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Please prindortype. Form designed for use on elha[12-pitch) ewriter. Form Approved.OMB No.2050-0039 <br /> }. UNtnORM HAZARDOUS WASTE MANIFEST 21,Generator ID Number 22.Papp 2J.Mantlest Tracking Number <br /> 1 (Continuation Sheet) r f r 1 r.f R '?ratn 1 r• r= r r. <br /> 24.Generator's Name <br /> Oak Harbor Freight Lines, Inc <br /> 25.Transporter_Company Name U.S.EPA ID Number <br /> 26. Transporter Company Name U.S.EPA ID Number <br /> ` 27a. 27b.U.S.DOT Description liaduding Proper Shipping Name HamN Class,ID Number, 26.Contziners 29.Total 30.Unit <br /> HM and Packing Group(if airy) No. Type Quantity WINOI. 31.Wase Coda <br /> 5 Non-RCRA..Hazardous waste.sogd(pity detxtsj TD D 311 <br /> V <br /> d. NrmRCRA, Hazardouswaste,6geAd(Iatapack; <br /> 1 FT 1q5 P <br /> t <br /> tu <br /> z <br /> z <br /> W <br /> i <br /> r <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> PrintedRypetl Name Signature Month Day Year <br /> O <br /> a _ <br /> 2 34.Transporter Acknowledgment of Receipt of Materials - <br /> PnntedfrypedName Signature Monts Day Year <br /> r 35.Discrepancy <br /> Ai <br /> CJ <br /> 36.Haze Her eport Management Method C e ( ad s�e? for hazardous waste treatment,disposal and recycling systems) <br /> z ! <br /> O <br /> Vi <br /> W <br /> O _ <br /> EPA Form 8700-22A(Rev.3-05).,Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />