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e rc,.,,, F-- — M. r»-„a,hl r,,,,e,,,.a<n It Form Aooroved. OMB No. 2050-0039 <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />21. Generator ID Number <br />22. Page <br />23. Manifest Tracking Number <br />(Continuation Sheet) <br />JCAIN10000 <br />Z <br />iiOV j� (p FC4CS <br />24. Generator's Name <br />Aca 6-.6-1V <br />25. Transporter Company Name <br />C c L'A�% /LC%�i _ <br />EPA ID <br />/9 <br />umber <br />zas L' <br />26 Transporter Company Name <br />um er <br />27a. <br />HM <br />27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />and Packing Group (if any)) <br />28. Containers <br />29, Total <br />Quantity <br />30, Unit <br />WWol. <br />31. Waste Codes <br />No. <br />Type <br />r i2r2�%6D a'1 /�livc/ 3, II A)1-1(1 31 4 <br />' 7Hti3ZxFJ7(7 t Z P,) <br />ov/ <br />a c4e:�"' <br />N/ <br />cori2ayv� U a+u� /}G r Dl4 Sas1�72syq�/G /�d5 <br />r <br />d/Z <br />UN3?yy,%� rH�k'uidz�l2rc.F1c,��P/ya501{7ji <br />— <br />- <br />a 2c <br />Dol <br />8% <br />a oo <br />l� <br />fit/ <br />r 5 I/ uNl`/�i <br />[�rR1, <br />��Nk�C <br />46 3j <br />fot7 <br />9 f �l, <br />} <br />ob -Ole <br />? <br />_A// <br />Qa yrIlLa 1fVAJt* j fat %t 1YtS/ 9 (4 7.31 <br />fsi <br />(orZ <br />tau/ s6nsao,-6 OR4 r? 1) <br />PE ,4,21- <br />oil <br />(0/Z <br />S <br />trOW10 <br />J <br />VX l7is/d CCAA``SS�'IDj �2�44IaIC72 -FOX/ L <br />657 <br />(�iZ <br />w <br />va <br />v o o <br />AMm oN/U," Nrr//I��7dFByG�/Lite r s S=1 <br />�`5% <br />!o/Z <br />ool <br />Or <br />006/a <br />P1 <br />A1114 <br />I <br />32. Special Handling Instructions and Additional Information <br />33. Trans oner Acknowled ment of Receipt of Materials <br />H <br />PrintedRyped Name Signature <br />Month Day Year <br />C <br />O <br />a <br />= <br />34. Transporter Acknowledgment of Receipt of Materials <br />Primed)Typed Name Signature <br />Month Day Year <br />r <br />35. Discrepancy <br />J <br />U <br />Q <br />LL <br />O <br />R36. <br />Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />Z <br />fN <br />W <br />O <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />