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F=: 1 <br /> Please tint or . Fottn desi nod for use on elite 12 'tch writer. FOR roved.OMB No.2050 pp39 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 121I.GeneniVIDNumbef 22.P 21.Man//tf�z�os/t Tractdne NumQber{/r/� {/.—^�j <br /> (ConNnuationSheet) V*•�-- <br /> 24.GeneraWs Name <br /> ?ep X70 -70 <br /> U.S, I <br /> 25,Transporter Company Nam'"`^ EPA <br /> 26,Transporter Canpany Name ( l r' v v j i .EPA ID Number •/ <br /> t <br /> 273. 27b.U.S.DOT Description(Including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM en4 PaddrV Group(d any)) No. Tym Otrantity WUVol. <br /> O{ <br /> a <br /> w <br /> x <br /> w <br /> O <br /> 32.Special Handling InsWCions and Additional Informat on <br /> a 33.Trans t Aektwrl rent of Rece of Materials <br /> PrintedfTyped Name Signature Month Day year <br /> O <br /> IL <br /> z 34.Trans r ent of Recei t o(Maleriels <br /> PdntedRyped NameSignatureMonth Day ear <br /> r <br /> 35.Digcrepanry <br /> . 11 <br /> W I <br /> � fIf <br /> 36.Hazardous Waste Report Management MeM d Codes(i.e.,codes for hazardous waste treatment,disposal,and tecycrkV systems) I <br /> I <br /> w <br /> CI <br /> EPA Form 870()-22A(Rev.3-05)Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRE[ <br />