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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST erator N I 22.Pae Its IT k Number <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> 25. Transporter Company Name A <br /> 26. Transporter Company Name T U.S.EPA ID Number <br /> 27a, 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> 31.Waste Codes <br /> HM and Packing Group(6 any)) No. Type Quantity WWoI. <br /> K <br /> QO <br /> K <br /> W <br /> Z <br /> W <br /> t7 � <br /> I <br /> i <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transpo 7 Acknowledgmentof Re iptof Matedals <br /> F Print /Typed a e Signature Month <br /> Day Year <br /> o er— 7 <br /> a <br /> i 34.Transporter Acknowledgment of RiCeipt of Materials <br /> Pnnted/Typed Name Signature Month Day Year <br /> F <br /> 35.Discrepancy <br /> J <br /> U <br /> Q <br /> LL <br /> D <br /> W <br /> Q 36.Hazardous Waste Repel Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> O <br /> H <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous edilions are obsolete. <br /> DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />