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Form Approved.OMB No.2050-0035 <br /> fAZAROOUS WASTE IHANIFE8T 21.Generator fD Number 22.Page RS.Marna Tndlnp Rumber <br /> (Contfnuaflon Sheet) A R 1 6 8 3 4 d >r <br /> L_ <br /> c z.; •.;e Name PED SIF OUXI tiD <br /> 25.Transporter Company Name U.S.EPA ID Number <br /> 26.Transporter Company Name U.S.EPA I©Number <br /> 27a. 2Tb.US,COT Desdppon(UWudhg Proper Shipping Name,Harard Claes,fO Nunba, 28.Contalnera <br /> HM and Padang Group(if any)) 29,Total A Urdt 31.Waste Codes <br /> Na. T Quantlly WL/Vd, <br /> u'mPYRRImmmmcwk um Tam <br /> x 332 <br /> i DF 71 p <br /> x 8,UN1739,wA8U - C/ _, DOOQ <br /> 1 CF is p M <br /> X T.( MIRMACM ACM1 6,H ' ' 79i <br /> i CF 41 P <br /> 0CO�O�IVBRI��BA1�iCC(M <br /> xan 1� <br /> 1 DF 19 P <br /> z <br /> W22x 1�evilxA�,Foai�>,oma, <br /> 1 CF 17 P <br /> I <br /> I <br /> 32.Spedal Handling Inslruc5ars and Addlgonal Infomtisfloa <br /> 134 w 71303 A:Auni�uw► h UQ1i4 w.71 W u1�9)=Q171 W.115W At11�1r'IJ;R>!'MA:A1'�] A <br /> W133.TransporWr—A&wMedgmentofReceE±MLaW& , <br /> Fes— PdriledlTyped Name S3gnatrre Month Day Year <br /> rx <br /> a. <br /> 34,Trans er ment of Recel(Of Materiels <br /> PdnledlTyped Name Signature <br /> f., Month Day Year <br /> 35.Alsaepency <br /> v <br /> 36.WIPIOut Vio deport Management Me s ,codas for ha78nicu6 waste tree dk and mrycl6V systems) <br /> C7 <br /> tt ' <br /> . <br /> EPA fnrrn 8700-22A(Rev.12-17) Previous editions are obsolete, DESIGNATED FACILITY TO EPA's O-MANIFEST SYSTEM <br />