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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFESTrato r �F 22. a e a ' Tracki u r <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> S <br /> 25. Transports Comps, e. J/7 , /!� �r ! jber <br /> U.S.EP�D lVum � <br /> 26. Transporter C.?F Na t ! U. EP u r <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 />� 1 <br /> a <br /> 0 <br /> � I <br /> w <br /> � I <br /> w <br /> I � I <br /> 32.Special Handling ImFS uctions and Additional Information <br /> tr 33.Transpo r nowledgment of Receipt of Materials <br /> F Pdntedfryped 7 � �sS gn re nth Day Year <br /> O <br /> CL <br /> 34.TranspvRerAcknowledgment of Receipt of Materials <br /> Printedflyped Name I Signature Mo e <br /> 35.Discrepancy <br /> U <br /> a <br /> LU <br /> a 36.Hazardous Waste Repot Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> r7 <br /> LU <br /> W <br /> O <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e•MANIFEST SYSTEM <br />�i <br />