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Please pr.nt or type. Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No,2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21 Generator ID Number 22,Page 23.Manifest Tracking Number <br /> (Continuation Sheet) 0 DLy I) Z/-Z— <br /> 24.Generator's Name <br /> R�JMWATW <br /> 25 Transponer Company Name <br /> U.S.EPA ID Number <br /> �C Z oma. Th c A Z�JC�C e; 7 7 <br /> 26. Transporter Company Name U S EPA 10 Number <br /> 27a 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number. 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No Type Quantity Wt.Nol. <br /> O <br /> H <br /> Q <br /> K <br /> LU <br /> z <br /> Lu <br /> c7 <br /> 32.Special Handling Instructions and Additional Information <br /> 33 Trans iter AcknoWedamenlofReceipt QLMalerials <br /> F,n,ed yped Name �--Signature +oolh Day <br /> U) <br /> 34 Trans der _ Acknowledgment of Receipt of Materials <br /> < PrintedfTyped Name Signature Monts _�y ea <br /> H <br /> } 35.Discrepancy <br /> H <br /> J <br /> U <br /> Q <br /> W <br /> rj <br /> W <br /> a 36.Hazardous 4laste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal.and recycling systems) <br /> z <br /> O <br /> U) <br /> LU <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />