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U.S. EPA Form 8700-22
<br />all Instructions before completing this form.
<br />lis form has been designed for use on a 12 -pitch (elite) typewriter which is also compatible
<br />th rd computer printers; a firm point pen may also be used—press down hard.
<br />idt julations require generators and transporters of hazardous waste and owners or
<br />-orators of hazardous waste treatment, storage, and disposal facilities to complete this form
<br />PA Form 8700-22) and, if necessary, the continuation sheet (EPA Form 8700-22A) for
<br />,th inter- and intrastate transportation of hazardous waste
<br />reporting burden for this collection of Informallon Is eatlmated to average: 30 minutes for general",.. 10
<br />es for transporters. and 25 minutes for owners or operators or treatment, storage, and disposal facilities. This
<br />ies time for reviewing instructions, gathering data, completing, reviewing and transmitting the form. Any
<br />ip"ndence regarding the PRA burden statement for the manilest must be sent to the Director of the Collection
<br />�gies Division In EPA's Office of Information Collection at the following address: U.S Environmental
<br />Ilion Agency (2822T), 1200 Pennsylvania Ave.. NW , Washington, DC 20460 Do not send
<br />rmpleted form to this address.
<br />I. Instructions for Generators
<br />1. Generators U.S. EPA Identification Number
<br />Iter the generators U.S. EPA twelve digit Identification number, or the State generator
<br />intification number if the generator site does not have an EPA Identification number.
<br />?. Page i of _
<br />Item 10. Containers (Number and Type)
<br />Enter the number of containers for each waste and the appropriate abbreviation from Table I
<br />(below) for the type of container.
<br />TABLE I: -TYPES OF CONTAINERS
<br />BA = Burlap, cloth, paper, or plastic bags. DT = Dump truck.
<br />CF = Fiber or plastic boxes, cartons, cases. DW = Wooden drums, barrels, kegs.
<br />CM = Metal boxes, cartons, cases (including HG = Hopper or gondola cars.
<br />roll -offs).
<br />CW = Wooden boxes, cartons, cases, TC = Tank cars.
<br />CY = Cylinders. TP = Portable tanks.
<br />DF = Fiberboard or plastic drums, barrels, kegs. TT = Cargo tanks (tank trucks),
<br />DM = Metal drums, barrels, kegs.
<br />Item 11. Total Quantity
<br />Enter, in designated boxes, the total quantity of waste. Round partial units to the nearest
<br />whole unit, and do not enter decimals or fractions. To the extent practical, report quantities
<br />using appropriate units of measure that will allow you to report quantities with precision.
<br />Waste quantities entered should be based on actual measurements or reasonably accurate
<br />estimates of actual quantities shipped. Container capacities are not acceptable as estimates.
<br />Item 12, Units of Measure (WelghWolume)
<br />Enter, in designated boxes, the appropriate abbreviation from Table II (below) for the unit of
<br />measure,
<br />iter the total number of pages used to complete this Manifest (i.e., the first page (EPA Form
<br />TABLE 11 -UNITS OF MEASURE
<br />00-22) plus the number of Continuation Sheets (EPA Form 8700-22A), if any).
<br />G = Gallons (liquids only). N = Cubic Meters.
<br />?. Emergency Response Phone Number
<br />K = Kilograms. P = Pounds.
<br />Iter a phone number for which emergency response information can be obtained in the event
<br />L = Liters (liquids only). T = Tons (2000 Pounds).
<br />an incident during transportation. The'emergency response phone number must:
<br />M = Metric Tons (1000 kilograms). Y = Cubic Yards.
<br />Be the number of the generator or the number of an agency or organization who is capable
<br />of and accepts responsibility for providing detailed information about the shipment;
<br />Note: Tons, Metric Tons, Cubic Meters, and Cubic Yards should only be reported in
<br />connection with very large bulk shipments, such as rail cars, tank trucks, or barges.
<br />Reach a phone that is monitored 24 hours a day at all limes the waste is In transportation
<br />(including transportation related storage); and
<br />Item 13. Waste Codes
<br />Reach someone who is either knowledgeable of the hazardous Waste being shipped and
<br />Enter up to six federal and state wast" codes to describe each waste stream identified Item
<br />9b. Slate waste codes that are not redundant with federal codes must be entered here, in
<br />has comprehensive emergepcy response and spill cleanupl'incident mitigation information
<br />addition to the federal waste codes which are most representative of the properties of the
<br />for the material being shipped or has immediate access to a person who has that knowledge
<br />waste.
<br />and information about the shipment.
<br />!tern 14. Special Handling Instructions and Additional Information
<br />rte• ' -,grgency Response phone number information should only be entered in Item 3 when
<br />irl phone number that applies to all the waste materials described in Item 91b. If a
<br />1. Generators may enter any special handling or shipment -specific information necessary for
<br />jah—, consolidated shipments) arises where more than one Emergency Response
<br />the proper management or tracking of the materials under the generator's or other
<br />,.;.g.,
<br />one number applies to the various wastes listed on the manifest, the phone numbers
<br />handlers business processes, such as waste profile numbers, container codes, bar codes,
<br />sociated with each specific material should be entered after its description in Item 9b.
