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Please print or type.(Form designed for use on elite 12• itch ewriter. _:,- :., r•h -.. , -. r. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page-- 23.Manifest Tracking Number <br /> (Continuation Sheet) — 4 _ C n C _ - 3 =L r` — — 8 E <br /> 24,Generator's Name <br /> a <br /> TarEae .E`�r�T-15�v <br /> I -Tt, • -SL_ S'- '_pcji=: c "ir- Rcz-sse'er <br /> 25. Transporter `Company Name U.S.EPA ID Number <br /> U.S.EPA ID Number <br /> 26. Transporter Company Name <br /> 27a. 27b.U.S.DDT Description(including Proper Shipping Name,Hazard Class,ID Number, 28,Containers 29.Total 30.Unit 31.Waste Codes <br /> HM and Packing,Group(if any)) No. Type Quantity Wt.Nol. <br /> 5.NON RORA.1^ LAI?DOUS ASTE LJQU!0S,{[/ ERV=—NT, 34.3 <br /> _.1: I <br /> ANAP. ,O C('JNDlz1`)NEF)i?!'A,N -r�r�.I- ON 'U 0 0 = 0 n 2 r 0p i- <br /> 3! ( <br /> f <br /> i <br /> i <br /> 3i <br /> I � <br /> I <br /> ( <br /> r <br /> � a <br /> O <br /> z I I <br /> W <br /> I <br /> 3 <br /> I <br /> i <br /> 32.4.Special Handli ig Instructions and Additional Information�l <br /> 33.Trans iter Acknowledgment of Receipt of Materials <br /> w Printed/Typed Name Signature Month Day Year <br /> O <br /> CL <br /> z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printedrryped Nae Signature Month Day Year <br /> t— <br /> 35.Discrepancy <br /> 'J <br /> U <br /> D <br /> Q36.HazardousW1ste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> 0 <br /> Cn <br /> LU <br /> a <br /> EPA Form 8700-22A Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> ...�n..'•'aC'-�QCE b i'7>_a':�r0"ham r-n'aryri 1t7i anc''!!a0:2u;'�? ai9S=t'i��B.T'.2i3':3 is tip 1ppifig. <br /> -%. T.. <br />