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Pleaseprint-or type. Form designed for use on elite 12- itch typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST G era or N ber 22.Pae 23. anile Tracki Number c r <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> 26. Transporter Company Na , <br /> U.S.EPA ID Number <br /> Near, rb%:%rs vt e�-f� Seri�c es Avo 3 3 a s� <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name.Hazard Class,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity Wt.Nol. <br /> O <br /> Q <br /> uJ <br /> w <br /> z <br /> w <br /> 0 <br /> 32.Special Handling Instructions and Additional Information <br /> X 33.Transporter A Ac led ment of Receipt of Materials <br /> H Printed/Typed -Si to Mon h Day Year <br /> Z 34.Transporter_ Acknowledgment of Receipt of Materials <br /> < Printed/Typed Name Signature Month Day Year <br /> 7--it i l t O <br /> r <br /> 35 Discrepancy ki L.11 <br /> J <br /> U <br /> Q <br /> LL <br /> W <br /> Q 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment.disposal,and recycling systems) <br /> Z <br /> t� <br /> LU <br /> LU <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />