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U.S. EPA Forrr
<br />8700-22 Item 10. Containers(Number—d Type!
<br />Read all 'nsiractioss before completing this fowl.
<br />Enter the number of cont for each waste and the appropriate abbreviation frorn Tab e '
<br />This form h:iis yeen designed for use on a 12-pito
<br />i !elite; I,__whter which is also compatible (below) for the type of -Vonrarter.
<br />viith standard comp-,ter painters: a fir nh po rt pen'
<br />nay also be used—press dawn. hard. TABLE 1,-TYPES OF CONTAINERS
<br />Fedora regatations require generators and trap
<br />crers of hazardous waste and owners or BA = Burlap, cloth, paper, Or plastic bags. DT = Dump truck.
<br />operators o' hazardous .vaste treatment, storage,
<br />*NA Porm 8700-22) aro, ii necessary, the conti
<br />and disposal facilities to complete this form CF = Fiber or plastic boxes, cartons, cases DW = Wooeer. drum, barrels, kegs.
<br />Ovation sheet (EPA Form 8700-22A) for
<br />60th irtcr ar:d intrastate transportatitin of hazard
<br />CM = hiatal boxes, cartons, cases (includingHG = Ho
<br />Hopper or gorrn;a cars.
<br />us waste. _ roll-offs).
<br />Public renortn by oeit ie• th iq coliectloi. of Into rmetic n it: cls I
<br />_ _
<br />tmargin :o average: 3a nnnuies for generators, f0 I CW = Wooden boxes, cartons, cases. TC = Tarr; ;ars.
<br />ninnies t::r tinac;:iters, and .i minutes to- cw ttr3 a operators
<br />irolades':^•,e for raviawi ;g instructions. gathor:rg dam corn
<br />o' Iron vera storage. and dfargert rglots,1 This CY = Cylinders TP _ Portable tanks.
<br />eling. revietvins and transmitting the fore. Any DF =Fiberboard or plastic drums, barrels, kegs. TT =Cargo tanks (tank trucks).
<br />: C?°rCSnCn'rer ;e: ;asa-di�ic the PRA ourden stowreni for the
<br />DM
<br />nandst emust be sent to the Director of the Collection =Metal drums, barrels. kegs.
<br />St:otagies Dry s'a� in -r-.-. C'rce rl-lnformaticr Colrecriona
<br />' P+otac',or•Al,
<br />I Ure founding address U.S. Envirormentai I Item 11. Total Quantity
<br />i,: r28r" .; :Pennsylvania Ave.. NW.. w-
<br />- ,_ . _
<br />;h;ngton. DC 2g46i1. Do nal send 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 extern practical, report
<br />I. Instructions for
<br />quantities
<br />eneraors using appropriate units of measure that will allow you to report quantities w'ti i precision.
<br />'tem f. Gen ra -A idaniifrcation Number
<br />Waste quantities entered should be based on actual measurements or reasonably accurate
<br />Enter the gerc Mors U.S. EPA Nveive digit idertifmatiOn
<br />estimates of actual quantities shipped. Container capacities are not acceptable a; ,stimates.
<br />number, or the State9 enerator
<br />identificstcr number if the generator site does not
<br />have an EPA identi9cation mber. Item 12. Units ofMeasure (V✓er'ghWofume)
<br />Item 2. Page f of'_
<br />Enter, in designated boxes, the appropriate 3bbreviatlor, from Table t! (belo;v) for th,? I , o`
<br />Enter the total number of pages used to co rplete
<br />measure.
<br />his Manifest (i.e., the first (EPA Form
<br />8700.22) plus the number of Continuation Shears
<br />page
<br />TABLE If.-UNITS OF MEASURE
<br />EPA Form 8700-22A), if any'),
<br />item 3. Emergencv Response Phone Number
<br />G = Gallons (liquids only). N = Cubic Meters.
<br />Eater a phone number for vi rich emergency respo
<br />incident
<br />K = Kilograms. P = Pounds.
<br />tse information can be obtained in the event L = Liters (liquids orly). T = Tons (2000 Pounds),
<br />of an durng transportation. The emergen
<br />y response phone number must: M = Metric Tons (1000 kilograms). Y = Cubic Yards.
<br />1. Bs the number of the generator or the number
<br />fan agency or organization who is capable
<br />of and accepts resporsibiiity for prov'ding detail
<br />information about the shipment; Note: Tans, Metric Tons, Cubic Meters, and Cubic Yards should only be reported if
<br />2. Reach a phone that is monitored 24 hours a da'
<br />at ail times she waste is in Ransportation connection with very large bulk shipments such as rail; cars, tank tr,.cks or :ages
<br />(!nc,u0ing transportation -elated storage): and
<br />item 13. Waste Codes
<br />3. Reach someone who Is either knowledgeable ol
<br />the hazardous waste being shipped and Enter up to six federai and state waste codes to describe each waste stream identtfieo in Itsir
<br />has comprehensive emergency response ands
<br />ill cleanuplincident mitigation information 9b. State waste cooes that are not redundant with federal codes must be entered he: e, in
<br />forth* material being shipped or has immediate
<br />access to a person who has that knowledge addition to the federal waste codes which are most representative of the properties of the
<br />are information about the shipment.
<br />waste,
<br />Note: Emergency Response phone cumber mormation
<br />should only be entered in Item 3 when Item 14. Special Handfing Instructions and Additional Infomtator
<br />there s ane phone number that applies to al' ft�fhe w�
<br />sie materials described in item 9b. If a 1 Generators may enter any special handling or shipment-specific information necessary for
<br />situation (e.g, consolidated shipments; arises when
<br />.mere than one Emergency Response he proper management or tracking of the materials under the generator's or Maher
<br />~hone number appiies to the various v;as'es listed
<br />n the manifest, the phone numbers handler's ousiness processes, such as waste profile numbers, ceriarrer codes bar
<br />associated 7411 Each specific materiai should be en
<br />cedes
<br />.red after its description in Item 9b. or response guide numbers. Generators also may use this space to enter addit+ania;
<br />ifstn 4 Manifest Tracking Number
<br />descriptive info.rmaton about their shipped materials, suc`� as chemical names, ccnstlmert;
<br />This un•cue tracking number must be pre-p^rued on
<br />the manifest by the forms printer. percentages, physics! state or specific gravity of wastes identified with volume urlls +:
<br />item .5 Ge;lerelor r: Mafln5 address. Phone Number di
<br />ld Site Address Item 12.
<br />Enter ilia nam pf the generator, the mailing adores
<br />by the designated facility would
<br />la which the Com lefed manifest signed 2. This space may be used o record limited types of federally required information to which
<br />thee is no specific space idedon the manifest,
<br />be mailed and the
<br />telephone number (incudi:hg area code) should be 1e
<br />Including any faciiily
<br />enerator's telephone number. Note, the d signations; the manifest tracking
<br />numbe of te original ma ifest for rejected wastes and
<br />normal business
<br />generator, or the number where the generator or his
<br />number for the residues that are re-shipped under a second manifest: and the specifica5on of FCB Aw:3ste
<br />authorized agent may be reached to
<br />provide in iructions in the eventthedesignated and,
<br />descriptions and PCB out-ot-service dates required under 40 CFR 761207. Generators,
<br />r alternate (if any) Facility rejects some or
<br />al! of fhe s .iplrent. Also enter the physical site add
<br />however, cannot be, equired to enter information ;n this space ,n meet sl ; ; r
<br />ss from which the shipment originates p a c PwL into, y
<br />only if this address is different than the mailing address.
<br />requirements.
