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JI <br /> Name"pnnt•ot,type Form Approved.OMB N6..2050-0039 <br /> UNIFO,RN1 HA7AR60U5•WASTE NIANIPtST 21:Genetat6'f iD Ntimbbr' 22.Page 23.Manifest Tracking Number =, <br /> (Continuation Sheet) , �' d <br /> i. <br /> 24.Generator's Name <br /> 6 , q 1 <br /> 25. Transporter Company Name 1 L t U.S.EPA ID Number <br /> A? <br /> 26.Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description including Proper Shipping Name, azar(Class,ID Number, . 5 28.,Containers 29,7611 '3b.UO <br /> HM and Packing Group(K any)r'. ", 31.Waste Codes <br /> � No. Type Quantity WlNol. <br /> i. <br /> W <br /> ' Z <br /> W <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> ignatu Month Day Year <br /> OCr Ica l 'ou-1b <br /> CL <br /> Z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature 'Month Day Year <br /> H- <br /> 35.Discrepancy <br /> ..1 <br /> U <br /> G <br /> LU <br /> 36.Hazardous Waste Report Management'Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> O <br /> N <br /> W <br /> EPA Form*8700-22A(Rev.12-17) Previous editions are obsolete. .r; DESIGNATED FACIIiTY79GENERATOR, f <br />