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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21.Generator 0 Number 22.Pae 23.Manifest Tracking Number <br /> (Continuation Sheet) CALOOOM1133 00 M79USKS <br /> 24.Generators Name <br /> AMOZONE SAME <br /> 25. Transporter 5 Company NameU.S.EPA ID Number <br /> BEDROCK INC DBA TSMT CO. MOEM5938998 <br /> U.S.EPA ID Number <br /> 26. Transporter Company Name <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28,Containers 29.Total 3I}.Unit <br /> 31.Waste Codes <br /> HM and Packing Group(if any)) <br /> No. Type Quantity Wt.Nol. <br /> O <br /> w <br /> TPP <br /> Z <br /> LU <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transporter Acknowledgment of Receipt of Materials <br /> Iu PrintedlTyped Name SignalMo Da Y <br /> O <br /> z 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> 35.Discrepancy <br /> J <br /> U <br /> a <br /> c <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 /> LU <br /> LU <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITYTO EPA's e-MANIFEST SYSTEM <br />