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i <br /> Please print or Form d far use on elite 2-pitch) r. Form Approved.OMB No.2054-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST rI^ � 23. Tradit Nwnber <br /> (Continuation Sheet) _SM ! G <br /> 24.Generator's Name <br /> U.S.EPA ID Number <br /> 25.Transporter Company Name <br /> U.S.EPA IU Number 1 <br /> 2B. Transporter Company Name <br /> dew h 14 Mr A <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Na ,Hazard Class,ID Number, 28•Corriiaurers 29•Total 30•Unit 31.Waste Codes <br /> HM and Packing Group('d any)) No. Type Quantity VI LNbl. <br /> O <br /> W <br /> Z <br /> W <br /> I <br /> 32.Spedd Handling Instructions and Addiflonal Information <br /> i <br /> 33.T r�r of ' of Materials <br /> us RintedrTyped Name 5ignatrne Month Day Year <br /> 34.T t o< of Materials <br /> Prirdedlfyped Name Year <br /> �- r <br /> 35.Decraparicy <br /> J <br /> Uj <br /> V <br /> k <br /> C <br /> 36.Hazardous Waste Report Management Method Codes(i.e.,oodes for hazardous waste treatmant,dsposd,and recycling systems) <br /> a <br /> DESIGNATED FACILITY TO DESTINATION STATE{IF REQUIRED) <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. <br /> j <br /> I � _ <br />