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U.S.EPA Form 8700-22 Note:If additional space is needed for waste descriptions,enter these additional descriptions
<br /> Read all instructions before completing this form. in Item 27 on the continuation sheet(EPA Form 8700-22A).Also,if more than one
<br /> 1. Federal regulations require generators and transporters of hazardous waste and owners or Emergency Response phone number applies to the various wastes described in either Item
<br /> operators of receiving facilities designated on the manifest to complete this form(EPA Form 9b or Item 27,enter applicable Emergency Response phone numbers immediately following
<br /> 8700-22)and,if necessary,the continuation sheet(EPA Form 8700-22A)for both inter- the shipping descriptions for those Items.
<br /> and intrastate transportation of hazardous waste. Item 10.Containers(Number and Type)
<br /> 2. This manifest reflects formatting changes made by U.S.EPA in December 2017. Enter the number of containers for each waste and the appropriate abbreviation from Table I
<br /> Beginning on June 30,2018,this manifest(Revision 12.17)must be used and all (below)for the type of container.
<br /> previous editions are prohibited.Go to www.epa.gov/e-manifest for additional TABLE I.--TYPES OF CONTAINERS
<br /> information. BA=Burlap,cloth,paper,or plastic bags. DT=Dump truck.
<br /> 3. This form must be purchased from a registered printer CF=Fiber or plastic boxes,cartons,cases. DW=Wooden drums,barrels,kegs.
<br /> (https://www.epa.govihwgeneratorsiapproved-registered-printers-epas-manifest- CM=Metal boxes,cartons,cases(including roll- HG=Hopper or gondola cars.
<br /> registry#how)and has been designed to be filled out using standard computer printers;a offs).
<br /> firm point pen may also be used-press down hard.After June 30,2018,this form can also CW=Wooden boxes,cartons,cases. TC=Tank cars.
<br /> be completed electronically in EPA's e-Manifest system. CY=Cylinders. TP=Portable tanks.
<br /> The public burden related to the Uniform Hazardous Waste Manifest,which is approved under OMB 2050-0039,is estimated to average(per manifest)60 DF=Fiberboard or plastic drums,barrels,kegs. TT=Cargo tanks(tank trucks).
<br /> minutes for generators;20 minutes for transporters;and 30 minutes for owners and operators of receiving facilities designated on the manifest.This is a
<br /> mandatory collection under 40 CFR Part 262,Subpart B,40 CFR Part 263,Subpart B,and 40 CFR Parts 264 and 265,Subpart E.An agency may not DM=Metal drums,barrels,kegs.
<br /> I conduct or sponsor,and a person is not required to respond to,a collection of information unless it displays a currently valid OMB control number.The Item 11.Total Quantity
<br /> ' completed form should be submitted in accordance with the instructions accompanying the form,or as specified in the corresponding regulation.Send Enter,in designated boxes,the total quantity of waste.Round partial units to the nearest
<br /> comments on the Agency's need for this information,the accuracy of the provided burden estimates,and any suggested methods for minimizing respondent
<br /> burden,including through the use of a-Manifest,to the Director,Collection Strategies Division,U.S.Environmental Protection Agency(2822T),1200 whole unit,and do not enter decimals or fractions.To the extent practical,report quantities
<br /> Pennsylvania Ave.,NW,Washington,D.C.20460.Please include the OMB control number in any correspondence.Do NOT send the completed manifest using appropriate units of measure that Will allow you to report quantities with precision.
<br /> forms to this address.Privacy Act Statement-None ofthe information collected under the Manifest Program is considered Personallyldentifiable Waste quantities entered should be based on actual measurements or reasonably accurate
<br /> Information(Pit)er ConfidentielBesineaslnformation(CBI). estimates of actual quantities shipped.Container capacities are not acceptable as estimates.
<br /> I.Instructions for Generators Item 12.Units of Measure(WeighWolume)
<br /> Item 1.Generator's U.S.EPA Identification Number Enter,in designated boxes,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 does not have an EPA identification number. TABLE II.--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 this 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). L=Liters(liquids only). T=Tons(2000 Pounds).
