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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST for ID Number 22.Page 23 ani t Tr kin Number _ <br /> (Continuation Sheet) N% J;m 0 <br /> 24.Generator's Name <br /> U3 X-1101TO --hy�p_ &ner <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> 26. Transporter Company Na U.S.EPA ID Number <br /> Oft a <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. Type Quantity Wt.Nol. 31.Waste Codes <br /> O <br /> Q <br /> W <br /> Z <br /> W <br /> C7 � <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> LU Printed Typed Na L C Signature Month Day Year <br /> rl *--V \� <br /> a <br /> N34.Transporter Acknowledgment of Receipt of Materials <br /> z <br /> Printed/Typed Na eIf Si nature Month Day Year <br /> � u <br /> } 35.Discrepancy <br /> r <br /> J <br /> U <br /> Q <br /> LL <br /> LU <br /> W <br /> Q 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> O <br /> W <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />