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Please print or type, <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21 Generator ID Number <br /> (Continuation Sheet) Farm Approved.OMB No,20500039 <br /> 24,Generator'sName 22 Page 23.ManifesF3racking Number <br /> 25-Transporter <br /> Company Name <br /> U.S.EPA ID Number <br /> 26-Traruspnrter—Company Name <br /> U.S,EPA ID Number <br /> 270. 27b.U.S.DOT HM amp Oesrnpbon(iodudrng Proper Shipping Name,Hazard Class,ID Number, <br /> aj Group[d anyl) 28.Containers o, 29.7ma1 30-Unit <br /> N 31.Waste Codes <br /> . _ Type Ruanlity WLNoI. <br /> UfJ,ne8,0RTTERI(ES. DRY CONTAINING <br /> 11 t L I?7HY 19 <br /> ERTTTT7ERUSr ERG A �411NIU£RSAI Wfl51E <br /> ID) • -, <br /> 0 <br /> WISTE CORRUS1VE LIQL116 EFtSIi., <br /> LU <br /> LU <br /> LU - <br /> � L <br /> t t � <br /> +� - t LAI PEE CIFP.Y. )ills <br /> --�,-Y 3� <br /> iJi�_•,t .'>-_t.,iii>'. ,(moi MTTERIES,9,EPG4V <br /> 144- <br /> !amps!amps + /� <br /> bMTE-- LAWS, (CIRCULAR } <br /> .rvgf,r. . r Q r <br /> LN-wAT=-U=ry—*=—. <br /> dinagg ardAd�iorrelYinlreiott -- - � l <br /> S ^ { .51r.irX t.LH <br /> or <br /> wig—05516W 6.w B 1657 7a,c�� ' 13 — <br /> ). �= <br /> d nt MArG <br /> Signature Month Day Year <br /> 34.Tre WOdsr—A�°°"�d re"tatRemptatMaaaels <br /> Hare Stgnarre Month Day Year <br /> 35. <br /> 36.Fia22rdoua'! ReW MM+nage^��1pd Codes Ge miles For hazardous 4t 7trnu4.dual and eeydr p sys�ms, <br /> Preve.`-`is0rts are,xisotele. <br /> GENERATOR'S INITIAL COPY <br /> 870i322Altier,ti <br />