Laserfiche WebLink
Please print or Form designed for use on elite 12-itch Iter.) Form roved.OMB No.2050-0039 <br /> UNIFORhkHAZARDOUS WASTE IA/1NIFEST 21.GeneratorlDNumber 22.Page 23.manhlfestTrackingNumbar <br /> (Continuation Sheet) v <br /> 24.Generator's Name <br /> Co <br /> `! d/ U.S-EPA ID Number , <br /> 25.Transporter Company Name <br /> .S.EPA ID Number <br /> 26.Transporter Company Name <br /> 27e.1 27b.U.S.DOT Description(including Proper Shipping Name,Hazard CWss,ID Number, 28.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packirg Group(if any)) No. Type ova" WINd. <br /> K <br /> aO <br /> K <br /> W <br /> 2 <br /> W <br /> O <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt Of Materials <br /> r Pdn yped Name Signatu r Month Day Year <br /> Fit <br /> O <br /> CL <br /> 34.Transporter Acknowl enl of Receipt of Materials <br /> PrinteNTyped Name Signature Month Day Year <br /> H <br /> 35.Discrepancy <br /> _1 <br /> V <br /> Q <br /> LL <br /> G <br /> Q36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> c7 <br /> Lu <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05)Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />