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Please print or type . Form Approved. OMB No, 2050-0039
<br /> UNIFORM HAZARDOUS WASTE MANIFEST 121 . GeneratDrIDNumber. ': Page 23. Manifest Tracking Number
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<br /> (Continuation Sheet) l .. , ' �.r .,r'� .. , �._' ys . ✓' -1 c..,� J - /7 � ' ' .,.� ..„i
<br /> 24. Generator's Name ; r FOW / All "
<br /> 25. Transporter . Company Name U .S. EPA ID Number
<br /> 26. Transporter Company Name 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)) No. .TWt.NoL
<br /> ype Quantity 31 . Waste Codes
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<br /> 32. Sp edal Handling Instree� uctions and Additional information 7r t a , f -`> , 3 ; ? rX r , ' 7 , / _ . .J ',A r1' '_, r w Gin
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<br /> 33. Transporter Acknowledgment of Receipt of Materials
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<br /> N 34. Transporler ftnowledgment of Receipt of Materials
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<br /> g Printed7Typed Name Signature Month Day Year
<br /> 35. Discrepancy
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<br /> F 36. Hazardous Waste Report Management Method Cdclbs (i.e. , codes for hazardous waste treatment disposal, and recycling systems)
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<br /> EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR
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