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0 <br /> designed for use on elite(12-pitch)typewriter.) <br /> Form Approved.OM3 No.205D-0039 <br /> US WASTE MANIFEST 21.Genento lD Number 22.Pago 23.MenI Tneltln IN bx <br /> (Contlnuatlon Shwt) , <br /> i <br /> 24.13"natorS Name <br /> 25.Transporter Company Name U.S.E A N <br /> 26.Tmrepoder_ Company Name US.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including PmperSHppug Name,Hazard Class,0 Number, 28.Containers <br /> 29.Total 30.Unit <br /> MM and Paclolg GmuD('rf airy)) No. Type Quantity WINol. 31.Waste Codes <br /> 0 <br /> Oa <br /> K <br /> w <br /> z <br /> our <br /> c7 <br /> 32.Speaal Handling lnstmctions and Additional Information <br /> 33.TnnsporNr AcIvoMed entolR ofMaledals <br /> F n Y Name Sig <br /> IY <br /> 0 <br /> = 34.Twspoftr—AC)MoMedgmentofRecbptofMataWs - <br /> PrintedrrypedName Signature Month Day Year <br /> I F <br /> 35.Discrepancy <br /> J <br /> U <br /> Q <br /> LL <br /> O <br /> W <br /> 36.Hazardous Waste Report Management Method Codes(Le..cotles(or hazardous waste tmatrnem.disposal,and recytling systems) <br /> i 2 <br /> co <br /> I y <br /> W <br /> O <br /> I <br /> EPA Form 8790-22A(Rev.3.05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />