Laserfiche WebLink
Z (yPe. Farm Approved.0MB ft 2050-0039 <br /> `.,UNIFORM HAZARDOUS WASTE MANIFEST 121.Generator lONumber 22.Pego 23.ManifeGITracking Number <br /> (Contlnuallon Sheat) C A a p 0 g 2 0 2 4 7 2 of <br /> 24,Generators Name $�[ <br /> l <br /> 25.Transposer Company Name U.S.EPA 10 Number <br /> 26,Transporter Company Name U.S.EPA 10 Number <br /> 27a. 27b,U.S.DOT Description(including Proper Shipping Name,Hazard Gess,10 Number, 28,Centelnars 28.Total 30.Unit <br /> HM and Packing Group(if any)) Na. Type QUM* W11Va1, 31.Waste Codes <br /> C ACMN$R i cF 120 P <br /> B.0=4 WABrB1vs <br /> XMmiaatr. it( i i)1Rr 279 P <br /> T.NA'#0M HAZARBOM WAt6E1`Bc €rt.+`4 , <br /> pom <br /> 3 CF 26 P <br /> ox <br /> o <br /> all <br /> x <br /> s>J <br /> L I <br /> 32,Special Handling Inslructfons and Additional Information <br /> 171 WCI 5M A AzLOM J)EW.134 WMJ03 AtrAI RMIA 6,181 04 W.1111 tit A:OMM 7)R& <br /> 33.Trans rter AeknovdedgmentotRocei tolmsterfals <br /> M Printedrryped Name Signature Month Day Yaar <br /> Q <br /> CL <br /> 34.Transporter-Acknowledgment of Rece€€of Materials <br /> PrinladfTyped Name Sfgnalure Month Day Year <br /> 35.Discrepancy <br /> r <br /> C <br /> a36.HM e Report Management Method G s . ., es for hazardous Waste keatma I, I a d recycling systems) <br /> z <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />