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:,-Please print or a. Form roved.OMS No,2050.0039. <br /> UNIFORM HAZARDOUS WASTE MANIFEST .1 Gansfatar I um ar 22, age qt nE TY►cfllnp WOW? <br /> IContinuation,Shoell C A S 0 0 0 2 6 6 2 017"52 <br /> 24.Genorator's Name rt a <br /> 25.Transporter 3 Company Name <br /> t}. ; Et•Nurtrbar <br /> X Transporter Company Nama <br /> 279. 27b,U.S,DOTpaecdptlan(Induding f�opar$nsppfnp Nama,Hdtarr!Gaea,l0 Number, 20,Centelner@. : 2B.Total so'".Unit at.Moto Codes <br /> FIM <br /> and Packing Group Of any)) No. *a Quanlily "JOA. <br /> L 7M WAS=C0RR0W#=A4t1fiAA*, <br /> tKNI <br /> 04111MMMSUMp't+11dC ACM,SVA4MM ACME 8►1I by. 00 P <br /> 0 <br /> W <br /> 0 <br /> 32,Spacial Handling inOacuons and Ad4lbnal Informa llan S)IM004 W 71503 A:A'AIRPXBOA <br /> 33.Trans odor Aaw Med menlofRecal tofMatedals pay Year <br /> FEW- PdnlednWad Name Sign . <br /> . �zk6ee , 12 2r <br /> U) 34. naporler, AcknoMed mentofRooaf tofMatedols - MonIIE pay ear <br /> Pdaladitypod Name S gneture <br /> t— <br /> r 35,Noompatmy <br /> C S. <br /> a <br /> X Ha rdous_ Report Management Method Codes(I.a„coos(arherardous Weafe Ireafmatrl;dl8pasal,end rscy_ng 4618ms) <br /> w <br /> a <br /> EPAI arm 810{122A(Rav,12-t7) Previous editions are otrpofete, I7 SI NAT 6 FA,_IL O EPA's e- IFESY SYSTEM <br />