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s Please pont or type. Form Approved:OMB No.2050.0039 <br /> t1NIFORM._k�AZAFtD0U9 W/lSfiE:MANIFESf 21 Generator ID Ntimber 22:Page 23.Manifest Trecldng Number <br /> Continuation Sheet I <br /> 24.Generator's Name <br /> r� <br /> 25.Transporter�� Company Na U.S.EPA ID Number <br /> � �"'1 _. <br /> j <br /> cJk- <br /> 26.Transporter Company Name <br /> U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers A.Total 30.Unit <br /> HM 'and•Packing Group(if ani) a 31.Waste Codes <br /> No. Type Quantify Wt.Nol. <br /> 0 <br /> z <br /> s, W <br /> �- ... <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter 75 Acknowledgment of Receipt of Materials <br /> LU Printed/Typed Name <br /> f Signature Month D Year <br /> o <br /> CL <br /> o <br /> CO 34.Trans rter Acknowledgment of Receipt of Materials e J <br /> Pdnted(ryped Name Signature Month Day Year <br /> F— <br /> 35.Discrepancy <br /> V <br /> 0 <br /> a36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> t <br /> a: <br /> EPA Form 870b:22A(Rev.12-17). Previous editions are obsolete: DESIGNATED FACILITYTQ GENERATOR <br />