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Please print or Noe. (Form designed for use on elite (12 -titch) tvoewriter.) <br />P— A ---i MAP Aln onrn_nnno <br />EPA Form 8700-22A (Rev. 3.05) Previous editions are obsolete. . ,, ;;, . , .r„ 1.,,1, o' GENERATOR'S INITIAL COPY <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />21. Generator ID Number <br />22. Page <br />23. Manifest Tracking Number <br />(Continuation Sheet) <br />24. Generator's Name <br />U.S. EPA ID Number <br />25. Transporter Company Name <br />U.S. EPA ID Number <br />26. Transporter Company Name <br />27a. <br />27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />28. Containers <br />29. Total <br />30. Unit <br />HM <br />and Packing Group (if any)) <br />Quantity <br />Wt./Vol. <br />31. Waste Codes <br />No. <br />Type <br />O <br />Q <br />LU <br />w <br />Z <br />w <br />O <br />t <br />32. Special Handling Instructions and Additional Information <br />33. Trans orter —Acknowledgment of Receipt of Materials <br />Fw- <br />Printedrryped Name Signature Month Day Year <br />O <br />a <br />Z <br />34. Transporter Acknowledgment of Receipt of Materials <br />< <br />Printed/Typed Name Signature Month Day Year <br />F- <br />35. Discrepancy <br />J <br />U <br />Q <br />LL <br />0 <br />Lu <br />Q <br />36. Hazardous Waste Report Management Method Codes (i.e., nodes for hazardous waste treatment, disposal, and recycling systems) <br />Z <br />C� <br />w <br />0 <br />EPA Form 8700-22A (Rev. 3.05) Previous editions are obsolete. . ,, ;;, . , .r„ 1.,,1, o' GENERATOR'S INITIAL COPY <br />