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Please print or tyne. Form designed for use on elite i 12• itch ter. Form Approved.OMB No.205MG38 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Canurtuatfon Sheet) 64 p$: V8 j .4orA <br /> 24.Generators Name L-oDr+ Ats D—L�i Le�r'�e 9 ,5 C <br /> 3 G. +��Fj-e, <br /> 25.Transporter Company NUrnU U.S EPA lU Number <br /> 26_Transporter_ Company Name US PPA ID Number <br /> 27a. 27h.US.00TDesrription(indud'uig Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 3a.Unit 31.Waste Codes <br /> HM and PadangGroup[rfacyl) No Type Guan* wwol <br /> atjC � � ) sa <br /> C <br /> Din 6 F- <br /> � � ��zy�s � <br /> oaqo <br /> LU <br /> LU 17 <br /> n1e�n1 Rr�e-+4 f�zR-mus li.,� <br /> l rD11 �O <br /> Ae <br /> LISKigtNc xm and Additional snfonnaWn <br /> z�jealls82 j,[6 at'IfY LP LH-z 6 /K-S5 2�SS Pia '��1S�6 A f <br /> z'� insex eea "VL ttf-bl&AWl—M cP �Sy mss 6}PA05zs �Adnowlec.ment or R of Materials <br /> �+ PanNKFyped Name Signature !.Month Day Year <br /> ? 34.T Adtr menl of Rempi or Materials <br /> Pnole-0yped Name Month 7—ay— ear <br /> r <br /> 35.Discrepancy <br /> a35.Hazardous Waste Report Management Method Codes ox.,codes for hxm dour wasla treahnent,disposal,and recycling systems) <br /> a <br /> r, <br /> ay <br /> u.r <br /> C3 <br /> EPA Form 8700-22A(Rev.3.05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />