Laserfiche WebLink
r TS' _ 04649 . <br /> Please print or type. Form designed for use on elite 12- itch ewriter. Form A roved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) � C. <br /> O 2 Q/�f 7 <br /> 24.Generators Name r, �4 lr <br /> 25. Transporter Company Name U.S.EPA ID Number74 <br /> p <br /> U.S.EPA ID Number <br /> 26. Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 286,Containers 29.Total 30.Unit 31.Waste Codes . <br /> HM and Packing Group(if any)) No. ' Type Quantity WIJVol. <br /> LU <br /> �: 41 :�• <br /> 32.Special Handling Instructions and Additional Information , <br /> 33.Trans rter vAcknowled mentof Receipt of Materials <br /> LU Printed/Typed Name r,. /f _Signature Month Day Year <br /> Q <br /> z 34.Trans orter Admowled ment of Receipt of Materials. •'F� <br /> Pdntedrryped Name , tura Month Day Year , <br /> t.= <br /> x , %, <br /> 35.Discrepancy M� <br /> LU <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,';disposal,and recycling systems) <br /> F,.; 1 rte <br /> EPA Form 8700.22A.(Rev.3.05) Previous editions are obsolete. <br /> DESIGNATED FACILITY T4 GENERATOR STATE(IF REQUIRED) ; <br /> °t1 <br /> 13106.03.54 <br /> tib._' ,•.•.fN•:. ,•phi.• .,r�'•'1,�,+y. w i ii' ':}�.�ff� .. S _. - • ... .. . 'k .. .. • as ' 121•W <br />