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Please print or type. Form designed for use on elite 2-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21 en or ID b 22.Page 23 fest TrackingNumber <br /> (Continuation Sheet) S <br /> 24.Generator's Name <br /> IDA A2 R"zr 6b <br /> . 1�. <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> T <br /> 26. Transporter Company Name <br /> U.S.EPA ID Number <br /> CkCwV% �r1�V�l�c�rs Alo0 ZZZ 6 <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)) <br /> No. Type Quantity Wt.Nol. <br /> tY <br /> O <br /> Q <br /> rx <br /> W <br /> z <br /> W <br /> CD <br /> i <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Trans orte Acknowled ment of Receipt of Materials <br /> F Printed Typed Name Signature Month Day Year <br /> n <br /> Z 34.Transporter Acknowledgment/Receipt of Materials <br /> Printed/Typed NamSig r onth Day Year <br /> r 35.Discrepancy <br /> F-- <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 /> 0 <br /> W <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />