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Pleasepriht or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050.0039, <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121.Generator ID Number 4 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) <br /> 24.Generators Name <br /> g�R1 s l <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> eoao 2 J.072 <br /> dU.S.EPA ID Number <br /> ' 26. Transporter Company Name <br /> 5 e.r kart e- Sn 4, , itImAi Soiutl S M ^t • ..b - <br /> r j - <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No` T e Quantity Wt.Nol. 31.Waste Codes <br /> YP <br /> w <br /> Z <br /> LU <br /> O <br /> le" <br /> x' 'R <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> H Printo/T Red Na Signal a Month Day Year <br /> u/ _ C Z f <br /> • O _ <br /> a - <br /> z 34. ransporterAcknowledlgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> U . . <br /> LL <br /> O <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> LU <br /> EPA'Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR STATE(IF REQUIRED) <br /> 13120.0885 <br />