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Pleast3 priritbr*:(Fodesigned-fort wbn elite(12 pitch)typewriter:) - - Form Approved,OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Q merakxlD N r, 22-Pag J 23.Manifes(Ttacking N tuber <br /> (Continuation Sheet) (^` 5--' J 5� 'D ' J� 1 j �"� 3 " <br /> 24.Generators Name <br /> 25.Transporter—z� Company Nam—e--,, <br /> 7 U.S.EPA ID Number <br /> 26.Traflsporter Company Name <br /> 28.6intainks ' <br /> 27a. 27b.U.S.DOT Dekdp6on(inducing Proper Shipping Name,Hazird Class,.IDThlrtlb6r 9.Total 30.Unit 31.Waste Codes <br /> HM and Packing Group(if any)) No, Type Quantity Wt./Vol. <br /> LLI <br /> LU <br /> Z <br /> �f r <br /> . JAN232018 <br /> ' .• _i�/''\I t 1.. Lis-1�t .. <br /> l <br /> 32.Special Hand5ng InsWrbons."Addidonal Information <br /> Ir 33.Transporter '7---Acknowledgmentof�RP'ceipt of Materials„ <br /> F pr niedfr ed Namur r s r Sienatu ' ! � gay Yea <br /> O t <br /> rZ <br /> Cn 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> F— <br /> 35.Discrepancy <br /> --���;.v�y'7�.:�,"'�.'4-�L3"'� .,._'.£,�:"-r rE�?"'r'_�',._tea;'�R'-:/:''3"a'p��.r';=',`b:'?pr.r�t E-c�r.-+:�E^"j.'�_ -•e`�+i.._�,__. - �-ise��•:•�„`.'1:-e'�*',t_�!,:^.,t:"c..;..._,-.�,,.� . <br /> V <br /> lai <br /> O <br /> a36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> s <br /> C7 <br /> w <br /> n <br /> EPA Form 8700-22A(Rev.3=05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />