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Please print or e. Form desi ned for use on elite 12 itch typewriter.) Form oved. OMB No, 20500039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21 Generator ID Number 22. Page 23. Manitest(r�h�{acking Number �^ <br /> (Continuation Sheet) � � {�� �j 3d 3 00 �/ v Vt t ' <br /> ri <br /> 24. Generator's Name <br /> n U.S. EPA IID NNurn { y� --7 <br /> 25, Transporter Company Mame <br /> �(1 , vlv a4 f <br /> J <br /> U.S. EPA ID Number <br /> 26, Transporter Company Name <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)) N0. Type Quantity WL/Vol, <br /> LU <br /> z <br /> w 1 <br /> + t� <br /> .r <br /> I <br /> 32, S andling Instructions andAddilional Information <br /> Ir <br /> 33. Transporter O. Acknowtedgnif scat of Materials <br /> t O Y <br /> LU Printedfiyped � p � <br /> a <br /> z 34. Transporter Acknowed mentofftecei tofMaterials <br /> g PriniedfTyped Name Sgnalure ay ear <br /> E✓ <br /> 35. Discrepancy <br /> r <br /> v <br /> US <br /> o I <br /> Q36, Hazardous Waste Report Management Method Codes (Le., codes for hazardous waste treatment, disposal, and recycling systems) <br /> z <br /> U> <br /> w <br /> a <br /> ESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br /> EPA Form 8700.22A (Rev. 3-05) Previous editions are obsolete. D <br /> r <br />