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pill] as print or typ--.(Form designed for use on elke(12-pilch pmritar.) Form APProv0d OMBNo-2050-0039 <br /> 23.MandlestTruldni;Number HAZARDOUS WASTE MANIFEST 2l.GmQKaI0rlDNuml3eF 2z.pagItt <br /> (Conflnuation Sheat) I Ir S41 I :.1 W <br /> 24.Generatoes Nam <br /> qHNER511[v IF plftcol� <br /> 1.501 nlKlfli, MEET , 'MKANN 111 0,711 (NuMi5 M.113 <br /> U.S.EPA ID Number <br /> 25. Ransponer— cemeanY Name <br /> U.S.EPAID Number <br /> 26. Transporter— Company Name <br /> 27a. 27h.U.S DOT Descflpfion(hunfing Proper SNpong N.me.Hazard Class,ID N,mhw, 11Contalp29,Total 30 um" 31.Wavle Cedes <br /> HM and Pa6ung Grm*(if any)) T.. Quante/ WtNol. <br /> It IJA I r�'7 q , p <br /> -TI <br /> O <br /> Yi <br /> 32.S pec lalHard,ngirsVx�ms"Add!twalinfomagon't;I Ll0tWe, <br /> 33.Transporter—Aclma~W ff.Receipt of Materials <br /> PmntmfWed Narse striatne rVonfl, Day Year <br /> 34.Transporter—Acknceredgmentof Receyt of Materials <br /> PrInted(Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> LL <br /> 36.Hazardous Waste Report Management Melhod Codes its,codes for hazadous waste treatment cisposal,and reycN systems) <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete GENERATOR'S INITIAL COPY <br />