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U,S. rPA Posh 3700 22 Elate: If additional space N needed for waffle descriptions, mist those, r ldihonal rl-salpi ons <br /> Read all indu ctioris before-, (ninpleftng this; farir in item 27 on MR continuation sheet(EPA f-onti 8700-22A) Also if more Ilion one <br /> 1. Federal regulations require generators and hanspail,ers of hazardous waste anti owners or Emergency Response phone numberapplios to Vie vaumv- wask's de"scido'd In either lien) <br /> operators of iecewhy fat:ilifies designated on the manifest to complete this form (EPA Form 9b of Item 27 Ruler applicable Emergency Response phono numbers (nmaddlely folkwAng <br /> 8700-22)and, if necessary, lire continuation sheet(EPA Fomi 8700-22A)for both frier- the shipping descriptions tot those Items, <br /> and intrastate hransportation of hazardous waste. Item 10. Containers{Nuri berand Type) <br /> 2. This mantled reflects P)rrnaatt:ing c t;ingdes awdo by U.S. EPA in December 2017. Enter the number of containers for each waste and the.aNnopriale abNowation from Table I <br /> Beginning on June 3% 2018, this m nif nt (Revfcion 12-1, must be wed and all (below) for the type of container, <br /> previous editions ore prohihiled. So to 4^dtiN°a epa Motile-fir anifest for additional TABLE I.--TYPES O( CON I AINf (_S <br /> information. BA = Burlap, cloth, papof, or plastic bags_ D A - Dianip truck <br /> 3 This tome must he purchased from a iegistered printer CF = Fiber of plashes boxes, caroms, cases_ DW = Wooden dnalnc barrels kogs. <br /> (hags //www_epta govihwgener Ito I's/app love(I-iogisfcred-pri Ile,rs-e pas-manifest- CM = Metal boxes, cations, gases (including roll- 1-IC, = Hopper at gondola r:ars. <br /> regishytthow) and rats been designed to be filled Drat using slandard compuler printers; a offs). <br /> firm point pen may also he used--press down hard. After June 30, 21 11 this [offer can also CW - Wooden boxes, cartons, ca sus. TC = Tank cars_ <br /> be completed elechonically in I PA's c hJanffes( syslRm. CY = Cylinders_ TP=- Pof Mdo links <br /> The pub C6wrk iWA,,14,V,s f r l 1'r,r at rh i, r{:nrr fur t rOld 205 VriO ri,,ttm laI to aiC,I-It,im m,er,safC1 ?, <br /> DF = FibRiboard or plastic drums, bar els, keys. ILL = Cargo fortes(t<rk t)ticics) <br /> �s rid0i nrr�f i r i rl o� 4 fir r_ar II art ed +S al rcnlh.ttYfwiesL Tlus lea <br /> mandah,r c a C nu LO r40Cii�Rirt<n, 1 bl IP Wl[TPA r Diu d© rl urP, t It rr 12 ,,Smbi rr2E Anx.,y.-n<yaoynot BM — Metal doia s, barrels, kegs. <br /> 4 P <br /> s < d'o ilr rtr d i rri un r rd> i ice di e d0 6r snout win htr.Tir:=condo for,{roll r rid sl rerun is i ntli i i i ( 1 Y Iterrll 11 TOltll(V811trfif <br /> contrrl'd forte hour)be,iuhP ilea ul n' rli:. n,inrd+ r nor �..n;i ul inr faun of n, ,�.cfa.ii rtu�a u,pur trio rc7u alrn Send I <br /> Enter, in designated boxe.,c, the loiol quantity4vastc,of Rofuxl pat teal I mats to Ihr uc>r.ir,-�sl <br /> contmudson lit A}.rice:need for In rnf m�aGorltt r .� of lhri�o, h-:I brad,it>tn I„s,r�. I�i, ern •,t<'xlr xt wd,Lrc nr'n rev nq rt�a(wturpni <br /> rrtidcn, ndy,og VIeusarieM0es,lr,mrrrr leri,CowVAshyoeM lo ,usenv,,,mranlPr„o<> ,rn,;Nn<yfzozzn.anlc � what(-unit, and do not an lei dedrnsIsorIfacirons. To (Ito Rxiotit[if; ctical, r spot icnaanidirs <br /> PamsownwAvo ri.J l,a vAn DC; ,M& I I m AGO Bw Odfl control no > rt „rip fore «uml=rxz.Un NOr we rid thn catnpret dnxnnitest � USlfig appropriate nniis 01 IY1P.a SUfe tilt-0t VJIII a1101hr y0U t(a IPpUIt gllantltlBS wltfr pleCly?lar. �I <br /> ernes in Nils adder ss Pm.^ryfrl.r and :;on o i ,u/:,ern., .v n (-•Rent ror/4n+.a:(r,gernnaxisk r 1P�:v'.mmlq lrlw f6rah!a Waste tluanhfies entered should be Moral on actual nw asuren oairR of wasonably actunle <br /> InAvmston(Pllar CurhJerrh71 t1uurrs,lid to s1 ,1(Hl) I <br /> _ _ ___ — _ estimates of actual quantities shipped. Conituner c Ipautl sera not rircepfable n.7 ca�;tunafes. <br /> t Ilt: iis�+titter(] tear t suoirator r l em 12, Orils ofrMerasure (Weighi/Volunie) <br /> Ifern 1. Genciaitn s 11 S EPA Jdentilu:atloa Number Enter, in designated boxes the appropriate abbroviatian from Table II ( mkm) for the unit of <br /> Enter [he goneratoi's U.S. FPA twelve-digit identification ni-mlber, or the state generator measure <br /> identification number if hie ycaRiritor�aite loos not have an Fs'A identification number. TABLE II--UPiII I S OF IviLASURE <br /> Rein 2 Page 1 of G= Gallons (liquids only). N = Cubic Mf,lerfi. <br /> Enter the total nundmi of palls used In nmaplcle This orvidesi (i.e_, the his)page (FFA Form I( = Kilograms. P Pounds <br /> 870012)plus fire mother of cotaker alvai AwRis (FI'A Four fd 00-22A), if any). L = Liters(liquids only). T - Tons(2000 PmYals)_ 1 <br /> Item 3 Emergency Response Phonic Number M =Maine Tons (1000 kilograms) y= Cubic Yards. <br /> Enter a phone number [tar winch emcrg aIwy rasponno infofnWhon can be obi anted in the event Note: Tons, Metric;Tons, Cubic Meters, and(101t;Yards should only be repelled for very <br /> of an mordent chung tat n gvildo pan. I tics c~~uergency iosponse phone nuinhot mut;L large bulk shipments, such as fad ears, tank hicks, or barges. i <br /> 1 Bo the rumhor of he(]sari+ askx of Ire nuarfa n of an agency or organizalion who is Ifern 13 Waste Codes <br /> capable of and aconpis ies1wrisMilily toe pro"ON1 tboiWd u)larmahon about the Enter up to six federal and state waste codes to descoho. (tali wanto shoran ulenlihed in item <br /> shipment; 9b. State waste codes that are not redundant write fedr r<d codes nalsi be enh Ic d here, in <br /> 2. Reach a phone firm is monitored 24 hot n; a day N all Mines foe waste is in transportation addition to the federal waste codes which are niosf repfesenlakife of Ilia proliel ties of fire <br /> Qhrluduag riansportaivan related sfofago) fill(] wa le. <br /> it Reach sonaaulo who as Rather kIIowlcdgetble of rho I NA aldous+n+asfe fining Ad Wed and item 14. Special Handling luslui:lions and liddifionai Inrorraaiion <br /> Ian-: Cori 1pfehel)Siva oweigm KI"Zporse anal spIll deala rshf idmit II ayrition Inlonwheri Genera ims in ay/er ka any special handling or duldrocid .: onitc inf0nir-dam 1 rlet t;fsi gal i <br /> I f 1 r Icy I I� , <br /> for rho material being