Attachment 9 - Uniform Hazardous Waste Manifest.pdf
PDF 29 KB Posted
- Attached to
- Hazardous Waste Removal and Disposal Italy
- Solicitation number
- SP450025R0014
- Issued by
-
Defense Logistics Agency
About this file
The document is a Uniform Hazardous Waste Manifest form (EPA Form 8700-22), which is a standard tracking document for the transportation and disposal of hazardous waste. The form is designed to track waste from its point of generation through transportation to its final disposal facility, with spaces for detailed information including generator and transporter details, waste descriptions, container information, and certifications. Key sections include fields for generator and transporter identification, EPA ID numbers, waste classification, container details, special handling instructions, and signatures required at multiple stages of the waste transportation process. The form is approved by the Office of Management and Budget (OMB No. 2050-0039) and is used to ensure proper documentation and accountability in hazardous waste management.
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Text version
Please print or type. Form Approved. OMB No. 2050-0039
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator ID
Number
2. Page 1 of 3. Emergency Response Phone 4. Manifest Tracking Number
5. Generator's Name and Mailing Address Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name U.S. EPA ID Number
7. Transporter 2 Company Name U.S. EPA ID Number
8. Designated Facility Name and Site Address U.S. EPA ID Number
Facility's Phone:
9a.
HM
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, and Packing Group (if any))
1.
2.
3.
4.
10. Containers No. Type
11. Total Quantity
12. Unit 13. Waste Codes Wt./Vol.
14. Special Handling Instructions and Additional Information
15. GENERATOR’S/OFFEROR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Generator's/Offeror's Printed/Typed Name Signature Month Day Year
16. International Shipments Import to U.S. Export from U.S. Port of entry/exit:
Transporter signature (for exports only): Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year
Transporter 2 Printed/Typed Name Signature Month Day Year
18. Discrepancy
18a. Discrepancy Indication Space Quantity Type
Residue
Partial Rejection
Full Rejection
18b. Alternate Facility (or Generator) Manifest Reference Number:
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator) Month Day Year
119. . Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1. 2. 3. 4.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
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| Please print or type. Form Approved. OMB No. 2050-0039 |
| EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. |
File details come from the government source that posted it. Updated .