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Form Approved ONIB No 2050.0039 <br />cease <br />print ur type. truml aesiynnu rui uan v, <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />(ConNnuallon Sheet) <br />21 Genera r IC Numty.r <br />7th _ <br />22 Page <br />2 <br />23. Manifest Tracking NumDv 1 <br />oo <br />24. Generator's Name <br />PRII W. - LDOt <br />U.S. EPA ID Number <br />25. Transpodef3__ Company Name SLT 88 WAY W. 11TR000OVM <br />26. Tfansponer __ Company Name <br />U.S. EPA ID Number <br />27a. <br />HM <br />Proper Shipping Nae, <br />21b. U.S. DOT Desatptlon (including Prom <br />and Padang Group (if any)) <br />Herard Mass, ID NumMr <br />28. Containers <br />20. Total <br />Quantity <br />30. Unit <br />WLNoI <br />3 t, Waste Codes <br />No <br />Type <br />i <br />i <br />O <br />Z <br />W <br />— <br />32. Special Handling Instructions and Additional Information <br />27A L 278 Line Reiiw ARE TRMSPORTAMN <br />ONLY V 3M TRANSPORTER <br />W <br />33. Transpoirter Ac0oMedgment of Receipt of Materials <br />P y <br />S Month Oay Year <br />0 <br />N34. <br />Transporter_ AcknoMed ment of Rece' t of Male nals <br />Printed/TypedName <br />Signahue Month Day Year <br />U <br />LL <br />35. Discrepancy <br />a36 <br />Z <br />Hazardous Waste Report Management Method Codes (i.e.. cod <br />is for hazardous wavin Irealment. dlsPnsal and rsryding systems) <br />W <br />Q <br />EPA Form 8700.22A(Rev.3-05) Previous editions are obsolete.) DESIGNATED FACILITY TO DESTINATION STATE (IF HtUUIHtu) <br />