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Please print or type. Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 1. or 1 ge 23 a s Trac 'ng Nu r <br /> (Continuation Sheet) <br /> 24.Generator's Name f� <br /> kii-&---E =�=5 <br /> �L✓ <br /> 25. Transporter&&- Company Name U.S.EPA ID Number Q <br /> I� 26. Transporter Company Name U.S.EPA ID Number <br /> h �rt/1r aS o3`i 3L22� <br /> k 27a. 27b.U.S.DOT Desorption(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wt.NoI. 31.Waste Codes <br /> I <br /> i <br /> O <br /> W � <br /> Z <br /> W j <br /> 32.Special Handling Instructions and Additional Information <br /> a 33.Trans Acknowied ment of Receipt of Materials <br /> w Printed lT at Month Day Year <br /> 7 / 7 <br /> z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printedlryped Name Signature Month Day Year <br /> rZ l <br /> 35.Discrepancy <br /> J_ <br /> a <br /> 0 <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 /> C7 <br /> W <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />