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i <br /> Please rotor e. Form designed for use on elite�ifchtter Form A roved.OMBNo.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFESTNumber 22.Page 23.Manliest Tracking Number <br /> (Continuation Sheet) <br /> 24.Generators Name <br /> 25, Transporter_Company Name U.S.EPA ID Number <br /> 26. Transporter Company Name U.S.EPA ID Number <br /> 27a. 27h.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if arty) Na. Type Quantity WVPoI. 31.Waste Codes <br /> ; <br /> f <br /> i <br /> i <br /> 1 <br /> S <br /> 0 <br /> F <br /> LU <br /> W <br /> 2 <br /> W <br /> C7 <br /> i <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowled ment of Receipt of Materials <br /> F Pdmed7fyped Name Signature Month Day Year <br /> a - <br /> = 34.Transporter Acknowledgment of Receipt of Materials <br /> Primed/Typed Name Signature Month Oay year <br /> r <br /> 35.Discrepancy <br /> J <br /> do <br /> U <br /> LL <br /> a) <br /> 36.Hazardous Waste Report Management Method Codes if e.,codes for hazardous waste treatment disposal and recycling systems) <br /> 2 <br /> N <br /> W <br /> O <br /> EPA Form 8700-22A(Rev 3-05) Previous editions are obsolete. <br /> GENERATOR'S INITiAI COPY <br />