<br />Item 6. r~ansp-id4 I 1 ComparyName, and U.S. EPA If
<br />I Number Item 15. Generator'siOfrerors CerliftalionS
<br />Enter the aampany name and U S. EPA ID number
<br />The generator st read, sign, and date t
<br />the first transporter who will transport the t s
<br />he waste nhose `geneion t ,
<br />waste. iehlce or driv:;r intormation may not be ante
<br />signing the wastecminimization certification statement. e tc, s who havame
<br />ed here,
<br />Iter 7. Transpertor' 2 Company tJamF and U.S. EPA ID
<br />been exempted by statute or regulation Tom the duly to make a waste rninimizatipn
<br />Plumber'TOMunder
<br />if appiiracla. ester lf:e company flame and U.S. EPA.
<br />vin, tianscott
<br />section 3002(b) of RCRA are also certifying that they nave compued
<br />ID number of the second transporter wro with the waste minimization, requirements. The Generators Certification also
<br />the v'.'aste. Vehicle or dnver information
<br />tf
<br />contains the
<br />may not be entered here, required attestation that the shipment has been properly prepared ane is in
<br />more than two transporters are needed, use a Cciit
<br />proper
<br />nuation Sheet(s) (EPA Form 8700-22A). condition for transportation (the shipper's certification). The con',er,l of the slippers
<br />Item t'. Desigriat3o Fad?,ty,Name, Ste Address, and U.
<br />. EPA ID Number certification statement is as follows: "! hereby declare that the contents of tris
<br />Enter ilii .oropany name and sire address of the fon i
<br />pits manifest. enter the fac,lity's phone numb
<br />g r t: designated hated to receive the waste consignment are fully and accurately described above by the proper shippi-g name, and
<br />listed are classified, packaged, marked and labeledlplaearded, and are in all respects ill proper
<br />rand the U.S. EPA twelve digit
<br />id bpro
<br />identifi;.a`icr rn,mbpr ,^,`the fa;.iiil,;.
<br />condition for transport according to applicable international and national cc:vema,enta!
<br />Item 9. U.S. DCT ,Dtsr�;r,,.on O'ncludirg Prclper ShiPPing
<br />Par.imber
<br />regJ
<br />lations, it export shipment and I am the Primary Expoler I cerffy thst
<br />rVame,. Hazard Class or D;viSior,, this ucons consignment conform o the terms he ' of
<br />.identification and Paclvrg Group)
<br />of attached EPA Acknow!e.dgma Co sen';'
<br />When a party other than the generator the
<br />item. 9a. If the wastes idenlaieo in Item 90 a;nsist of
<br />a
<br />prenares shipment
<br />: _nt for tlfs earty
<br />th hazardous and nonhazardous may also sign the st•inper's cer>ficatior, statement as the
<br />y r
<br />materials.
<br />s there igen aft' fhe hazardous malei is by en
<br />crnesnonding hazardous
<br />e f the shipment
<br />offeror of !tie shipment.
<br />ring a "X" in this Item next to the 2. Generator or Offe yr personnel may preprint the "On
<br />material identified In item 3
<br />ftem
<br />words, behalf of in the signature
<br />. block or may hand write lhs statement in he signatara block
<br />96. Enter the U.S. DGT Proper Shipping Name,
<br />Number fUIV/NA) and Packing Group for each
<br />prior to signing the
<br />azard Class or Division, Identification generator,offeror certification, to indicate that he individual signs as the employee a a tent
<br />waste as
<br />teohnical name(s) and reportable quantity re`erarr.,e:,
<br />identified In 49 CFR 172. Include of the ~tamed principal.
<br />f
<br />Note: itadditiona. space Is needed for v,aste descriptl
<br />atcabie.
<br />ppl Note: All of the above information except the handwritten signature required in iter: 15 'Trap
<br />ns. enter these be
<br />in !tem 27 on tris Ccnf;^uatior, Shisel (EPA Form8700
<br />addiforal descriptons pre-printed.
<br />22A), Also. !f more than one
<br />Frnerganc. F.es err*ie ch cite number aupiies to the va
<br />u' :lPm ?; 'ntsl at:.: i'can a cmm&n`v Respons�
<br />tons wastes described in either item 9b
<br />„,hc
<br />s!,ippiau uesr;r:pr;r,fs for those items
<br />e ~,umbers immeciately following the
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