Laserfiche WebLink
Ric, 7-05LAr <br /> 10 - 31- 0 <br /> Please print or type. <br /> Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121 Generator ID Number 22.Page 23.Moriftst Tracking Nmipk�r. <br /> .(Continuation Sheet) <br /> 24,Generator's Name <br /> U.S.EPA ID Number <br /> 25 Transporter. Company Name ": t – --�— - . <br /> 26. Transporter—ACompany Name U.S.EPA ID Number <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)) Noi Type Quantity Wit.Nqj. <br /> tY0 <br /> 9 1 <br /> Z <br /> LU <br /> O <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> LU PrintedfTyped Name Signature Month Day Year <br /> Z34,Transporter Acknowledgment of Receipt of Materials <br /> Z <br /> Printedirryped Name Signature Month Day Year <br /> 35.Discrepancy <br /> LLI <br /> !7c 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recyIng systems) <br /> Z <br /> 0 1 1 1 1 <br /> co <br /> LU <br /> O <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br />