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P edsP nrmi or 1vras. /Form npsinnnd 4nf iso nn nlitc N? dr. <br />v <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. <br />UCJWINHI CU)CHVILI I 1 I V UCry CIVIr VR <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />_ . -_.,_, 1..,.f <br />2,1 or Number t�� j <br />22. Pa <br />Fe" <br />,,, <br />-23. Manifest Tracking Number <br />(Continuation Sheet) <br />�„ (l V v J 6 —r- <br />U b6 3 59 --- Cj - <br />1 t...l_ <br />24. Generator's Name .- <br />( <br />i <br />25. Tr a o er Co pa y Nam ., a • U.S. EPA ID Numb <br />� _N T- Y6 .5 Y,,( r—, rn v3 0 <br />U S. EPA ID Number <br />26. Transporter Company Name <br />27a, <br />27b, U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />28. Containers <br />29. Total <br />30`.lJnit <br />31 Waste Codes <br />No. <br />Type <br />HM <br />and Packing Group (if any)) <br />Duanfily <br />Wt.Nol. <br />a <br />• <br />/ <br />t <br />t <br />r <br />r <br />t.. <br />IFI <br />2 <br />W <br />C7 <br />Y <br />p� <br />3 <br />4 <br />V <br />32. Special Handling Instructions and Additional Information <br />wPrintP�dd(Ttped <br />33.Trans orter_—Acknowledgment of Recei tof Materials ' <br />Name $' r ure Month Dia/y /4Ye <br />a <br />Z34. <br />J <br />Transporter Acknowledgment of Recei tof Materials <br />¢ <br />Pdnteirfyped Name ignature Month Day Year <br />. f <br />35. Discrepancy - - <br />J <br />U <br />G36 <br />Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal. and recycling systems)' - ' - <br />z <br />N <br />W <br />� <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. <br />UCJWINHI CU)CHVILI I 1 I V UCry CIVIr VR <br />