shi,ap„d of tier rmiuedirale, a class io t person who has that knowledge for ilia proper management 01 hacking of Iho materials under the gMnenitar's of otter/ <br /> and infrnmation about fire <,lupment- handler's business processes, side as iv ash profile numbers container codes, Pear <br /> Note: Emoigency Response phone ouinber infoini sir eW only be entered in hem 3 when code:,Ur response guide numbers_ Generniors also may use dins space to oohei <br /> there is orla phone number that opplie s if) all the wasto uIalmials described in Has)91). It a additional desciptive infounatron about[hear shipped imdeii is swD no; diotnic;al <br /> sdualion (ri.q., inmooLdalud ..il rooms) au ,es where more than one Emmgm cy Response name > cure.lucent olceufaide,, c"ate of s uocifY crraint i of wastes fdtt I;idmd <br /> phone number ,applies fo the vniOus wastes listed an fire n)anifesl, 1ho phone numbers 'ol i physical 6 ) <br /> assoeialed wratia each specific material should he mil(ned after d. dn'scrIlAlon In Rena 91) <br /> evifh voliune units in IkcSfn 12 <br /> Item 3, Manifest rrackhal N+arnbrat 2 f his space may be toed uie <br /> ioovided oil the u)on <br /> nand)united types of kahs ally rttqu���rf infooli Idol ;0) WWII <br /> c +s Ito.,p.ctfic space xr`est, l rebri rnf t oahemair i Vily <br /> This unique hacking mini mu:,t be pee llrinied all the rnanifesf by fbe tarns punier. haei <br /> doggluA one;, the rumlifest k adup number of the onge)al nratado<si fat felccic�d wardus <br /> Ifern 5. Generator's Mailing Addeess, Phono Number anal Sil�Acirlress and residues that are re-shipped orator a e acond msndost; and rho �.pccihcait m of <br /> Enter (tie name of ;lu,gencrati,f, the imAng address In which the conapletad mandest signed palychlolinated biphenyl (PCB)waste de5utphors and PGB out of-servkf dratr: requirhfd <br /> by the designated facility should he rnadad, and Hie ganeralor's felophone natural. Note, the under ai0 CFR 7G1 207 Generators, howevci, c annof oc:f('quai('It to enter iufol mollon al ' <br /> telephone number (uacludul area code) should be the normal business nirmber for the His space la meet date togulaloay requirer earls <br /> generatnq or ilia imnilror whole hoe genefalof or tere, rfulhorizod agent turfy be reached to Rent i5. Gereraloi'ra/Ofremr s God f`icaliows <br /> pfovide im,,h aclions In fire event tit(, desliflol;ad and/or nlhimade (iR any) facility reject., some of I I he generator nusl lead ago and (]fate the wasic mouilu,ration ceaiiric:tauon sl,ar fiom o Ili <br /> all of the ahipurml Also enter lire phrK el she address from which the sNp iferh oiUmatui J a <br /> signing file VJaSte IIIIIIIIl1lZa ban i( iht R811011 31a 19frlenl Ill );E`fir fa!'I liUl;:;`dll(i hot.(:? Ilol E <br /> only if than address is dif(erentthan hoe nralh ig address. been exempted by afaudo or rogulAtiun hofn trio duty to look(- a fvn de' nainan i/AiC a <br /> Ilem (i Transporter I ( omptany Nrlrnra, .anal II S, EPA Ill Nunihel codlhcalion wide sedum 3002(b) of RCRA are also certifying Had 11 ,y Now omildisd <br /> Enter the cofnpany irmie oriel U S Uls, II; Iuariabci of the hilt liansportel who will Unspodlhe ddh the waste naininw;)irorr reouireurenis_ The Generator's Gefhiutsfion ,duo unr(<-rills fire <br /> waste.VeNde of duvet inkmK hen nitai; net be enceied here- ice il"Ind ahestrldon that Hie shapmenl has beers propamly ptepraed rand is fir pi lvA <br /> Rem 7 Transporer?