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Form Approved.OMB No. Please print or type. 4.Man' st 7ra N r 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone ,I �40193 41 F L E UNIFORM HAZARDOUS IWI L WASTE MANIFEST 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) ding Way Way Generators Phone: r r f� U.S.EPA ID Number 6.Transporter 1 Company Name wast U.S.EPA ID Number 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site AddressY s ro n m ent a 1 Mgt, LLL: .- . . r_,ul Q , Facility's Phone: , 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes 9a. No. Type Quantity Wt.Nol. HM and Packing Group(if any)) otO t- )k Z 2, UJ c� 3: a 4. 14.Special Handling Instructions and Additional Information 5 GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable internarinna ani tional governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached owledgment of Consent. c that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a la a quantity generator)or(b)(if I am a sural gene r)is true. Month Day Year gna re ene r's10 eror's Printed/yped N 1 .International Shipments El Import to U.S. ❑Export fr U.S. Port of entry/ it: Date I vin S. ? ransporter signature(for exports only): W 17.Transporter Acknowledgment of Receipt of Materials Month Day Year Si ature Transporter 1 Printed Typed Name O _ Month Day Year IL - Signa ure Z Transporter 2 Printed/Typed Name H 18,Discrepancy 18a.Discrepancy Indication Space 0 Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: U.S.EPA ID Number Fr- 18b.Alternate Facility(or Generator) J U < Facility's Phone: Month I Day Year W 18c.Signature of Alternate Facility(or Generator) a z 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disp3sal,and recycling systems � 4 LU1 2. 20.Designated Facility Owner or Operator:Certification of receipt of hazard materials c red by the manifest except as no d in Item 18a Month Day Year Signature 7 Printed/Typed Name l E NA CILIT s e-MIFT SYSTEM EPA Form 8700-22(Rev.12-17) Previo s e itions are solete. GA' ANES