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Please print or type. 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 /> U.S.EPA ID Number <br /> 25. Transporters Company Name <br /> i <br /> 26.TransporterU.S.EFA ID Number <br /> Transporter�--� Company Name � <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> 31.Waste Codes <br /> HM and Packing Group(d any)) No. Type Quantity Wt.1Vol. <br /> O <br /> UA <br /> z <br /> 1 <br /> 32.Spepial Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> F PrintedlTyped Name Signature Month Day Fear <br /> — <br /> 0 <br /> .., 1. <br /> CO 34.Transporter _AcknoM4m rd of Receipt of MabrM <br /> PrintedlTyped Name,,:.. Signature Month Day Year <br /> 35.Aiscrepancy d <br /> v <br /> LL <br /> i.Hazardous Wasle Report Management Method Codes(.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> t7 _ <br /> W <br /> O 1 I I <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. I GENERATOR'S INITIAL COPY <br />