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Please print or type. Form designed for use on elite 12 itch typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 10diGnerat ID Number. 236nqRstTracking umber <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> UT <br /> U.S.EPA ID Number <br /> 25. Transporter Company Name <br />' 26. Transporter Company Name <br /> 1 r U.S.EPA ID NumberCA ] 'J <br /> 6V-5 V! <br /> 27,9. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 26.Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if arty)) No. Type Quantity Wt.Nol. <br /> O <br /> w <br /> z <br /> w <br /> t9 <br /> 'N� <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter! Acknowledgment of Receipt of Materials <br /> LU PrintedfTyped Name Si nature <br /> 9 Month Day Y ar <br /> a - 1 <br /> Z 34.Trans iter Acknowled ment of Recei t o Materials <br /> PrintedlTyped Nam Signature Month Day ear <br /> 35.Discrepancy Y6 [y"� <br /> J_ <br /> Q <br /> LL <br /> O <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 /> O <br /> LU <br /> LU <br /> v <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />