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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 2 • e r I u 22.Pae fest Tr n <br /> (Continuation Sheet) ' <br /> 24.Generattofs Name <br /> �.jo LA A <br /> � <br /> * <br /> 25. Transporter U.S.EPA ID Number <br /> Company Nam SCS` <br /> 26. Transporter Company Name <br /> U.S.EPA ID Number <br /> 1"Cx� <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 /> O <br /> W <br /> Z <br /> Cw7 <br /> 1- <br /> 32.Special Handling Instruclicns and Additional Information <br /> 33.Trans Mer Acknowledgment of Receipt of Materials <br /> FW PdntedlTyped , ._ Sign L. Month Day Year <br /> Z 34.Transporter Acknowledgment of eceipt of Materials <br /> Phnted/Typed a I Signaturenth D Y r <br /> r• <br /> 35.Discrepancy <br /> J <br /> U <br /> a <br /> W <br /> C <br /> W <br /> Q 36.Hazardous Waste Report Management Method Codes{Le.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> y <br /> W <br /> D <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />