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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator ID Number 22.Pap 23. <br /> 23.Man/lfest Tracking Nu/mbar <br /> (Continuation Sheet) C1�70006I3�, a®T (037 1/p v,5/i <br /> 24.Generator's Name <br /> yle�,✓ Sy stP i�.G <br /> 25.Transporter �► Company Name U.S.EPA ID Number <br /> 26.Transporter Company Name U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30,Unit <br /> HM and Packing Group(6 any)) No. I Type Quantity M.Nol. 31.Waste Codes <br /> K <br /> O <br /> W <br /> Z <br /> W <br /> 32.Special Handling Instructions and Additional Information <br /> C 33.Transporter Acknowledgment of Receipt of Materials <br /> LU PdnledlTypad Name / Signature Month Day Year <br /> a 1(2 <br /> Z 34.Transporter_Acknowledgment of Receipt of Materials - <br /> Pdnted1Fyped Name Signature Month Day Year <br /> F <br /> 35.Discrepancy <br /> J <br /> U <br /> LL <br /> O <br /> W <br /> a 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Z <br /> O <br /> rn <br /> w <br /> O <br /> EPA Form 8700-22A(Rev.12-17)Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br /> OR 14472_WT_006391693SKS 596 <br />