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Form Approved. OMB No. 2050-0039 ERATOR UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />21. Generator ID Number <br />0/4e. -00.7.) t 62- --) Leli <br />22. Page <br />'..2_ <br />23. Manifest Tracking Number <br />6(q ---)03.-)i-t/ _-r7L., <br />Generator's Name T-(41/ e; -Ifati. <br />t:C -LID rtki. tin_ p, (-0(fii-lui, c74 6-17s,)-(:)- <br />U.S. EPA ID Number <br />Transporter _ Company Name i • A ' ' 1,,.- i V Lt.til.\--)CAZ4-1 (11-'l L.LC I C-Pit(xn i sc)--9 12_ , <br />I U.S. EPA ID Number <br />Transporter Company Name <br />I <br />27a. 2711 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)) No. Type Quantity Wt./Vol. <br />I <br />_. <br />i A GENI _ <br />Special Handling Instructions and Additional Information TRANSPORTER I Transporter ''- Acknowledgment of Receipt of Materials <br />RrintpcI./Typey NaTe Signactre— ",. . . Month Day Year, <br />ti //Al • L - /I/a,- ety I - c-, j 1 ..,.----.-.."-- -.- I 7..)PI <br />Transporter Acknowledgment of Receipt of Materials <br />Printed/Typed Name Signature Month Day Year <br />I III I DESIGNATED FACILITY I Discrepancy <br />Hazardous Waste Report Management Method Codes (i.e.. codes for hazardous waste treatment, disposal, and recycling systems) <br />I I I I <br />I I I I <br />EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete.