Attachment 16 - HW Manifest Continuation Sheet.pdf

PDF 25 KB Posted

Attached to
Azores Hazardous Waste Removal Federal contract opportunity
Solicitation number
SP450025R0001
Issued by
Defense Logistics Agency

About this file

This is EPA Form 8700-22A, a Uniform Hazardous Waste Manifest continuation sheet used for documenting the transportation and disposal of hazardous waste materials.

The form includes fields for recording essential information such as the generator's name and ID number, transporter company details with EPA ID numbers, DOT descriptions of hazardous materials, container quantities and types, waste codes, and special handling instructions. It also contains sections for transporter acknowledgment signatures and dates, discrepancy reporting, and hazardous waste management method codes. This appears to be a blank template form that would be used to track hazardous waste shipments related to the Azores Hazardous Waste Removal contract opportunity.

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Text version

Please print or type. Form Approved. OMB No. 2050-0039

UNIFORM HAZARDOUS WASTE MANIFEST

(Continuation Sheet)

24. Generator's Name

25. Transporter Company Name

21. Generator ID Number 22. Page 23. Manifest Tracking Number

U.S. EPA ID Number

26. Transporter Company Name U.S. EPA ID Number

27a.

HM

27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, and Packing Group (if any))

28. Containers No. Type

29. Total Quantity

30. Unit Wt./Vol.

31. Waste Codes

32. Special Handling Instructions and Additional Information

33. Transporter Acknowledgment of Receipt of Materials Printed/Typed Name Signature Month Day Year

34. Transporter Acknowledgment of Receipt of Materials Printed/Typed Name Signature Month Day Year

35. Discrepancy

36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM

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File details come from the government source that posted it. Updated .