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Please print or Form designed for use on elite 12- itch typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121,Generator ID Number 22.Page 23.Manifest Tracking NNu^umber1 f ,,C <br /> (Continuation Sheet) �l��3 �`Z 2 01 VGWI-,�J �--LE <br /> 24 Generator's Name <br /> G1JS <br /> STranspo - _ C mpany N me (CI` / /} ] /1` U.S.EPA ID Number Zq <br /> /► ✓/1 ) v 1 ( EPA <br /> ID <br /> D NNrrriber <br /> 'u <br /> 26. transporter U.S. A_ m a y N�_ 3/y^�V� r` 3 <br /> YI / <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 /> Hny))M and Packing Group(if a <br /> No. Type Quantity WLNoI. <br /> 1 <br /> O <br /> F <br /> w <br /> Z I <br /> LU <br /> O <br /> 32 Special Handling Instructions and Additional Information <br /> � 33.TransporterAcknowled meat of Receipt of Materials <br /> F PrintedlTyped Na-meSignare _ Month Day Y ems, <br /> !I 2 (,�( <br /> LL <br /> Z 34.Trans oder Acknowledgment of Receipt of Materials <br /> X Print yped Nam / Sig e onlh Day Year <br /> Z c ��c�cf3 ��f �s- C C�� lv <br /> } 35, iscrepancy <br /> H <br /> J <br /> U <br /> Q <br /> LL <br /> O <br /> LU <br /> Q 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> U <br /> to <br /> w <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />