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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 1 22.Page23.ManifestTracki Number <br /> (Continuation Sheet) <br /> 24.GeneraWs Name <br /> C) op TraL <br /> TWO AT-AT-F41NOT- IMP •• <br /> 25.Transporter Company Name •••• :• •• •••• ••• •• • ••• U.S. .... ......... <br /> 26.Transporter—Company Name <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 WLNoI. <br /> 0 <br /> TPQ <br /> W <br /> W <br /> 32.Special Handling Inatructions and Additional Information <br /> a, 33.Transporter Ackn oWed ment of Receipt of Matelots <br /> LU <br /> p� e Month Day Year <br /> yr <br /> M 140- <br /> O <br /> a <br /> a 34.Transporter Acknowledgment of Receipt of Materials <br /> Pdntedrryped Name Signature Month Day Year - <br /> 35.Discrepancy <br /> J <br /> U <br /> LL <br /> O <br /> W <br /> 36.Hazardous Waste Report Management Medd Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> y <br /> W <br /> O <br /> EPA Form 8700-22A(Rev.12-17)Previous editions are obsolete. DESIGNATEii FACILITYTO EPA's e-MANIFEST SYSTEM <br />