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Please print or type. <br /> L413 3-3 3 <br /> Farm Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFESTZZ <br /> or ID Number 22.Pa 23,Manifest Tracking Number <br /> (Continuation Sheet) D0 03�' 7 b b 3- <br /> 24.Generator's Name 11L YIN 4 TTM VF-L P"4Z,4 6 I$ <br /> 25. Transporter Company Name r--- U.S-EPA ID Number <br /> 11111,R:: "S '� E s OD So � 9 <br /> 26. Transporter_ Company Name 1 U S EPA IDN ber <br /> V rh ND l I U Z <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name.Hazard Class,ID Number, 28.Containers <br /> HM and Packing Group(if any)) 29.Total 30 Unit 31.Waste Codes <br /> No, Type Quantity Wt.Nol. <br /> O <br /> f— <br /> Q <br /> rY <br /> LU <br /> M - <br /> LU <br /> c7 <br /> 32 Special Handling Instructions and Additional Information <br /> ILI 33.Transporter Acknowledgment of Receipt of Materials <br /> W Prinled;T ed Name Sign <br /> O 1 , <br /> AND <br /> �� Month Day Year <br /> /v /O 1 Z4 Zd <br /> Z 34.Transporter _ AcknoMedoment of Rece of Materials <br /> Printed ed Name Signature Mo th D ea <br /> r 35.Discrepancy <br /> \ I <br /> H <br /> J <br /> U <br /> Q <br /> W <br /> 0 <br /> W <br /> Q 30,Hazardous Waste Report Management Method Codes(.e..codes for hazardous waste treatment.disposal,and recycling systems) <br /> Z <br /> c� <br /> Lu <br /> Lu <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEfV. <br />