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Please print e. Form designed for use on elite 12- itch typewriter.) Form A roved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 233..yManifest <br /> 7Tracking Number <br /> (Continuation Sheet) 6a3lz� S 1 <br /> 24.Generator's Name C <br /> _ U.S. P ID Number <br /> 25, Transporter Company Name _' r 6 /^y P1 8<k <br /> ill <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 /> O <br /> Q <br /> w ` <br /> z <br /> w r <br /> c� <br /> f <br /> I <br /> t <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> Signal Month Day Year <br /> LMPrintedlTyped Name � <br /> 0 1\ <br /> O t a^ <br /> a. <br /> 41 <br /> Z 34.Transporter —Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> f— <br /> r 35.Discrepancy <br /> r-- <br /> J <br /> U <br /> a <br /> 0 <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> c� <br /> w <br /> 0 <br /> DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. <br />