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fo e6l I2 itch) Wider ) <br />Form Approved. OMB No. 2050.0039 <br />lease <br />pnni or Type. (Form designed r use on e ( p <br />UNIFORM HAZARDOUS WASTE MANIFEST j21,GnwImber <br />(Continuation Sheet) <br />24 Genereta's Name <br />25 Transporter Company Name <br />s�r,00c <br />26. iranspoder Company Name <br />22 Page 23. ManiUcl Tracklny Number <br />U.S. EPA ID Number <br />~ <br />It 07 V�L <br />US EPA ID Number <br />Class, ID Number <br />28 Containers <br />29, Total <br />O�" <br />30. Unit <br />WUdol <br />3t. Wasle Codes <br />27s, <br />HM <br />27b. U.S. DOT Descnplion (indudkp Proper Shipping Name, Hawd <br />d <br />and Pa*q Coup til any)) <br />No <br />Type <br />I <br />-t <br />32. Sped ending Instruclbns and Additional Information <br />33. Transporter mens of Recei t 0 Materfets <br />Printedrryped Name <br />0A Uf4 <br />S, Month Day Year <br />zz <br />F <br />34. Transporter _.-__ ment of Receipt of Materials <br />PMWy* Name <br />Signeture Month Day Year <br />U <br />aCL <br />C9 <br />35. Disoreparn.Y <br />36. Hazardous Waste Reporl Management Method Codes (i.e., code <br />lar hazardous waste treatment, disposal. and reeydng systems) <br />Uf <br />o <br />i ) <br />rTwrc nr or=nluaFnl <br />EPA Form 8700-22A (Rev 3-05) Previous editions are obsolete i DESIGNATED FACILITY IU ULZ)IINA rrvry <br />