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Please orint or tyDe. Form Approved, OMB No. 2050-0039 IERATOR . I UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />21. Generator ID Number 22. Page 23. Manifest Tracking Number <br />Generator's Name <br />oty , d Transporter Company Name / /7„A„ 7-A„.....v,,..i.---e c_...‘.., 57"re <br />— I <br />79 7' <br />U.S. EPA ID Number Transporter Company Name <br />I <br />27a. 27b. U.S. DOT Descnption (including Proper Shipping Name, Hazard Class, ID Number, 28 Containers 29. Total 30. Unit 31. Waste Codes HM and Packing Group (if any)) No. Type Quantity Wt.Nol. <br />.. 4 GEh Special Handling Instructions and Additional Information <br />re Lu i-- ce <br />0 a <br />c .) <br />Transporter ' Acknowledgment of Receipt of ate Is 1 PnntediTyped Narne I Signature <br />d,e4-1- tV c / <br />Mo5—r2rYc....._, <br /> I I <br />Transporter _ Acknowledgment of Receipt of Materials 7 <br />I— <br />g Printed/Typed Name Signature Month Day Year <br />I III DESIGNATED FACILITY Discrepancy <br />Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />1 I I I <br />I I I I <br />EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM