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Form Approved.OMB No.2050-0039 <br /> Please print or type. 23.Manifest Tracking Number 1 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 22.Page it <br /> 21.Generator ID Number UlUl4t% <br /> (Continuation Sheet) { <br /> 24,Generator's Name <br /> WiDr Ill <br /> 4520 S Highway04 I <br /> U.S.EPA ID Number <br /> 25. Transporter Company Name I <br /> U.S.EPA ID Number <br /> 26. Transporter Company Name <br /> �;28, 29.Total 30.Unit 31.Waste Codes <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, QuantityWt.Nol. <br /> HM and Packing Group(if any))R(', .►OT Rogulatod'+Aak�riat Lfquid(LATE?Ci r <br /> r.,. RCRNNan-DOT Regulated Nliat©riai Liquid(LATEX) I <br /> 7)Non-RCRNNon-DOT Regulated NtaWal Liquid(LATE)Q t <br /> 0 3)Non-RCRNNon-DOT Regulated Mallerial Solid(KAOLIN, — <br /> SILIC&METHYL CELLULOSE) <br /> w � <br /> z <br /> w <br /> 32.Special Handling Instructions and Additional Information <br /> FRt01 48U113-111 15N6 u1 LNUO, 0063-0;RW 10 7)Eltte, Eibot13-u 55#4 6)Eftv4; 6146 i 4)30#6 <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> w Printed/Typed Name Signature <br /> � Month Day Year <br /> O <br /> a <br /> u) 34.Transporter Acknowledgment of Receipt of Materials <br /> z <br /> Printed/Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> U <br /> Q <br /> 0 <br /> a36,Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> O <br /> Cn <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. <br /> GENERATOR'S INITIAL COPY <br />