8700-22A Continuation Sheet

Requirements for Generators, Transporters, and Waste Management Facilities under the RCRA Hazardous Waste Manifest System – Proposed Fee Rule (Proposed Rule)

0801.21 Continuation_1page

Private Sector

OMB: 2050-0039

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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 Typeapplication/pdf
File TitleManifest Continuation4-1.pdf
Subjectsample continuation sheet for the new hazardous waste manifest form
AuthorUS EPA, Office of Solid Waste
File Modified2016-05-24
File Created2004-04-09

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