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Picas r print v,type Form Approved.OMB No.2950-6039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST j21-C--raWc1DNurrtbsf <br /> 24.GeneraWs Name J} F 22.Page 23.irEanEfestTrxidng Number <br /> (Continuation Shoot] -1/ 7 <br /> U-S.EPA ID Number <br /> 251. Transporter Company Name ' I _ <br /> n- Trams iter___ Company name U3,EPA ID Number <br /> 2Ia. 27b U.S.DOT Desrarplm(indudirg Proper Shpprg Name,Hazard Class.ID Number. 2$ C0^Wers <br /> N a+ aiq (t4°$nY1} No. Type Quantity VYtlVot. 33.Yissfe tides <br /> .l <br /> AV .+7 <br /> 4' <br /> W K <br /> Z <br /> U <br /> NO <br /> 4 <br /> ,r 0 <br /> 32.Special Handing Instructions and Additional Information <br /> 33.Tramponer AdnWed ment of Receipt of Materials <br /> w PriQ5WTypedN r Signatula�. -- .- --_-- -�' ��-- Month Bay YW <br /> 40 <br /> n 34,Traraporler ntofRecei lg als <br /> PrintedlTyped Name `p N '. .' $fgrraglre Month Day 'rear <br /> r _ <br /> 35,f]wepancy <br /> 4 36 Hazardous Waste Regan Ham-igemen!Method Codes(i-e codes for hazardous waste Ireatmenl,disposal,and recycling systems) <br /> 2 <br /> C7 <br /> LU <br /> 0 <br /> EPA Form 8700.22A(Rev-12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />