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Fiease rin.&F e. Form deli nedfor.ifsi3.ori-elite 12- itch Wv ter: Form ApvmM.0M No.205D DI139 <br /> 23:Manifest Tracking <br /> 121.GeneratorIDNurnber .-`" ?2'Page NumberUNIFORM! ZAHARDOUS WASTE MANIFEST "" + <br /> (Continuation Sheet) �..�. ,. f <br /> Q 24.Generalo(s Name J <br /> EPA ID Number� 25.Transporter Company Name U.S. • <br /> 26. Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Descriplian{including Proper Sfilpping Name,Hazard Class,ID Number, 28.Containers 29.Total„ , 30.Unit 31.Waste Codrls <br /> HM and Packing Group{it any}} No. Type Quantity WLNof. <br /> DiDol <br /> �x 5 3; L , QAC 6 5 5 <br /> ur- <br /> lata- -�-�VA h . Ct ' <br /> LD <br /> D Pte = <br /> LU <br /> 32. peclal Handling lnstrudions-and Additional lnfom ation.. .' ;. <br /> C- =l� ^� r � � . C,'�> -' '-fa 7 c:.-A <br /> 33.Transporter Acknowled menl of Receipt of Malerials <br /> LU Prtntedffyped Name Signature. Month. Day. Year <br /> oG <br /> L1. <br /> Z 34:Transm5er AcknoMedg mentof Receipt of Malerials <br /> Pr nledlTyped Name sgnatufe -I.Month Da <br /> Year <br /> } 35.Discrepancy <br /> LLI <br /> 36.Ha u Waste rt Management Method {.e:, for hazardous.waste trealmen d' a d recycling systems) <br /> L � ° ' <br /> w <br /> EPAFurm 8700-22A(Rev.1051:Previous'editions are ob,iSIGNAT D FAGfl;l�lf T�:G.EN.El3A�flR <br /> "te: L <br />