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Please Drint or type.11orm designed for use on elite 2-pitch)t ewdter. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Pa 23.Manifest Tracking Number <br /> (Continuation Sheet) CALF 43762 LPj652C[479SK <br /> 24.Generator's Name <br /> ri�� 01=TpAry fi$i AA f� <br /> �. . F <br /> 25. Transporter Fr Company Name U.S.EPA ID Number <br /> Pioneer Tank Lines MND044176113 <br /> 26. Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b,U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30,Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 31.Waste Codes <br /> O <br /> Ton <br /> z <br /> ur <br /> 32.Speclal Handling Instructions and Additional Information <br /> 33.Trans oder E Acknowled ment of Recei t of Materials <br /> H PrintedrTyped Name Signature Month Day Year <br /> Q Terry Grant <br /> i1E3 t , <br /> CL - <br /> Z 34.Trans iter <br /> Acknowledgment of Receipt of Materials <br /> PrintedfTyped Name ignature on ay 73ar <br /> 35.Discrepancy <br /> J <br /> U <br /> LL <br /> LU <br /> W <br /> Z 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> t7 <br /> U, <br /> w <br /> v <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />