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U.S.EPA Form 870( Iter, 10.Containers(Num d Type)
<br /> Read all instructions before completing this form. d/ Enter the number of con Iners for each waste and the appropriate abbreviation from Table I
<br /> 1. This form has been designed for use on a 12-pitch(elite)typewriter which is also compatible ()elow)for the type of container.
<br /> with standard computer printers;a firm point per.may also be used-press down hard. TABLE I.-TYPES OF CONTAINERS
<br /> 2. Federal regulations require generators and transporters of hazardous waste and owners or BA=Burlap,cloth,paperor plastic bags. DT=Dump truck.
<br /> operators of hazardous waste treatment,storage,and disposal facilities to complete this form CF=Fiber or plastic boxes,cartons..cases. DW=Wooden drums,barrels,kegs.
<br /> (EPA Form 8700-22)and,if necessary.the continuation sheet(EPA Form 8700-22A)for CM=Metal boxes.cartons,cases(including HG=Hopper or gondola cars.
<br /> both inter-and intrastate transportation of hazardous waste. roll-offs).
<br /> - --- "-""----- "" - -------- -"-- ""----
<br /> CW=Wooden boxes,cartons,cases. TC Tank cars.
<br /> Public reporting burden for this collection or information Is estimated to average) 30 minutes for generators.10 CY=Cylinders. TP=Portable tanks.
<br /> minutes for transporters,and 25 minutes for o viers or operators of treatment.storage,and disposal facilities. This! _ DF=Fiberboard or plastic drums.barrels,kegs. TT=Cargo tanks(tank trucks).
<br /> includes time for reviewing malho.tions.gothenng data,completing,reviewing and transmiming the form. Any DM=Metal drums,barrels.kegs.
<br /> correspondence regarding the PRA burden statement for the manifest must be sent b the Director of the Collection
<br /> Strategies Division in EPA's once of Information Collection alone following address. U.S.Environmental I Item 11.Total Quantity
<br /> Proledion Agency(2622T),1200 Pennsylvania Ace..NW.Washington,Dc 20460. Do not send Enter,In designated boxes,the total quantity of waste. Round partial units t0 the nearest
<br /> I me completed form to his address, whole unit,and do not enter decimals or fractions. To the extent practical,report quantities
<br /> I.Instructions for Generators 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 /> Item 1.Generators U.S.EPA Identification Number estimates of actual quantities shipped. Container capacities are not acceptable as estimates.
<br /> Enter the generators U.S.EPA twelve digit identification number,or the State generator Item 12.Units of Measure Waigh7Nolume)
<br /> Identification number if the generator site does not have an EPA identification number, Enter,in designated boxes,the appropriate abbreviation from Table II(below)for the unit of
<br /> Item 2.Page 1 of reasure.
<br /> Enter the total number of pages used to oomplete this Manifest(is,the first page(EPA Form TABLE II.-UNITS OF MEASURE
<br /> 8700-22)plus the number of Continuation Sheels(EPA Form 8700-22A),'d any). G=Gallons(liquids only). N=Cubic Meters.
<br /> Item 3.Emergency Response Phone Number K=Kilograms, P=Pounds.
<br /> Enter a phone number for which emergency response information can be obtained in the event L=Liters(liquids only). T=Tons(2000 Pounds).
<br /> of an incident during transportation. The emergency response phone number must M=Metric Tons(1000 kilograms). Y=Cubic Yards.
<br /> 1. Be the number of the generator or the number of an agency or organization who is capable Note: Tons,Metric Tons.Cubic Meters,and Cubic Yards should only be reported in
<br /> of and accepts responsibility for providing detailed information about the shipment: cr,nnection with very large bulk shipments,such as rail cars,lank trucks.or barges.
<br /> 2. Reach a phone that is monitored 24 hours a day at all times the waste is in transportation Item 13.Waste Codes
<br /> (including transportation related storage);and
<br /> 3. Reach someone who is either knowledgeable of the hazardouswaste being shipped and E iter up to six federal and state waste codes to describe each waste stream identified in Item
<br /> has comprehensive emergency response and spill cleanuplincident mitigation information 91t. State waste codes that are not redundant with federal codes must be entered here,in
<br /> for the material being shipped or has immediate access to a person who has that knowledge addition to the federal waste codes which are most representative of the properties of the
<br /> and information about the shipment. waste.
<br /> Note: Emergency Response phone number information should only be entered in Item 3 when Item 14.Special Handling Instructions and Additional Information
<br /> there is one phone number that applies to all the waste materials described in Item 9b. If a i. Generators may enter any special handling or shipment-specific information necessary for
<br /> situation(e.g.,consolidated shipments)arises where more than one Emergency Response the proper management or tracking of the materials under the generators or other
<br /> phone number applies to the various wastes listed on the manifest.the phone numbers handlers business processes.such as waste profile numbers,container codes,bar codes.
<br /> associated with each specific material should be entered after its description in Item 9b. or response guide numbers. Generators also may use this space to enter additional
<br /> dem 4.Manifest Tracking Number descriptive information about their shipped materials,such as chemical names,constituent
<br /> This unique tracking number must be pre-panted on the manifest by the forms printer. percentages,physical state,or specific gravity of wastes identified with volume units in
<br /> Item 12,
<br /> Item 5.Generator's Mailing Address.Phone Number and Site Address 2. This space may be used to record limited types of federally required information for which
<br /> Enter the name of the generator,the mailing address to which the completed manifest signed there is no specific space provided on the manifest,including any alternate facility
<br /> by the designated facility should be mailed,and the generators telephone number. Note,the designations;the manifest tracking number of the original manifest for rejected wastes and
<br /> telephone number(including area code)should be the normal business number for the residues that are re-shipped under a second manifest;and the specification of PCB waste
<br /> generator,or the number where the generator or his authorized agent may be reached to descriptions and PCB out-of-service dates required under 40 CFR 761.207. Generators,
<br /> provide instructions in the event the designated andlor alternate(if any)facility rejects some or however,cannot be required to enter information in this space to meet state regulatory
<br /> all of the shipment. Also enter the physical site address from which the shipment originates requirements.
<br /> only it this address is different than the mailing address. Item 15.Generators/Offemr's Certifications
<br /> Item 6.Transporter 1 Company Name,and U.S.EPA ID Number 1. The generator must read,sign.and date the waste minimization certification statement. In
<br /> Enter the company name and U.S.EPA ID number of the first transporter who will transport the signing the waste minimization certification statement,those generators who have not
<br /> waste. Vehicle or driver information may not be entered here. been exempted by statute or regulation from the duty to make a waste minim¢ation
<br /> Item 7. Transporter 2 Company Name and U.S.EPA ID Number certification under section 3002(b)of RCRA are also cenlfying that they have complied
<br /> If applicable,enter the company name and U.S.EPA ID number of the second transporter who with the waste minimization requirements. The Generators Certification also contains the
<br /> will transport the waste. Vehicle or driver information may not be entered here. required attestation that the shipment has been properly prepared and is in proper
<br /> If more than two transporters are needed,use a Continuation Sheet(s)(EPA Form 8700-22A;. 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 /> Item 8.Designated Facilely Name,Site Address,and U.S.EPA ID Number consignment are fully and accurately described above by the proper shipping name,and
<br /> Enter the company name and site address of the facility designated to receive the waste listed are classified,packaged,marked and labeledlplacarded,and are in all respects in proper
<br /> on this manifest. Also enter the facility's phone number and the U.S.EPA twelve digit condition for transport according to applicable international and national governmental
<br /> identificedon number of the facility. regulations. If export shipment and I am the Primary Exporter,I clrif,that the contents of
<br /> Item 9.U.S.DOT Description(Including Proper Shipping Name,Hazard Class or Division, this consignment conform to the terms of the attached EPA Acknowledgment of Consent."
<br /> Identification Number,and Packing Group) When a parry other than the generator prepares the shipment for transportation,this party
<br /> Item 9a. If the wastes identified in Item gb consist of both hazardous and nonhazardous may also sign the shippers certification statement as the offeror of the shipment.
<br /> materials,then identify the hazardous materials by entering an"X°in this Item next to the 2. Generator or Offeror personnel may preprint the words,'On behalf or in the signature
<br /> corresponding hazardous material identified in Item 9bblock or may hand write this statement in the signature block prior to signing the
<br /> Item 96. Enter the U.S.DOT Proper Shipping Name,Hazard Class or Division,Identification generatodofferor certification,to indicate that the individual signs as the employee or agent
<br /> Number(UN/NA)and Packing Group for each waste as identified in 49 CFR 172. Include of the named principal.
<br /> technical name(s)and reportable quantity references,If applicable. Note: All of the above information except the handwritten signature required in Item 15 may
<br /> Note: If additional space is needed for waste descriptions,enter these additional descriptions be pre-printed.
<br /> in Item 27 on the Continuation Sheet(EPA Forth 8700-22A), Also,it more than one
<br /> Emergency Response phone number applies to the various wastes described in either Item 90
<br /> or Item 27,enter applicable Emergency Response phone numbers immediately following the
<br /> shipping descriptions fur those Items.
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