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o rype. (Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No,2000-0404.Expires 7-31-86 <br /> „J=JIFORM HAZARDOUS 21.Generator's US EPA ID No. Manifest Document No. 22. Page Infor ation in the shaded <br /> WASTE MANIFEST e is not required by Federal <br /> (Continuation Sheet) 1-2,4 law. <br /> 23.Generator's Name L.State Manife t D ume.Num r <br /> -T Qjh O-V PR If NTL n C I P.C U rr ec3 h kbC°o. Sd &.77 <br /> U ,,SbR+u6V-S14 T <br /> Ac ARMwo! M.13tate Generator's ID <br /> 24.Transporter Compcfny Name 25.US EPA ID Number N.State Transporter's ID <br /> 11 <br /> 0.Transporter's Phon U/S 34 J S <br /> 26.Transporter'Ji Company Name 27. US EPA ID Number P.State Transporter's ID 7 j/ <br /> -ZE,4j A TE SY TE,r.S .✓-C Ala /� zo /� O.Transporter's Pho /S - 1 <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 /> nM No. I Type Ouantit Wt/V,I <br /> b. w tN� t,C1 r; L I r,, ID V _ <br /> C. a u Qco�- 1 vE 04 4•-c-e:. + IAL UO-1 �(oG 3 / 1 r <br /> C. U�j /JS- E A 1 (VL IU VCU - <br /> ;�`°vr: +rc�1u� ►-A e.-�alnl.. vu-174 <br /> N Kai CT� / �+ <br /> E /V <br /> R <br /> A e. <br /> T <br /> O <br /> R <br /> f. <br /> I 9 <br /> h. <br /> i. <br /> Ll <br /> S. d conal Descriptions for CM�ateriallss sa=.d Above T.Handling Codes for Wastes Listed Above <br /> Ull v ( 0 1 <br /> kjjE C, 4—R— <br /> M <br /> L►;TY c-0Isr A.3E.tLS va►�c aa`y <br /> 32.Sp al Handling Instructio formation 5(jC I Q r 4I F0jrw S Y) 3 I/-�-� <br /> L�LUUE s Kc �Ft Ir&T-C� i —7 —7 C/ <br /> T 33. Transporter _ Acknowledgement of Receipt of Materials Date <br /> a Printed/Ty ed Name pSignature onDayYear <br /> N '�'C1Tc <br /> s <br /> F <br /> 0 34. Transporter Acknowledgement of Receipt of Materials Date <br /> T Printed/T d Name ignalrdW Month Day Year <br /> 07 131 <br /> F 35, Discrepancy Indication Space <br /> A <br /> c <br /> I , <br /> L <br /> I <br /> T ' <br /> r <br /> Style F16-6 Labelmaster,Chicago,IL 60646 EPA Form 8700-22A(3-84) <br />