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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.PZ! 23.Manifest Tracking <br /> ppNumber <br /> (Continuation Sheet) `Z ol V <br /> 24.Generator's Name +�"^L �' '�w AA- <br /> 25.Transporter Company Name _ <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM an king Group(if any)) No. Type Quantity Wt.Nol. 31.Waste Codes <br /> O <br /> W <br /> Z <br /> W <br /> 0 <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> FW— Pdntedff d N / Signature Month Day Year <br /> O f <br /> M <br /> Z 34.Transporter Acknowledgment of Receipt of Mated s <br /> PdntedfTyped Name Signature Month Day Year <br /> f— <br /> 35.Discrepancy <br /> J <br /> v <br /> LL <br /> G <br /> g36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> O <br /> U) <br /> W <br /> O <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />