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No.2050-0039 <br /> Please rint or e. Form desi ned for use on elite 12 ler Form A roved.OMB , <br /> Tracid"Number <br /> UNIFORM HAZARDOUS YYASTE MANIFEST 21.Generator ID Number 22.Page 23.Nanifast <br /> (Continuation Sheet) . <br /> 24.Generator's Name r <br /> �-Qo Lv� �LUCC Co n� <br /> 25.Transporter Company Name U.S.EPA ID Numberb'ls 4CL MO'b 0q56 3 <br /> t <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,lD Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Paddrrg Group(if any)) Ne, Type Quantity Nivol. <br /> I <br /> 1 <br /> W <br /> z <br /> W <br /> x <br /> i <br /> I <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Trans of Recei of Malls <br /> W PrintedlTyped Name Month Day Year <br /> z 34.T mentOf Rete' of M <br /> Printdlfyped Name gnalure Year <br /> rr 36•Discrepancy <br /> C <br /> J <br /> LL <br /> C <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment disposal,and regdr)g systems) <br /> z <br /> f7 <br /> a <br /> EPA Form 8700-22A(Rev.3.05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />