Veolia North America — Hazardous Materials Safety Interpretation

Page 1U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration 1200 New Jersey Avenue, SE Washington, DC 20590 DEC 2 2: 2016 Jennifer Eberle Manager, Transportation Compliance Industrial Business Veolia North America 1 Eden Lane Flanders, NJ 07836 Reference No. 16-0156 Dear Ms. Eberle: This letter is in response to your September 1, 2016, letter requesting clarification of the Hazardous Materials Regulations (HMR; 49 CFR Parts 171-180) applicable to shipping papers. Specifically, you ask whether guidance provided in a letter of interpretation issued February 15, 2011, under Reference No. 10-0262, pertaining to the display of emergency response information in accordance with§ 172.604(a)(3)(ii) is still valid. The answer is yes. It continues to be the opinion of this Office that the placement of the emergency response telephone number and contact information described in Reference No. 10-0262 is consistent with requirements in§ 172.604(a)(3)(ii) and (b)(l). I hope this information is helpful. Please contact us if we can be of further assistance. Sincerely, - T. Glenn Foster Chief, Regulatory Review and Reinvention Branch Standards and Rulemaking Division#

Page 2~~~ ~ I 72. tco<1{w)C1)0) G)veOLIA g~p~ f~ I 0 -6/ s r:::. September 1, 2016 Standards and Rulemaking Division Pipeline and Hazardous Materials Safety Administration Attn: PHH-10 US Department of Transportation East Building 1200 New Jersey Avenue SE. Washington DC 20590-0001 Request for Validity Statement Concerning Interpretation Letter Ref. No 10-0262 To Whom It May Concern: On August 15, 2016, Veolia was issued a violation by an inspector of the Alabama Department of Public Safety, Motor Carrier Safety Unit for improper form and manner of emergency response information on a shipping paper. Specifically, the inspector cited that the manner in which the emergency response information is indicated on the USEPA Uniform Hazardous Waste Manifest is not in conformance with the requirements of 49 CFR §172.604(a)(3)(ii) because it is not prominent, readily identifiable and/ or clearly visible, and is of the same font/size as the rest of the shipping paper. Veolia pursued removal of the violation through the DataQs system and included an interpretation letter (Ref. No 10-0262) indicating that the manner in which Veolia currently displays the emergency response telephone number in Section 3 of the USEPA Uniform Hazardous Waste Manifest is in compliance with the requirements of the Hazardous Materials Regulations. The Alabama Department of Public Safety denied the request and stated the following: "The attachments are old. The violation is found to be correct and the violation to stand as written. The regulations clearly state in 172.604 (a)(3)(ii): Entered once on the shipping paper in the manner prescribed in paragraph (b) of this section in a prominent, readily identifiable, and clearly visible manner that allows the information to be easily and quickly found, such as by highlighting, use of a larger font or a font that is a different color from other text and information, or otherwise setting the information apart to provide for quick and easy recognition. The intent behind the regulations is for a first responder to be able to reasonably and quickly ascertain an Emergency Response Number, your shipping papers do not allow such." Veolia is submitting this letter as request to verify that PHMSA's guidance provided in interpretation letter (Ref. No. 10-0262) is still valid and that the manner in which Veolia is currently indicating the emergency response contact information on the USEPA Uniform Hazardous Waste Manifest is in compliance with the requirements of the Hazardous Materials Regulations. Veolia North America 1 Eden Lane Flanders , NJ 07836 tel 973-691-7331 fax 973-691-3978 www.veolianorthamerica.com#

Page 3Attached for your review is the Driver /Vehicle Examination Report listing the violation identified by the Alabama Department of Public Safety, the associated shipping paper and USDOT Interpretation Letter - Ref. No. 10-0262. Your written response to this request is greatly appreciated. If you require any further information regarding this request please feel free to contact me at jennifer.eberle@veolia. com / 973-691-7331. Thank you, Jennifer Eberle Manager, Transportation Compliance Industrial Business VEOLIA NORTH AMERICA#

Page 4DRIVERNEHICLE EXAMINATION REPORT Aspen 3 0 0. 17 ALABAMA DEPARTMENT OF PUBLIC SAFETY r,mTOR CARRIER SAFETY UNIT PO BOX 1511 MONTGOMERY, AL 36102-1511 Phone: (334)242-4395 Fax: (334)277-3285 Report Number: ALMNOE004532 Inspection Date: 08/15/2016 Start: 01 .37 PM CT End: 2 0720 PM CT Inspection Level: II - Walk-Around HM Inspection Type:Non-Bulk VEOLIA ES TECHl\JICAL SCLu·11ur'J::, Llr.~ 1 EDEN LANE FLANDERS. N.J 0783f) USOOT#: 00609181 ::. 1c; : r,~ x#: 2957:':2 Driver: OWENS, DARWYN K License#: 0520171561810 State: FL Date of Birth: Q5121 /H156 Phone#: (~i. 3)34/- / 111 Fax#: CoDriver: · License#: State: Date of Birth: Location: ROADSIDE MilePost: I Gi. Shipper: .~ ' AM E Highway: 1-65 Origin: MOBI LE. AL Bill of Lading: 000716272VES County: MONTGOMERY, AL Destination :.AUBURN, AL Cargo: CHEMICALS -i !VEHICL E ID~~TIC!C~ ~ i lOtJ· -- 1 Unit ~ Make Year State Plate# Equipment ID ! 1 TR STRG 2001 IL Pt.50144 VIN GVWR CV0 ,\ # CVSA IS&ued # OOS Sticker ! --- I 477521 --- ·- ------ BRAKE ADJUSTMENTS No Brake Measurements Required For Level 2 I VIOLATIONS ---- 2FZHATAK&1 AH48413 53,200 \/1 0 Code 172 6028 Section Unit OOS C1 tat1on # Verify Crash V1 olat1ons Discovered 172.602(b) 1 M N f\J f-orm and manner of Emergency Response 1nformat1on 172.604(a)t3)(11). Emergency Response info not prominent, readily 1dent1f1able and/er clearly v1s 1 ble. sar,1e font/size as rest cf form St<:~ ~#: H~zMat: 3 Fla:r.rn~!:Jl e ; 6. 1 (Pc: s c:~) ; ? (H2zarc!ou-o W?ste) Placard: YPs Cargo Tank: 1 Special ~_!:1 ~~ ks: No Data for Spec;al Checks State Information : Nearest Ci·, r,;:;r·nG0'11 ERY 'Aechanic Certific a:1 on Plea-.e repa11 viclations noted on lh1s report. sign the certification below. and return this report ,·nth1n fifteen 11 5) days to the address at the top of the report Rt·ta.n a ' my at the motor t •rricr's principal place of business or where the vehicle is housed for 12 months from the dale of the inspection. RETURN W ITHIN FIFTEEN ( 15) days by MAIL or e- mail \) : · ; \. SUinfo@dp~ . ai ub ~: rniti gov or FAX to 1.J :,4 )- ~ 71 -3:?85 S1g!"ld ~ UfC :J r :\ 1~ 'm~e r x ____ __________________ Fuc1l1t1 . ____________ Date . _____ _ The undersigned cen1 1 o' that all violations on lh10 report have been corrected and action taken to assure compli ance with the Federal Molar Carner Safety and Hazardous Material Regulal.ons insof,ir as lh<. "e applicable tor ·o'. o· '"·"ers and d11 ve" This cl?rtrfication MUST Bt:. _' '. GNED by the Mo'.o· i...rner and RETURr,ED WITHIN FIFTEEN i 15) days by MAI L or e·ma1I at MCSUinfo @dps.aiabama.gov or FAX to (334)-277-3285. Further .·formatrcn can be found al http ii· ' ".Y alea gov/MC ~·~~r:;i. aJ~:~--=:Jg ~~ ""~ r ~-=-- -"-"·, .. , llJJJJJJ[ll ~Jll lll!l!~~~!l!!~,111111#

Page 5~·· . ll J Ill I Ill II I llll lll~llll llll llllllll Plv,JSt! print or type. (Fann designed for use on elite (12-pitch) typewriter.) U NIFORM HAZARDOUS 1 1. Generator ID Number W ASTE MANIFEST .:. L ?. · : .j j : "! - Form Approved. OMB No. 2050-0039 5. Gcncra"1 ''' Name and M.1ihna Address G en oralo~ s Site Address (if different than mailing address) I ?. Transporter 1 C ~ : n pc iny Name I - ~,..LI " E~ ~.,, .. , ... . , I t. l ~1 :' .. -·' . . ~,... · -l e:: ~· t :. . ~ · ... ~ ..... ... _ ...J~ _1 - L :. ~ · .. } 1. ·, U"" · ·~l '" U.S. EPA ID Number p · ! _ T l) · :• 3 0 ~:. Transporter 2 Com1 "'"' Narnc i·: · 'SHJLD C Afi. ~ --: .: r me U.S. EPA ID Number , ~; j : · ;) s 8 . De;; 1y; -. :. ' "'1 F aci li tyName a nc S 1 : c f\ddrcs~ r·· , - - , 1 ~ 1'·'.' ~ ,. . -. 1_ ;' ;: ; ·- _ l...t l ...' .. ....,._, ; r,_.,. .! . .i. _,.,· ~~ 1-- 11 1 <:" . ~, · n .. 1, . ,. c,· · L·'"' l . --. ,,1,_ ·.Ji. • . U.S. EPA ID Number - , " 9a_ 9b. U .S. DO I L.> .. «;ription (including l'1 «1x:r Shipp:ng Name, tlazattl Class, ID Numbcr, 10. Con~1 i nc1S 1 IM and Packing Grou; . ' any)) No. Typo 11. Total Quantity 12. Unit WINol.. 13. Waste Codes c !·11 4 :} (} " I" 1100: Ui88 DO O! c ; : -- ~ · - · ·" : .. p x UL!UJ D F 1 J ~ ~ x .· .... ~! F ., _ , " . . , _ , !' ' l . • ' 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare ''<,: the contents of lhis •.o ns i~n rn c n l arc fully and aCC\Jmlely descnbed above by lhe proper shipping name, arrl arc classified, packaged, marked and lnbeledlplac;irded, and arc in all respects in proper cm , · '• on for transport accc ":,ng to npplic<1ble intem;ilional and national governmental rcgulalions. If export shipment and t am lhe Primary Exporter, I certify that the contenls of lhis consignment confom1 lo lhi; '""llS of Ille alla~ U ';\ Acknowlcdgmenl of Consent I certify thal lho wasle minimization stalcmenl idcn~fied in 40 CFR 2&? i. ,-; 1\ (if I am a large qu;rnhly 9c11cra1or) or (b) (1f I am a sma~ quantity generator) is true. Generalofs/OHy~O(s, Pri nlcd/Type<rn~mc Signature Month .- , . / /) , _.(} Day Y ear ( l· /(, , / ,·, If<.. / ; ,:·If" 1 I · ! r · 1 -' 16. International Shipments D ._ '··'-· \,V · / ·'_,l( _. A.'/~ I u i:- Import to u s _ 0 Export from U s Port or entry/exit -·- - - --- -- - ----· - - - -- ----- - ~ Transporter signature (fo< cxpor1s only): D;itc leaving U.S.: ffi 17. Transporter Acknowledgment of Receipt of MateriJls l;:: Transporter 1 Printed/Typed Name Y ear ~ DARW'"'!N 01 , 'j ENS f 6 <1)1-:----,,...-.,,..,,.-,...,.."""'-.,..,.,-------------------- ~ Transporter 2 Printed/Typed Name Month D ay Y e ar a: I- I I I p :~ ~ ) 18. Discrepancy f8a. Discrepancy Indication Space 0 Quantity 0Residuc D Partial Rejection 0 Full Rejection 1 Manifest Referena. N H mil<!r' ~ 18b. Ntemale Facility (or Generator) U.S. EPA ID Number :J u ~ Facility's Phone: 5:J~t~ 8c ~.~ S~ig - na -t-u ro-o~fN~l ~ em --, at - e ~ Fa -a~ · 1i ~ty~(o-r~Ge,.-n e -ra ~ tor ....,..)------------------- I I Month I Day Year I ~1------------------------------------ u; 19. Hazattlous Waste Report Management Method Codes (i.e., CQdcs for hazardous waste ~ea t inen t , disposal. and recyr. systems) ~ 1. r l 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifc,;I except as '" ( 1Item 18a Printed/Typed Namo Signature I EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. Month Day Y oar I l I ··1 : \ ,· Ci·1 ~;T;\TE ( iF REQUIRED) ~#

Page 6U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration FEB 1 5 2071 1 200 New Jersey Ave. SE Washington, D.C. 20590 Mr. Tom Baker Director, Environment and Transportation Veolia ES Technical Solutions, L.L.C. 1 Eden Lane Flanders, NJ 07836 Ref. No. 10-0262 Dear Mr. Baker: This responds to your December 14, 2010 letter requesting clarification on emergency response telephone number requirements in§ 172.604 of the Hazardous Materials Regulations (HMR; 49 CFR Parts 171-180). You provide examples of manifests where the generator/offeror is "ABC Company, Inc" while the person registered with the emergency response information provider (ERI provider) for these shipments is a different company, "VESTS". "VESTS" is also the unique identifier assigned by the ERI provider. Specifically, you provide scenarios and ask for verification that they comply with §§ 172.604( a)(3)(ii) and 172.604(b )(2) requirements. Your scenarios are restated as follows: Scenario 1: In the case where the generator/offeror identified on the manifest is also the ERI provider, by entering the emergency response telephone number in Item 3 of the manifest and the generator's/offeror's name in Item 5 of the manifest, you ask if the shipping paper is in compliance with §§ l 72.604(a)(3)(ii) and l 72.604(b )(1) with respect to the display of the emergency information. Scenario 2: In the case where the generator/offeror identified on the manifest is not the person registered with the ERI provider, by entering the emergency response phone number in Item 3 of the manifest and a statement in Item 14 of the manifest identifying the person who is registered with the ERJ provider, you ask if the shipping paper is in compliance with§§ 172.604(a)(3)(ii) and 172.604(b)(2) with respect to the display of the emergency response information. As shown in the two examples of manifests you provide, the placement of the emergency response telephone number and contact information is consistent with requirements in§§ l 72.604(a)(3)(ii) and 172.604(b)(l) for Scenario 1 and§§ l 72.604(a)3)(ii) and 172.604(b)(2) for Scenario 2. I trust this answers your inquiry: If you need additional assistance, please contact this office at 202-3. 66-8553. . . Sincerely, · r , · . (Q,_:;~ Ben~o1 Acting Chief, Standards Development Standards and Rulemaking Division#

Page 7G)veOUA (NVIRONMfNTAl ',(RV!( ( '> December 14, 2010 U.S. DOT PHMSA Office of Hazardous Materials Standards Attn: PHH-10 East Building 1200 New Jersey Avenue S.E. Washington DC 20590-0001 RE : Request for Interpretation Regarding Indicating the ERi Provider on EPA's Uniform Hazardous Waste Manifest To Whom It May Concern: Veolia is requesting guidance from PHMSA regarding the completion of the uniform hazardous waste manifest with respect to compliance with 49 CFR 172.604, the requirements for including the emergency response phone number on shipping papers. Generators of hazardous waste are required to use the uniform hazardous waste manifest, EPA Form 8700-22, when shipping hazardous wastes. US EPA has provided specific instructions for completion of the uniform manifest, including the entering of the emergency response phone number in Item 3 of the form. The instructions for completion of Item 3 of the manifest as referenced in 40 CFR Part 262, Appendix, are as follows: Item 3. Emergency Response Phone Number Enter a phone number for which emergency response information can be obtained in the event of an incident during transportation. The emergency response phone number must: 1. Be the number of the generator or the number of an agency or organization who is capable of and accepts responsibility for providing detailed information about the shipment; 2. Reach a phone that is monitored 24 hours a day at all times the waste is in transportation (including transportation related storage); and 3. Reach someone who is either knowledgeable of the hazardous waste being shipped and has comprehensive emergency response and spill cleanup/incident mitigation information for the material being shipped or has immediate access to a person who has that knowledge and information about the shipment. Veolia ES Technical Solutions, L.L.C. 1 Eden Lane, Flanders, NJ 07836 tom .baker@veoliaes.com (973 ) 691-7330#

Page 8QveouA fNVIRONMrNIAl ',rRVlf<'> Note: Emergency Response phone number information should only be entered in Item 3 when there is one phone number that applies to all the waste materials described in Item 9b. If a situation (e.g. , consolidated shipments) arises where more than one Emergency Response phone number applies to the various wastes listed on the manifest, the phone numbers associated with each specific material should be entered after its description in Item 9b. Below are several questions related to the emergency response phone information when entered on the manifest in accordance with USEPA's instructions and how those entries comply with the PHMSA regulations in 49 CFR 172.604. Please respond in writing as to whether PHMSA is in agreement with the answers provided by Veolia to these questions. Ql) In the case where the generator/offeror identified on the manifest is also the emergency response information provider (ERi provider), by entering the emergency response phone number in Item 3 of the manifest and the generator's/offeror's name in Item 5 of the manifest, is the shipping paper in compliance with 172.604(a){3)(ii) and 172.604(b){1} with respect to the display of the emergency information? Al) Veolia believes that the manifest completed in this manner complies with 172.604(a)(3)(ii) and 172.604(b)(l). That is, by entering the ER telephone number in the space identified on the manifest form as the "Emergency Response Phone" the shipping paper complies with 172.604(a)(3)(ii), in that the ER telephone number is "entered once on the shipping paper in a prominent, readily identifiable, and clearly visible manner that allows the information to be easily and quickly found, such as by ... setting the information apart to provide for quick and easy recognition". In addition, section 172.604(b)(l) requires the name of the person identified with the emergency response telephone number to be identified in one of several ways. One such option is "entered elsewhere on the shipping paper in a prominent, readily identifiable, and clearly visible manner that allows the information to be easily and quickly found." By entering the generator's name in Item 5 of the manifest this requirement is also satisfied. Q2) In the case where the generator/offer identified on the manifest is not the person registered with the ER/ provider, by entering the emergency response phone number in Item 3 of the manifest and a statement in Item 14 of the manifest identifying the person who is registered with the ERi provider, is the shipping paper in compliance with 172.604(a){3){ii) and 172. 604(b){2} with respect to the display of the emergency response information? Attached are examples of 2 completed manifests to better illustrate this question. In "Example 1" and "Example 2" the generator/offeror of the waste shipment is "ABC Company, Inc" while the person registered with the ERi provider for these shipments is a different company, "VESTS". In these examples, "VESTS" is also the unique identifier assigned by the ER/ provider. The two examples differ only in the wording of the statements appearing in Item 14 of the manifests. Veolia ES Technical Solutions, L.L.C. 1 Eden Lane, Flanders, NJ 07836 torn. baker@veoli aes.com (973) 691-7330#

Page 9G)veouA fNVIRONMfNIAl ',fRVICf'> A2) Veolia believes that both manifests, Example 1 and Example 2, completed in this manner comply with 172.604(a)(3)(ii) and 172.604(b)(2). That is, by entering the ER telephone number in the space identified on the manifest form as the "Emergency Response Phone" the shipping paper complies with 172.604(a)(3)(ii), in that the ER telephone number is "entered once on the shipping paper in a prominent, readily identifiable, and clearly visible manner that allows the information to be easily and quickly found, such as by ... setting the information apart to provide for quick and easy recognition". Furthermore, according to 172.604(b)(2), "The person who is registered with the ERi provider must be identified by name, or contract number or other unique identifier assigned by the ERi provider, on the shipping paper immediately before, after, above, or below the emergency response telephone number in a prominent, readily identifiable, and clearly visible manner that allows the information to be easily and quickly found, unless the name of the identifier is entered elsewhere in a prominent manner as provided in paragraph (b)(l) of this section." Reference to paragraph (b)(l) allows the name to be "entered elsewhere on the shipping paper in a prominent readily identifiable, and clearly visible manner that allows the information to be easily and quickly found." In these examples since "VESTS" is the person who is registered with the ERi provider, the statement "ER Service Contracted by VESTS" (Example 1) or "ER Identifier - VESTS" (Example 2) has been entered into Item 14 of the manifest as a means to comply with 172.604(b)(2). The ER information entered in this manner complies with the PHMSA requirements in that the information is readily identifiable and can be easily and quickly found. Your written response to this question is greatly appreciated. If you require any further information regarding this request please feel free to contact me at tom.baker@veoliaes.com or 973-691-7330. Thank you, Tom Baker Director, Environment and Transportation Veolia ES Technical Solutions, L.L.C. 1 Eden Lane, Flanders, NJ 07836 tom.baker@veoliaes.com (973) 691-7330#

Page 10I 0 ~ m io § m ~o ~ ~ EXAMPLE 1 1111111111111111111111111111111111111111 1 1111 1 Please print or type (Form designed for use on elite (12-pitch) typewriter) UNIFORM HAZARDOUS , 1. Generator ID Number WASTE MANIFEST ABC123456789 , 2. Page 1 of , 3. Emergency Response Phone 1 (999 ) 999-9999 1 4 Fonn Approved OMB No 2050-0039 . Maa·aTcrocroro o i VES 5. Generators Name and Mailing Address ABC Company, Inc SAME 1 First Street Generator's Phone: I, --i '} \ A r:: r .., 0 n" Somewhere, State 01234 I 6. T ransporter 1 Company Name Tom 1 s Transport Service 7. Transporter 2 Company N ame Generators Site Address (if different than mailing address) U.S. EPA ID Number I DEF234567890 U.S. EPA ID Number I 8. Designated Facility Name and Site Address U.S. EPA ID Number VEOLIA ES TECHNICAL SOLUTIONS, L.L.C. 1 EDEN LANE FLANDERS, NJ 07836 I NJD980536593 Facility's Phone: q71 1J. 7_1 ono 9a. 9b. U.S. DOT Descnption (including Proper Shipping Name, H azard Class, ID Number, HM and Packing Group (if any)) 10. Containers 11. Total 12. Unit No. Type Quantity Wt.Nol. 13. Waste Codes 1. UN1993, WASTE FLAMMABLE LIQUIDS, n.o.s., F003 0001 c:: 0 (TOLUENE, XYLENE), 3' I I, RQ (0001 ) x 001 OM 00400 p FOOS 0035 ~ w w (.!) z 2. 3. 4. 0 sO • O •o ' 0 ' O ' o : o o , o 0 0 14. Special Handling Instructions and Additional Information ER Service Contracted by VESTS l)W: 700253 A : MARFS 0 15. _, 16. International Shipments GENERATOR'S/OFFEROR'S CERTIFIC ATION: I hereby declare that the contents of this consignment are fully and accurately descnbed above by the proper shipping name, ard 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 Pnmary Exporter, I certify that the contents of this consignment conform to the terms of the attached E PA 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. Generators/Offerors PnntedlTyped Nam e S ignature Month Day Year I I I I D Export from U.S. D Import to U.S. ~ Transporter signature (for exports only): Port of entry/exit: Date leaving U.S.: c:: w 17. Transporter Acknowledgment of Receipt of Matenals Transporter 1 P rintedlT yped Name Sign ature Month D ay Year 0 I I I I D. "' z T ransporter 2 Pnnted!Typed Name Signature Month Day Year <( 0 I I I I c:: I- 0 I 18. Discrepancy 1 Ba. Discrepancy Indication Space D Quantity 0 Type 0 Residue D Partial Rejection D Full Rejection 0 Manifest Reference Number: 18b. Alternate Facility (or Generator) U.S. E PA ID Number ~ :::; (3 if Facility's Phone: I c 18c. Signature of Atternate Facility (or Generator) w I Month I Day Year z !;;: I (.!) u; 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste ~eatment, disposal, and recycling systems) w 1. c 12. 1 3. 14. 0 j 20. Designated Facility Owner or Operator. Certification of receipt of hazardous matenals covered by the manifest except as naed in Item 18a PnntedlTyped Name Signature Month Day Year I I I I EP A Fonn 8700-22 (R ev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) 0 0 0 ~ ~#

Page 11I 0 0 e : ~ : ,, O<" -r ~ ~ : >-: G : o : EXAMPLE 2 1 1 1111111 1 1 111111111111111 111111 1 1 1 1 11111 1111 1 Please print or type. (Form designed for use on elite (12-pitch) typewriter.) UNIFORM HAZARDOUS , 1. Generator ID Number WASTE MANIFEST ABC 12 3 4 5 6 7 8 9 Form Approved. OMB No. 2050-0039 , 2. Page 1 of , 3. Emergency Response Phone 1 (999)999-9999 1 4 .MacroTo koo?5ro o i VES 5. Generators Name and Mailing Address Generators Sile Address (if different than mailing address) ABC Company, I nc SAME 1 First Street Somewhere, State 01234 I Generator's Phone: I , ...., ') ' c: c - ...., a Q (\ 6. Transporter 1 Company Name U.S. EPA ID Number Tom's Transport Service I DEF234567890 7. Transporter 2 Company Name U.S. EPA ID Number I 8. Designated Facility Name and Sile Addrass U.S. EPA ID Number VEOLIA ES TECHNICAL SOLUTIONS, L . L . C. 1 EDEN LANE FLANDERS, NJ 07836 I NJD980536593 Facility's Phone: a ·n _,A..,_, an a 9a. 9b. U.S. DOT D escription (including Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group (if any)) 10. Containers 11. Total 12. Unit No. Type Quantity Wt.Nol. 13. Waste Codes 1. UN1993, WASTE FLAMMABLE LIQUI DS, n.o . s., F003 DOOl a::: 0 (TOLUENE, XYLENE ) , 3' I I, RQ (DOOl ) x 001 DM 0040 0 p FOO S D035 ~ w w (!) z 2. 3. 4. 0 c; O 0 0 § . o ,00 0 0 14. Special Handling Instructions and Additional Information ER IDENTIFIER - "VESTS" l)W: 700253 A:MARFS 0 15. GENERATOR'S /OFFE ROR'S CERTIFICATION: I heraby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, ard are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport accorning lo applicable international and n ational governmental regulations. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment conform lo the terms of the attached EPA Acknowledgment of Consent. I certify that the waste m inimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if l am a small quantity generator) is true. Generators/Offerors Printed/Typed Name Signature Month Day Year I I I I ...J 16. International Shipments i:- Port of entry/exit: D Import lo U.S. D Export from U .S . ~ Transporter signature (for exports only): Date leaving U.S.: a::: w 17. T ransporter Acknowledgment of Receipt of Materials I- Transporter 1 Printed/Typed Name Signature Month Day Year a::: 0 I I I I CL tn z Transporter 2 P rinted/Typed Name Signature Month Day Y ear 0 < a::: I I I I I- 18. Discrepancy 0 1 8a. D iscrepancy Indication Space D Quantity 0 Type 0 Residue D Partial Rejection D Full Rejection 0 1 Manifest Reference Number: 0 18b. Alternate Facility (or Generator) U .S. E PA ID Number ::::; § ~ ; ~ · u g ;: ~ Facility's Phone: I O<" c 1 Sc. Signature of Atternate Facility (or Generator) w I Month I Day Year ~ I z ~ r ~ ! : G : (!) iii 19. Hazarnous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) O ! w 1. c , 2 . . , 4. ,3. 0 j 20. Designated Facility Owner or Operator. Certification of raceipl of hazardous materials covered by the manifest except as naed in Item 1 8a P rinted/Typed Name Signatura Month Day Year I I I I EP A Form 8700-22 (R ev. 3-05) Previous ed1t1ons are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) 0 0 0 ~#