<br /> Item 3.Emergency Response Phone Number M=Metric Tons(1000 kilograms). Y=Cubic Yards.
<br /> Enter a phone number for which emergency response information can be obtained in the event Note:Tons,Metric 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 bulk 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 six federal and state waste codes to describe each waste stream identified in Item
<br /> shipment; 9b.State 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 the waste is in transportation 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 Information
<br /> has comprehensive emergency response and spill cleanup/incident mitigation information 1. Generators may enter any special handling or shipment-specific information necessary
<br /> for the material being shipped or has immediate access to a person who has that knowledge for the proper management or tracking of the materials under the generator's or other
<br /> and information about the shipment. handler's business processes,such as waste profile numbers,container codes,bar
<br /> Note:Emergency Response phone number information should o6ly be entered in Item 3 when codes,or response guide numbers.Generators also may use this space to enter
<br /> there is one phone number that applies to all the waste materials described in Item 9b.If a additional descriptive information about their shipped materials,such as chemical
<br /> situation(e.g.,consolidated shipments)arises where more than one Emergency Response names,constituent percentages,physical state,or specific gravity of wastes identified
<br /> phone number applies to the various wastes listed on the manifest,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 types of federally required information for which
<br /> Item 4.Manifest Tracking Number there is no specific space provided on the manifest,including any alternate facility
<br /> This unique tracking number must be pre-printed on the manifest by the forms printer. designations;the 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 the specification of
<br /> Enter the name of the generator,the mailing address to which the completed manifest signed polychlorinated biphenyl(PCB)waste descriptions and PCB out-of-service dates required
<br /> by the designated facility should be mailed,and the generator's telephone number.Note,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 may be reached to Item 15.GeneratorslOfferor's Certifications
<br /> provide instructions in the event the designated and/or alternate(if any)facility rejects some or 1.The generator must read,sign,and date the waste minimization certification statement.In
<br /> all of the shipment.Also enter the physical site address from which the shipment originates signing the waste minimization certification statement,those generators who have not
<br /> only if this address is different than the mailing address. been exempted by statute or regulation from the duty to make a waste minimization
<br /> Item 6.Transporter 1 Company Name,and U.S.EPA ID Number certification under section 3002(b)of RCRA are also certifying that they have complied
<br /> Enter the company name and U.S.EPA ID number of the first transporter who will transport the with the waste minimization requirements.The Generator's Certification also contains the
<br /> waste.Vehicle or driver information may not be entered here. required attestation that the shipment has been properly prepared and is in proper
<br /> Item 7.Transporter 2 Company Name and U.S.EPA ID Number condition for transportation(the shipper's certification).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 driver information may not be entered here. consignment are fully and accurately 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 labeled/placarded,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 and national governmental
<br /> Enter the company name and site address of the facility designated to receive the waste listed regulations.If export shipment and I 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 the shipment for transportation,this party
<br /> Item 9.U.S.DOT Description(Including Proper Shipping Name,Hazard Class or Division, may also sign the shipper's certification statement as the offeror of the shipment.
<br /> Identification Number,and Packing Group) 2. Generator or Offeror personnel may preprint the words,"On behalf of in the signature
<br /> Item ga.If the wastes identified in Item 9b consist of both hazardous and nonhazardous block or may hand write this statement in the signature block prior to signing the
<br /> materials,then identify the hazardous materials by entering an"X"in this Item next to the generator/offeror certification,to indicate that the individual signs as the employee or
<br /> corresponding hazardous material identified in Item 9b. agent of the named principal.
<br /> Item 9b.Enter the U.S.DOT Proper Shipping Name,Hazard Class or Division,Identification Note:All of the above information except the handwritten signature required in Item 15 may be
<br /> Number(UN/NA)and Packing Group for each waste as identified in 49 CFR part 172.Include pre-printed.(Handwritten signatures are not applicable if the generator is preparing and signing
<br /> technical name(s)and reportable quantity references,if applicable. an electronic manifest using EPA's e-Manifest system.)
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