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U,S.EPA Form 8700.22 dote:If additional space is naed0ti for waste descriptions,enter thl additional descriptions
<br /> Read all instructions before completing this form. in Item 27 on the continuation sheet(FPA Form 8700-22A) Also,if more Phan one
<br /> 1. Federal regulations require..generators and transporters of hazardous waste and owners or emergency Response pitons number applies to the various wastes described h ei#her flem
<br /> aPeratgrs of raegaiving faciliilas desl nl n e manifest to complete'this forma(EPA Form 9b or Item 27,enter applicable Emergency Response phone numbers Immediately following
<br /> if7Ut 22}rand,iijneCessary;trio cortIinua o eat(EPA Form 8700--22A)far both inter-' the shipping descriptiaiis forihosa items.
<br /> _. " Item 10.Contalrror5 Number and T e
<br /> and intrastate transportation u#hazardous waster - � { Ye. }
<br /> 2. This manifest reflects formatting changas made by UJ S.EPA In December 2017. Enter the number of containers for each waste and the appropriate abbreviation from Tclble I
<br /> Beginning on Juice 30,2018;til€ .inaniFest{Revision 12.17)must he used and all (below)for the type of container.
<br /> previous editions are prohibited.Go to wwww.epa.govle-manifest for additional TABLE I.--TYPES OF CONTAINERS '
<br /> information; BA=13urlap,doth,paper,or plastic bags. DT=Dfimp truck.
<br /> 3. This form must be purchased from a registered printer CF=Fiber or plastic boxes,cartons,rases. DW Wooden drums;barrels,kegs.
<br /> (https:llwww epa:govlhwgeneratorslapproved-registered-printers-epos-manirest- CM=Metal boxes,cartons,cases(including rcil- HG=Hopper or gondola cars.. '
<br /> registry#how}and has been designee)to be filled:Out using standard computer-printers;a offs}:
<br /> finn paint pert may also be used-press dawn hard:After June 20,2018,this form can also CVV=Wooden boxes,cartons,cases. TC=Tank cars,
<br /> be completed electronically in CPA's e-Man[fast system. CY=Cylinders. TP=Portable tanks,
<br /> Fri,B1-1rl hordenrelaledtolhaunirormAazardousWasleManha.LAli ILnSrrr�*e dnfohtR2aro-eoi9,l5o:,>maledto.vrag0(pe,ni,nreet)60 DF-Fiberboard or plastic drtims,barrels,kegs. TT=Cargotanks(tank truel
<br /> I minutes for ganoratorsl W minules for lranspudl and D wr les fol and aperalors ofreratving facilities designated on lila r snffesl.This 4s
<br /> mandator/wliec€Ionunder4aGFR PaA232,Sebpadtl,40f FR Fad 263.S,Apan8,and#9 CFR Perls 2£d and 265,SulrlE.Aaarencymay not
<br /> DM=Metal atoms,barrels,kags.� .
<br /> condccl or sponsor,and a pewee is vol recil to respond to,a col lion ofmfol linless s disµaya a cuneully,valid l mnirolaull This Iters 11.Total Quantity -
<br /> 4coorpleledrormshaeldues�h,nin�a Isar" n,e,,Ilhtha+n,ln,ennn3 ae11rnA9ay,n,the(OMnr a5.perreriinfheeeneepandh9r gulalion-sena Enter,in designated boxes,the Intal quantity of waste.Round partial units to the nearest
<br /> comments an the Agency's need fir lh�s in IonaUl Cho ac urary h
<br /> rihe itMde I hur4ana mtes,aand airy suggestell fnelhoda to mirill lig respondent
<br /> durclan,n¢ludir�thrduglr lheusedt e-4lanffasl.Iq the Oir.lo.,Collac1i9h51rateg�es Cirision,U.S.C-nvironmenlai Profiecliav Agorcyf26221d,12W whole unit,and donot.enterdeclmais or fractions.To the extent practical,report quantifies
<br /> I Pennsylvania Ava.,NW,Washinglan.R,C.29460 usingappropriateunits of measu re that Will allow you to report quantities with praclsdn.
<br /> toms fn fhis address.Privacy Aci slalement-FlonaoRhAin(anrsfion cclfecfeduaderfl,a rdanifesl Progremis consideredPersoaNlyidenlrRa6fa Waste quantities entered should be based on actual measurements or reasonably accurate
<br /> Ufa mhric rPur�rcrnada„alaersrnes nrwmarcen resrr T _.__ estimates of actual quanlitles shipped Container capacities are nut acceptable as estimates.
<br /> I.Instructions for Generators Item 12;Units afMeasrtre(WeighWolcrme)
<br /> Item 1,Generator's U.S.EPA Identification Number Enter,in designated 6
<br /> 4Xe8,the appropriate abbreviation from Table II(below)for the unit of
<br /> Enter the generator's U.S.EPA twelve-digit identification number,or the state generator measure.
<br /> identification number If the generator site class not have an EPA identification number, TABLE ll.--UNITS OF MEASURE
<br /> Item 2.Page 1 of� G=Gallons(liquids only). N=Cubic Meters.
<br /> Enter the total number of pages used to complete[his manifest(i.e.,the first page(EPA Form K=Kilograms. P=Pounds.
<br /> 8700-22)plus the number of continuation sheets(EPA Form 8700-22A),if any), t.=Liters(Ill only). T=Tons(2000 Pounds).
<br /> Item 3,Emergency Response Phone Number M u Metric Tons(1000 kilograms). Y=Cubic Yards,
<br /> Enter a phone number for which;emergency response information can be obta[nad in the event Note:Tons,Metrlc Tons,Cubic Meters,and Cubic Yards should only be reported for very
<br /> of an incident during transportation.The emergency response phone number must: large bulls shipments,such as rail cars,tank trucks,or barges.
<br /> 1. Be the number of the generator or the number of an agency or organization who is Item 13.Waste Codes
<br /> capable of and accepts responsibility for providing detailed information about the Enter up to sly federal and state waste codes to describe each waste stream identified in Item
<br /> shipment; 9b.Slate waste codes that are not redundant with federal codes must be entered here,in
<br /> 2. Reach a phone that is monitored 24 hours a.day at all times tha waste is intransportation addition to the federal waste codes which are most representative of the properties of the
<br /> (including Transportation related storage);and waste.
<br /> 3. Reach someone who is either knowledgeable of the hazardous waste being shipped and Item 14.Special Handling Instructions and Additional lnforivatfoo
<br /> I comprehensive emergency response and spill cleanuplincident mitigation information 1, Generators.mayenter.any special handling or shipment-specific information necessary
<br /> for the material being shipped or has Immediate access to a'pgrsdr who has that Imo'Nledge for tl aproper management or tracking of fl e materials under the generator's or otl7er
<br /> and information about the shlptnent, .:. handlar's business processes;such as waste profile numbers,container codes,bar
<br /> Note:Emergency Response phone Umber information shmId only be entered In Item 3 when codes,or response guide.numbers.Generators also ray use this space to enter
<br /> there is one phone number that applies to all the tiwste materials described in Item 9b,.lf a' additional descriptive.information about their shipped materials,such as chemical
<br /> situation(a.g.;consolidated shipments)arises where more than ono Emergency Response' names,constltuent.painontages,physical state,or specific gravity of wastes identified
<br /> phone number applies to the various wastes listed oil the.manill'i the.phone numbers with volume units in item 12.
<br /> associated with each specific material should be entered after its description in Item 9b. 2. This space may be used to record limited lypas of federally reciu[rad information for which
<br /> Item 4.Manifest Tracking Number there is no p tic space provided on the manifest,including any alternate facility
<br /> This unique lradd ig number rilbe pre-printed on the manifest by ti designations;thee forms printer. manifest tracking number of the original manifest for rejected wastes .
<br /> Item 5.Generator's Mailing Address,Phone Number and,Site Address and residues that are re-shipped under a second manifest,and,lhe specification of
<br /> Enter the name of the-generator,the mailing address to which the completedmanifast signed polychlorinated biphonyl(PCB)waste descriptions and PCB out-of service dates required
<br /> by the designated facility should be mailed,arid the generator's telephone numbar.Nate,the. under 40.CFR 761.207.Generators,however,cannot be required to enter information in
<br /> telephone number(including area code)should be the normal business number for the this space to meet state regulatory requirements.
<br /> generator,or the number where the generator or his authorized agent rriay he reached to . Item 15.Generator's70fferor'3 Certlflcatlons
<br /> provide instructions In the event the designated and/or alternate{if any}facility rejects some or t.The generator must read sign,and date the-waste minimization certification 5tatement.ln
<br /> all of the shipment.Also enter the physical sits address from which the shipment originates signing the waste minimization certification statement,those generators wile have not
<br /> only if this address is different than the mailing address. been exampled b statute or regulation from the dutyto make a waste m€nimization
<br /> _ y g _
<br /> item 6.Transporter 1 Company Namearta I FPA!1J Number cellifcatlan under section 3002(b)of RCRA are also certifying that they have compiled
<br /> Enter the company name and U.S.EPA IFI number of the first transporter who will transport the with the waste minimization requirements.The Generator's Certification also contains the
<br /> If waste.Vehicle or driver Information may rsot be entered"nere. required attestation that the shipment has been properly prepared and is in proper .
<br /> fiern 7.Transporter 2 Company Name and U.S-EPA id Number condition for transportation{the shipper's cedficafien).The content of the shipper's
<br /> If applicable,enter the company name and.U.S.EPA ID number of the second transporter certification statement is as follows:"I hereby declare that the contents of this
<br /> who will transport the waste.Vehicle or drflier infommabon may net be entered hare. consignment are fully and accuralely described above by the proper shipping name,and
<br /> If more than two transporters are needed,use a continuation sheet(s)(EPA Form 8700-22A) are classified,packaged,marked and labeledlplacardod,and are in all respects in proper
<br /> Item 8,Designated Facility Name,Site Address,and U.S.EPA ID Number condition for transport according to applicable international arid national govemmental
<br /> Enter the(:ilrnpany name and site address of the f2cillty designated to receive the waste listed regulations.If export shipment and 1 am the Primary Exporter,i certify that the contents of
<br /> on this manifest,Also enter the facility's phone number and the U.S.EPA twelve-digit this consignment conform to the terms of the attached EPA Acknowledgment of Consent."
<br /> Identification number of the.facility., ._, When a party other than the generator prepares[he shipment for transportation,this party
<br /> Item 9.U.S.DOT Descrlption(Inciuding Proper Shipping Name,Hazard Class or Division, may also sign the shipper'$certification statement as the offeror of the shipment.
<br /> Idenfificafion Number,and Packing Group) 2.'Generator or Offeror personnel may preprint the words,"On behalf of in the signature']
<br /> Item 9a.If the wastes identified in[tern 9b consist of both hazardous and nonhazardous black or may hand write this statement in the signature block prior to signing the
<br /> rnakerials,Then identify the hazardous materials by entering an"X"in this Item next to lila generatorlofferor certification,to indicate that the individual signs as tile.employee or
<br /> corresponding.hazardous material identified in Item 9b. agent of the named principal.
<br /> All of the above information except the hand
<br /> !tarn 9b.Enter the U.S.DOT Proper Shipping Name,Hazard Class or Division,Identification
<br /> Nil All signature required may he
<br /> in Item 15'
<br /> Number f UNINAJ and Packing Group for each waste as identified in 49 OFIR part 172.Include pre-printed.(Handwritten signatures are not applicable if the generator is preparing and signing
<br /> an electronic manifest using EPA's a Manifest system.)
<br /> technlcai name(s)and reportable quantihy references,if applicable.
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