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Please print or type. Form des* ned for use on elite 12- itch typewriter.) 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 L, ® N 33 '1 ? 1 g27Y / `? <br /> 24. Generator's Name 11Z r ' 4� L C <br /> A44 f <br /> 25. Transporter Company Name U.S. EPA ID Number <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 /> SCJ AJ 'Z j?.4 ®US ®c t23 <br /> pew 6vS &417 S® L (!) <br /> E � <br /> f <br /> LU <br /> f <br /> t <br /> tpC I <br /> F <br /> yf� <br /> i <br /> 1 <br /> t � <br /> 32. ecial Handling Instructions and Additional Informal* <br /> j6;0) s 7L7 Ate Ift s (6 %Cpsj ) <br /> 33. lransDorter Acknowledgment of Recei t of Materials <br /> H Printed/Typed Name Signature Month Day Year <br /> O <br /> CL <br /> 34. ansp2der . AcknovAedgmentofReoelptofMatedals <br /> Printed/Typed Name Signature on _ Day ear <br /> r— <br /> 35. Discrepancy <br /> J <br /> V <br /> U <br /> LU <br /> Q36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> Z <br /> O <br /> Uj <br /> w <br /> NESI PA ED FACILITY e' TO DESTINATION STATE (IF REQUIRED) <br /> EPA Form 8700-22A (Rev. 3w05) Previous editions are obsolete. <br /> i <br />