(,ant any Name and 0 S. EPA ID Nr reN cnndillon lot «anspod arm l (the d1l)RIc,r's c aruticafirnt) The (smin r of thn :rapt ei's <br /> If applicable, enter the comp illy town and U.S. EPA ID number of the Record hansportei certification .element is as ioilrnrs: "i heteby declare that Ihaa mnit:rts of This <br /> avhowill h opent Rhe. vhasle Vc to do of (Inver in terlalia ) may not be eufcled her(', err:; fully mid accivalely des�Ahod above by the prof �l ;hipp lrg ra aaH, ofal <br /> It trial(,, (Iran two hanWorlms rite macA d use it Nadi ualioH sheehI (LPA Foma 870(1-22A) ale classified, padfabod, marked and hVelodrplanlood, _and no; in tali te.},clefs al p tlito <br /> Rem if Desrcnaled Facility Alamo Site Adi'rl. , and 0 S. EPA ID Number condition for hanspor f according to applicable uNWA or a d anu Irrilonra) ifl,vnninaetaial <br /> Enter Hie cone ani n,amo rand site arld"m, ,of Me fnc,drb chase ntl;acl to receive fire waste; listed togcdal oim R expoit sin{eta id oral I out the Pnmaiy I x , im, I l.ctilify Uwl ihn ua donlri, oa' <br /> I / l .I � <br /> on this manifest Also enicf the fmAily's pfuma n rntm! and ire tl.S_ EPA twelve-digit dw;corlsagrmenl conforna to the ierms of the ahached LPA Aclmol+blyg id of C{ omit " <br /> Identification nunibm at the facility. When a party ohiof ;bran Hiroo gc rorator paopmes the Alip"Od lei l+frn.pouratuna, hoc party 4 <br /> Item 9 U.I� Do/ DP,cdrjrioo (Inchloi q Probe Shippi,lg ,';lame. Mefferd Class w Division, nary also Agn the shp or's irw uric )ham s,lsiefnmh on fire;offeror of the shipment. <br /> Ideniiflcalion Number said Psckarq Group) 2. Generator of Offe.for pInr onncl inay prepalni the Moors On hf-M all of in the crgnahare <br /> Ifern 9a. If 6ae wastes, idc,ati al in lien, T) 1 lal,sisl of both harird0us and nonhazardous block or inay hand,Mute this sii-foment Ill Inca tiagnaltae t,Icu:;i trim[ tfi sign tut the <br /> rnatenals, Then idenhhy 'ua haz auto u m tmbils by emoting tan ' {° in f1)is Item next to MR <br /> geri=,fafof/offeror ceruficahon to rdictale tool Mr iIrdiswutal steno on, lilt; ; nployee ur <br /> corresponding hazarclou ; iia heird uienhhixf an ( cm 9b agent of lire named pro)rifval <br /> Note: All of Rho ,.above infottnation except the Imi-dwntfen satJrahmn •ngmaed in Hein 15 may fir <br /> Item in) I nte;r Hie ILL C. DO�f f fotu,i .;latp[mal,t Fd,err ,,, I laztard Clas car Javision, Icienlifeation l <br /> I Nurnhei Ufdli"�,iA and !'alski,lJ t;rou! iu1> tact) v;rra sac, a., irienhhcaltit 141 (FIR ?ari '17?. Inchade pre-printed. (I-hiudwrihen rgn;dures rue not applicable if Rio gammurni is luep,ou ,y ;Q ,tgnirltl i <br /> { ) I an olectronic mafufosf uefng EPA's a Manifest system } <br /> technicaa naraae(s) mid fepo)tahfe quanfn�i r,:ferenl e;� if apphcn ,le <br /> i <br /> 4 <br /> i <br /> t <br /> s <br />