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� y <br /> Please rine or t' d. Form designed foi use on e.ite 12 itch t ewriter. Form A roved.OMB No.2050-0039 <br /> n M rc I r STE n A IFFCT 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> uliFvrii>.1 i�I,�iJ,r2uvvv J'.A..,�:A.4:1..._. <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> U.S.EPA ID Number <br /> 25. Transporter Company Name <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.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity Wt.Nol. <br /> i <br /> �� 4LN�tr1t t'rliiti <br /> 0 <br /> W <br /> z <br /> w <br /> i <br /> g• <br /> I <br /> i <br /> I <br /> ) <br /> i <br /> 1 <br /> 32.Special Handling Instructions and Additional Information, <br /> 33.Trans orter Acknowled ment of Receill of Materials Signature Month Day Year <br /> tw— Printed/Typed Name <br /> O <br /> CL <br /> z 34.Trans o ter Acknowled ment of Recei t of Materials Month Day Year <br /> Signature <br /> Printed/Typed Name <br /> H <br /> 35.Discrepancy <br /> J <br /> U <br /> L <br /> LULU <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,dis)osal,and recycling systems) <br /> z <br /> c� <br /> LU <br /> 4 Form 9700-22A(Rev.3-05) Previous editions are obsolete. <br /> DESIGNATED FACILITY TG GES 1=sso-1T0F, <br />