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Please print or type. <br />Fnrm AnnmvAd AUR Nn 9nrn_nn3a <br />EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />121. Generator ID Number <br />22. Page <br />23. Manifest Tracking Number <br />{ i j <br />;n"R. Nvqes Name <br />25. Transporter ' Company Name klita.t 1FV,- ULA h t .r <br />U.S. EPA ID Number <br />26. Transporter Company Name I.%Yr�r:i.t'. r;ftOX % " 3s r i TFtr{ r+ ,ter : <br />U.S. EPA ID Number <br />i4X1Y.,.; A 2 A 0-'5 9,i( ti <br />27a. <br />HM <br />27b. U.S. DOT Description (Including Proper Shipping Name, Hazard Class, ID Number, <br />and Packing Group (if any)) <br />28. Conlainers <br />29. Total <br />Quantity <br />30. Unit <br />Wt./Vol. <br />31. Waste Codes <br />No. <br />Type <br />O <br />w <br />a <br />ru <br />0 <br />32. Special Handling Instructions and Additional Information <br />33. Transporter Acknowledgment of Receipt of Materials <br />Uj <br />O <br />a <br />Printed/Typed Name Signature <br />Month Day, Year <br />34. Transporter Acknowlodgment of Receipt of Materials <br />Printedfryped Name Signature <br />F <br />Month Day Year <br />J <br />U <br />D <br />w <br />Q <br />z <br />i.7 <br />35, Discrepancy <br />36, Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />LU <br />LU <br />p <br />EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br />