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` Please,`rint or! e. Form designed for use cn elite 12 itch t ewrilec Form A roved,OPAS No.2050.0039 <br /> 21.Generator ID Number 22,Page 23,"IntfestTracking Number <br /> (r <br /> UNIFORM H� ARDOUSrNASTEMANIFEST � ��� A 11 <br /> e•(Continuation Sheet) CA b h2 Y- CJ 71 h J <br /> 24.Generatots Name <br /> U.S,EPI Number <br /> 25,Transporter Company Namr if x\NS 6()6 @ t y 'L <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,Conlainers 29,Total 30.Unit 31,Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity Wt.Nol, <br /> o f <br /> LU <br /> z <br /> w _ <br /> 1..�1 <br /> 32,Special Handling Instructions and Additional Informallon <br /> 33.Trans orter Acknoviled mentofRecei lofMaledais Signature Vonlh Day Year <br /> N Pdnted(Typed Name � AI <br /> 1 <br /> 0 [� <br /> �e& L� /' <br /> O <br /> o. onl ay 75—ar <br /> 3d.Trans oder Acknowled mantof Reoei t of Mafedals gnaluie <br /> PtintedlTyped Name <br /> t— <br /> 35.Discrepancy <br /> J <br /> V <br /> d <br /> a <br /> a9 <br /> Haiesdous Waste RepoliManagement Method Codes{i,e„codes tot hazardous waste treatment,disposai,and recycling systems <br /> z <br /> w <br /> � pESIGNATEp FAGiLITYTQ pE571NATION STATE(1F REG1uIReD) <br /> EPA Form 8700.22A(Rev,3-05) Previous ecillons are obsolete, <br />