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Please print or type, Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Page 23.Manifest Tracking Number <br /> (Continuation Sheet) <br /> 24.Generator's Name <br /> 25. Transporter Company Name U.S.EPA ID Number <br /> 26. Transporter Company NameU.S.EPA ID Number <br /> :.Litt t sr.),:. � ..i..,ti�-� "..';•.' •,c,'..,.., ; ; r :.,j _ ;, f _a .. 't <br /> � 1 <br /> 27a. 27b.U.S.DOT 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 /> O <br /> w <br /> z <br /> w <br /> c� <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter _ _Acknowledgment of Receipt of Materials <br /> H Pfinted/Typed Name Signature Month Day Year- <br /> 0 <br /> ear <br /> O <br /> a <br /> z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name gnature Month Day ear <br /> H <br /> 35.Discrepancy <br /> J <br /> U <br /> Q <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 /> c� <br /> LU <br /> 0 <br /> EPA Form 8700-22A(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br /> 4 <br />