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Please print or type. IC MAW '��Fo fn Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST21. ID <br /> 22 <br /> e 23. f t N <br /> (Continuation Shee) <br /> 24.Generabes Name <br /> ' v <br /> 25.Transporter Company Name -" - <br /> in <br /> U.S.EPA ID Number <br /> 26.Transporter Company Name(+' jJ._ ���� ` �� <br /> Q Y <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(9 any)) No. Type Quantity WtfVol, 31.Waste Codes <br /> K <br /> aO <br /> K <br /> w <br /> Z <br /> W <br /> f.7 <br /> J <br /> 32.Special Handling Inshuclions and Additional Information <br /> w 33.Tra ment of Receipt of Materials <br /> LU ntedlTy a ! ig Moreh Day Year <br /> 34.Transporter ils,4 AdnoWedgmerd of Receipt of MaWals <br /> PrintedrTyped NameSigna Month Day Year <br /> jotVW <br /> i�l'i7ms a a g <br /> 35.Discrepancy <br /> J 01 <br /> U <br /> Q <br /> LL <br /> O <br /> W <br /> G 36.Hazardous Waste Report Management Mettatl Codes(i.e.,codes for hazardous wade beatment disposal,and recycling systems) <br /> z <br /> S2 <br /> L <br /> LU <br /> EPA Form 8700-22A(Rev.12-17)Previous editions are obsolete. DESIGNATFFACILITYTO EPA's e-MANIFEST SYSTEM <br /> w.w u...waw w..�w..nn.wutir.....w.w etivMrf..�.nr..rr N....�.�.w..r......eh.r•,.wrr...rr.r <br />