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Please print or type. Form designed for use on elite 12-pitch)t ewriter. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22 Page 23.Manifest Tracking Number <br /> (Continuation Sheet) <br /> 24 Generator's Name <br /> TARGE CCf:Crn c iDr cT1rc ineCIAi_T;T --;_,T, c T r, F�:i. <br /> 1 (�+ ?:..1V r FZE-f,L1 _ L'.��I'J i r I F'I� _/ XC-C. I_AIM !'+..v:� RI-Y a tJ <br /> I._ IMr'1'_ 1. 1 L++:. fit_ - <br /> T- T R P C,, 57 04 <br /> U.S,EPA ID Number <br /> 25.Transporter — Company Name <br /> Num er <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 /> x ..__.—__ T.-Ii iT j, OQ� r'' _ _ - <br /> i1O• .. _ __ <br /> r.Q. -r maQ yT t jrjW Y j'=' —, <br /> 3.6 `!ON' r:'_``A HA7ARD01 _ WASTE _1001D !LAT <br /> Xi <br /> 1 <br /> � 1 <br /> O <br /> w <br /> z <br /> W <br /> O <br /> i <br /> + <br /> 32.Special Handling Instructions and Additional Information <br /> _ _ <br /> 1 x 30 <br /> 33 Transporter Acknowledgment of Receipt of Malegals <br /> w aj PdntedlTMonth DYear <br /> yped Name Signature 1 <br /> F- <br /> O <br /> a <br /> Z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> F- <br /> 35.Discrepancy <br /> U <br /> Q <br /> LL <br /> 0 <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 15.. rbc-:— !r.. H' <br /> cn <br /> W <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />