Laserfiche WebLink
Pleas:print or type. SC MA PPW 12/9/2OOeForm Approved.OMB No.2056-003 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21' ID 22•Pepe T k N r <br /> (Continuation Sheet) AM 2, l <br /> 24fanCeralofs Name �r �, <br /> 25.Transporter Company Name ft"Mow Tmmk + r i•�M O O$Y 6 O'~a i o`.^O=`%�i., <br /> U.S.EPA ID Number <br /> 26.Trarsporter ConnpanYNanw <br /> r rv� 31 <br /> 27a. 27b.U.S.DOT Description(Indudng Proper Shipping Name,Hazard Class,10 Number, 28•Cardairlers 2g.Tola1 30.tMl <br /> 31.Waste Codes j <br /> HM and Packing Group(d anY)) No. Type Dualditl W1.fVd. <br /> r <br /> K <br /> QO <br /> K <br /> :I <br /> W , <br /> Z L <br /> 1 <br /> ! 1 <br /> 1 i <br /> • f <br /> 32.S pscaj Harding Inslructms and Additional Infomaion <br /> ! <br /> 33.Trans meet of Receipt of Malenals <br /> W PrintedR Signature / Month Day Year I C <br /> jv4 1H 1-0 <br /> U) 34.Transporter AcknoWe4rient of Receipt of Materials .I <br /> Prntedrryped NameSig Month Day Yy <br /> ~ 1 Q M 3 � <br /> 35.Discrepancy <br /> J <br /> U t <br /> a <br /> LL <br /> Q36.Hazardous Waste Report Management Method Codes 0 0.,Codes for Iu>mrdous waste ueatrrenC disposal.and mcydirg systems) <br /> z <br /> C7 i <br /> W <br /> D <br /> EPA Form 87022A(Rev.12-17)Previous editions are obsdete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br /> /'arrw M.ehwr�wr ear•werw...e�e.^�^"�aw.ww rr..w.+.w...r.a��.r.r....ew.r.aYnN... <br />