Laserfiche WebLink
I <br /> Plea3e rl t;r Form designed for use onelite 2-pitch) typewriter.) Form ApRroved,0N1I3 No.20500039 <br /> UNir RM'HAZARDOUS WASTE MANIFE T 21•Generator ID Number 22.Page 23,Manifest Tracking Number <br /> (Continuation Sheet) 4' i I L r 2 t� ✓ <, �'� �:.' �`� ^� <br /> 2.4,Generator's Name <br /> SAME <br /> 25. Transporter. "J _ Company Name (tt15m !-ar1:sC)rs Enyi't7j12')'pont! :�ervjGe.�Transporter- Inc. I U.SL �i��5e,Ct�=22'��,0 <br /> 26. Transporter Company Name U.S.EPA ID <br /> ,gNumber <br /> 1-4)11! <br /> 271, 27b.U.S,DOT Description(including Proper Shipping Name,Hazard Class,ID Number; 28.Centel ners 29,Total 30,Unit 31,Waste Codes <br /> HM .and Packing Gfoup(if any)) y, ! No. Typo, QuantityW4Nol: <br /> �,;. <br /> i <br /> i <br /> t LI T <br /> i <br />[ 32,Special Handling Inslwc06ns and Addi tional Inforn Monl <br /> i <br /> 33.Transporter Acknowied mentofRacal to Mat rials a <br /> H Prinledtiyped Name Slgnat Month Day Year <br /> V) <br /> 34.Tmns rter Acknowled mentofRecat lo(Mate,rlat$ _ <br /> Printedrryped Name Signature Toni ay Year <br /> 35.Discrepancy <br /> I <br /> C <br /> s <br /> 38.Hazardous Waste Report Management Method Cc as(i e„codes for hazardous waste treatment,disposal,and recycling systems) <br /> FPA Form 8700.22A(Rev.3,05) Previous editions.ar�of;Diets. DESIGNATED FACILITY TO GENERATOR <br />