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UNIFORM HAZARDOUS WASTE MANIFEST 21. Generator ID Number
(Continuation Sheet)
Form Approved. OMB No. 2050-0039
22. Page
23. Manifest Tracking Number
24. Generator's Name
U.S. EPA ID Number
25. Transporter _______ Company Name
U.S. EPA ID Number
26. Transporter _______ Company Name
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
GENERATOR
27a.
HM
DESIGNATED FACILITY
TRANSPORTER
32. Special Handling Instructions and Additional Information
33. Transporter _______ Acknowledgment of Receipt of Materials
Printed/Typed Name
Signature
Month
Day
Year
34. 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)
EPA Form 8700-22A (Rev. 3-05) Previous editions are obsolete.
DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)
| File Type | application/pdf |
| File Title | Manifest Continuation4-1.pdf |
| Subject | sample continuation sheet for the new hazardous waste manifest form |
| Author | US EPA, Office of Solid Waste |
| File Modified | 2016-05-24 |
| File Created | 2004-04-09 |