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Please print or type. Form Approved.OMB No,2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFES 2 22.P Track n N ^ <br /> (Continuation Sheet) V1+ <br /> 24.Generators Name <br /> aka -�-/A-een 34tm Dt. Q(��j <br /> T_.-�//J/ U.S EPAkNumber <br /> �Y�o3V 7%� <br /> 25.Transport Company Name �� /��i J/ <br /> U.S.EPA ID Number <br /> 26.Transpoder Company Name <br /> 27a, 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30,Unit <br /> 34.Waste Godes <br /> HM and Packing Group(ifany)( No- Type Quantity WtNol, <br /> t <br /> 1 <br /> I <br /> rY <br /> O <br /> w <br /> z <br /> w <br /> l <br /> 32 Special Handling instructions and Additional Information <br /> 33.Transpora Acknowledgment of Receipt of Materials <br /> w Pnnted/Typed SignatureMonth Day Year <br /> CL <br /> In 34.Transpoder AcknowtedgmentofReceiptofMatedais <br /> PrintedTyped Name Signature Month Day Year <br /> F <br /> 35.Discrepancy <br /> V <br /> a <br /> LL <br /> O <br /> Lu <br /> Q 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> t7 <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.12.17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br /> OR14472_WT_006777838SKS 13 <br />