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Please print or type. Farm Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121.GeneratorlDNumbef 22.Page G 23.Manifest Tracking Number ' <br /> (Continuation Sheet) n rVQ Zd Z Af'Z Ort:/ ?900 USS <br /> 24.Generators Name <br /> 25.Transporter_ Company NameV 1 ..� U.S.PPA ID Number <br /> (/b'( S A � �'o l�r, `�ns r diw6 313,6 91 <br /> 26.Transporter—A—Company Name Y It�lrit,/� !j O� <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number,- ` `/{ 28.Containers 29.Total U34,Unit <br /> HM and packing Group('d any)) 31.Waste Codes <br /> No, Type Quantity WLNaI, <br /> 0.� <br /> O <br /> w <br /> z <br /> u� <br /> C� <br /> T� <br /> . .F <br /> it <br /> ,I <br /> i� <br /> ,I <br /> 32.Special Handling Insbuctions and Additional Information it <br /> a <br /> r <br /> I <br /> a 33.Transporter Acknowledgmentof Receipt of Materials II f <br /> LU PrintedlTyRd N Signature i( Month Day Year <br /> 34.Transporter Acknowledgment ei Receipt of Materials <br /> Printed/Typed Name Signature ;? Month Day Year <br /> r- � G p2 <br /> r 35.Discrepancy <br /> J i <br /> o <br /> Q36.Hazardous Waste Report Management Method Codes(f.e.,codes for hazardous waste treatment,disposal,and reeding systems) <br /> z <br /> C7 <br /> y <br /> W <br /> D <br /> EPA Form 8700.22A(Rev.12-17) P€eviousedifions are obsolete. DESIGNATED FACILITY TO EPA's e•MANIFEST SYSTEM! <br />