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Please nni or Form designed for use on elite 12-itch <br /> UNIFORM HAZARDOUS WASTE MANIFEST Generator ID Number am 22.Pa .OMB No.2050-0039 <br /> 23.Manifest Tzadring Number <br /> . (Continuation Sheet) <br /> 24.Generator's Name V n <br /> 25.7ransporter�Company Name 0.S.EPA ID Number <br /> Asn,74 <br /> 26.Transporter Company Name "2 -;511 <br /> UI JI MA Number <br /> 27aIII and27bU.S.DOT Description(Including Proper Shipping Name.Hazard Gass,ID Number, <br /> HM and Paddng Group(i(any)) 26.Containers 29.Total 30.Unit <br /> No. Type Quantity yyt,Arol. 31.Waste Codes <br /> 0 <br /> aO <br /> C <br /> w <br /> Z <br /> Lu <br /> 32.Special Handling Insh dons and Additional Infomration <br /> w 33.Trans menl of of Materials . <br /> F P inted/Typed Ne <br /> C Signature <br /> O (n f'.S' r t� Morph Day Year <br /> Z 34.Trans Acknowled mentor of Mriah <br /> Pdnted/Typed Na <br /> F Ignaorre <br /> on ay ear <br /> 35.Discrepancy <br /> J <br /> Z5 <br /> I <br /> O <br /> W <br /> 36.Hazardous Waste Report Management Method Codas(i.e"codes for haraMous waste treahnent,tlisposal,and r i s ems <br /> z a n9 Ycl Y <br /> WIM <br /> j <br /> EPA Form 8700-22A(Rev.3-05)Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUI <br /> Y <br />