Laserfiche WebLink
fi <br /> ,lease print of type.(Porro designed for use on elite(12-pitch)typaMter.) Form Approved.OMB No,2050-0039 <br /> UNIFORM`HAZARDQUS WASTE'MANIFEST 21.Generator ID Number 22.Page 23.Manif"t Tracking Number <br /> (Continuation Sheet) 717 <br /> 24.Generator's Name(All pe f`Vd I— C IZ t/!" G( <br /> r <br /> U.S.EPAIDNumber <br /> 25,Transporter. CompanyNamo ' <br /> U.S.EPA ID Number <br /> 25,Transporter o <br /> r <br /> 28.Containers <br /> 27a. 27b,U.S.DOT DeWplbn[Including Proper Shlpping Name,Hazard Class ID Number 24 Tg1W! D.Und' 31,Waste Code <br /> HM and P&,tdq GrolT v any)) <br /> i <br /> U1 <br /> cz <br /> 32.Spoaai Hand!i sandAdd&nal lr,.imAon <br /> '33.Taanspader .totliecse�iioflda `,' ,..' - - _ <br /> w Printedfryped Name Signafura month ay Year <br /> 34,Transpolar Adw%Wgment of Mceipt of MateMs <br /> PrintedfTypadName Signature Day " Year <br /> 35.Discrepancy <br /> J <br /> LU <br /> ..e <br /> 36.Hazardous Wada Report Mendpement Methal Codes(.e.,codes for hazardous waste treatment,disposal,and recyding systems)' <br /> z T <br /> r <br /> EPA Form 8700-22A(Rev.3.05) Previous editions are obsolete. I7ESfGNhTED FACWTV TO G'ENERA'TOR <br />