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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) <br /> UNIFORM HAZARDOUS WASTE MANIFEST Form Approved.OMB No.2050.0039 <br /> 27.Generator ID Number 22.Page 23.Mamfes Trgcking Number /� <br /> (Continuation Sheet) ��Q !� !6 /J(((4 C <br /> 24.Generators Name r(/ <br /> 25.Transporter_ Company Name U.S.EPA ID Number <br /> (,BGS <br /> 26.Transporter__ Company Name /S <br /> V t /' `�V t UCMI <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class.10 Number, (( 4 CJ Y k 28.Containers <br /> HM and Packing Group(if any)) 29.Total 30.Unit 31.Waste Codes <br /> No. Type OuanWy WWoI. <br /> I <br /> z <br /> W <br /> 0 <br /> / I <br /> 32.Spedal Handling Ir>shudons and Additbnal Information <br /> w 33.Transporter vledgment of Receipt of Materials <br /> Uj Printedffyped N me �+� r� gi �� Rlprrth Day <br /> rYear <br /> O <br /> a <br /> z 34.Transporter`_Ackm-iledgment of Receipt of Materials <br /> Printed llypedName Signature Ripnth —pas <br /> L3 �(,p <br /> 35.Oiscrepancy <br /> v <br /> LL <br /> ui <br /> rL <br /> z36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous%vasle treatment,disposal,and recycling systems) <br /> t9 <br /> rn <br /> w <br /> n <br /> EPA Form 8700.22A(Rev.3.05) Previous editions are obsolete. Dl_SIG !r>T ED F/.ti--ILIT Y TO DESTIi,V,TIGM STAT---(IF;i )UIRED) <br />