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Please print ort pqAForm designed for use on elite12- itch typewriter.) Form Approved. OMB No. 2050.0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21 . Generator ID Number 22. Page 23. Manifest Tracking Number <br /> (Continuation Sheet) - ®® V 3� � � j ® � <br /> 24. Generators Name <br /> Ama , CAAd 6J <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.A/oi. <br /> � L)Ik/ GOAS, TC Pawn 144 OA, l uUA SUQC1 bf. lboox <br /> SoLu77OA. � l� l� <br /> k 3 <br /> DOO <br /> 1 I <br /> IL"SIu A/ NOs, 3 (G . tXb ��� <br /> ® Ulf 2 72-p WASTE CDRAC& Iule f <br /> Nos , �C �, �� CC�,�oL f¢y ® tsocH ►-�� tC t �) DF <br /> z 7L �Z aga t L4 L%r 4-laop)ttBSf4494 tl#M QE I <br /> / (as) t1b r� 5®t� �"la�� t <br /> t <br /> ` ° U � 34:�, 40;rous 7 � , 3 fy. 2 z ZZ®.!!vj1 3_.s <br /> I e <br /> 11 (> 1302 lOPE40W 77' u / 'V, 2 <br /> Er f" <br /> ODD <br /> t <br /> Vu 3r 1oAS7t0K1 b1Z1titr14624)c4S Cvxrtart oL� <br /> L <br /> Aso S, �. t <br /> ► w l9,A�.3 ®R� Cv�3 / �� ® /2 /�G- ter o, � �� C,�l�� s t, ,� �.. (_ � 7 �-��lrr <br /> 32. Special Handling Instructions an Additional i form t n �� i'� L 1 A 9 �07�/ ! S 17. 7 . SOl- 1 <br /> L �� �,w® �d / S eD , e4jo © KtPiZ + LoItrcc /) <br /> 7 OA ciC� L40 SL 6 (0 0X30) / M clC o / VS ( ` 4 ®1Cf �rt � t-.� � SL °'13 t� K <br /> 33. Transporter Acknowledgment of Receipt of Materials <br /> LLI Printed/Typed Name Signature Month Day Year <br /> O <br /> CL <br /> 34. Trans orter Acknowled ment of celpt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> h- <br /> 35. Discrepancy <br /> J <br /> V <br /> d <br /> a <br /> Q36, Hazardous Waste Report Management Method Codes (i.e., codes for hazardous_waste treatment, disposal, and recycling systems) <br /> O <br /> c <br /> LU <br /> EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />