Uniform Hazwaste Manifest-sample2.pdf
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- USNS SIOUX EMERGENCY DRYDOCK
- Solicitation number
- N40442-10-T-4027
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Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039
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UNIFORM HAZARDOUS WASTE MANIFEST
(Continuation Sheet)
21. Generator ID Number 22. Page 23. Manifest Tracking Number
24. Generator's Name
25. Transporter Company Name U.S. EPA ID Number
27a.
HM
27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, and Packing Group (if any))
28. Containers
No. Type
29. Total Quantity
30. Unit Wt./Vol.
31. Waste Codes
32. Special Handling Instructions and Additional Information
33. Transporter _______ Acknowledgment of Receipt of Materials Printed/Typed Name Signature Month Day Year
35. Discrepancy
36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
Printed/Typed Name Signature Month Day Year
34. Transporter _______ Acknowledgment of Receipt of Materials
EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete.
U.S. EPA ID Number
26. Transporter Company Name _______
DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)
VOID
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