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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST Ge rator ID u 22.Page 2 st Tracking Number <br /> (Continuation Sheet) � ,� C�G� <br /> 24.Generators Name <br /> I <br /> U.S.EPA ID Number <br /> 25. Trans er Company Name /] S. <br /> EP <br /> Po P Y y ��� /' / GY /d ►q�'j� <br /> /7167,00 <br /> 26 Tr sporter mpany rime <br /> ✓✓✓((( 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)) 31.Waste Codes <br /> No. Type Quantity wt./Vol. <br /> -------------- <br /> O <br /> w <br /> z <br /> uu <br /> t� <br /> ------------- <br /> I <br /> 1 <br /> 3 <br /> I <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter edgment of Receipt of Materials <br /> UJ Printed[T ed <br /> Yp Signature Month Day Year <br /> fY �� l <br /> O <br /> A <br /> Z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name I Signature Month Day Year <br /> t— + <br /> r <br /> } 35.Discrepancy <br /> J_ <br /> C� <br /> LL <br /> G <br /> W <br /> a 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems} <br /> z <br /> C7 <br /> LU <br /> LU <br /> D <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />