name <br /> U.S. EPA ID Number <br /> 26, Transporter Company Name <br /> 27a. 27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 28, Containers 29. Total 30. Unit 31 . Waste Codes <br /> HM and Packing Group (if any)) No. Type Quantity Wt.Nol. <br /> DF 2oI <br /> /7• !' 132- 40S�11 7xr C ae`jog 1 <br /> r Jvtowjqc '/M sue, <br /> LU <br /> CD <br /> � o V 32 .o2. �i Comrrc� $c� r ,OSi 9'tS C I <br /> zi <br /> VAI 326Y MQ> #Awd L /QXjf6 9r <br /> r � <br /> UA ? 2(0(0 �v/fSTJ G� �rwe. U( ) t & r <br /> ®--- <br /> ® c C, ®S , IcSaOru�t ��Kr o�� <br /> L9 /q L <br /> 174 / vqS A Sd Lv i7a .c/ jZ .� 3 ( 6 <br /> 32, S at Handling Instructions and <br /> rr�5' s®lL� Ad ti nal orma on - <br /> L <br /> AJr Lyon)/9 �sx. �� ! /J lf <br /> X , 7aJC4L160 A " Jr ( / x S) 2, 15 COM04� SoLLe Ulf) Sot � IV C1 ICY) ct jt <br /> c C /d 3t,� 22C/�1S` <br /> r1 *41 4L l6CAe W) 160om 444btp l0L/PSC 20 (6)?. '5"Dowm11[1tP *( it' Lf CP43Oxpy <br /> 33, Transpoder . AcknovAedqmentofRi.2ceiptofMate6als <br /> U1 Printed[Typed Name Signature Month Day Year <br /> ii <br /> a. <br /> 34. Trans orter Acknowled ment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day ear <br /> FM <br /> 35. Discrepancy <br /> 120v <br /> LU <br /> Q36, Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> C9 <br /> w <br /> EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINVf ION STAt E (IF REQUIRED) <br />