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n orlype. (Form designed for use on elite(12-pitch)typewriter.) V Form Approved.OMB No.2000-0404.Expires 7-31-86 <br /> .,JNIFORM HAZARDOUS21.Generator's US EPA ID No. Manifest Document No. 22.Page Information in the shaded <br /> WASTE MANIFEST ^ areas is not required by Federal <br /> (Continuation Sheet) I r? �NA law. <br /> 23.Generator's Name L.StateMan'fes c t <br /> ' /(I`/ FRN Z @ I RcQvn- to QV � � <br /> �� <br /> A� fz"ri�1(N?r 'T-Q,h(a i e4 9 S-�g7AI M. tate Generator's ID <br /> 24.Transporter Company Name 25.US EPA ID Number N.State Transporter's ID <br /> iO.Transporters Pho e <br /> 26.Transporter Company NarfM 27.US EPA ID Number P.State Transport <br /> I� Q.Transporter's Phone <br /> 29.Containers 30. 31. R. <br /> 28. US DOT Description(Including Proper Shipping Name, Hazard Class,and ID Number) Total Unit Waste No. <br /> HM No. Type Quantity WtNol <br /> a. ww%-Te tai p Lf(qulo <br /> LoU,,asluE LAL Ea1 .Ac., 7G0 AbeLv— <br /> b. - <br /> aUQKos i ljl� (,10 ,0/ CURBOS f U6 <br /> G S12 <br /> C. <br /> G d. <br /> E <br /> N <br /> iE <br /> R <br /> A e. <br /> T <br /> O <br /> R <br /> f. <br /> 9 <br /> In <br /> L � <br /> x <br /> Additional Descriptions tor�paterials Listed Above T.Handling Codes for Wastes Listed Above <br /> iiii�1 LJL)0 a <br /> S �AuST' t-So T> <br /> 32.Special Handling Instructions and Additional Information <br /> co u ES res P, uA-7- E 4-1 1.2- --7 7 q � <br /> T '33 Transporter Acknowledgement of Receipt of Materials Date <br /> R <br /> Printed/Typed Name Signature Month Day Year <br /> N <br /> s <br /> o 34. Transporter Acknowledgement of Receipt of Materials _" Date <br /> T Printed/Typed Name Month Day Year <br /> E <br /> R <br /> F 35. Discrepancy Indication Space <br /> A <br /> C <br /> L <br /> T <br /> Y <br /> Style F16-6 Labelmaster,Chicago,IL 60646 TRANSPORTER # 1 EPA Form 8700-22A(3-84) <br />