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Please print or type. Form designed for use on elite 12 itch typewriter.) -,1 2. i;V ,14 j .,;% (,)O-1 Form Approved OMB No 2050-0039 <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br />t Aida Pia;JAW1 1'&'i1W'1Vf);oV11a-1'p.-Atai«i.".r Iits aid lgdt daft?J(iiii-49aiei.lilt, 4;i'tir"f al 139 li:AiiJi1ing. <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />Generator ID Number <br />22. Page <br />23. Manifest Tracking Number <br />(Continuation Sheet) <br />121. <br />I <br />jt r, . ,..► t yt <br />24. Generator's Name <br />i E7tir,rP� ,:ra <br />U.S EPA ID Number <br />25. Transporter _. Company Name <br />26. Transporter Company Name U.S. EPA ID Number <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 />Hf.1 <br />and Packing Group (if any)) <br />Quantity <br />W1 No]. <br />31. Waste Codes <br />No. <br />Type <br />140 V4 10,1141%1NAZA1O.W7119 WAST f . i.•100IDS- WO1..)VICM41 <br />f <br />400 11(,'QA 1UVAROP 1f11r WA•'.slt•. 1.10010!1. W4 [If #3ffli <br />ON <br />A10N •#2t: IIA I WAf#LliV,; WA!t t f . i.1(.111#17't. :! ; :: •.< . . , <br />'•-31-LAGAN 11 <br />0 E) ► <br />_.. <br />0 <br />'di l�.v i k- i, ON T CRA IWAI" IX)O9 WASTE. LIQU 11;+.i, i. �....►.•�. <br />t <br />.. <br />w <br />t <br />z <br />u.i <br />aliill ftr;tlti#IAZA#11.'H]tf�,lAi�t�i[:.f.ti�ti#I1.:�.¢I.It�,fl!<'/tN't, <br />At AN 1Ti1 <br />001 <br />1) f <br />0040.. <br />± r <br />Ft' r> VIAZf11'?13{_1M; tAtMTH',1101111 <br />( <br />s <br />32. Special Handling Instructions and Additional Information <br />Gt.X3,41 ;)XS S 10 . tit crrl , <br />W <br />33. Transporter _Acknowledgment of Receipt of Materials <br />H <br />Printed/Typed Name Signature Month Day Year <br />O <br />Z <br />34. Trans orter Acknowledgment of Receipt of Materials <br />PrintedlTyped Name Signature Month Day Year <br />H <br />35. Discrepancy <br />J_ <br />V <br />d <br />W <br />W <br />Q <br />36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />w <br />EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY <br />t Aida Pia;JAW1 1'&'i1W'1Vf);oV11a-1'p.-Atai«i.".r Iits aid lgdt daft?J(iiii-49aiei.lilt, 4;i'tir"f al 139 li:AiiJi1ing. <br />