<br />or response guide numbers. Generators also may use this space to enter additional
<br />1. Manifest Tracking Number
<br />descriptive information about their shipped materials, such as chemical names, constituent
<br />percentages, physical state, or specific gravity of wastes identified with volume units in
<br />is unique tracking number must be pre-printed on the manifest by the forms printer.
<br />Item 12.
<br />i. Generator's Mailing Address, Phone Number and Site Address
<br />2. This space may be used to record limited types of federally required information for which
<br />ter the name of the generator, [lie mailing address to which the completed manifest signed
<br />there is no specific space provided on the manifest, including any alternate facility
<br />the designated facility should be mailed, and the generator's telephone number. Note, the
<br />designations; the manifest tracking number of the original manifest for rejected wastes and
<br />ephone number (including area code) should be the normal business number for the
<br />residues that are re -shipped under a second manifest; and the specification of PCB waste
<br />nerator, or the number where the generator or his authorized agent may be reached to
<br />descriptions and PCB out -of -service dates required under 40 CFR 761.207. Generators,
<br />wide instructions in the event [lie designated and/or alternate (if any) facility rejects some or
<br />however, cannot be required to enter information in this space to meet stale regulatory
<br />of the shipment. Also enter the physical site address from which the shipment originates
<br />requirements.
<br />ly if this address is different than the mailing address.
<br />Item 15. Generators/Offerors Certifications
<br />i. Transporter 1 Company Name, and U.S. EPA ID Number
<br />1. The generator must read, sign, and dale the waste minimization certification statement, In
<br />ter the company name and U.S. EPA ID number of the first transporter who will transport the
<br />signing the waste minimization certification statement, those generators who have not
<br />;ste. Vehicle or driver information may not be entered here.
<br />been exempted by statute or regulation from the duly to make a waste minimization
<br />'. Transporter 2 Company Name and U.S. EPA ID Number
<br />certification under section 3002(b) of RCRA are also certifying that they have complied
<br />ipplicable, enter the company name and U.S. EPA ID number of the second transporter who
<br />with the waste minimization requirements. The Generator's Certification also contains the
<br />I transport the waste. Vehicle or driver information may not be entered here.
<br />required attestation that the shipment has been properly prepared and Is in proper
<br />nore than two transporters are needed, use a Continuation Sheel(s) (EPA Form 8700-22A).
<br />condition for transportation (the shippers certification). The content of the shipper's
<br />certification statement is as follows: "I hereby declare that the contents of this
<br />i. Designated Facility Name, Site Address, and U.S. EPA ID Number
<br />consignment are fully and accurately described above by the proper shipping name, and
<br />ter the company name and site address of the facility designated to receive the waste listed
<br />are classified, packaged, marked and labeled/placarded, and are in all respects in proper
<br />this manifest. Also enter the facility's phone number and the U.S. EPA twelve digit
<br />condition for transport according to applicable international and national governmental
<br />!ntification number of the facility.
<br />regulations. If export shipment and I am the Primary Exporter, I certify that the contents of
<br />J. U.S. DOT Description (Including Proper Shipping Name, Hazard Class or Division,
<br />this consignment conform to the terms of the attached EPA Acknowledgment of Consent."
<br />(cation Number, and Packing Group)
<br />When a party other than the generator prepares the shipment for transportation, this party
<br />m 9a. If the wastes identified in Ilam 9b consist of both hazardous and nonhazardous
<br />may also sign the shipper's certification statement as the offeror of the shipment.
<br />Iterials, then identify the hazardous materials by entering an "X" in this Item next to the
<br />2. Generator or Offeror personnel may preprint the words, "On behalf of in the signature
<br />-responding hazardous material identified in Item 9b.
<br />block or may hand write this statement in the signature block prior to signing the
<br />m 9l• Inter the U.S. DOT Proper Shipping Name, Hazard Class or Division, Identification
<br />generatorlofferor certification, to indicate that the individual signs as the employee or agent
<br />m TINA) and Packing Group for each waste as identified in 49 CFR 172. Include
<br />of the named principal.
<br />:hn,_ dme(s) and reportable quantity references, if applicable.
<br />Note: All of the above information except the ha wrjtlen_fluill�fTgliirQ n
<br />be pre-printed. r sl�c
<br />,te: If additional space is needed for waste descriptions, enter these additional descriptions
<br />L
<br />Item 27 on the Continuation Sheet (EPA Form 8700.22A). Also, if more than one
<br />iergency Response phone number applies to the various wastes described in either Item 9b
<br />Item 27, enter applicable Emergency Response phone numbers immediately following the
<br />SEP 0 8
<br />pping descriptions for those Items
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