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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST1.G nerator ID u b 22.Pa 23 n' ackin N r ^ <br /> (Continuation Sheet) <br /> 24.Generator's Nameev p <br /> h wT, <br /> 25. Transporter Company Name �� U.S. I�u>ZjAs <br /> 26. Transporter Comparivililailre U.S.EPA ID Number U <br /> VL CSC S <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wt./Vol. 31.Waste Codes <br /> i <br /> i <br /> i <br /> i <br /> 0 <br /> w ' <br /> z <br /> � 6 <br /> 32.Special Handling Instructions and Additional Information <br /> 33.TransportAcknowledgment of Receipt of Materials <br /> LU Printed/Typed Name Signature Month Day Year <br /> a <br /> Z 34.Transporter--LLAcknoWedgment of Receipt of Materials <br /> Printed/Ty,ed Name "Signature M Day Year <br /> 35.Discrepancy <br /> J <br /> U <br /> Q <br /> LL <br /> f� <br /> W <br /> Q 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> 0 <br /> rn <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />