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Appendix G-4

Hazardous Waste Manifests for the Off-Site Transport of TSCA-/RCRA-Regulated Materials to the Wayne Disposal Facility in Belleville, Michigan

Table

Number Shipping Date Load Weight (kg)

Shipping Document

Tracking Number Disposal Facility

1 10/2/2012 29,620 000527320 VES Belleville, MI2 10/2/2012 29,370 000527321 VES Belleville, MI3 10/2/2012 31,070 000527322 VES Belleville, MI4 10/2/2012 31,330 000527323 VES Belleville, MI5 10/2/2012 29,700 000527324 VES Belleville, MI6 10/2/2012 30,390 000527325 VES Belleville, MI7 10/2/2012 31,650 000527313 VES Belleville, MI8 10/2/2012 32,350 000527314 VES Belleville, MI9 10/2/2012 31,370 000527316 VES Belleville, MI

10 10/2/2012 31,280 000527317 VES Belleville, MI11 10/2/2012 31,760 000527318 VES Belleville, MI12 10/2/2012 30,990 000527319 VES Belleville, MI13 10/23/2012 30,480 000527349 VES Belleville, MI14 10/23/2012 30,510 000527350 VES Belleville, MI15 10/23/2012 30,350 000527351 VES Belleville, MI16 10/23/2012 29,820 000527352 VES Belleville, MI17 10/23/2012 31,380 000527353 VES Belleville, MI18 10/23/2012 30,400 000527354 VES Belleville, MI19 10/23/2012 32,300 000527463 VES Belleville, MI20 10/23/2012 30,010 000527464 VES Belleville, MI21 10/23/2012 32,790 000527465 VES Belleville, MI22 10/23/2012 33,110 000527466 VES Belleville, MI23 10/23/2012 30,550 000527467 VES Belleville, MI24 10/23/2012 31,750 000527468 VES Belleville, MI25 10/24/2012 30,740 000527355 VES Belleville, MI26 10/24/2012 29,580 000527356 VES Belleville, MI27 10/24/2012 30,630 000527357 VES Belleville, MI28 10/24/2012 30,930 000527358 VES Belleville, MI29 10/24/2012 31,230 000527359 VES Belleville, MI30 10/24/2012 32,170 000527360 VES Belleville, MI31 10/24/2012 31,290 000527469 VES Belleville, MI32 10/24/2012 29,490 000527470 VES Belleville, MI33 10/24/2012 31,500 000527471 VES Belleville, MI34 10/24/2012 31,560 000527472 VES Belleville, MI35 10/24/2012 31,390 000527473 VES Belleville, MI36 10/24/2012 31,150 000527474 VES Belleville, MI37 10/25/2012 28,570 000527361 VES Belleville, MI38 10/25/2012 28,460 000527362 VES Belleville, MI39 10/25/2012 34,120 000527363 VES Belleville, MI40 12/17/2012 31,430 000527326 VES Belleville, MI41 12/17/2012 28,310 000527327 VES Belleville, MI42 12/17/2012 31,220 000527328 VES Belleville, MI43 12/17/2012 30,110 000527329 VES Belleville, MI44 12/17/2012 35,290 000527330 VES Belleville, MI45 12/17/2012 32,150 000631682 VES Belleville, MI46 12/17/2012 29,000 000527331 VES Belleville, MI47 12/17/2012 29,490 000527332 VES Belleville, MI48 12/17/2012 31,910 000527334 VES Belleville, MI49 12/17/2012 32,450 000527335 VES Belleville, MI50 12/17/2012 30,660 000631683 VES Belleville, MI51 3/5/2013 30,950 000631946 VES Belleville, MI52 3/5/2013 21,510 000631947 VES Belleville, MI53 3/5/2013 30,610 000631952 VES Belleville, MI54 3/5/2013 33,030 000631953 VES Belleville, MI55 3/5/2013 29,710 000631954 VES Belleville, MI56 3/5/2013 30,410 000631955 VES Belleville, MI

FINAL COMPLETION REPORT FOR THE SILVER LAKE AREA REMOVAL ACTIONGENERAL ELECTRIC COMPANY - PITTSFIELD, MASSACHUSETTS

TABLE G-4SUMMARY OF SHIPPING DOCUMENTS FOR THE OFF-SITE TRANSPORT OF

TSCA-/RCRA-REGULATED MATERIALS

4/15/2014G:\GE\GE_Silver_Lake\Reports and Presentations\2014 draft Final Completion Report\Appendix G\G-4\0841411214_SilverLakeTSCA-LowVOCs-DisposalLog.xlsx Page 1 of 2


Shipping Document




TSCA-/RCRA-REGULATED MATERIALS

57 3/5/2013 33,050 000631956 VES Belleville, MI58 3/5/2013 30,640 000631957 VES Belleville, MI59 3/5/2013 31,710 000631958 VES Belleville, MI60 3/5/2013 30,340 000631959 VES Belleville, MI61 3/5/2013 30,660 000631960 VES Belleville, MI62 3/5/2013 17,390 000631961 VES Belleville, MI

Total 1,899,170

4/15/2014G:\GE\GE_Silver_Lake\Reports and Presentations\2014 draft Final Completion Report\Appendix G\G-4\0841411214_SilverLakeTSCA-LowVOCs-DisposalLog.xlsx Page 2 of 2

Waste Manifests

Af'iype (Form designedJor use on. elite. (12'pitch) typewriter.) Form Approved. OMB No. 2050-0039 ,;loRM HAZARDOUS It: Generator tO Number

, WASTE MANIFEST ' ~ ,, , ,. ,, <'ilineMorifSJte"1illirr~ss (if different than mailing address) · ·

6. Transporter 1 Compa~y Name

7. Transporter 2 Company Name

8. Designated Facility Name and Site Address \~!.aYhtl~ DJ":~t:J..')~.:;._~t U~{";,

~~"··n_1{~ N j ~1~! SER·r'~C~·:· r t~t''/f

3.

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GENE!'<M. f:'.t.ECTHIC (.)~ ·!st::a. f·~tl'I$1'~C:S t"fC

1 "'1.fY'l'•.:•f~H:"[ f". ~· !\ ,.."1 ·~):<·~ ' ~' <If fl. "'''t, <'fl,-> '.J j . .O .• < ~

U.S. EPA 10 Number

lhlYfl~~: U.S. EPA 10 Number

I r,.,~ a._ r ( it r-

U.S. EPA ID Number

14. Speci<,~l Handling Instructions and Additional Information ~:;t'.:i.(;J_. 1• / 1 c .. ··;:-.B :.~~C~H ·< r:::t: !.JIM·ENl·, 4h!t) ·tti.'flHiS. ! 1 2--.mn'.)'-,'"tfJ~ F~::.t-~~-:; .. ·i •·

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13. Waste Codes

15·. GENERA.TOR'siOFFERCfR•s·C·ER'i'Ii=iC'AtiON:- l'h'e?e'by.d~clare that ffi'ii c·on'tt~ntSOf)his cbriS~gnirltlnt'are-:fully arid accurateiy des·cribect·above by:the' p'fOper 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 Primary Exporte~ 1 Cf:'!rtlfy that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. 1 certify that thewaste-minimfzation statementidentified_ln 40 CF,R 26227(a) (if tam a large qua~!Lttgenerator) or (bt_{l.fJ-a~ a small quantity generator) is true.

....J 16.lnternational Shipments 0 U ~ lmportto .S. a; Transporter signature (for exports only):

ffi 17. Transporter Ackiiowledgment of Receipt of Materials·

~ Transporter 1,-PfJhledrfyped Name 11 ./

~ A<-:...:;,r;;//¢ ~/e>:Jr-/C/ z{ ~ TransPorter 2 PrintedfT yped Name

~

18a. Discrepancy Indication Space

118. Discrepancy

§ 18b. Alternate Facility (or Generator)

0 ~ Facility's Phone~

0 Quantity

fn 18c. Signature of Alternate Facmty. (or Generator)

~

0 Export from U.S .

Signature

I Signature

I

,,.,) Po~ofentrylexit --------------Date leaving U.S.:

0Resfdue D Partial Rejection

Manifest Reference Number:

Month Day Year

I l l

0 Full Rejection

%~----------------~~~~--~~~--~~~~--~~~--~~--------------------~--~--~__, ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

.,;91. r r ·~ ~1- 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the ma~ifest except as ncted in Item 18a

Pn'ntedflyped Name Signature

I " EPA Form 8700-22 (Rev. 3-05) Prevtous edtttons are obsolete.

Please print or type (Form designed -for use on elite (12-pitch) typewriter) ' Form Approved OMB No 2050-0039

UNIFORM f-iAZARDOUS 11. Gene(ator ID Number

WASTE I'IIANIFEST ' M ,A, [) C 0 2 0 B .. ~ (l ~) 3 j_2. Pl1 of I' 3. Emergency Respon~e Phone

{800) 424.Ql()O r (fooc52u~r3 21 VES 5. Generato(s Name and Mallihg Address

(3J:;~l>lt\i..EL£CJB1C CO Ge1rr~~te A~r1s!.f diffe[e9t,!!)an mailing address}

c GE . L E.LEC. RIC •.- .,1 .• AJT ,:JMJ.n <:;,A.Lf,l?="INE 15e STICS /\VE ' '~~'f.! t. ~•cs "-"f:':

'fi :~ 4S4..U3~;J f>.'DTSF!El.LI, 'f.H 01 ~i! I PfTiSFIEtD. MA ~l'l.i'Gf

Generato(s Phone: 6. Transporter 1 Company Name U.S. EPA 10 Number

F'AGE' E'TG.,INC IN y D 9 ·':1 e g ~ p Q 1 ~

· 7. Transporter 2 Company Name U.S. EPAID Number r'RC>VIDE~·JC£ AND 'J'-10RC...:.STI:3.R R.R j-M A D 0 e .. 9 a 2 0 {! .,

4 I

8. Designated Facility Name and Stte Addresw~ YijE; .. CliS.PI;:."lSAL INC. U.S. EPA ID Number

49350 N i.(.}4 SEf~'i!CE [.'JRt.VE ..

800 5fi2n4S9 SEU..EV!LLE. Ml 481 '1 i JM . !) (j' .. 8 (.} (~ (j :! . ~ ; .;.> Facility's Phone:

9a. 9b. U.S. DOT Description (induding Proper Shipping Name, Hazard Class, ID Number, 10. Gontainers 11. Total 12. Unit HM and Pa eking Group (ff any)) No. Type Quantity _ Wt.Nol.

13. Waste Codes

a: 'j,_ 1N;·.,K;! ( i , t·I,"'-O::N _'\I)'JtJti VilE~.~:, It;, ci-.) t_,t,:, fi .O. "'· . (t-~-._;1:; :~;. l...'\.'1, --i~ ~--<.:-<::' ! L£:t,[)) . ~.l lH I~) ILf:AO;' PG'fYS} .etp-,( 0

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... rpt ·!t E~P t 't IP!:1E D ~5:28. PCB l:tEMOVE'f' ~f.t(ll~ ~ERV'C£'0ATF "!t2tJi2{1·12 +· 'i} ~· \: ,, • "i "~l-. •' - ~ ,..,., ;., _.,.._ . . . _ ... ,___.... ..,.,. ·. l • ,... ... .... r ..,. "'' •,_. · r .~. \ · , • ~. . . ·,

~.t,<\TH~t~.L. .FHOM ::.HLVE!R. lAJ-<1: Pr~O.JECT. CiD Rf}i'~"Jl!IRED Pft.C"tqN(~ BUP A'fTAG"HED. PO# ·!11 '1?;;:'672 15. GENERAT.OR'S/OFFEROR'S CERTIFICATION: I hereby declare that the ~tents 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 certffy 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 qua~il¥-~nerator) or Jbi11f"ktm a small quantity generator) is true. -

Generato(s/Offero(s Printed/Typed Name ( ~~,- · :x~~~-~ .. ~ Month ~-Year r~:'IB!::Fn p_,"..P:"~t.Lr) U:\GENT Fc::R GE~ \ 1 ·-~ , - 6~

1to ·· 12:.. .J~~ •. . . • :· "-?L --' • ...... 16. International Shipments 0 Import to U.S . 0 Export from U.S. Port of entry/exit: t:-~ Transporter signature (for exports only): Date leaving U.S.:

a: 17. Transporter Acknowledgment of Receipt of Materials w ~ Transporter 1 !finted/Typed Name Signature

/!.t..-'-;L ,h - 1Mtep~t:J2. ~ ;vl; ){.,-.e. !1. tJ t/1 ~' _f u "t: I .....__,:,-~{..?-// ~-t .t-4_.._ ~" .~· ..... ,_,'..f .

:i Transporter 2 Printed/Typed Name · Signature / Month Day Year

a: _l -' I I I-

l 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity 0Type 0Residue 0 Partial Rejection 0 Full Rejection

Manffest Reference Number: -·

~ 18b. Alternate Facility (or Generator} U.S. EPA ID Number ' I';

-.~:..· c.o·, •. ; -

0 l

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) r 13. r· 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as naed in Item 18a

PrintedfT yped Name Signature Month Day Year

l I I c .. EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050-0039

)

UNIFORM HAZARDOUS 1. Generator ID Number

WASTE MANIFEST .I r · n ,.. " n ,

5. Generato~s Name and Mailing A"ddress

Generato(s Phone: 4:1 ~'J. 494-535S 6. Transporter 1 Company Name

r. Transporter 2 Company Name

GENER.l\L ELECTRIC Ctf\ Atrf'CMAt:f CAI..ACOI\Ir.: '!!.'it! .Pl. A~TICS A, VE PI'TTSFIEt.O, MA 0170'1

F'f:K>VlDI::NCE.: AND V\fOI~CES'!"I:':H RR. 8. Designated Facility Name and Site Address

W.6.YNE DISPOS.AJ_ INC ·~9'3fi0 N !·~·1 SEHVICI? !.''HIVE

Facility's Phone: B•)i.l ~)~;,. ;~~-5-489 BELLE 'iiU E ~J!I 1'181 i 1

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class. ID Number, HM and Packing Group (if any))

3.

4.

Genefa\OI's Site AGaress (if different than mailing address)

•3ENERAL ELECTRIC 00 159 FIL-\ST!C-5~ /WE

lf'rTTt!lriELD. MA 01201 U.S. EPA ID Number

IN: v 0 9 s U.S. EPA ID Number

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U.S. EPA ID Number

14. Spec1al HandHng Instructions and Additional Information f.J·lf.3:'! 7.1 PCB SOIL. SED!ME.NT, .'l,Nl) Of0::5f~l'S. t·J.22QtJ(W·:'DL f1(:8'S •: ! ')'!

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Generato(s/Offero(s PrintedfTyped Name

....1 16. InternatiOnal Shipments 0 rt 1

U S ~ lmpoo . . !!!: Transporter signature (for exports only):

0 Export from U.S . \,J Port\fentry/exn: -~-'---------------Date leaving U.S.:

ffi 17. Transporter Acknowledgment of Receipt of Materials

li;: Transporter 1 Printed/Typed Name d ~ (..a.),A Y )..}G.:- rf /Jf.:. e 5 ~ Transporter 2 Printed/Typed Name

0:: 1-


118. Discrepancy

~ 18b. Alternate Facility (or Generator) ...I

0 Quantity

Signature

I

0Type

Month Day Year

Ito h2. lft2_ Month Day Year

I I l

0Residue 0 Partial Rejection 0 Full Rejection

Manifest Reference Number: U.S. EPA ID Number

~ I - Facility's Phone: ffi~1;8c=.~Si~gn~a~tu~ne~o~fAI~t~e-rn~at-e~Fa-c~ility-r(o~rG~e-n-era~t~or~)------------------------------------------------------~----------------~~~-.~~~~

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~~- r r I Month I Day f. Year

J

r-20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as naed in ttem 18a

PrintedfTyped Name Signature Month Day Year

L I I J EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

..• ;,. .. . Please print or type (Fonn designed for use on elite (12-pitch) typewriter.) Fonn Approved OMB No 2050-00' ' '

UNIFORM HAZARDOUS r· Generator ID·Number ,2. Page 1 of ,3. Emergency Response Phone

rooa:sg273 2 3 WASTE MANIFEST' . M A D 0 0 l 0 € 409 3 3 (800) ·~¥400 VES 5. Generator's Name and Mailing Address

o.rr~RJ\~CT~ . ~ff~~~t ~ft~mf!~n mailing address) ·. : . A N: A . ALA .. "1'59 PI.)I.STICS /WE 15.9 ~l~!3TIC'"' >«VF.:

4~4-6::'5!1 Prt"TSFIF.LI:.l, MA Oi2i1'l l PIHSFIEUJ, MA U'l.20i

Generato(s Phone: 41~

6. Transporter 1 Company.Name U.S. EPA ID Number f"I',C:::: EiC.,INC IN y D !9 fl r'i 9 ~;t 9 '-:l " 't 7. Transporter 2 Company Name U.S. EPA ID Number rnovu:·s~r:r~ .~t-ID WOPlCESrt:R R.R ·" JM '

A !;"_) () ,1') lJ 0 :~ Q 1:! 3 4

8. Designated Faclity·Name and Site AddreswA 't'NE t.'l$FK."$AL INc. U.S. EPAID Number ~9350 H t..e4 SERVICE OP.tVE ..

BOO 5~2-548~ S~JJ.EV!U,..f::, V.! 4!11 1·! I M ! o 'o ...; ~~~ 0 ~r c~ fi 3 3 F acUity's Phone:

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard aass,ID Number, 10: Containers 11. Total 12. Unij 13. Waste Codes HM and Packing Group (if any)) No. Type Quantijy 'MNol.

X 1.1\!I~;:J;!: ";.. t'!•l\i.:A!.~·;X..~~~i_ V'{<"-l;:;,l1~; .;;1, -<U U. n.o.r,. (t'Ctf ';.;, ·~

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i I 14. Special Handling Instructions and Additional Information t:H•.ll:1 I'! 1"\,Q ;::tf..Jfl., ::::.t'.:J..1!r.«'n'::Nf. .1' Nlll.>r.<!:M•tf: • no<; · Ul. 1-'··-" .~:5 c:·, ~.,

!O 1 ! ·~ AII .H~ NU!'I~E!ER_, _ __b~Z."!l_ ... ____ , PG"8 r-<EMOVt$J) FROM .SERVICE" DATE 7{~01.2 + '!} M.:."fE•·ll ,6.L FROM :t11LVER U~!(E PFt<) JEC'f Glf) RJ.::(Jl.'IREO. PACKl~Ki' SU? ,t.., l1'A<,'M!;D !;)()# ·1 '11'1 T2.fJ?1. 15. GENERATOR'S/OFFEROit'S'CER'IiFICATION: I hereby declare that the contents of this consignment are fuUy an~ accurately des,cribed aqove by the proper shipping name, and are classified, packaged,

I marked and labeled/placarded, and are in aU re&pects in proper condition for transport according to applicable international and national governmental regulations. II export shipment and 1 am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of ~~ I certify that the waste minimization slatement identified in 40 CFR 262.27(a) (if I am a large q~neratorl ol'(!ll"frt I a s~ _quantity generator) is true.

I Generato~s/Offeror's Printedffyped Name

\~~ ~~~brJffJ~~ Month Day Year

I ROBf.')J.T F•r..f.i,I\Ll.O {1~0EHr F('lf"t •3f.}

' -.....JJ!I. I 10 10"2..1 \2-..... 16. lnternalional Shipments 0 Import to U.S. 0 Export from U.S. - Poh of entry/exn: ! j:.... ::!: Transporter signature (for exports only): Date leaving U.S.:

ffi 17. Transporter Acknowledgment of Receipt ot Materials

Iii: Tran~:nted!Typed Name ~ Signature ~ Month Day Year

~ , . . d/1(/~ ,-~ ~4/h~ L- J. /'?, ./.._ ./../.-.,._ ..... <E. •• . \ 110 1021 l2-(/) o::/ . ::i Transporter2 Printed/Typed Name Signature Month Day Year

0:: I I I I 1-

1 18. Discrepancy



~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number ::i <:;

I Lf Facility's Phone: 0 18c. Signature of Alternate Facility (or Generator) I Month I Day Year . w ~ I z ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

,2. ~1. r r· 20. Designated Facility Owner or Operator. Certification of receipt of hazardous ma1erials covered by the manifest except as ncted in Item 18a Printed/Typed Name Signature Month Day Year

I I I I ..

EPA Fonn 8700-22 (Rev. 3-05) Prevrous editions are obsolete . GENERATOR'S INITIAL COPY

0

.. . ,...,/ -: _ -:.

Please print or lype. (Form desi ned for use on elite ( 12,pJich) lypewrfter.) Form Approved. OMB No. 205().()039 UNIFORM HAZARDOUS

1.1. Generalor 10 Number

WASTE MANIFEST I

5. GeneratQ(s Name and MaUing 1\ll'aress - ~ - • -

~W!f:B~~~':c~Srft? 1 ~9 'r~{~~TifZ:.'5 lWE

. . ·-. ··~ -~ r:!ITT :o,Fir:LO. MA 01?01 Generato~s Phone: 41 ~ q"4 -li;,iiir• 6. Transporter 1 Company Name


PFlO\IIOENCE AND WQR!::;ESTEf~. Fi.R. 8. Designated Facility Name and S~e Address .

\f..lAVNE OISPOS~'\L If-¥.>, •!{1350 N 1~4 SERVICE DRIVE

• BEl.lEW.L..:. Ml 4(-1 1'! 1

G~"lillm6~sS'~e Matll$s (if different than maiing address)

OENERP,L ELECTRIC CO 159 PLASTfCS AVE

1 pm·mnt:to. MA o-:20·1 U.S. EPAIONumber

IN 'f' 0. 9 . U.S. EPA ID Number

f M .r ... !) a U.S EPA 10 Number

6 5 9- ~~ ~ 9 'I r \

!'j ~I 0 J n ,, i:l '

,,

Facility's Phone: 801.1 ~)~12~4H9 ; .. 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, 10 Number, HM and Packing Group (d any))

10. Containers 11. Total 12. Unit No. Type Quantity WtNol.

13. Waste Codes

li:lll:::at. Ja.ill C'(WI? PCI.'.\1 D::

'I Ci T i\ i' .• v .. o2 ~~ :1" 'f r , .,. ,., ..

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14. Special Handling Instructions and Additional Information £~FKU 7·1 DCB SO!l, 5EOIMENl·, J~.J-l!.~ DE9~1S. f1::2T.Y.lC\l'.IQ!. l::lC'E'S .:·!%

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15. GENERATOR'SIOFFEROR'S CERTIFICATION: I heietiY dedare that the Contents of this conslgnnieni are fully ami' iJCcur.itely described above by ihe proper snipping name, ard are dassified, packaged, marlle<l 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 1 am the Primary Exporter, I certify that the contents of this consignment confonm to lhe terms of the attached EPA Acknowledgment of Consent. 1 certify that the waste minimization stalement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b_¥(tfi·~ a small quantity generator) is true.

Generato(s/Qffero(s Pnntedfl')lled Name , • • ~atur-1'0/. \ ) _ f (f\ / . \1. K~ ,:e.&-t.: . .',1\- Month Day Year

HC'f3ETH PAP ALt.:::; {fo.GEHf FOR r3t} ',,_~ \~~1£.\D~) +7'1-'· ~ I 101 <.1>2l 12. ..J 16.1ritemationaJShipments 0 0 '-" .l. -· t- Import to U.S. Export from U.S. t'tlrt of entry/exit: -~----------------~ Transporter signature (for exports only): Date leaving U.S.:


~ Transporter 1 PrintedfTyped Name 0 , . ::; J~ I .

1 // - * ' ··-"'- .-.ria ..-f' • _# ! Trans~er2'Pifn~~N;~me / r~ · ..,- > '7 ..., -

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j!: 18b. Alternate Facility (or Generator) ~

0 Quantity 0Type 0Residue 0 Partial Rejection 0 Full Rejection

Manifest Reference Number.

LL~ Facility's Phone: ~~1;8c=. ~si~gn~a~tur~e=of~AI~te-ma~te~F~aa~·li~ty~(~~Ge~n~era~to~n.---------------------------------------------------._---------------.r.7.~--"-~~~

~ z~------------------------------~----------------~----------~----------------------~---L--~---4 ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatmen~ disposal, and recyding systems)

/~ ; - ,2. r 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as niXed in Item 18a PrintedfTyped Name Signature

I EPA Form 8700·22 (Rev. 3-05) Prevtous editions are obsolete.

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Please print or type. (Fonn designed for use on elite (14-pitch) tyP.e\_Yriter.) Form Approved. OMS No. 2050-Q039 UNIFORM HAZARDOUS , 1. Generator ID Number

WASTE MANIFESTt M A D 0 .0 2 (} 8 ~ 0 9 3 r· Pl1 of , 3. Emergency Response Phone

. (800) 4:.WU400 r o'i5~os~27'32 s VES 5. Generator's Name and MAiling Address

G ~~r:r~· t.o · ~t~&'Jt~",U~n mailing address) • ' . ~ . ' .... • . ,j.

P.. AL!I. _, .JNt: 159 pi.J,ST!CS/l.'liE '159 • ·r!CS A.Vf.:

<li :) 494-.f.'iJfit'l Pl''fT, · f:-'l..r..l, MA <J·i Xl'i I PITI'SFiELO. hilA m·~a·1

Generators Phone: 6. Transporter 1 Company Name U.S. EPA ID Number Pll.OE CfC.,INC I N y n g c e 9 ::i 0 9 •! ~~

7. Transporter 2 Company Name U.S. EPA ID Number f''HO\IIIJENCt; ,,NtJ \NOJ'l.CCSTE'R RH. 'I M A () Q •f; { I !) .;\ ( ) ~* :~ <l

8. Designated Facility Name and Site Address WA VNE. DISPOSAL INC. U.S. EPA ID Number

~1~3!•0 N t~t.M SF-RV!C;E DP.JVE .,.

<300 :)t!).l-5489 BELLEVILLE, Ml 4tl1i1 J M l [ , () ' f:. 0 t.· {; 6 ' •< Faclli 's Phone:

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 1!): Con1ail)e!S 11.Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type I Quantity_, WtNoJ.

I{ 1. Nl\.jU/, , 1-!;<,;J''.I •q_j~.:iiJ~ Wh~ It, ::JOUU, n.o . .s . if"".;..'t) b, ~ I.V.Jt! t--~t:n

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! !;1.;\ tl .f:l~ NUtmER -·~so~ ......... ~ .. ,_,::f• I~Fi'iK'V'ED !-Tl•:JM '5E!~\fl{!;' fJATf:. 71';!6/20-11 "i · 'l li.4A f EHiAL FROM &ll \IER L~i<E PRO,!ECf. •:10 REOt.iiRF..D. PACKING SUP ,A,TTA(;!-IE[1 P(itt 1 'I i 17 2tiJ:!

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby deClare that the contents of this consignment are fuUy and accurately described above by the proper shipping name, ard are dassified, packaged, marked and labaled/placarded, and are in all resP,ects in proper condition for transport according to applicable intemalional and na~onalgovemmental 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 niinimizaUon statement identified in 40 CF_R 262.27(a) (d I am a large 'i'f"""' ~eral9i~~-a smal quantity generator) is true.

Generators/Offeror's PrintedfTyped Name \.~~~re ·~~-~1 ,~ 1\ Month Day Year

~8ERT Pf!.P.~LLO {AOfNT FOR<*:.} ~, ' . - .. ('~> 'F{Q_~ 1\0 ~112... _, 16. lnteinational Shipments 0 Import to U.S. 0 Export from U.S. - Port of entry/exit: i-;!;; Transporter signature (for exports only): Date leaving U.S.: ' ex: IIJ

17. Transporter Acknowledgment of Receipt of Materials ~11. ~ Transporter 1 Printedff ypP,D)lame f.l ~

Si::;u;, ~>&€:~ Month Day Year

~ ()J~YIJC . f/0 e-5 I 'llr~ c -- " ·· 110 Q2.112..s. ~ Transporter 2 Printed/Typed Name Signature r Month Day Year 4:

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18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity 0Type 0Residue 0 Partial Rejection 0 FuU Rejection

Mannest Reference Number:

~ _, 18b. Alternate Facility (or Generator) U.S. EPA ID Number

0 Lt Facility's Phone: I 0 18c. Signature of Alternate Facility (or Genemtor) t Month I Day Year IIJ

I r !;,( z Cl 19. Hazardous Waste Report Management Method Codes (i.e., codes for halardous waste treatment, disposal, and recycling systems) u; -; 1. ,2. r r· .-

I 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as naed in Item 18a

Printedfr yped Name Signature Month Day Year

I I I I .. EPA Form 8700-22 (Rev. 3-05) Prev1ous edrtions are obsolete. GENERATOR'S INITIAL COPY

Please prjnt or type. (Form de~igned (or use Qn elite;(.12-pitch) typewrit~r.) ~; ~ , Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 1'-Generator ID Number

WASTE MANIFEST 'I MA t' {i 0 ~ 0 S 4 G 9 3 12. Pag~ 1 of 1 3. Emergency Response Phone 14. r.,anifest Tra~king t:!t~mber

J ~ l!aom 1¢-t-~ooo . . 1 0'.00 52 7 313 VES 5. Generator's Name and Mailing Address GENER<\L ELEf.~fHIC rJ)

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6. Transporter 1 Company Na!Jie • t"""-<Z..t.:..l""'"" ~~ ,,...~ · P r,c-J 11 -r;_ ... -r-•.. rrr.><::-r.:-~~ ..:;.-~-t' IVo P ! , (- ·~ < •

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7. Transporter 2 Company Name rn.:..; >'II:JI:NCf:: AND V"JCifKJ.:~;TEF( RR

a. Designated Facility Name and Site Addres~NA YNE OISPOSAL lNC.

49350 N 1~4 SER.VK.:E. [lRfVE

Facility's Phone:

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group (if any))

3.

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U.S. EPA ID NumberMI# D 0 :'1 'f. ~i / '7 I $ (,.. "' ... *--¥--EH~· -,~~...,____"'--_,__., I . . u ~ - .. •. ~..,--.,.

U.S. EPA ID Number I M p. [ I 0 5 •g !} 'J ') f:; ., -1

U.S. EPA ID Number

1 0. Coiltainers 11 . Total 12. Unit Quantj)Y . Wt.Nol.

13. Waste Codes No. Type

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14. Special Handling Instructions and Additional Information !;:.K'.:l: I · ~ t·•U;j :;,\ • .'!L, ,;st:U!Mt:."i 1 .'\ "lU Ut:.t'il~i~. . !'! 2:b..l'.i;~'l'J,J! !-><:).-.\ ;S -:1 '!'~

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15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare thai the ·contents of this consignment are fully and accurately ~escribed above by the proper shipping name, and are classified, packaged, marl<.ed 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. 1 certify that the waste minimization statement identifj_ed in 40 CFR 262.27(a) (if I am a large quantity~erator);o( bl.~ a small quantity ~eneraJEr) is true.

Generato(s/Oiferor's PrintedfTyped.Name ( _ _:,~1J_ ' !'\ \''ff'f.'·) l . • ~ '(~, ......, ··.Jf RC+•r=.m PAP..!i.LV::.> (',t>,GENT ~··or~ GE) \~~V~\V('t\i)\S...Lt?2L2_ €JE:

Month Day, Year ·

110 1~2JI~ ; -1 16. International Shipments 0 .._ Import to U.S. ~ Transporter signature (for exports only):

0 Export from U.S. PJrtofentry/exit: ------------------~Date leaving U.S.:


li: T'P'li,P?l!2L1 ~t;dfType<!)Jame ,-

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~ 1-

18a. Discrepancy Indication Space l18. Discrepancy

~ 18b. Alternate Facility (or Generator) :J u Lf Facility's Phone:

0 Quantity

fil 18c. Signature of Alternate Facility (or Generator)

~

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I . .A/f..-.._ Month Day Year

llD PZ-It2... Signature Month Day Year

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Manifest Reference Number. U.S. EPA ID Number

l Day Year

z~----------------~~~~--~~--~--~~~~~~~~~~--------------------~--~~~~~ ~ 19. Hazardous Waste Report Management Method Codes ~ .e . , codes for hazardous waste treatment, disposal, and recycling systems)

I Month I I

~) ,2. r- r· 20. Designated Facility Owner or Operator: Certification of receiR,\,of hazardous materials covered by the manifest except as nded in Item 18a

PrintedfTyped Name ·u. Signature

,l; 1.-Month Day Year

I I I EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

0

Please print or type. (Form designed.for use on elite (1g~pi,tch) typewriter.) Fonn Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS ,1 . Generator ID N4mber

WASTE MANIFEST · . ... ~ , _l1 ~ ,,

5. Generator's Name and Mailing A'ildi'eu· ' v . - ~ ~ ~ w • ~erators SitErAMrl!ss (if different than mailing address) ·.

Generator's Phone: .a i :1 49•t ./5.:~5!<

·7. Transporter2 Company Name

){i~Ni~R:\L ElJ::Ci~f (;c;) .. TfN.MATfC.~I..Il.t~JNr: .. 'If·~ Pt. At-;;"TJGS 1\VF Pln'!">FIEl !:1, MA 01 ?Oi

GENERAL ELECTRIC {I) ·tso PLM.mcs .we

U.S. EPA 10 Number

PI K:-\!tOENCE ANI) \NQROI:STI!RR.Ft. I· M A I) () *' ' ~~ 0 ::,. 0 ;3 ::\ 1 8. Designated Facility Name and Site Address . •

WAYNE fJtSpr'.:..\'5AL !NC. :19350 N f,.git S8'tV!CE !)RIVE ..

9a. 9b. U.S. DOT Description (Including Proper Shipping Name, Hazard Class, 10 Number, HM and Packing Group (if any))

3.

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14. Specal Handling lnstJuctions and Additional Information E"RG:·rn Pf ... "B SOIL, SF.I)iMf~NT, !\NO OEMfS. !i:.,'I2!J!.iOIJii!)l. P':B'S ..; ;t%

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15. GENERATOR'S/OFFEROR'S e·ERTiFICATION:"I ~ereby declare that the rontents of this consignment are fully and aceurately described abOve bY the proper shipping name, and ere classified, packaged, ma~ed and labeled/placarded, and are in all respects in proper condition for transport actording to applicable international and national govemmimtal regulations. If export shipment and I am the Primary Exporter, 1 certify that lhe contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (WI am a large'!"""'";., >r.'l rater) or (b)~ a small quantity generator) is tJue_

Generator's/Offeror's Printed/Typed Name \_J~1lf(\'i \~ rx '\ f , .. f..:" \PE: ~~·."'§ Month Day Year

!(0!3EHl P~\Pil,LLQ (/\CENT f OR GEl , ll't-~~rl. ~'Atf · ~ ~ J lO k).ZI )"Z ... -' 16. International Shipments 0 US 0 '"U - I. _, j:- Import to . . Export from U.S. Ponof entry/exit: --------- -------- -~ Transporter signature (for exports only}: Date leaving U.S.:

ffi 17. Transporter Acknowledgment of Receipt of Materials ;;

l;i: Transporter 111/[intedffyped Name r , Signai\Jre -AI / .' _//j

o i) ' "' f I '- / _,_,,.,r __;,. / o.. (, ..._ .. ) \ A ,_ i.. t. ?1 vt. (...\ ,, v,-··A,~·, ~ Transporter 2 Printed!Typed Name Signature

g I

Month Day Year

lfO k)2J:• · 'Month Day : ')'ear I I .1' .

0Residue 0 Partial Rejection 0 Full Rejection !18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity 0Type

ManHest Reference Number. § 18b. Alternate Facility (or Generator) U.S: EPA 10 Number

I u ~ Facility's Phone: I Month I Day Year

I ffi 18c. Signature of Alternate Facility (or Generator)

~ z~----------------------------~~----~------~~~----~----~----------------------~--~--~--_, ~ 19. Hazardous Waste Report Management Method Codes (i.e .• codes for hazardous wasle treatment, disposal, and recycling systems)

(~ ; · 1~ r r 20. Designated Facifity Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a PrintedfTyped Name Signature Month Day Year

I I I I EPA Fonn 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

IO

-- . Please print or type. (Fonn designed (or use on elite (12-pitch) typewriter.) 1-onn Approved. OMB No. 2050-0039

UNIFORM HAzARDOUS ,1. Generator ID Number

WASTE MANIFEST . u A n " Jl ~ 0 c A fl n .. 5. Generator-s Name and Mailif\g ~dcfress -

Generato~s Phone:41:!) 41)4-5358 6. Transporter 1 Company Name

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Generator's~SHe~Aildress (ff di!lerent than mailing address)

Gb"'Nl:RAL aEC'rRfC CO ·15~ Pl.AS1'!CS p,V£:.

U.S. EPA 10 Number

_. ..

i'H.OVIOENCX:. AND WCiRCESTE:R l'LR. IM A DO Y.i, ~0 2 ·.1 ~ 'l 8. Designated Facility Name and Sile Address

WJ., YNE O~'POBAt INC. U.S. EPAIDNumber

4(,•:~00 M 1-94 S.E.RV!CE DHIVE .. Fac~ity's Phone: ;~(J(l W:~--5 4il ~i BELLEVILLE. Ml -1811'!

9a. 9b U.S. DOT Description Qnduding Proper Shipping Name, Hazard Class,ID Number. HM and Packing Group (if any))

3.

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14. Special Handling Instructions and Additionallnfo1111ation

'- 1 f·~"-. IU: ~! NU~.~ I'Jf:T<::..SI-......fP!/.------·-·· ·- F•::.::a RDJ.C\!ED ~Rf'•M :.SERV!CE DATf: i'f:.W/20"2 -j- -~~ it) ., 't F t'?l l{ l Ff>'("'t.J '-~ II \11='!; J A:.C~_M(\lf:f')' ·"''IIJ ~"JFr\! !ir~rn r:>.~.-"'l<lroJ{;l ~· J;;:; ATL~f'i .. u::r } f.'Ji"~ i ·i ·1·1 ·:';fO·I 15. GENERATOR'S/OFFEROR'S CERTIFICAnoN: I hereby declare lhat lhe contents of this consignment are fully and accurately described above by the proper shipping name, ard are classified, packaged,

marl<ed and labeledlplacarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations./! export shipment and l am the Primary Exporter, 1 certify that the contents of lhis consignment conform to the terms of the attached EPA Ad<nowledgment of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b).!IU~ a sma~ quantity generator) is true.

~ 1S.Intemationa1Shiprnents DlmporttoU.S. 0~~-fromU .S. V Pitofentry/exit: -------- ----- ------~ Transporter signature (for exports only)~ Date leaving U.S:: '


!;: Transporter 1 PrintedfTyped N\ime 0 }_/ ,.,. ... .., /

3; !""'·","' I ·";fr,, ... n .·· t• ~ Transporter 2 PrintedfTyped Name

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1 Sa. Discrepancy Indication Space l18. Discrepancy

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... ...... -Mont11 Day Year

It~ fpJf>.. Month Day Year

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0 Partial Rejection 0 Full Rejection

U.S. EPA JD Number

I Day Year

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1 Month J I

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20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted In Item 18a

PrintedfTyped Name Signature Month Day . -'Year

I J l J EPA Form 8700-22 (Rev. 3-05) Prevrous ed~ions are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12~pitch) typewriter) .. Form Approved OMB No 2050-0039

UNIFORM HAZARDOUS 1. Generator ID Number ,2. P~ 1 oft 3. Emergency R~ponse Phone r· Manifest Tracl!ing Number

WASTE MANIFEST 'M./l, [' 0 0 20~ 4 0 9 :3 ~ taoo} 42~_aoo rJoos-27317 VES 5. Generato~s Name and Maili g Address

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, .... ... 4G4-.'13fit; PI1T::JFfi::l.U, fVI~. m2!H (lrfSFIUD, AAA n ·t.ID1

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8. Designaled Facility Name and Site AddreSW.II.'I,.Ii£: t'JSPOSAL INC. U.S. EPA 10 Number

tJQ:350 N i-94 SErN!C~ DRIVE ...

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15. GENERATOR'S/OFFEROR'S' CERTIFICATION: I hereby declare that the contents of this consignment are fully and accura!ely described aboye by the proper shipping nama, alll are classified, pa"!\ttaged, marked and labeled/placarded, and are in au respects in proper condition for transport according to gppllcable international and national governmental regulations. If export shipment and I am the Primary Exporter, I certify that t11e contents of this consignment conform to !he-terms of the attached EPAAcluiowledgment of Consent. I certify t11at the waste minimilation statement identified-in 40 CFR 262.27(a) (~I am a large qua~nerator)·or (b)~ a small quantity generator) Is true. . -·-

Generators/Offeror's Printed/Typed Name

(--~ ~ Olt«'~b)R~~~ 1lo l&i ,li: ROBERT P/IJ::!~U.!.) N-'<.OE:Nf FOB OEi \

...J 16. International Shipments 0 Import to U.S . 0 Export from U.S.

\./ Po~ of entry/exit ~ ' ~ Transporter signature (for exports only): Date leaving U.S.:

11:11::: 17. Transporter Acknowledgment of Receipt of Materials w ~ ,....,

li;: ~~;.~o.£!er).Jri~ted!T_Y_£ed N1~me ( ,• !Sign:~~ -~/~ llb pilii. ~ ,;;;;, ;_/ (/ . / ~· 1<.,_,~ j ,_. ... ' ,.. .... .r ~;-~

rn Month Day ~ Transporter 2 Printed/Typed Name Signatu\Y -~ - .....l ~- Year

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0 Partial Rejection 0 l'ull Rejection 18a. Discrepancy Indication Space


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20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by t11e manifest except as ncted in Item 18a

Printed/Typed Name Signature Month Day Year

I I I I . . EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1ttons are obsolete . GENERATOR'S INITIAL COPY

c

Please print or type. (Fonn desi ned for use on elite (12-pitch) typewriter.) Fonn Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 1. Generator ID Number

WASTE MANIFEST· ~""~g·~ ~ v,.e'AiJaress (if.differen! than mailing address)

6. Transporter 1 Compan~ame

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10. Containers

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15. GENERAfOR'SiOFFERO~·s·cER'i'fFICAfJON:Thereby declare illai Uie conients'orthis'conslgnment are:ruw;; and' acciJr8Te)i3esc'ritJedaoove by'tne pi'opei'Shipping name, and are classified, packaged, marked and labeled/placarded. and are in aU respects in proper condition tor transport according to applicable international and national governmental regulations. If export shipment and I am the Primary Exporter, 1 certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment or ,Pensent. 1 certify that the waste minimization statement idenfified In 40 CFR 262.27(a) (if I am a large q)liRti~nerator) 9'\_(1!) (if I ~)II, a small quantity generator) is tn.Je.

Generators/Offeror's PrintedfTyped Name \ S,a!U(e ~ -~ .LJ ff l ( , ~- A;::~.\- Month Day Year

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ffi 17. Transporter ACknowledgment of Receipt of Materials

li;: Transporteri-1' Printedlfyped Name

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20. Designated Facility Owner or Operator: CertificatiOn ofrecelpt of hazardous materials covered by the mannest except as nded in Item 18a


I I L _I EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

PI ease pnnt or typ~ •. (F d . ed to orm esrgn alit (12 'tCh) ty ·t ) ruse on_ . e ·pi . >. p~w,n er. Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS r· Generator ID-Number •

WASTE MANIFEST ' M A[) 0 0 :1 Q B 4 0 9 "j ,2. P' 1 o13. ~merge:cy R!!Sponse Phone

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6. Transporter 1 Company~~ • ~-~'"'it..:~"T::: er~~,:~, ";,:;'' E 6! J}t:;ll-1'4 c: A ! I/ .Z:J~~.:.. 1

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9a. 9b. U.S. DOT Description (Including Proper Shipping Name, Hazanfcclass, ID Number, 1 O, Contain•rs 11. Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) .t No. Type _ Quantity Wt.Nol.

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14. Special Handling lnslructions and Additional information ':.1-<',;. :1 ( 1 l·"Uj :t<;t->~,L, ;:,t;:l.il!!."t:.Nf, ,Do, 'a.' Vt::.!:~·<f~. ,1 ;tl!J'~!Jlt<it:.~! r:n:·:B·:s .. : , ·~~

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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, 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 Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknolll1edgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large ~~ne~).o~· a~~:quantily ~enerator) is true. -

Generat~s/Offero~s Printed/Typed Name 1, .~~ ~~1 ':.)'"'~~ .~:~ Month Day Year

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a:: 17. Transporter Acknowledgment of Receipt of Materials w _..., ~ TranSPQ~r 1 Printed_ltyp,ed Name · Signature ,.,.-·" /~--./,.,.. • .- ~-· ..... Month Day Year 0 ;/.,-4 ( / _,-; .. I ~ r- .., ..... 110 1 0~[2, 0... .... (.i '' •./ /,.1 .• 1 .. 34 ., __ ... . -_::..;!t'·{__

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20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a

Printed!T yped Name Signature Month Day Year

I I I I .. EPA Form 8700·22 (Rev. 3-05) Prevrous editions are obsolete. GENERATOR'S INITIAL COPY

.....

Please print or type (Form designed-for use on elite (12-pitch) typewriter) Fonn Approved OMB No 2050-0039 UNIFORM,HAZARDOUS I'· Generator 10 Number

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13. Waste Codes .. Type

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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. 1 certify.that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b);il-l.a/11 a small quantity generator) _is true.

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Man~est Reference Number: >- 18b. Alternate Facility (or Generator) U.S. EPA ID Number 1-::::i -u

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~ 1. 12. _r 14. , 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a


I I I I .. EPA Fonn 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete. GENERATOR'S INITIAL COPY

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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, 1 certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quaniliYgeqerat<![) or~fallj a small. quantity generator) i~ true. .

Month Year Day

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ffi 17. Transporter Acknowledgment of Receipt of Materials 1 -

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~ 1 . r r-20. Des1gnated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manffest except as ncted in ~em 18a


J I I I EPA Form 8700·22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050-0039 UNIFORM HAZARDOUS 11. Generator ID. Number

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13. Waste Codes

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15. GENERATOR' S/OF.FEROR'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. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b),(ff.l.a~ small quantity generator) is true.

~ 16. lnternalional Shipments 0 Import to U.S. 0 Export from U.S. ··..; Po~ of entry/exit;··--------------------~ Transporter s1gnature (for exports only): Date leaving U.S.:

ffi 17. Transporter Acknowledgmenl of Receipt of Materials ~ Transporter 1 PrintedfTyped Name

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120. Designaled Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manif~st except as ncted in Item 18a PrintedfT yped Name Signature

I Month

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I I Year

EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

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Please print or type (Fonn designed ·for use on elite (12-pitch) typewriter) Fonn Approved OMB No 2050-0039

UNIFORM HAZARDOUS , 1. Generator ID Number

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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 cond~ion 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 ol Gonsent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large q_uafifitY ge~eratqr) 9~tb) (~am~ ijll1311 quantity generator) is true._ __ __

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Prtntedfryped Name Signature

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13. Waste Codes HM No. Type

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15." 'GENERATOR'S/OFFEROR'S·CERTIACATION: I hereby dedare that th.e contents of this Consignment are 'iuliy and accurately described above by the ·proper shipping name, and are classified, packaged, marked and labeled/placarded; ·and are in all respects in proper condttion 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 confonm to the tenms of the attached EPA Acknowledgment of Consent. I certify thai the waste minimization statement identified in 40 CFR 262.27{a) (if I am a large quanti!Y.Jlenerator) or (b)jif.l.al(l a small quantity generator) is true.

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~ ~) · r- r r j 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a

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1 s. GENERATOR'SIOFFEROR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fuily and accurately described above by the proper shipping name. and are classified, packaged, marlled and labeled/placarded, and are in all respects in proper condition for transport acoording to applicable intemational and national governmental regulations. If export shipment and I am the Primary Exporter, 1 certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. 1 certify that the waste minimi;tation statement identified In 40 CFR 262.27(a) (if 1 am a large quantity generator) or (b) (if.l-a!'l a small quantity generator) is true.

Month Day Year

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ffi 17. Transporter Acknowledgment of Receipt of Materials •

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20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials ce>vered by the manifest except as nded in Item 18a Printed/Typed Name Signature Month Day Year

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15. GENERATOR'SIOFFEROR'S CERTIFICATION: I" declare that the contents of this consignment are marked and labeledlplacarded, and are in all respects in proper condition for transport according to applicable international Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Ack;no~~ed•ame•nt

1 certify that the waste minimization statement identified in 40 CFR Z62.27(a) (if I am a

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14. Special Handling Instructions andAdditionallnforrnation ~H'.J-17! PCB S·:-•IL, Sf:.THME"rr • . ~NP OEf.:if~t~. t·1.?.2000Wt:l• r:-lCB':j ~ 1 ~,,

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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 Consenl I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity .. ~nerator) or,(b) .(ifl am) Sl)lll}quantity generatoQ.is true. •

..J 16. 1ntemational Shipments 0 j:... Import to U.S. ~ Transporter signature (for exports only):

0 Export from U.S. Portofentry/exit: - ------------------Date leaving u.s.:

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20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the man~est except as ncted in Item 18a

Printed/Typed Name Signature

I EPA Form 8700-22 (Rev. 3-05) Prevtous editions are obsolete.

-- . -· Please print or type. {Form designed for use on elite (12-pitch) typewriter.) Form Approved OMB No 2050 0039 -

1 UNIFORM HAZARDOUS r- Generator 10 Number , 2. Page 1 of:l 3: Emergency Response Phone r· Mol)ff52u~t4 6 8 VES WASTE MANIFEST n " " _ 1'\

' - ' - J. "''"'·' _....., '''''"' 5. Generator's Name and MailingA"dareS5 · - ·.- Generator's "Site Address (if different than mailing address) r-~:NERIII FL.f.!'""l'Pl("' ,.,, .. ., GENER~ ELE'."TRIC C<) ~i1'NlM rn: c:~lAtr~if' 1 -~9- ~ .. ;\\.ST!(:-s fo.\1::

r-. 'l!i9 PU\S1'H~5 AVF Generator's Phone: <\ 1 ~' 4!:14- ';9<'(',

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6. Transporter 1 Company Name U.S. EPA ID Number ' .:=-"t"•"•.O::•:oA

IM P!~·::>\n or:Nc:r.:: f, ~·-Et.Ul!J~1F-tt.-:~E~rn;; F~ r~ r-\ !) {) ~~ !? 0 2 J_) 17'1 1 7. Transporter 2 Company Name· ··· U.S. EPAIDNumber .. . , .

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· ... •/<l.to 'i'NE DlS!'-lt.)':>At. If IC U.S. EPA ID Number

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14. Special Handling lnstruc1ions and Additional Information f;Jt3:!!i i7(. :t~ ':::LHL, ~>EUlMENT . t,ND DI:2!.1Rr:~ !•! .-12 (JlJ(}'<;".Jf1t fJJ:~ -e-· s .r 't ·~s.

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15. GENERATOR'SJOFFEROR'S CERTIFICATION: I hereby dedare that the contents of this oonsignmeni 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 allached EPAAckoowledgment of Consent. 1 certify I hat the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large q~~ntity-generator] or (b) (itra~all quan~ty generator) is true.

Generators/Offeror's Printedffyped Name ~, . st:tre- . \ .:r:.:tL~) _ '{C: f>~"f.c ·-f~·\ Month Day Year t~·\_\F~FF~·i r.:~'f..J3}\LJ ·~··,: .i.(}~·!·{r r.,·.~r-~ <3E\ ',.jJ:' _:-.. .l I V''\t t v ' E"'::f:: l , -.. -I . ' I \.'l)')oQ, ~· r """- f" . ( l -·' ~j · !_;J( •w· \ ( : /. ~ .. , \ .: •..

_. 16. International Shipments 0 Import to U.S. 0 Export from u.s: -'-../·Port J entry/exit: t-


0::: 17. Transporter Acknowledgment of Receipt of Materials -w .. ' 1- Transporter 1 Printedffyped Name Signature /;/· .. /' .· ···-;.- Month Day Year 0:::

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en TranspOrter 2'Printed!Typed Name Signature j./ -~·

..._ _ _..,.., Month Day Year z

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1 1 B. Discrepancy

1 Ba. Discrepancy Indication Space 0 Quantity Drype 0Residue D Partial Rejection D Full Rejection

Manifest Reference Number. >- 1 Bb. Alternate Facility (or Generator] U.S. EPA ID Number 1-:::i u

I < Faci lity's Phone: u... c 18c. Signature of Alternate Facility (or Generator] I Month I Day Year w !;;( I z (.!)

19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, di5posal, and recycling systems) (i)

~) , 2. ,3. r 20. Designated Facility Owner or Operator: Certification o(receipt of hazardous materials covered by the manifest except as ncted in Item 1 Ba

Prinledffyped Name Signature . Month Day Year

I ~ I I I , .;; · . ..

EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete. GENERATOR'S INITIAL COPY

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Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved OMB No 2050-0039 UNIFORM HAZARDOUS I'· Generator ID Number

WASTE MANIFEST M •\ D (J 0 2 i) a "' 0 9 ·:. .;

12. P:l 1 of 13. Emergency Response Phone

{800) 424~'3()0 r· M(fooc5g2u73 55 VES 5. Generator's Name and Mailing Address

OENE.R'\L Ei~E·:.:TRIC CO G~ll..~~IQJ:'R~e ~r~~.(ir~~nJJIJ.an mailing address) ·. GE "'E L -·~ ,. 1, .. •,.( )

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Generato(s Phone: ~+ l ~ ·'l i:!4<131:il) .1' l~' ... l, ..

6. Transporter 1 Company Name U.S. EPA ID Number :·'ACt:. ere :tx: I N 1' , ..

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7. Transporter 2 Company Name U.S. EPA ID Number ;:\r.:.::~··iOJE.i~ .t-t~"t: At~U.) llJC!R.,"".:E. ~rf [ 'f..t FL F~. JM ~. n (l r:r ~) .-. I) a ··T ,_.

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8. Designated Facility Name and Site Address WI\ YNE C•ISPC~SAL iNC. U.S. EPA ID Number

4(1:~50 N ! .. Q.•l '3ERV!CE [1q1V£ ~

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9a. 9b. U.S. DOT Description (induding Proper Shipping Name, Hazard Class, ID Number, 10: Contai.ners 11. Total 12. Unit 13. Waste Codes HM and Packing Group (ff any)) No. Type . Ci'antity .L Wt.Nol.

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.... ' .... . ... t •. _ .. _J .. - ·-- ·~- .. . '1 ··-~ ·-. .-.... PCE HEM0• .'EU n~~OM Sf.FN iCE 0..-'\ff:: t~f:YJQO !:? j .. '! ) , ~:: .;\.!T: !·"".;. L~~.L F~~(!!-1. ~ .. :p_ ·/Ef{ .1. .~V.C t:.~F~(·r~.-;(; ... ;:;r. CD ~"¢f.<:)\J!f.!EI .'! i~!.fc-:;·r(t f·4() SL;Ft .~T'f'A(it-tEJ) P(rff. ! ·1 1 ··t ~, 2tr11 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.confonn to the tenns of the attached EPA Acknowledgment of Consent. 1 certify that the wast!J minimization ~tatement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quanti!Y generator) _is true.

Generato(s/Offero(s PrintedfTyped Name ,Signatu~-.c'( • ~~~ , ~J'" ~~ ... ' Month Day Year r~r ,8EP! t -J~,f .. '.4~ . .L() {A~3E~rr FOP .:3E) (l~t£ 0,\.:~ J{. , ~\VeAl)\':, C/' ·, f-.£:,. I Jo 12'1-1 J2-'• ""~ • . . , •. ;..! ••·.•. - ( •. ~ .:::::::;;.

_,I 16. International Shipments D Import to U.S. D Export from U.S. ' . .... Port of entrylex1t ~ Transporter signature (for exports only): Date leaving U.S.:

0:: 17. Transporter Acknowledgment of Receipt of Materials -w ~ Transporte~nted/Typed N~e «_. Signa\ure ~ . _.,.- Month Day Year

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1 18. Discrepancy

18a. Discrepancy Indication Space D Quantity 0Type 0Residue 0 Partial Rejection 0 Full Rejection


~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number :::i u

I ~ Facility's Phone: c 18c. Signature of Alternate Facility (or Generator) I Month I Day Year w ~

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(!) 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment. disposal, and recyding systems) Cii

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PrintediT yped Name Signature Month Day Year

I I I I .. EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1llons are obsolete. GENERATOR'S INITIAL COPY

Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved OMB No 2050 0039 UNIFORM HAZARDOUS ,1. Generator ID Number

WASTE MANIFEST • ,, ,... " ,, ,. _ . .._ ,, ~ !'\ J l _ ...

, 2. Pa:: 1 of , 3. Emergency Response Phone

_.,((., ton"' _. •.... 4 ic·f-::uv. r M6ooc~g2umr3 56 VES

5. Generato(s Name and Mailing A'dilress - .. - - ~ .. Gerieratb(s 'Site Adilfess (if different than mailing address)

.... GEN)::'R~L ELE("TRK: CC· Gt:NEf~\L ELECTRIC C)~.J An'~~- il. TT Ct~LJ\f''f'Jl'>'c ·J o9 PLAH!C8 fWE

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6. Transporter 1 Company Name U.S. EPA ID Number

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7. Transporter 2 Company Name . ..

U.S. EPA ID Number .. ·-· Pi'~·.:Y·lri)ENC:£' ,-l.ND \N::)RCi::STE'.R H~R·~ ·"· · ,.

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" 8. Designated Facility Name and Stte·Aadress ., ·- · .. · vVdYNE fJlSPOS,.~L tt·r.:: U.S. EPA ID Number

49:!1~0 t-.~!··94 f;~:JN!CE DR!'/ E

Facility's Phone: .:iOii !)~\d ··D4':ti:)D f:o.EU.EV!LLE:, Ml ;l£i11! I ~~~ i I' r • :.; :; '·' ,,

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13. Waste Codes Type

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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 condttion 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. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (bl_{iU.i!,m a small quantity generator) is true.

Generato(s/Offero(s Printedffyped Name ,. Sig~u ~V~ lc.jfA . "{'~· . t ~~{ )\ .. -

Month Day Year . ~ :A_ . ,, ..... .. -if- l

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-... ~..1 Poh of entry/exit:

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~ ~ Transporter SIQnature (for exports only): Date leaving U.S.:

0:: 17. Transporter Acknowledgrneo.\ of Receipt of Materials w 1- Transporter 1 Printed!Typep N~Jfie .·

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V) z Transporter 2 Printedf!W1ed Name Signattlre Month Day Year <(

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l 18. Discrepancy

18a. Discrepancy Indication Space D Quantity 0Type 0Residue D Partial Rejection D Full Rejection

t'-.·..:.-

Manifest Reference Number: >- 18b. Allernate Facility (or Generator) U.S. EPA ID Number 1-:::J u ~ Facility's Phone: I 0 18c. Signature of Allernate Facility (or Generator) I Month I Day Year w !;;( I z ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

~ 1. r. r r 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a

Printed!Typed Name Signature Month Day Year

I I I I . . EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete . GENERATOR'S INITIAL COPY

Please print or type (Fonn designed for use on elite (12-pitch) typewriter.) Fonn Approved OMB No 2050-0039

UNIFORM HP.ZARDOUS , 1. Generator ID Number

WASTE MANIFEST ~,$ f.. rJ {J t) ') !) B ·4 I) ~) "j ..;

, 2. Pa9111 oi l ~-. Emergency R~s~nse Phone

&l !HQt1) •tH·~.:.K.\f) r· MoHooc5g2u~f3 57 VES 5. Generato(s Name and Mailing Address

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Generato(s Phone: ~.., ~ ';-

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7. Transporter 2 Company Name U.S. EPA ID Number t··: ~JC! ~!~f.J[Er~-.tc1: t;t\tC!'V\fi~JRCCSTEfZ rtr;;. I

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B. Designated Facility Name and Site Address tlVA·.VNC-? ~)~ ~·;t:lt"f .. S":.l :.t .. iN•:~. U.S. EPA ID Number

-19 -~ tiO H '- [~ •'! S~: Fi'•'lC."E pq~Y.f.:. ~

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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 lo applicable international and national governmental regulations. If export shipment and I am the Primary Exporter. 1 certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. 1 certtfy that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quan~!Y~et~erator) or (l;l){lfTh~a small ~antity generator} is true. ·- .

Generato(s/Offero(s Printedffyped Name ,' '~: 1;~\i~ -_"':"_.' " ··.:'~>-"':'·~~~/ ' Month ~Year :: .t~ ,b(· r J ~ r ,; r-P'~.u .·: ) ;.aou-: 1 F<")H OE) ·,. ~· ; 1" • . \ ·:::" . ;·.,_· .... · ~-;.,.;

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...J 16. International Shipments 0 Import to U.S . 0 Export from U.S.

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Po~ of entry/exit: ~ ~ Transporter signature (for exports only): Date leaving' U.S.: . 0::: 17. Transporter Acknowledgment of Receipt of Materials w 1- Transporter 1 P~nted!Typed Name Signature

7~-~ ;z::·-· Month Day Year 0:::

0 ); /; /~~ -t!: /l.-f'&-:/ i/7/41 v 'T,"_. I 7""""~-;1.~ :.)/ ?(_ .e._.. l )o 12.41 rz_ c.. en z Transporter 2 Printed/Typed Name .J' Signature / Month Day Year <(

I I I I 0::: 1-

1 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity 0Type 0Residue 0 Partial Rejection 0 Full R~jection

Manifest Reference Number: >- !Sb Alternate Facility [or Generator} U.S. EPA ID Number 1-:::i u

I ~ Facility's Phone: 0 18c. Signature of Alternate Facility (or Generator) I Month I Day Year w ~ I z (!) 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) iii ~ 1 r· r r· )

20. Destgnated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a

Printedffyped Name Signature Month Day Year

I I l I .. EPA Form 8700-22 (Rev. 3-05) Prevtous ed11ions are obsolete. GENERATOR'S INITIAL COPY

m

Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS , 1. Generator ID Number

WASTE MANIFEST , ,. ,, , ,.. . .., ~, ,.., ,., , .,

,2. Pag~ 1 of , 3. Emergency Response Phone ,4. M

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0est Torac~g ~u!!l~e~-.

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Genera to(s Phone: '1 1 :.l •i94·b J!'1R 6 Transporter 1 Company Name


8. Designated Facility Name and Site Address VV>\YNE OISPOS.h.L ~NC tt~i:350 r-.! i-?ii SEWJ!''.:.E DRIVE ..

G'eneratO(s'Site Adctress (if different than mailing address}

GENERI.\L ELECTRIC CO ~59 PLf-.ST!CS /\'!E

U.S. EPA ID Number

''-!Y D'S· '~ U.S. EPA ID Number

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14. Special Handling Instructions and Additionallnfonmation

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13. Waste Codes

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 labeledlplacarded, and are in all respects in proper condition for transport according to appficable international and national governmental regulations. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment confonm to the tenms 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_~enerator} or (bUifJ..(lm a small quantity generator} is true.

Generato(s/Offero(s PrintedfT yped Name

....1 16. International Shipments 0 ~ Import to U.S. D Export from U.S. 'v A,rtof entry/exit:--____ ... _______________ _

z Transporter signature (for exports only):


!i;: Transporter 1 Printedffyped Name

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118. Discrepancy

~ 18b. Allernate Facility (or Generator} ::J u it Facility's Phone:

D Quantity Drype

Date leaving U.S.:

Signature ) /1-.'IJ. I . /_ L/~~--~__j_ ~

Month Year

SigrlatUre'-" f Month Day

I

0Residue D Partial Rejection 0 Full Rejection


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~i r· r 20. Designated Facility Owner or Operator: Certification-of receipt of hazardous materials covered by the manifest except as naed in Item 18a PrintedfT yped Name Signature Month Day Year

I I I I EPA Form 8700·22 (Rev. 3·05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

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Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050 0039 -UNIFORM HAZARDOUS 11. Generator ID Number

WASTE MANIFEST M ,¢.. D 0 0 2 () B 4 0 9 ..3

,2. Page 1 of ,3. Emergency Response Phone

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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·geQeratpr).on(bt'(iii\am a S!Jlall quantity generator) is true.

Generato(s/Offero(s Printed!Typed Name \ --~~~M:).~ '· ~. ,)~J~~-~~--- 1 Month Day Year ~~:c~;t'1f:':F~~-1 f.)_:\P :"\: J ·:.J (.:lt.'?.fl-.ff ~~()J~ (Jt;:}

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0 Import to U.S . 0 Export from U.S. ...... .

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a:: 17. Transporter Acknowledgment of Receipt of Materials -w 1- Tra!J§llllller 1 Printed!Typed Name Sign~_..., ~c:-::..--: ...... - .• ~- -... - - -·-··- Month Day Year a:: 0 t- .... I ·-... . -~ .. ,c. r; I ~; .... _--·~ ·--~~ ~ .. --.--... ~ ~·-:- ~ ---r-.e !2.-1-lt-z .. c.. ;...;....j . ~., .. I 1 .. -- ~!"' C ···"':.._. l b-~- ~~

en Transporter 2 Printed/Typed Name Signature z Month Day Year

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1 18. Discrepancy

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Manifest Reference Number: >- 18b. Alternate Facility (or Generator) U.S. EPA ID Number 1-::J u

I <( Facility's Phone: u.

Cl 18c. Signature of Alternate Facility (or Generator) I Month I Day Year w ~ I z ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

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I I I I .. EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed·for use on· elite (12-pitch) typewriter,) Form Approved OMB No 2050..0039 UNIFORM HAZARDOUS 11. Generator ID Number

WASTE MANIFEST u >, ~ ~ r; ~ n A ,; . n t,\ ·:r 1

2. Page 1 of 13. Emergency Response Phone 14. Manifest Tracking Number

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9a. HM

9b. U.S. DOT Description (including Proper Shipping Name, Hazard aass, ID Number, and Packing Group (if any)) · ·

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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 an respects in proper condition for transport according to applicable international and national governmental regulations. ff export shipment and I am the Primary Exporter, 1 certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) {if I am a large Qljl!ntity.~erator) or~ ) {if\am a small quantity generator) is true .

.....1 16.1ntemational Shipments 0 D \J -l t- Import to U.S. Export from U.S. Port of entry/exit: -------------------~ Transporter signature (for exports only): Date leaving U.S.:


~ Transport~pJrintedffyped/a e / /

0 4'.-t:r ~, / /&·/ ...-b. ,t(, 3; ,,u:: "-G-' ··"' . / /) . / ; ., --~ Transporter 2 Printed/Typed Name

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18b. Alternate Facility (or Generator)

D Quantity

Signature

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/:: .. . ...-:.&-Signature

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D Partial Rejection D Full Rejection

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u I it Facility's Phone: ~~1~&~-~S~~~n~aru~r~e~o~fN~t~em~a~re~Fa~c~ility~~~r~G~en~e~ra~to~~~------------------------------------------------------~-------------------r~~--"-~~v.=~

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20. Designated Facility Owner or Operator: Certification of receipt of hazar~s materials covered by the manifest except as ncted in Item 18a Printed/Typed Name Signature

I EPA Form 8700-22 (Rev. 3-05) Prev1ous edltions are obsolete.

1 H ·\IU:;'~l t •<UMHf;J~--- .. £..7.:...3~_: .. -... P'C:f! RI'.:M•:)Vt':D FR•..::'M SEHV!CE f.JATE 8!l{!!2~n:t + 'i)

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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 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or

D Quantity Drype 0Residue


EPA Form 8700·22 (Rev.



c

Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMS No. 2050-0039

UNIFORM HAZARDOUS I'' Generator ID. Number

WASTE MANIFEST • , .. .. . ~ .. 5. Generato(s Name and Maning A'il~reSs ' . " -

Generalo(s Phone: .~ - · ., .<AAL. · .-:< '-6. Transporter 1 Company Name (. • :-~~·-•>, ... ~ .. ·.;\..~

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7. Transporter 2 Company Name ·, ~ u:S.'EPA'IDNUmoef - " "'"" ' •

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8. Designated Facility Name and Site .A,d.aress U.S. EPA ID Number

Facility's Phone:

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10. Containers

No. Type 11 . Total Quantity

14. Special Handling Instructions andAddiUonallnfonnation !~'Ft:..:i . '! 'i ! i·'CH SOIL, S.ED!MEN1. N-.![1 DE8RIS. ~ -i'l'?.J'(!GI;''-1!: : •

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15 GENERATOR'S/DFFEROR'S CERTiFICATiON: i hereby declare 'tiiat the-contents ofihis consignment are -fully ani! accurately described ai>Ove.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 interna1ional and national governmental regulaUons. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment confonn to lhe terms of the attached EPA Acknowledgment of Consent 1 certity thatlhe waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quanJity.g~(l6rator) or ib). (if)-am.a small quantity generator) is true .

.....1 16. International Shipments 0 D ..._. · \. j:... Import to U.S. Expori from U.S. Port01 entry/exit: - - --- -------- - - ----~ Transporter signature (for exports only): Date leaving U.S.:


~ Transporter 1 Printed/Typed Name Signature .,L._ Month Day Year

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~ 18b. Alternate Facility (or Generator) ::::; u '(}_ Facility's Phone:

D Quantity

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ti

Drype 0Residue · D Partial Rejection D Full Rejection


I Day Year

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~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal. and recycling systems) ,, I ~ ll ,4.

20. Designated Facility Owner or Operator. Certification of receipt of hazardous materials covered by the manifest except as naed in llem 18a

PrinledfTyped Name Signature Month Day Year

I I I I EPA Form 87QQ .. 22 (Rev. 3-05) PreVJous editions are obsolete. GENERATOR'S INITIAL COPY

3.

4.

15. 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 arid national governmental regulations. If export shipment and I am the Pnmary Exporter, 1 certify that the contents of this consignment conform to the terms of the attached EPJ\Acknowledgn1ent I certJfy that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large

,-.. < '· '

0 Quantity Drype DResidue 0 Partial Rejection 0 Full Rejection

4.

8700-22 (Rev. 3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY

EPA Form 8700-22 {Rev.

W.ll..YNE C'i .:;f"~()15 Al. H·K~ ~1~-7'30 N H,:O•l SEIN!CF: !)1"~1\I E"

are obsolete.

VES

U.S. EPA ID Number

13. Waste Codes

0 Full Rejection


VES

~ >, tJ, ·~ ···: ·~- '3 ;._..

f.:> ~) 'l 2 fJ .:~ -~ ,,

· · -;; i ~~ /;_" 15. declare that the contents or this consignment are fully and accurately described above by the proper shipping name, arll are classified, packaged,

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Generato~s/011ero(s · f.?(-~ .r: ~.' f J C: t lf .l ~":~: f..--~- >'/•i ::.Fi:tq f:- l)f~ L'j~~:~


Number

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Please pnnl or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050 0039 . UNIFORM HAZARDOUS 11. Generator ID Number ,2. Page 1 of ,3. Emergency Response Phone

rMolotcrs~u74 7 4 WASTE MANIFEST ~ r " ,. .. , ., (: . ,... ' :. .2 I CI. \ 1\\ .,. ' ~l':tl\( VES 5. Generalo~s Name and Mailing tidilress - "' " -

G~nenitb~s~ite Address (if different than mailing address)

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8. Designated Facility Name and'Site Address .·' " U.S. EPA ID Number · .... .,,,;, V~'AYNE ~)15r·'l:)S.I\L !t-JC •

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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 cond~ion for transport according to applicable international and national governmental regulations. If export shipment and 1 am the Primary Exporter, I certify that the contents of this consignment confonm to the terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identifi~d In 40 CFR 262.27(a) (if I am a large quantity generator) or (b) ,(ifi'81TT'8;small quantity generator) is true.

Generato~s/Offerol's Prin1ed/Typed Name :· ~.:tlrt; ,,. ,~UI )6. :J~:. ~~ ":\ "Month Day Year i:?. - .~:lf:.)E ~tf' l:;_AF ... l\LL~) ,AI.'.F:'r-,rc ~-c-,F~ (:~~-! ...... :

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1 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity Orype 0Residue 0 Partial Rejection 0 Full Rejection

Manifest Reference Number: >- 18b.Aiternate Facility (or Generator) U.S. EPA ID Number I-:::J u it Facility's Phone; I 0 18c. Signature of Alternate Facility (or Generator) I Month I Day Year w ~ I z C)

19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) c;; , , 11 , ~ 14. l 20 D.S90""' '""" """"" Q~- Co.r~tiM 0 .... 0 -··· ~"'' _., tiy •• ~"'"" -· ~- ;, ... '&

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Please print or type. (Fonn designed for use on elite (12-pit<;b) .. typewriter.) ..

a:: 0

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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, ard are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national go.vemmental regulations. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment confonm to the tenms 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 quanti!Y .gll!leratop, or(b) ,(ifl~l'1_ a small quantity generatpr) is true.

~ 16. International Shipments 0 Import to U.S.

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I' I I I EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY


~ UNIFORM HAZARDOUS 11. "'M""" ID N•mb• 12. Page 1 of 13. Emergency Response Phone 1

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marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental reguiations. 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 quan!if:Y,.g~rator) or (b) (if I Jill\~ small quantity generator) is true.

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I I I I " EPA Form 8700-22 (Rev. 3-05) PreVIous editiOns are obsolete. GENERATOR'S INITIAL COPY

Please print or type {Form designed for use on elite (12 pitch) typewriter) - Form Approved OMB No 2050-0039

t UNIFORM HAZARDOUS l1. Generator ID Number 12. Pag~. 1 of ,3. Emergency Response Phone r Mol1crsg2u~r3 6 3 VES WASTE MANIFEST M (., 0 0 0 2 \) ::: .!j lj 9 J ) :20(1) .. Q-1~,);~(10 c ...

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1!~n50 t-J !-f:1 'Sf:.Ri!C:E DRIVE

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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, pac~aged. 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 ~rimary 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 qu~tltftYgllnt!rator).Qr (b);(if-l ·.am''1 small quantity _generator) is true. ' .,. .... . .

Generators/Offere(s Printed/Typed Name \..~~t£gA \ .~} f I. \1. ~ -· · . '·r:-~·,M::'::~:.- Month Da~ :ear ~;:-.<~f:n:: !::~ ' ~ : ) tl. f' _~~t J t.) ~·~'.Jf!}lT f:~:)f~ t3Ei .... ..'l.:£ '\1--..l~1-~~1-1bc__;-\.:; k C:.:~~ I to I 2;:,1 12-...J 16. International Shipments

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I I I I .. EPA Form 8700-22 {Rev. 3-05) Prev1ous editions are obsolete . GENERATOR'S INITIAL COPY

,, '1 •

W~.YNE O!SPOS.A.L INC. ~~350N 1~4 SEHVICE DR!VE •

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WASTE ~NifEST · I ~ M- .a. D 0 t) 2 0 8 "! 0 f1 3 12. Pall.e 1 of 1 3. Emergen,cy Response Phone 14. M~nlfesi!Tracklng Number

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7. Transporter 2 Company Name P~O\flOE:NC'E AND WORCES1'ER RR.

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15. GENERATOR'SioFFERClit;S CERTIFICATiON: I hereby declare-that tlie oontenls ollhis consignment are fully and accurately d~saibed a,t>pye I>Y lhe proper shipJing name, ard are classified, packaged, marked and labeledlplaci!r®d. and are In all respects in proper oondition for transport according to applicable intematiOnal aild national governmental regulations. If export shipment and 1 am the Primary Exporter. 1 certify lhaf the-contents ollhis oonsignment ·conform to the terms of lhe attached EPAAcknowledgment of Co~~t. l 'certify -thatthe ~te minimization statement idenlii.e!l in40 CFR 262.27(a) (if I am a large quJIIIIilY~ralor) o,r{efflfl am"\SlJ!i ll;l.uanliiY genera¥) is true. _;_ _

....1 16. International Shipments 0 ~ Import to U.S. :!!!: Transporter signature (for exports only):

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I Day Year

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I Month I I

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T-20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials oovered by the ma~ifest except as ncted in ftem 18a

Printed/Typed Name S1gnature

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r· Month Day Year

I I I EPA Form 8700-22 (Rev. 3..05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COP~

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WASTE MANIFEST cL--.. '"' " ,. , _1_. n • ~~ .,., ., 5. Generalo(s Name and Mailing Alflliess •· ., " '

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G!iliem6(sSite A'd6iess (if different than mailing address)

GENERAL ELE.CTRIC 0') , 15e PLASTICS AVE

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15. GENERATOR'SiOFFEROR'S ·cERTIFICATION: I tiereby decliue that the contents of this Corisignnient are fully and accur.iteiy 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 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large AU~ nerator) or~ a small quantity generator) is true.

~ 16. 1nlemational Shipments 0 Import to U.S. D Export from U.S. ~ ~7en~/exit: ----- ---------------~ Transporter signature (for exports only): Date leaving U.S.:

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0:: Transporter 1 Printed/Typed Name

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ULL~ I Facility's Phone:

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~1. 11 ll r-20. Designated Facmty Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ntted In Item 18a Printed/Typed Name Signature Month Day Year

I I I I EPA Fonn 8700-22 (Rev. 3~05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

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fFV\ILf:"R:. NUMBER, _ ___ . ·--·- _b_··- ----. PCB P.EMi)VED FRClM SEHV!C.E [i_.!'~ TE ~~! .,...-; ) f?-fr5 \, ..

MATER.I . .O.L FROM SILVER L6.~<E PRO.lt;(:T Ct'D HEOVi~~ED. Pi1C!f!NO SU P .11 T !'J\,C;:Hf Off. ·111 1 " ':!.(;!? 15. GENERATOR'S/OFFEROR'S CERTIACATION: I hereby declare that the contents of this consignment are tufty and accurately described above by the proper shipping name, ard are classified, packaged,

marked and labeled/placarded, and are in an 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 confonn to the tenns of the attached EPA Acknowledgment of Consent. 1 certify_tliatthe wastrminimization statem~nt identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (ff Lam.a.SJl;ISH quantity generator) is true. -

Genet'l!to(s/01fero(s:Pifnted1Typed Name . (---s~~C?~VJ..D.t<e '. · ~- f-~t Mon_th Day Year

FK)£!ER~ P~P.4.lL ... .) \A~ENT FOR 00 ''··~ . ,-<.e: - · ' tv.'l-\t:,r. ·FC~. (:'£_ I \'2.1 l7 112-_, 16. International Shipments

D Import to U.S. D Export from U.S. Port of ~ntry/exit j:.... ;g; Transporters ignature (for exports only): Date leaving U.S.: /

« 17. Transporter Acknowledgment of Receipt of Materials -w --~: Transporter 1" Printed!Typed\'e .-t" _

SignatuQL \--~/~ t\t, ,., ,rz. ~ \?'c6-e:<tA:· J!':-.'\1. • " ~·7A I , ..A ~- .:>

:f Transporter 2 Printed/Typed Name Signature , Month Day Year

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1 18. Discrepancy

18a. Discrepancy Indication Space D Quanttty DType 0Residue D Partial Rejection D Full Rejection

Manffest Reference Number:

~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number ::::;

~ Facility's Phe>ne: I 0 18c. Signature of Alternate Facifity (or Generator) I Month J Day Year w ~ I z s-2- 19. Hazardous Waste Report Manag~ment.Mel\lod Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) U) ~~ 1. r r r·

20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in·ltem 18a

PrintediT ype d Name Signature Month Day Year

I I I I .. EPA Form 8700-22 (Rev. 3-05) PreVIous editions are obsolete. GENERATOR'S INITIAL COP't

Please print or typ~. (Form desi n_ed.for u~e on eJite (1~-pit!:h) tyl)ewriter,) Form Approved. OMB No. 2050-0039

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UNIFORM H~RDOU$ 1.;..Ge,n~iiiJOf I.!?!N!Jmbf r . .

WASTE M~~~FJ:~T!:-::1t;, l ~ .~t.r ........ " .... ,. n .. ,. ..



f'f~.OVlOGf'-lCf~ .\NO \1'/0RCtL'STEr~. R.R 8. Designatea Facility Nanie and Site Address

. · W.'\ YNE OISPO.."l.AL INf.), 4(1350 N 1-&J! SERVICE DF~IVE ...

Facility's Phone : 000 592-:548!} SEtl.EV!LLE, Ml ii& 1 'i 1

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, HM and Pa'cking Group (if any))

· G'oer3l6(s'S"rteAtfflress·(if different than mailing adaress)

OENERAt ElECTRIC ("t) 15Q Plft.ST!CS A\1E

I PIITSfiELO. Ml\ 01201 U.S. EPA ID Number

l~~VD9 8 • U.S. EPA ID Number

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f5. GENERATOR'S/OFFERoR'S CERTIFICATiON: I hereby declare'tliat the conients of this consignment are fully and accurately desCribe~ above by the jlroper 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 lhe attached EPA Acknowledgment of Consent. 1 certify that the \'la~te min[m(zatig_n stat~ent 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 .

...1 16. International Shipments 0 F- Import to U.S. 3::: Transporter signature (for exports only):

D Export from U.S. ......., P~rtofentry/exit: _.....,.,.:..../_'~---------------Date leaving U.S.: ,~ /


t;: Transporter 1 Printed/Typed Name 0 /"""' 3; (,.....').,.- J/ C't · ;~A;

~ Transporter 2 Printedffyped Name

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118. Discrepancy

~ 18b. Alternate Facility (or Generator) ...I

D Quantity

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0Type

/ Month Day Year

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Signature Month Day Year

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D Residue D Partial Rejection D Full Rejection


u..~ Facifity's Phone: o~1~8c=. ~si~gn~a~tu~re=o~f~~re~m~a~te~'F~aa~·li~~~~~rG~e~n~era~ro~r~)--------------------------------------------------~----~-----------r~~~~--~~

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20. Designated Fadlity Owner or Operator: Certification ·of receipt of hazardous materials covered by the manifest except as ncted in Item 18a

Printedffyped Name Signature "

I EPA Form 8700-22 (Rev. 3-05) Prev10us editions are obsolete.

., _ .. .. __ .,

Please print or type (Form designed for use on elite (12-pit'6il) typeWriter) ... Form Approved OMB No 2050 0039 UNIFORM HAZARDOUS J 1. Generator ID ~u-mtier

WASTE M~NIFEST , M A D f.!; (' 2 0 G 4 \) 9 :<

J 2. Page 1 of,. 3. Emergency Response Phone

J_ (f.lOO;I ·'121~.100 14

·~o~o-o6g3iesa 2 VES 5. Generato(s Name and MaHing•Address • -Genei'ator'fSite Address (if different than mailing address)

Galll..~ ELECTP.!G f.~O G~~ EL!it.::ntrt:~ CO .. A T'!N:MATT Ci>J....I\!::O) NE l )!l :M .•• UfiC$ AVP-ny P!,ASTICS AVE I !.>iT'l.'S.l•'JFJ.D. MA (1!2(11 . Generato(s Phone: 4!:, 494-~il.'lH Pl'~~p;i{.D,li.A 0 12(H . \,.,. '"

6. Transporter 1 Company Name U;S:·EPAID Number

EQ h"'ORl'fE!..AST.-~: J :M A :0 0 1.! 4 tl T 4 l -~ ....

7. Transporter 2 Conipany Naine . ~ .·;;- t:J,S-"EI?AlD Number .. PRO~ .A'NDJVMCBB'f1lf:\. ltl~. : .L~ .A. D (' ' 9 ( l ?. 0 3 _';I ·~ A ' ' .,_ . J· . ~ ~. .·,

a. Oeslgn,ated ·FaCility Name and'Site AddressWA~-ciS;Pr.~;...i-mc. · .,.. •.-. Q!$'i~A ID ~ber

,19~50 N; l-f14 SD;Vn::'E DRIVE .. Facility's Phone : P,{)ll :i~? .. :S41~~

.Bi'J.L.l:ll~l:l.L-I.E, Hi .j~ l ! J. IM ! D u •! i! .:' .:; 0 {} .. -~

9a. 9b. U.S . DOT Description Oncluding Proper Shipping Name, Hazard Class, 10 Number, 10. ~ontainers 11. Tqlal 12. Unn HM and Packing Group (~any)) Quantity WtNol.


X 1. N.!'won, £I.A..Z.~~l'.)(•lJ~ WASl'l:i, S':•LID, !.I.•Js,: .• (PC'B•S. 'f.Sh#'t41t77f 'IX"JS ?<.:i:J a: 0 LIL\D), 'J, 1!1. R.Q (LEAD. rcs•S)

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14. Special Har1d1ing lnsbuctions and Addnionat lnforrn~ti!Jn~'' '·!lR'-1": i't!"- prJB SO.!!.-, ~ED!MEN'!', .ftJ,fi} D.BDW&. H~'\m P':t~S <:1%

' 1~J~.n,,mtl>1r-'~ml:t't {e ;;;:~::'·'::::;;~~-~;;~ :;;~~~Vl!~•FR(\11,1. {~Vlt:s D;>-ni l !/JliVl2. + 1} -----· -·4--- . ':C;f .. ::~ ;._ ; •'' '

' !-..fA'!'l1lUAL FROM if.tl""' '·JSR l •• <~-J:"Y.fi.>~I;Jl1aCf. rC/D Thh\ll..URED. Pt-.CK!NCi $l.IP .ATTAC!!E:D !Jf)# 1!11 7:1:57:!

15. GENERI' 'lllR'S/OFFEROR'S 'CERTIRCATION:' i;.~Pr~dedare'i!lifttie ·conienifoi ihlS ~nment are fuly l'll,d ~ratelf llt;~ i!l!DV~ by the proper shipping name, and are classified, packaged, marked and labeled/placarded, and are in all respe~ iifprof'ier condition for transpo"rtoaocording to applicable lrile'btionala'nd nation~! governmental regulations. II exJXlrt shipment and I am the Primary Exporter, .. I certify that the contents of this CO(lsignment confonn to the tenns of the attached EPA Acknowledgment of Consent. 1 certify tpat tl)e waste mJ.nl$,tion statement identified in 40 9FR 262.27(a) _(if I am a large quantity g~ne~tor) .or (b) (if I al,l),a.sll!.an qua~tity generator) is. true.

Generator's/Offelo(s Printed/Typed Name ,.~-~~~ Y,Jf)~ , ;;~:--.~~-} Mon~ Day Year R.o:m:m:r PAP /lU,O (.N3ffi\11' "FOR \~'u) yj-_" ; ... : ... ~~r \J-r / ~_'1.)()\::.- 'f-l-V-~- I I 2-1 r7 112...

~ 16. International Shipmen!s 0 Import to U.S. 0 Export from U.S. .. ..- '· Port of entryfexit:

~ Transporter signature (fQr exports only): Date leaving U.S.; /

a: 17. Transporter Acknowledgment of Receipt of Materials /'\. /1 ~/ w

~ Tran~ern1fPrint~me · •· - ~,/ /5.) A). Signa:J!L'' ....._ ~-

Month Day Year

o r fi" :14,. ·p +tz.. I \7112-f:L .:::> "· . ,,, ,- ' I ./ :-.____~ U) .. . . :i TranSporter 2 Prfntei:I!Typed Name Signatul'i Month Day Year

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l 18. Discrepancy ; ·.h

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18a. Discr~pancy Indication Space D Quantity Drype 0Residue 0 Partial Rejection :£~~~ 0 Full Reje<:t!on>:::~,

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~- 18b. Altemate Facility (or Generate() U.S. EPA ID Number ,;;,1

u I ~ Facility's Phone:

0 18c. Signature of Alternate FacRity (or Generatar) I Month I Day Year w ·!;i I z * 19. Hazardous Waste Report Management Method Codes (i.e., cOdes fur hazardous waste treatment, disposal, and recycling systems)

~1. ,2. r- r· '20. Designated Facility Owner or Operator: Certification of rereipt of hazardous materials covered by the manifest except as ncted in Item 18a

PrintedFTyped Name Signature Month Day Year

I I I I .. EPA Form 8700-:22 (Rev. 3-05) Prevtous edtllons are obsolete . GENERATOR'S INITIAL COP'

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.. ... Please print or type. (Form designed for useo{l elite (12-J)itch) typewriter.) Form Approved. OMB No. 2050.()()39

UNIFORM HAZARDOUS 1.1. Generator ID Number

wAsTE MANIFEsT . 1 M A o o u 2 tl e ..., o e :; 12. P~ 1 of j 3. Emergency Response Phone j4· ManlfesiTracklng Number

l I !800)42d~9JO(J I 0 0 0 52 7 3 31 VES 5. Generato(s Name and Mailing Address '3EH~R.'\.L ELECTRIC tj'P

AT'f .MATT CAlACfJNE 159f -~~ICS ~V(:

Generato~s Phone: 41 ~1 494•fi .. 'l5$ 6. Transporter 1 Company-Name PAOE t'Tct..JNC


PITTSFIELO, MA 0·1 il01

I'R-:JViOr..NCE ..-'\NO WORCESTER R.R.

e. Designated Facility Nanie 'arid SiteAtldress\ NAYNE ~~ISPQSAL INC. 1!9~ N ! . .f.l4_ SEf:lVJCE lif~IVE

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I PITTSFIELD, MA lJ'\21)1 : ..... ; ~.;.

l) ~S . EPA ID Number -j ''!~ ·y D 9 B -~' ~ f:'i !::"

800 692~~43Q BEU~.V!ll.E. Mt .ole! r·t M • o o 4 a o s o a 3 ~ .. I Facility's Phone:

t--1.;.0.-'C-on_ta_inre'-"rs--'il! ,..: 11. Total No. Type i '· .. .. C!uantity L

9a. 9b. U.S. DOT Description {including Proper Shipping Name, Ha:zad Class, ID Number, HM and Paclting Group (if any))

12. UnH Wt.Nol.

13. Waste Codes

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14. Special Handling Instructions and Additional Information t::.R~: , I , fJ".;t;t ~ML, i::u::tJIMt:!'ll , h Nl.} t.n:~::.. ~1 ~.II!IJ.IlJWU!.. P<. B';:'; < '' '%

n:tAti.sR ~MHER_ SJ 3 .. 6..-~.--- PCB REMOVED FROM BEFNICE t:">A TE \ \ ~- 'U> • 't 1)

-M • .!,TERIAL FROM SJLVER L~O.K!£ Pt~OJE'CT. CtO fl!E.( r\JIREO. P.<\CK!NG SUP ;1:1Tft.CH~J#. '~ l-1172672 15. GENERATOR'SIOFFEROR'S CERTIFICATION; I hereby declare that the contents of this consignment are funy and accurately described above by the proper shipping name. and are classified, packaged,

marl<ed and labeled/placarded, and are in all respects in proper CIHldition for transport according to applicable international and national governmental regulations. If expert shipment and I am the Primary Exporter, 1 certify that the coritents of this CIHlsignment confonn to the terms of the attached EPA Acknowledgment of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27{a) (If I am a large quantity generato~ or {b) (jJ.LQ!Tl a small quantity generator) is true.

Generato(s/01fero(s Printedffyped Name ROBERT' PP.P.~LLO {;A.GENl FOR (-}E}

_, 16. International Shipments 0 t- Import to U.S. ~ Transporter signature {for expor1S only):

ffi 17. Transporter A~~gment of Receipt of Materials

~ Transporter'fPri'dfT~ Name ./7' ~ t..-4-Jttl;.$.[ _ / ~-6.:-J#K .. ~ Transporter 2 Printed/Typed Name

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118. Discrepancy

~ '18b. AHemate Facility {or Generator) :J 0 :f Facifity's Phone:

0 Quantity

fil 18c. Signature of Alternate FaciUty (or Generator)

0 Export from U.S. .

Portofentry/exit --- --------- -----Date leaving U.S.:

tr~ \i,IZ-Monlh Day Year

I I I

0Rasidue 0 Partial Rejection 0 FuN Rejec1ion

Manffest Reference Number: U.S. EPA 10 Number

I Day Year

~ ~~1-9-. H-u_a_ro-ou_s_W_a-ste_R_e_po_rt_M_a-na-ge_m_e-nt-M-et-ho-d-~--~~(i.-e.-,ro-d~e-s~fu~rh_Ma __ rd_~_s_w_a~~w-a~tme--nt~.~~·~--~-~~.a-nd~recy--~di~ng-s-~~te-m-~~------------------------~--~----~--~

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I Month I I

r 20. Designated Facility OWner or Operator. Certification of receipt of hazardous materials covered by the manifest except as ntied in Item 18a


I I I I EPA Form 8700·22 (Rev. J..05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

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Please print or type. (Form designed for: us~ on. elite (12-pitph)_ typewriterl Form Approved. OMB No. 2050-0039 UNIFORM·ti~D.OUS 11. Generator 10 Number

WASTE MA,NI~~ST .:d U - A ,.,_,.. _1'\__~· n ., ,.. ,.. ~ 5. Generato(s Nama and Mailing~lJllres"s Gllneratb(s"Site AI:IPress (if different than mailing address) , ..

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Generato(s Phone: 41:?. 494·.5358 6. Transporter 1 Compaily·Nilme' •

PAGE ETC. 1f,~ 7. Transporter 2 Company·Name -

PI~:JVIDENafr AND WORc',~:ErtE:.R lil;~ a: Designated Facility Name ahd Site Address _ • ,

WAYNE DISPOSt~.L INC.. 149350 N 1-94 SERVICE DRI'iE

9a. 9b. U.S. DOT Description (induding Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group (~any))

GENERAL af;!C'f'RIC CO • 15!1 PLASTlC.S AVE

I PITTSF'IELO. MA 0120:1 '· U.S. EPA tD Number

I -~t v () g 8 - .. U.S. EPA ID Number

. J. ~ A D.O ~ . ~- '"''if-$' .. : EPA· ID Number

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10. Containers 11. Total 12. Unft No. Type Quantity Wt./Vol.

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t) J'Jf: PCBi

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15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby dedare thatlhe contents of this consignment are fully and accurately desCribed above by the proper shipping name, ard are classified, packaged, marted 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. 1 certify that the contents of this consignmentconform to the tenms of the aHached EPA Acknowledgment of Consent. 1 certify that the waste minlmi2ation statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (~I am a sman quantity generator) is true.

Generator's/Offeror's Printed/Typed Name <~~a.tt~~r.y , .. •.· · ·\\'.'( ·, \ ) !'1)_:··\ { 1';/ ,, \~ V ~~ ;:c~~_;- IMo fZ.nth' 1 :,

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:;;;: Transporter 1'Prillted!Typed Name

~ uJ ~'f. A>r,-::i Transporter 2 Printed/Tyjled Name

~

18a. Discrepancy Indication Space l18. Discrepancy

~ 18b. Alternate Facility (or Generator) :::i

0 Quantity

0 Export from U.S .

0Type

".Jporttf entry/ex~: -----------------Date leaving u.s.: .

Month Day Year

lt7J \l I t2 Month Day Year

I I I

0Resldue 0 Partial Rejection 0 Full Rejection

Man~est Reference Number: U.S. EPA ID Number

ULL.~ L Facility's Phone: ffi~1;8c~.~Si~g~~ru~r~e~of~N~te~m~a~te~Fa~c~mty~(or~G~e~ne~ra~to~~~-----------------------------------------------L----------------,~~--~~-v~

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I Monfu I Day Year

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r· ·Print ediT yped Name Signature Month Day Year

I I I I EPA Form 8700·22 (Rev. 3-05) PrevJous editions are o~olete. GENERATOR'S INITIAL COPY

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Pl11ase Rrint or tvP.l'!· (form.sJesigned for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039 UNIFORM·HAZARDoUS•Jt.Generator 10 Number '

WASTE MANIF~S! -,. _ ·~ " ~ ,

6. Transporter 1 Company ~me

PAGE<: E1 .. C .. INC .. 7. Transporter 2 Company Name

Pf-lOVIl"lENCE! AND WOl~E'STER RR. 8. Designated Facmty Name and Site Address

WAYNE O!SPOSAI. INC. 19~ f~l.!l 'SSJV!t:F. DFWE

Facili ll's Phone: BOO 6Q2-5~~ BEU. EVILLE. Ml ·"S 1 i 1

9a. 9b. U.S. DOT Description (including Proper Shipping Name. Hazard Class, ID Number, HM and Packing Group (rt any))

o:: X 1'NJ.\:..'l.Oi'7, HAZ.A.Rf)()IJS WASTE. SCUD. n ~.&, (PCB'S, o LE~P}, 9, ~tl , RQ (Ul.AD, PCB'S)

~o NOQ·- 0 uitliM!ite!s (if different than mailing address)

GENERAL E.'LECTRIC (X,t • · 159 PG'I..STlCS AVE

I Pl1TSfiELD, MA <11201 U.S. EPA 10 Number

1 N v 0 9 8 U.S. ~PA 10 Number

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15. GENERATOR'S/OFFEROR'S c-ERTtFICATION: I hereby deClare lllat ihe -contents of this tionslgnnitmt are tUli{and iu:euiately ilisCribed above ·by lhe 'prope'r shipping name. aoo are dassified, 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 lhe Primary Exporter, I certify that the contents of !his consignment confonn to the lenns of the attached EPA Acknowledgment of Consenl 1 certify thai the wa~te min~~ s]atS(!lenUden~~ in 40 CFR 262.27(a) (if I am a large quantitY generator) or (b),.(i"±_i~C~!., a small quantity generator) Is true.

..J 16. 1nlemational Shipments 0 US 0 \. J = \ / J.-' .. Import to . • Export from U.S. "-'' Port ofenlly/exit ---- ---- ----------~ Tran~er signature (for exports only): Date leaving U.S.:

ffi 17. Transporter Acl<nowled!!ment of Receipt of Materials

li. Transporter 1 Printedfl'yped ~~)

~ R...!:.e.-.l.< \·'(l .tJ A~I ·T, o z Transporter 2 PrlnledfTyped Name ...; < 1!:

18a. Dl,screpancy Indication Space

118. Discrepancy

5 18b. Alternate Facility (or GeneTalor)

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0 Quantity

fa 18c. Signature of Altemate Facility (or Generator)

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Printed/IYPed Name Signature

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14. MXIfest Tracking Number

1 -u00527335 VES

b!1il~ 5. Generator's Name and Mailing Address ~Eilf~'\~LECT~ C(l,

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15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby dooare that ihe OJiltents of this consignment are fi.dly and a<;C~.JrateiY. d~cribed.above 'by the proper shipping name, ard are classified, packaged, marlted and labetedlplacarded, and are in all respects in proper condition for transport ateording to applicable international and natiOnal governmental regulations. If export shlpmert and I am the Primary Exporter, I certify that the contents of this consl9nment conform to:the terms of the attached EPA Acknowledgment of Consent I certily·that lhe waste minimization statement identified in 40 CFR 262.27(a) (ff I am a large quantity generator) or(b) ~mall quantity generator) Is true., .~

0 Export from U.S. Porto! entry/exit:__,,..:./ ________________ _ _. 16. lntemaUonal Shipments 0 ..._ Import to U.S. Z Transporter signature (for ~orts only):

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15. GENERATOR'SIOFFEROR'S CERTIFICATION: I fieneby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, arrl are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport aocording lo applicable international and nationalgovemm&ntal regulations. If export shipment and 1 am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the· attached EPA Acknowledgment of Consent t certify that lh,e waste ,minjmlzation statement jdentified in 40 CFR 262.27(a) (If I am a large quantity generalflr) or (b) {lf-1 _~@!1 small quantity g'"erato~ is true,., _. "' _ ·~

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15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby deciare.that the contents of this consignment are fully and a~rate!Y.~~~cribed_aqove by the proper shipping name, ard are dassified, packaged, marl<ed and labeled/placarded, and are in aU respects in proper condition for transport according to applicable international and national governmental regulations. tf export shipment and I am the Primary Exporter, I· Certify t11at the cop tents of thi~ consignment conform to the ~rms of the attached EPAAckriow1edgment of Consent . I certify that. the ~aste minimization statement identified.i,n..,40 CF~ ~62:27(a) (~I am a large quantity generator) or-(b) (HI ~!ll·t~·SIII,a)l q1!3ntity ge,nerator) is true. ,.,.

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15. GENERATOR'SIOFFEROR'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, p~ckaged, marked and labeled/placarded, and are in an 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 thatthe contents ofthis 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) (ill am a large quantity generator) or (b) (ifl am a small quantity generator)_is ~e: . . ~

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15. GENERATOR'S/OFFEROR'S CERTIACATJON: 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, hit tl),e'~Xl!Jten\s r;>f tl)is consignment conform to.the terms of the attached EPAAcknowledgment of Consent. I e;ertify !flat the~~~ .minimiza~o~ sl!!tement identified in 40 CF~ 262.27(a) (if I am a large quantity g~n~rator) or (b) (lfl..aiQ.a small quantity generator) is true.

Monlli Day Year

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. . 14. Special Handling Jnsbuctions and Additional Information _...._"' · ' ,._ ..- ~..., <>'-'''-'•• ~:>.<;,L(;l.<'"="· - • _......,..,.., • . · ~' ··• · ,,.., .. .. - ~- '•· .:..· "' ,, . ~

'tP,i!.E.:ER J.."trr:JfEl~.R~ __ _t 1.t:J.: .... ___ \"'.;.::.e 1ilit,$:rvro FP.'Cllt1. ~-~VICE DA'l'E l/4/11 ·l n r- !d;\ T.ERLA..L l 'R.Ol:;! &I'-' \i.Sf~ L.I\Tf;:E 1!-'.Rm EC.".f. 0/D :REQU:l'RED :f'At:'tiDif(l· ~l il-' ATT:AC'ffi.ID Pt:.:<# r 1 r ! nt~n

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby deClare that the c6ntents 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 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 o~~~

1 I certify that. the waste mioimization statement identified in 40 CFR 262.27(a} (if I am a large quant_i.tuenerator} or~~(ifl am SJil.3~ant9Y generatort is ~~....... ,.. _ • _,..,.... Generato(s/Offero(s Printedffyped Name \..-~rnr-~~ hY.o\MG)~i~- P31' ~~S:i y~ Yl!)5ERl.PJ\.PtJ.-L(' (}'I. <lENT FC:'£. GE) 6. ., I

....1 16. lntemational Shipments D Import to U.S . D Export from U.S. Port of entry/exit: t-:!!: T ransp!)!ler signature (for exports only}: Date leaving U.S.: ' ' ./

a::: 17. Transporter Acknowledgment of Receipt of Materials 1 .

w ~ Tra~nted!Type7, «: ' Signature~ Mo~~ J~ Y~ ~ / ~//qA. · ·1. r.r;fAt:?§tv I' A ....,._,../ ~:-.: .... ~;..-._ ..... ...J ,o 6; 1 ~ Transporter 2 Printedffyped Name Signature Month Day Year <(

I I I I a::: 1-

i 18. Discrepancy

18a. Discrepancy Indication Space D Quantity CJType 0Residue D Partial Rejection D Full Rejection L


~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number ....1 0 ~ Facility's Phone: I 0 18c. Signature of Alternate Facility (or Generator} I Month I Day Year w ~ I z (!) 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recyding systems} iii ~1. r ,3. r·

20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except.as ncted in Item 18a


I I I I .. EPA Form 8700-22 (Rev. 3-05) PreVIous editions are obsolete . GENERATOR'S INITIAL COPY

Please print or type (Fonn designed for use on elite (12-pitch) typewriter) Fonn ~proved OMB No 2050-0039 UNIFORM HAZARDOUS jt Generator 10 Number

WASTE MANIFEST j, M A D f) 0 2. V ff .ii ~~ 9 3 5. Generat~s Name and MaRing Address

Generat~s Phone: 4 1:;,; 4{;•l-:;i.IS!i 6. Transporter 1 Company Name

1:14-n . .rJE S'f(! :ll'~·c


~ • .e>J., m.w..~PJ.::: r:-•r. ATTN:M.tt.TI' Co.~i\!t.<\C<:.'INE 159 pr...,Asncs A VB PI'l."l'Sl71ELD. MA Q 1201

P;.Kr'llVill'l':~~ ,'!.,4>u:;; wow.:.:t:snm .. RR 6. Designated Facility Name and Site Address

WAYNE DISPOHAI.. iNC' ~Sl'~;,l) "N l-94 fS.ERV1C'1l DSUV~!

Facility's Phone: 200 ':.\92 . .:5489


3.

4.

12. Page 1 of 1 3. Emergency Response Phone

~ I I (1~00:1 ·124·~~0Cl Generato~s Site Address (if different than mailing address) <JEN.SR..e,.L El.!:.i(?'!l!UC C.'t::1 1St) Pl-AS.'I'XCS.A"VB

I Pt T't'SFtF.,!,tl, M A I)~ ';_J.(ll " . .:.. ;.;.':;_'' (_ '•

U.S. EPA ID Number

I rii -~ r> Sl 'S U.S. EPA ID Number

IM .I., ~; .. ~

"' tJ;$, J:PA ID Number

I M D 0 ,!

10. Containers 11. Total 12. Unit No. Type Quantity Wt.Nol.

lidJ /tlf lliJ. 1 D 1'

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14. Spedal Handling Instructions and Additional Information .~G. p t Pdi &:~IL. ~;_F.JJ9~EN'l.'. A.:ND DEBI\!R H 1.19(l•Tr-~•'Dl . PC})'~! ., ~ ~ ;.

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13. Waste Codes

[!i'J{i~ PC.i1 1

l.JAO:l

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 con9ition 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 EPAAckn<rMedgrnent of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generate ) qr,(bJllfT'aQl a ~IJI!III quantity generator) is true.

Month Day Year

I031a5i\3, ...1 16. International Shipments 0 D '-' j:... , . Import to u.s. Export from u.s. 2!: Transporter signature (for exports only):

~ortof~ntry/exit: --7'-/---------------Date leaving U.S.: .f '

ffi 17. Transporter Acl<nowledgment of Receipt of Materials

t;: Transportei1J?rintedfTyp.l~N~ny 1j' / 1 / ~ ff AJv Jt -. ~lt ~~. (_.//1 1 /(J ~ Transpoiter"2'Printedffyped Name

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116. Discrepancy

~ 16b. Alternate Facility (or Generator) ::::i 0 if Facility's Phone:

D Quantity

ffi 16c. Signature of Alternate Facility (or Generator)

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Signature .... ~ ~

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DResidue


Month Day Year

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U.S. EPA ID Number

J Day Year

z~--------~~~--~~~~~~~~~--~~~~~~~~~~~----------------------~--~--_.---1 ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

I Month l I

~- 1. r ~~-'""l( 20. Designated Facility Owner or Operator. Certification of receipt of hazardous materials covered by the ma~ifest except as ncted in· Item 16a

Printedffyped Name · Signature ·

T

r-Month Day Year

I I I EPA Fonn 8700-22 (Rev. 3-05) PrevJous editions are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050-0039 UNIFORM HAZARDOUS 11. Gene. rator ID Number

WASTE MANIFEST · M /~ r) 0 i) 2 1) ll •1 1: f• ~ 12. Page 1 of' , 3. Emergency Response Phone J4. Moanifeost lorack6ing3Numlb!r9 5 5. v ES

3- (r!OI)j '12•t··f1)06 J ~.

5. Generato(s Name and Mailing Address . ~ j:'{ ' ~ -· i. <~i':l<l:!iR.AI. Er.EC!PJC C.(l ,~_'r'!1>l ; M.:.t','i'T ('...1\J,,~r:.;()N.E

15~ l)L.>\.STJ(~~ A"V!5 pn·nwmr..D. tf..fr cr:~.r:1

Ge~rato~s Site Address !if different than mailing address} • . OE~BP.AI:ELEC'r ~.11:1 GO , - ,1,

6. TransportEW1 Company Name P.~~.CJj E'i (~) •. r.r·:c 7. Transporter 2 Company Name J.'ROVIDT~'"C!1 AN£} wr.)J.~CJ'.i.!.t:rl:iF!. I<. fl..

8. Designated'Facility Name and SiteAddreSSW'J-i. YN!1D1Bl?''·~;n, INC 49~51) "W"k.>,.~ f.l1.:1.f\i'.!\"'.::S I:WJVE

Facility's Phone: il()() .'>tn-S•;ifg

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group [If any}}

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10. Containers

No . Type

t D T

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U.S. EPA ID Number IN y 1) S• li

U.S. EPA ID Number Jt.,{ A J) (• . S

. lfSi EPAJD Number

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11. Total 12. UnH Quantity WtNol.

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13. Waste Codes

[J!'.){Jg PCB!

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114. Special Handling Instructions and Additional lnfonnation <><\.v ·' "' ·-•.. ·' ~'>'..1.1-.1•, c"'"""'''""''"-':'!- • -l '.l'tl..•' v:.:o.:t~;':t •. ,, ,;,.•,'V'~ \"-' 1! I:' -t:.··::. ·~ .. , .,

I I l-- T.Ri•J!..fi!~ .. t<rm!O.b1~"-3~. -----~ PCf~ 'Ri:W-iOVED FR.OJ•A l'.ffiRVf.!::'E OATIS 1/Jf:l j ·I i} ' MA!:l!''RI,r:>.L FROM ,'iflVlER L.<'·.J::!.!PRO:!ECT. C!.OR!Kjt:tf.&.El) p,v:.l{!NG SJ.U• A'IT.i!...C.'f.l.ED !:r.o.::of.l1!! t :•2~72

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby decline" that the contents of this consignment 'are fully, and accurately desG(ibed 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 EPAAcknowledgmefit of,Co~t. I certify that the wa.ste min[mizatio.n sta~ent identified in 40 CFR 262.27(a} (if I am a large qllfl'lliYa~loJl;o/{bJ (rfl ~~ ~ntily generator.l_ is true. _

....1 16. International Shipments 0 i- Import to U.S. ~ Transporter signature (for exports only}:

D Export from U.S. '- Port of entry/exit: ---=----------------1 Date leaving U.S.: ~


~ TransQorter 1 Printed/Typed )lame 1 1

o f { ) A:'',..) c, n 1 IV -es g; ·- ,..; ' I ' ~ Transporter 2 Printed/Typed Name

0::: ..... 118. Discrepancy

1

18a. Discrepancy Indication Space D Quantity

5 18b. Alternate Facility (or Generator}

c:; if Facility's Phone: ffi 18c. Signature of Alternate Fae~lHy (or Generator}

~

Drype

• ~'LLJ Signature/ 1 k .r ~~~ 1 _./t.......C -z -- L/ \.....A'! . 10~0~51\~ Signature f Month Day Year

I I I I

DResidue D Partial Rejection D Full Rejection


I Day Year

z~------------------------------------------~--~--~--~----~----------------------~---L--~--~ * 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardo115 waste treatment, disposal, and recycling systems}

-1Month

1 I

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I 20. Designated F aciiHy Owner or Operator. Certification of receipt of hazardous materials covered by the ma~est except as naed in Item 18a Printed/Typed Name SIQllSture

1 ..

r· Month Day Year

I I I EPA Fonn 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

~·--· 'IWt.. .;. •. 'I ~· . )

Please print or type (Fonn designed for use on efite (12-pitch) typewriter) Fonn ~proved OMB No 205Q-0039 UNIFORM HAZARDOUS 11. Generator ID Number

WASTE MANIFEST M A D 0 t) 1- •J P. .-.t (l 9 :! 12. Page 1 of 1 3. Emergency Response Phone 14. MQanifeQst liQrackSing

3Numlberg S S VES

,-9, I (tiOO) <!.H-9J')) 5. Generator's Name and Maning Address Generato(s Site Address (if different than mailing address}

GENERAl .. w . .l~C'J;Rf0 CO l ~·9 P'LA~TlC.S AVE

Generato(s Phone: 413 •1.9•1 -..S~.:;;;

Ol'iNF~~4.L ELEJ.:l'PJC C'(l A'!'TN:1'.1A'!T CAL,r.;::o:NE ! .59 Pt.ASTJ("S ~.:VP, P!tTgfi~i:LD, U.A Ct2Cl _. -- ~ ... ~L'"' C •


l?AOE l:i'l"C.)'?NC 7. Transporter 2 Company Name

PllO'.I!t!:f..~~ AND WQ~CEB·T!iR.R.R.

8. Designated Facnity Name _and Site Address.tJJJ.,.YNB DHIPClSA:J.,.lNC~

491:!1.0 'N t~N S.fiD.~v!C'E D.!Uv'I\ .. BEU,.E\J'fl .. l ,E, MI 4iH 11

Facility's Phone: SO•) '>92 .. :)4il.9

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U.S~ EPA ID Number

I !i y D p .. 0

" U.S. EPA 10 Number

. t tf.A r> (1 =·

·•· lf.Si EI!'A'ID Number

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Con~iners 11. Total HM and Packing Group (if any}} No. Type quantity

12.Unit WtNol.

o::: }( 1. N/'..}') l),!if~.Zll!llJC>Uff 'WIST!::, i?ICIL!!.i. n.o ,·.,.,'!='(:-!:Vii' , ~~~Tif o LEA\CX;, 9. ill,. R(~ (I,EA.r~, .PGI:..1'fn

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3.

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14. Special Handling Instructions andAdditionallnfonnation ERG : I '11. PI.':'B EC\!.1., SEDJMEt.IT .. AND D:mrPJJJ. llZro<X\\I!•n!. };!('S'S ~!'l'i.

·m.,~.J!.,.!::;~ Ntll' l.t9:ER., ______ .fo..J::.Ie~ ~-- PCS .!'<B,K>'Vf'ID !<ROM '&SIT\'! :n ttA'!U i/4/ D' I· l)

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 intemational and national govemmental regulations. If export shipment and I am the Primary Exporter,. I certify that the contents of this consignment confonn to the terms of the attached EPAAcknowledgment of Consent 1 certify that the waste minimization statement identified in 40 CFR 262.27{a) (if I am a large quantity generator} 9r (b) .(If~ a small !luantity generator} is true.

Generato(s)Offero(s Printedffyped Name r,_·.M·~atu.:t~'~ ~ 1 ) / . . ·~·,_.AC:-:E:lJ\" Month Day Year ROB~!RTP,l•.PAl..-LO (A·:".nlN'l'F•)R QU) \. · .r .• · . . '~.lf.~'l\tX..:.- c ' ·\') L;.F:.. a-.310~ ·11 ~ ' .~ .£) . 1-/ ' . !,~ f.J. I.,UJ

...1 16. lntemational Shipments 0 ~ Import to U.S. ::!!:: Transporter signature {for exports only}:

D Export from U.S. '---' Por of entry/exit -~----------------


~ Transpo~ Print:ryped Name

o.. <.o o I , l lr:.."~ /\. ·' ; 1j ~ Transporter 2 Printed/Typed Name

~ 1-

18a. Discrepa_ncy Indication Spaoo

118. Disc~pancy

j; 18b. Altemate Facility (or Generator) ...1 0 ~ Facility's Phone:

0 Quantity

ffi 18c. Signature of Altemate Facility (or Generator)

~

0Type

Date leaving U.S.: ,

Signature (:,./.,.,-'

I /-;;;::.' 0

.~ ..... • rirc .... \:

Month Day Year

10316511~ Signature Month Day Year

I I I I


Manifest Referenoo Number: U.S. EPA ID Number

' I

2~----------------------------------~----------~~~--~----~--------------._------~--_.--~ __ _, ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems}

1 1. 12· r

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I EPA Form 8700·22 (Rev. 3..05) Prev1ous editions are obsolete.

-~·

Please print or type (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039

1 UNIFORM HAZARDOUS It Generator 10 Number 12. Page 1 of 1 3. Emergency Response Phone r-Mooo69

3ie9 s 1 WASTE MANIFEST M h [I 0:; i• 2 'l 5 .; 0 9 '! :< (9(10) 4;)·1 9)(Y> VES 5. Generato~s Name and Mailing Address

Gr ... NEH.AL ELEC'!'f>J(~ ('•:\ Generato~s Site Address if different than mailing address)

~ GENEP ATTh:M.tt.T'!' ·:'."-L.~.cc~NE 15~ P!.A.!TT1C~ AVE

li\3 49<1 .)J:,c; P!1'T8f'lELD. u.e, 0 J ZO i I Generato~s Phone: 6. Transporter 1 Company Name U.S. EPA 10 Number i='AOE iiTC )1.3:' I N y l.) 9 ; f <I 1: ~, () ~ .. 7. Transporter 2 Company Name U.S. EPA ID Number

-;fRfPTXE.W:1i ,'\.~ 'N').R~T!i'R '~ P. I H A D ( ' ~ {' 2 0 3 .. 4 -8. Designated Facility Name and Site Address ~/ •\ "t"NJ? f"TSPOSAL INC U.S. EPA ID Number

49150 N r ~cl ~niP. VICE DR.T\IE

!lOO !>9'1.-5489 BELUl'~!1U-!!, Uf 11811 !

l l,l( I t l \) .. i! v ~ \} 6 , -Facility's Phone:

9a. 9b. U.S. DOT Description (including Proper Shipping Name. Hazard Ctass,ID Number, 1 0. Containers 11. Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type 9uantity 1 Wt.Nol.

X 1. J"i/\Jtl.ll, .!1 . .'\..'!.!\tti)l..'l'~ '.¥1'.~ l't.l. ~·-~ ,[V.! C11J1'fi.T t I:' 'X)~ P. .. f' l a::: LE.Al1i, r;_ Ill, RQ \'Ll':'.AD, PCD'f.i 0 3o. /,'fc. ~

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- - '" . --- ·- ·- .. - -·- . - . --( 14. Special Handling Instructions and Addzallnfonmation .::.3.~\. .. J. l J ! r .. ..a.... 1:1' .... ''-LI'• C~,;;J.J:.J.• t:.r;;..t"'f!., ?-'.J. 'C..rL

r"' '!;JI .. ;\f!..ER !~ l},ffiEP. __ __r~~---- PO::II Rm&:lVED F!~f).M 5!;l~_t11CE D

H~~!F..'RLI\1 FRCI)...i ;m, 'J5R !.J\ .. J{E PR•)lJ.!C.".i. CID 'ri.EQl..JJRED PN:K!NG aiP 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately descnbed above by the proper shipping name, and are classified, packaged,

marked and labeled/placarded, and are in an respects in proper condition for transport aocording to applicable international and national governmental regulations. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment confonm to the tenms 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_Q~nerator) or (b) (iflamaS(llall q~ntity generator) is ~e.,..

·~-·-Generato~s/Oifero~s PrintedfTyped Name ( Signatu~ \J{-rlltf · ~- ,_~,_..._' Men~ Da~ J~ ROBERT P.!IJ'.~..Ll,C• (!\•JENl' FOR(! "1~\lf:- . ~~~' ~D'S. t'=I'Q ~ r· 16 'I :)

-J 16.1nternalional Shipments D Import to U.S. D Export from U.S. ' ..... Port of enlly/exit: ~ Transporter signature (for exports only): Date leaving U.S.:

0:: 17. Transporter Acknowledgment of Receipt of Materials w ~ Transporter 1 Prinrryped Name Signature L ., [~ Z . Month . Oa:s_: r~ ~ / ' } ; t -" f l / C.!'--'7 I -1C( U t'. I /I '7--/ ~1 Y"~1<:> 31 0 ~1 . ~ Transporter 2 PrintedfTyped Name / Signature ,/ Month Day Year

0:: I I I I 1-

l 18. Discrepancy

18a. Discrepancy Indication Space D Quantity DType 0Residue 0 Partial Rejection 0 Full Rejection


~ 18b. Alternate Facility (or Generator) U.S. EPA 10 Number ::::i 0

I ~ F'acility's Phone: ' 0 18c. Signature of IIJternate Facility (or Generator) I Month I Day Year w

!;( I ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

-~1. 12. r r·

1 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted In Item 18a

PrintedfT yped Name Signature Month Day Year

I I l I .. EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approv

~ UNIFORM HAZARDOUS 11. Generator ID Number 12. Page 1 of 13. Emergency Response Phone r Mo foocs g3ie9 58 WASTE MANIFEST M .t., .D (• 0 Z •) 0 -'! (; 9 ~ ~ (_1)00; '12"' 93ft-) VES 5. Generato(s Name and Mailing Address Generato(s Site Address (if different than mailing address)

.:JENF.R..4.L ELE:~TPJC •::'(\ GENER..!J_, .liLEC'TPJr:• CU AT'!N.}.{.l>,TT C.'\LAG0NE 1 ~-~ P!.AS'!1C.8 t..\t"E I ~·9 P'-ABTIG6 .::... V5

Generato(s Phone: 413 4~.SJ~Ii P!Tftlf'.ZL.l::,M!" ClJ•)l 1 PITT'lFTFLfl. M~ n1 :-'(n 6. Transporter 1 Company Name U.S. EPA ID Number

r~;\oc nrc·. }NC I ~T y D ~ ~ .; (, <; () 4 .,

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PRQV!Dt::r-K .. "L AND W)RCiiSTER RR I MAD i) :· 9 C.· 2 !) li ~ , 8. Designated Facility Name and Site Address~. A. !'NF: DISJlCoSA.t. INC U.S. EPA ID Number

493.¥_, N I-94 5ER VK'1! rntiVE

Facility's Phone: :JM .5~-~489 BBLLEV!LLE, MI .i/!111 I M J D .... ,, ii i) :; C' 6 - 1

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Ccntainers 1\. Total 12.Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity ,- Wt.Nol.

X \. N/'.JQTI, H.~>,.?.!\R.DC•i..Jfi WP.,.ST!"~ S0l,!D. n.'..> ~ (PC'B'!!!, ~1JIM"f! .!».)$ f"L"'B I c:::

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3.

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ill 14. Special Handling Instructions and Additionallnfonnation

-&9;;3 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, 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 Primary Exporter, I certify that the contents of this consignment confonn to the tenns of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a) fll lam a large quantity generator) or (b) (itl am,~ small quantity generator) is true.

Generatl)(s/Offero(s Printed/Typed Name /-Sig~:b--\k'~ . ~..:> A(~T Month Day Year R()Jlffil-1' P:'\P.Al..J..(• (AQEN'f FOR Gii) \_,1~. _ ,1 A~'Ab'::. Wv.~ I03!0~i~3

....1 16. International Shipments 0 Import to U.S. 0 Export from U.S .

'-' Port'of entry/exit: .... ~ Transporter signature (for exports only): Date leaving U.S.:


g TranspoUPrintedfTy~ ~ Signature V .---? Month Day Year

55 A(;~ 4 /f - e---?/46- if_ I &-#~~~./---~.a-<...-J l b3. I D~ 1'3 ~ Transporter 2 Pnnted/Typed Name Signature Month Day Year

c::: I I I I 1-

l 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity 0Type 0Residue 0 Partial Rejection 0 Full Rejection '\t


~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number ::::i u ~ Facility's Phone: I c 18c. Signature of Alternate Facility (or Generator) I Month I Day Year w !;t I :z ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treabnent, disposal, and recycling systems)

~ 1. It ll r· 1 20 o,;g""" '-"""'"'"',_"',..,.oo""""'"....,~'""~'-"' byU. m•""'~~M-• ~m 1~ Printed/Typed Name Signature Month Day Year

l I I I .. EPA Form 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete . GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12-pitch) typewriter) Fonm Approved OMB No 2050-0039

UNIFORM HAZARDOUSI 1 ~ Genera~or I~ N~mber WASTE MANIFEST .vl ' "-' r ·4 n ('. t (· .. 12. P:r 1 of 13. Emergency ~~spo~se Phone

(\l'Yf' ~"'·1 -.~,. .. r· Ma fo (J6g3ie9 59 VES ) Generator's Name and Mafling Address

·~ENC.~Al. F.J...E"""!'J>f~'' ("r'\ Ge~~~:J ~~te f-dd~~!iWifferent than mailing address)

: ~ ~ ~ . . . ~' i' ;t ~ J' . , ..., )

AT'!'N:M'.4.Tf r:-'.11!. 1\ICfJNF t ~9 fiLA ~Tlt""S ~ yr;

• ~-~ 'Pl,Asnr~ .o\ '"' .;1] .;.,;.t ).~ ~" !'!1'1'SFIEI D t .V •'I 'Ci I PJl"r>~Ht•l Tl 1 "' r11 '('I

Generato~s Phone: 6. Transporter 1 Company Name U.S. EPA ID Number

I 7. Transporter 2 Company Name U.S. EPA ID Number

I 8. Designated Facility Name and Site Address U.S. EPA ID Number

Facility's Phone: I 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 1 o. Containers 11. Total 12. Unit 13. Waste Codes HM and Packing Group (ifany)) No. Type _Quantity 1 Wt.Nol.

X 1. • ~JMTE LW.'I'Ji$

I .!-' 'l 1

I a: 0 36Jl/t-~

: D 'f K l•lt/L,l)~ 1 '-

w 2.

I I z w C) -

3.

I I 4.

I I - . .... _ -- . -- ... ~- -~. ~

I( ) Special Handling Instructions and Z_~{gon ...

15. GENERATOR'SIOFFEROR'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 Pri!llary Exporter, I certify that the contents of this consignment conform to the lerms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization stalementidentified in 40 CFR 262.27(a) {if I am a large quanti)Y..,9.9nerator) or (b)J\f I am-as(llal~q~Qtity 9enerator) i~~e, _ - '-

Generator's/Ofleror's Printed/Typed Name R•)!lERT P.'\.P·'I.i.L(' 1<-\.QEN']' !'•)t~ Cfi·, r, __ ~<t-t\YvLUJ~~~bt:)~.r& 1'6~ 1 c/s 1 1~;

...J 16. International Shipments D Import to U.S . D Export from U.S. ~ •

F- Port of entry/exit: 3il: Transporter signature (for exports only): Date leaving U.S.:

ffi 17. Transporter Acknowledgment of Receipt of Mat~als .---.. ...... ~ Transpor{~:Jyme /t)f' L /A I fl-. Signature // /..- J ...,£._ Month DaS v~

I ' . / . .A·"--'" . .,.J''/-: _ ... , o ~lo 1' rn .

r -~ Transporter 2 Pnnted!Typed Name Signature Month Day Year a: I .. I I I I- -......

1 18. Discrepancy

•. .,

18a. Discrepancy Indication Space 0 Quantity Orype 0Residue .0 Partial Rejection D Full Rejection

Manifest Reference Number. > 18b. Alternate Facility (or Generalor) U.S. EPAID Number !::: ...J -(3 .I ~ Facility's Phone: c 16c. Signature of Alternate Facility (or Generator)

I Month I Day Year w t;( I z lr ~- Hazardous Waste Report Management Method Codes {i.e., codes for hazardous waste treatment, disposal, and recycling systems)

~~ . , 2. r r· 1 211. ""''""' FooOy """"" .,.-. ,,_ cl•ooO• •-~ "'""''' """" "t., ~""• - • •"'"'" Hom"' Printed/Typed Name Signature Month Day Year

I I I I .. EPA Fonm 8700-22 (Rev. 3-05) Prevtous edittons are obsolete. GENERATOR'S INITIAL COPY


WASTE MANIFEST M A p (' 0 :: 1) ? ., (' \,l ~ ;. I (!JC'{f) 424 '1}1)(' I 1 UNIFORM HAZARDOUS 11. Generator tD Number 12. Page 1 of 1 3. Emergency Response Phone 14. MQanifeQst TQrack

6ing

3Numl begr S Q VES

~S~. ~G-en_e_ffi~~~(s~N~a-m-e-an-d~M~a~ili~ng~A~d~dr-es-s----------------------------L-~~~~G~en~e-ra~lo~(s-S~it~e~Ad~d~re-ss-{~if~di=~-re-n~l~~a-n~m~a~ilin-g~a~dd~re~s~s)~~~~~~~--~~~--~

1 Gf:."N!:i.~<\L n,e•..:T}IJ('. (:<:· <JENERA!. ELEO:."l.f'J• • ·.I ATTN M.t.TT :~.11.!,..<\C•JN[ 1~9 PLA~TICS /I VE 1 '.9 P.!...I.\.STE"S .~. 'lf

Generato(s Phone: 4U .;S>o!...:>.\~ii l'ITTS!1SLD. !.!! ('l ;:e: i l llfTTStfFi n !.(.'\ IIPI\1

U.S. EPA ID Number 6. Trnnsporter 1 Company Name

PAGP rrrc· J1-1t.. I_ ' y l) 9 '; r. ~ (:" 0 ........


8. Designated Facility Name and Site Address IN A YNE. DJ!.'t'I~JSAL INC

49~50N 1-94 SERVICR DRIVE

Facility's Phone: 000 592-5499 BELLEVTI..LE MI 4~! ll

9a. 9b. U.S. DOT Description {induding Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group {if any))

a:: X 1. 0

~

10. Containers

No. Type

U.S. EPA ID Number

l U.S. EPA ID Number

11 . Total 12. Unit Quantity • . Wt.Nol.

Y;,..Arc

n T 3o6l6 K

13. Waste Codes

DJOS l-'- fll

i t---+.:--2. ------+-t---t-----+---+-----+---1 +------11 3.

I I 4.

I I 14. Special Handling Instructions and Additional Information

38o3

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare ~at ~e contents of this consignment are fully and accurntely 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 ~is 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 generntor) oc_{W(lii'afll a .li!f!~l quantity generator) is true.

Genernto(sJOffero(s Printedfryped Name I . s; natur 3. \ \./I {: L [ ~':_ ~y~ \ .. Month Day Year

R·)!lERTPI>.P/-J.V.•U\GENTP:.1/_13J.i) ,,,~·~(·~ .... tl ~::j Fo \?.. ~ tv~ 10,51 rs ....1 16.1ntemational Shipments 0 0 -...; \ j:.... Import to U.S. Export from U.S. Port of enlly/exit: --------------------------------2!: Transporter signature {for exports only): Date leaving U.S.:


~ Transporter 1 Printed/Typed Name 1

)

~ (J.) ,4 Y tt :-c 11 r "_; e-- ~ ~ Trnnsporter 2 Printedfryped Name

0:: 1-


t 18. Discrepancy

~ 18b. Alternate Facility {or Generntor) ...J

0 Quantity DType

/)

Signature../ J } ' ........._ f"f·J' I ; /&V~,AA ~- ---

Month Day Year

I 0.310 .5i 13 # ·--1,'1

Signature

I Month

I I I Day Year



~~.~..- I ~F~ao~· t~ity~·s~P~hon~e.~· ~~~~~~--~~----------------------------------------------------~-----------------r~~--~--~~~ fi3 18c. Signature of Alternate Facility {or Generntor) I Month I Day Year

!cc z~--------------------------------------------------------------------------------------------~--~----~---i ~ 19. Hazardous Waste Report Management Method Codes ~.e., codes for hazardous waste treatment, disposal, and recyding systems)

L.

'~~ - I~ Ia 1

20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a Printedfryped Name Signature

I

r· • :~ L '~

Month Day Year

l I I EPA Form 8700-22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elitej 12-pitch) typewriter) ~ ~ _1-::-:::----:-:'lr::-::-----:::--------;;:--:-----r-;-;:~;::-:-:--;:::-:-=:rF::-;orm=A+pp=r-ov_e_d _O_M_B_N_o_2-'0-'-50_·.:..00--,39

~ UNIFORM HAZARDOUS , , ._Generator 10 "Num~er · ~ • -· · · ·.. ·• •• -- ··-· 12. Pa_w 1 of T3. Emergency Respo.nse Phone 14. MQanifesQt TQracSking3Num1~be9r Sl V ES

WASTE MANIFEST .!d · r> (• '' .:. • · ~ ., r =~ -, ,/. 1 C.1:lf'WT• ·f'1 ~-x~· 1

5. Generato(s Name and Mailing Address (!!:"N""L~-t..L.liLEC'TPJC C'l::> ~11f~:(iteAdd.~~~1l~W.~r~t.~an mailing address)

/• T""N;M!\'f'I C'~A.!.ACONE I SO PtAm AVE

413 4">-i 'i1~1i Generato(s Phone: · · ·· 6. Transporter 1 Company Name PAOE El..:.: .ll"iC


! )9 PLAS"f!Ctl A.VE Pi"I"l'Sl'1ELD, lf./>. t'! ::C·l

I'ROVIDUNCE AND WORCESTER R R

8. Designated Facility Name and Site Address'?JA YNB ~Ut1''')!).1. INC 49"50 N 1 -~~~ tmtVTCE OP.J'-'F.

Facility's Phone: lfOO 592"5.._,9 BE!..L!'!VII.LE. M! !!~!! l

9a . 9b. U.S. DOT Description [including Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group (if any))

I Pf'f1 SFJ.FI.n !-fiC. o)l,ltl(

10. Containers

No. Type

U.S. EPA ID Number

I N y I) 9 "

U.S. EPA ID Number l M ."- D f) ~

U.S. EPA ID Number

I M l D 0 ·~

11 . Total 12. Unit Oyantity 1 Wt.Nol.

~/MI..TE ! D '!' P\

X 1. Ni~)'J.I 1. rL"..L..~.!-<.L-~"4-r~- w;~~·l !:!. lS\..~!..!1.!. !1 ')~., \,...l.llf~.~1:J,~~,

g; W:J'.D}. ?, IU. RQ (LI:.t.D, P::!l'S)

~

., 9 ,.. 9 " '* ,

9 (' :r l' R ~ ~

il ,J !.-) 0 6 .> . 13. Waste Codes

L•J'.Jt< ]"'1 '!:.' !

M/•~·7 l/l39a ffi~~~--------------------------------------------------~--------r-----¥-~-----r----+-----+-----~----; :z 2. w (!)

3.

I I 4.

I I "\4. Special Handling Instructions and AddjiP~allnformation :.."'"" ·' • • ~::·"" ~?~~~ ~~''""=>' ~ • ~...,_, &J.::.:.>"-!o · • ·"-'·'·"' '",_ ..

' ,I '!'P.t>.EJ:iR N'l'MBEP.. ~:J_ &:t!J ____ :. P<::::B RllMC'\'ED FROM :rnF . ..n-(1; D/~'IT\ Jl1/l ~ f n

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 labeledlplacarded, 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 minim~tion statement idenMed in 40 CFR 262.27(a) (if I am a large qu~ntity.ge.!leratoi).2r (b) (n i"a~ s~-ijuan~ty generator)(:; true. • • .. ....--

::= 16. International Shipments D Import to U.S. D Export from U.S. - Po~ of entry/exit: ----,.----·-----------

ii!: Transporter signature (for exports only): Date leaving U.S.: /

ffi 17. Transporter Acknowledgment of Receipt of Materials ·' J ' / __

~ Transport)lr·H~rinted/Typed Name < . . Signature .- <':/> / ..• \" . , . ·; ~~~~~ ~ay~ te~ ~ "<£) D / t':' /_) (_,,, ' v '--··' !_) ,.!.:.,...(/;__.f.:,._. I --1:.(~_.,. . _ .. / / -· t:.J-!.·..':'."-'4. " '-1 ""I CJ !:)! 1 v ~hT~ra~n~sp~o~~~r'2~Pn~·n~re~dff~yp~ed~N~a~me~------------------------------------~~-gn-a~ru-re------------~----------------------~~Mon~th~~D~ay~~Ye~~~

I!: I I I I

1Ba. Discrepancy Indication Space

118. Discrepancy

E:; 18b. Alternate Facility (or Generator) ...1 u it Facility's Phone:

0 Quantity DType 0Residue D Partial Rejection D Full Rejection

Manifest Reference Number: U.S. EPAID Number

I ~~1~~~- ~S-~-na~tu-re~o~fAI--te~m~~-e-Fa~~~· lity--(o-rG_e_ne~r~aro~r-) 77~~--~~~--~----~~~~~--~~~~--~--------------------------~'M-o-nth-~I-D_a_y~l--~_ea_r, ):1 19. Hazardous Waste Report Management Method Codes [i.e., codes for hazardous waste treatment, disposal, and recycling systems) '-) · r r 1

20. Designated Facility Owner or Operator. Certification of receipt of hazardous materials covered by the manifest except as nrted io Item 1Ba

Printed/Typed Name Signature

I Month

I Day

I I Year


Appendix G-5

Hazardous Waste Manifests for the Off-Site Transport of RCRA-/Mercury-Regulated Materials to the Michigan Disposal Waste Treatment Facility in Belleville, Michigan

Table


Shipping Document


1 10/12/2012 20,210 000631629 VES Belleville, MI2 10/12/2012 20,910 000631631 VES Belleville, MI3 10/12/2012 21,770 000631632 VES Belleville, MI4 10/12/2012 20,560 000631633 VES Belleville, MI

Total 83,450



RCRA-/MERCURY-REGULATED MATERIALS

4/15/2014G:\GE\GE_Silver_Lake\Reports and Presentations\2014 draft Final Completion Report\Appendix G\G-5\0841411214_SilverLakeTSCA-RCRA-Mercury-DisposalLog.xlsx Page 1 of 1

Waste Manifests

c

Please print or type. (Form designed·for use on eHte (12·pitch) typewriter.) Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS , 1. Generator ID Number

WASTE MANIFEST M .<> !..' 0 !) 2 0 f'. 1 0 !=• ·- 1

2. Page 1 of 1 3. Emergency Response Phone 14. Manifest Trac'!,!ng Number

l l{!:100} 4';?,4,f??OO I 000631629 VES 5. Generato(s Name and Mailing Address

6. Transporter 1 Company Name PA(iit:: r:·r (~. ~ n·~c


OENEHAL _f1.ECTRIC CO 1\rfN:M.A.T . C,<II •. AC0"1E 1'1.\.9 Pt..ASTK':S AVe f'Jl1TS!"!Fi 11 MJl. Oi '?01

8. Designated FaCility Name and SiteAddres5MI(,;H, D!SP~'.)SAL \NASTE WEATMEMT: 4ft.~5tl N !·~4 SERVICE !_:!RIVE '

Facility's Phone:

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, HM an({ Packing Group (if any)) ·

[, 1 ~ ·r ~, .. ,., .. tt •' ~ '"' ''['·1 I . t .,.f t .. L . Nf'("\ 1,.,1 , ...... ,

10. epntainers

No. Type

'r D T

U.S. EPA ID Number J "' 't' rJ 9 ,~ ;.:; q '3 9 q A

U.S. EPA ID Number

t U.S. EPA ID Number

IM I i:" 0 0 i) .,

J. 4 6 ! •. I :•

11. Total 12.Unit 13. Waste Codes :WtNal.

...v.r,

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3.

4.

14. Special Handling InstructionS and Additional InfOrmation !::.H\.7·:'1 ~ . . Nlt::Rf-..~.IH.T ti• •. m .. , ~t::l.)IM;::N . , ,'o\J'ILI - ~t:!t<th-:> . • t!...: 1 ..:~•.:;tJI!... · ,

TR•\U.ER Nt.!Mt<!:~R __ Q_:l~ ~.-5.-.~ + '!)

15. GENERATOR'SIOFFEROR'S CERTIFICATION: ·I hereby deClare ihat the contents of this consignment are fully and at:CUrately 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 aCGOrding to applicable international and national governmental regulations. If export shipment and I am the Primary Exporter, I certify \hat the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Cons:~~~ I certify that the waste minimizlition statement identified in 40 CFR 262.27(a) (if I am a large quantijy~erator) or (Q) (~r'am alm~ll q!!anpty, gejlerator) is ~e . .., .- .~ .• ~ · . .l ;~-

Month Day Year

1\0 jtL.pZ.. ....J 16. International Shipments 0 0 •! j:..... Import to U.S. Export from U.S. Port ofentry/exH: ------------ --- ----;;!!;; Transporter signature (for exports only): Date leaving U.S.: ,

ffi 17. Transporter Acknowledgment of Receipt of Materials .•

li: Transpo~ 1 _P~jetedffyped Name / . L Signa.'1.f/ ,{ _..~ /1 / ~ jt· I I (C.-~ C/r.:u~- L I / ·r / 16· L~ v-..:.._. ~ Transporter 2 Printedffyped Name c( 0:: 1-

18a. Discrepancy lndicalion Space

118. Discrepancy

E:: 18b. Alternate Facility (or Generator) ....J u ~ Facility's Phone:

0 Quantity

ffi 18c. Signature of Alternate Facinty (or Generator)

~

Signature

I

Orype 0Residue


Month D~ ~~ I tO I CL jl<£-

Month Day Year

I I I

0 Partial Rejection 0 FuU Rejection

U.S. EPA ID Number

1 Day Year

z~----------------------------~----~--~~~--~~~--~--~~----------------------~--~--~--~ ~ 19. Hazardous Waste Report Management Method Codes ~.e., codes for hazardous waste treatment, disposal, and recycling systems)

I Month I I

~ ~ - 12 Ia r 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the man~est except as ncted in Hem 18a


I I I I EPA Form 8700M22 (Rev. 3-05) Prevtous editions are obsolete. GENERATOR'S INITIAL COPY

\::,.

Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050-Q039 UNIFORM HAZARDOUS 11. General~~ ID Numb~r ,2. Page 1 of 13. Emergency Response PhoM r Mlfoll6g3ie6 31 H 4 0 0 .•.

i (000) 4~!-l:f!.JOO VES WASTE fJIANIFEST M A. U 0 0 2 f) :,;..;

5. Generato(s Name and Matring Address >GF'~IER;I!,L fl .ECl'RtC c·o .. 9j~ftrf.;~tmt~~/e1~n mailing address) ·.

0 AfiN:MAT ('A.L.I\C(lNl:: '15!? Pl..JI.~mcs tWE i[~ 1!\l.ASrtCS AVE PIT"i'SFIE'U1 M/1 O'i}f•i: I F11''rr·, 'l·- l['l 'F\ Q1'2f1 z.1 i ·;:~ 4B4-!;3so l ' .. ). I·- - - t ,:y I "'- .J

Generator's Ph one: 6. Transporter 1 Company Name U.S. EPA ID Number PAC~E E~f.C.,:t,:c I ·fl! .., ;:.1 r• 2 ~~ 9 ~; ,~.: 9 •I

7. Transporter 2 Company Name U.S. EPA 10 Number

' I 8. Designated Facility Name and SiteAddress~.41CH. OISfl(JS.a.L Wf'!:;'fE 'l'~EA 'rfi.tfHT U.S. EPA ID Number

4&'mO N I~M SERVICE f.'RIVE . ~

;3(jl) 5-\12--6•\69 BELLEVILLE, M! 48~11 I ~.~ l D t r (l ··i I \ ; .:! -~ Facli s Phone:

9a. 9b. U.S . 001: Description.(tncluding Proper Shipping Name, Hazard Class, ID Number, 10.•GgrJ!i!~ ~--~£Un~ 13. Waste Codes HM and Paclting Group Of any)) No. Type " WtNol.

X 1.1'' ' '·-":'-:'' , , _r·w,t_i·wou_,· -"-'"-' ;v, ..... :. ' ;:., ·":1 A .. u.; , n.u.:.., ~ _,.,

·•''.J<J'..f ll:: !;MCF~GUR'Y:;, Y. lll, R\':..1 0

~ ·j (J r 249lD If

I w 2. I :z

w C) -

3.

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4.

14. Special Handling lnsllUctlons andAddttionallnfomiation !::r-t-~ ; 1/1 Vrot::t~L.'.It( T '."'I.JIL., !:A!:;iJ!M;:T>t. : f'.l'i~ .. • :.: .:.l::lN:! -~' · f' ..-'~~1 ; ; ' M t !

c • fF,ilYP f·!l li>t!fJER __ ,._5Z_,j_~-------w· + ·l)

M.C.TEf~t,q __ t-=f·<OM S!L''\lER U·~{E PH.<J.JECT CID R'£:}JVIRE.t\ t:1.t1.CI~lNG SUP ,.i\1Tl•.CHED P•J# '1 I ,, ·J7267?

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I ~ereby deClare' that the contents of this consignment are fully a~d accurately described al!ove by the proper shipping name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport aocording to ~pplicable international a~d national governmental regulations. If export shipment and I am the Primary Exporter, t certify that the contents of this consignment conform to the ·terms of the attached EPA Acknowledgment of Consenl 1 certify that the waste minimization statement identified in 40 CFR262.27(a) (if I am a large quantittg~neratpr) or(~) (if l,ani"ii~aU quantity.generator) itt~ ,. .~.._'"" , ...,.-

Generato~s/Offerol's Printed/Typed Name . -t~kiEtJ~UQ' . \' '·-' ·--~ ---•··~ Month Day Year \, .I? · ·.:(. --.- . · . r;~{:;1N)Ft-k~. 1 to 1LZ.1 L~ _, 16. International Shipments D Import to U.S. D El\port from U.S.

-t- Port of entryfex~: ' 2!: Transporter signature (for exports only): Date leaving U.S.:

ll:: 17. Transporter Acknowledgment of Receipt of Materials i j , .... j \ w I .. · ~ ~ ; l

ti: Transporter~intedfr~ Name _ •. , \ ... •\ r s~tre './ ..< ! }!/ \ •

t•~~~,t'[. 0 .. ' ('- . l > ' I , · (---~) ·,· ... r '} ~JI..J::;;:'....._"f.t_ 11. "< ·,J .. i· ~ ,., ./.._ e,.. 1.....- t '· ,.!'1 .... en

..... :z Transporter 2 Printedffyped Name Signl!ture Month Day Year <(

I I I I ll:: ~

i 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity Drype 0Resldue 0 Partial Rejection 0 Full Rejection

Manifest Reference Number. >- 18b. Alternate Facility (or Generator) U.S. EPA ID Number 1-:::i (.)

~ FaciiWy's Phone: I Q 16c. Signature of Alternate FaCility (or Generator) I Month I Day Year w !;;: I :z (.!) 19. Hazardous Waste Report Management Method Codes O.e., codes for hazardous waste treatment, disposal, and recycling systems) (i5

? 1. ,2. r- r j 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as nded In Item 1Ba

PrintedfTyped Name Signature · Month Day Year

I I I I .. EPA Form 8700·22 (Rev. 3-05) Prev1ous edtbons are obsolete . GENERATOR'S INITIAL COPY

- p

Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-Q039

UNIFORM HAZARDOUS _,1. Generator ID Number

WASTE MANIFEST 11. ~ f! o !1 1- fl A " n P ..•

12. Page 1 oll3. Emergency Response Phone

'I ($-\00\ •t'f.il~3l)O . r Moooc6g3ie6 3 2 VES

5. Generato(s Name and Mailing Address Genef<llq(s Site Address (if different than mailing address) · . .. .. GENERAL ~~r~s C9 •'3ENE.R.t\L ELECTWC CO

) t\ TIN: . ...,AI....A ~· .. NE 159 Pt.ASTIC.S AVE 15t~ f . ICS 'AVF.: .

Generato(s Phone: 413 494-153i!ia PITIS. D. M,4 Oi:?.!!"F I PiTfGT-lH.D. MA 01201 ;

6. Transporter 1 Co~y Name U.S. EPA 10 Number

lK? BULl<; 1HJ.\NSPCF~T iN'C. _lP <\ r• e i' ., ·1 ., (,}

' :. .. J .I -1. Transporter 2 Company Name l U.S. EPA ID Number

I 8. Designated Facility Name and Sije Addres\

4ICH

D!SP()Sl~L WASTE. THE.Ci"~"ME1'ff U.S. EPA 10 Number

4035(1 N i-~14 SERVICE DR.tVE ,. Facility's Phone: 6~}(; !:t~12-54t39 BEI.l.E-,lH...LE, M! ·'Ei'O I I M ! C· (; 0 \; .i •i ' : '7 ··'

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, .,.,.._ 10. Cantainers 11. Total 12. Unit HM and Packing Group (if any)) No. _sua~~ WtNol.


1 ·t·~A30l'?. Ht,~ll'tf{lY~uS ~tVr'>\~·rE . S(;t_ tL;-~ n.-o. u .. :--"-' . .. - f)J{I9 ' 0:: ~ 0 (hj[f{(;\)RV )~ ~d ~ !fl~ f~.t.~;

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2. z w (!)

3.

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14. Special Handling Instructions and Add'rtionallnformation ER•3;1 T! M12'H.D JRY SO'L ;:;EJ.'IMENT. /•J\10 DE8R!S. '1 'n• ·. ·,.~~.ii'Ot PCE.\. '5 1(' 1•i,.l. f ..,.., .,_ l _::li , ,.,

-- ·r o:..;: 1=1:1 Ni IMEEf:J ~3 A .;f';;'

•• , , ___ , •· • - • .r- ~ ·- - - .~. ~- ...... ~ . . ... - - I 11

MII.H::H!•\1 !=HC•M SIL'.'E~. LAKE PROJECT. CID f,'£:.':',UI~F.D P,ll.CJ.<.li'JG ~7UP ,:<T'fACHE[' r-~)# ·• '·! -~ !:twn 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. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) Of I am a large QI!SntftY gen~rator). O( (b) .011 arJlli! small quantity generator) is true.

Generato(s/Offero(s Printed!Typed Name ' ~-~t-.. ~ ~t{t.k . :'f~· ~:~~J ... ;\ Month Day Year

~nHEf.-H PAP·~.u o \'-GENI' ~~oFr G€) ·~. · l. ·. ""'~\-.. -+.:-:·· 1 /!th !.\51r . t-t_...e. ~~ 1 to· I t·2.1 \"2-... .... .... . ·.~. 'ill: . .• - - .. ; .. > ~ \,; . . -=-_, 16. International Shipments D Import to U.S. D Export from -u.s.

-, Port of entry/exij: j:... /

~ Transporter signature (for exports only): Date.leaving U.S.: -0:: 17. Transporter Acknowledgment of Receipt of Materials .r···-----..... , '/ .I .-. w ~ T~rter_} Print]dfTyped ~me

1 . .. \..§j9ture. :1" / /' (' .) .• ~::J--- · Month Day Year

g, f..,)f~· PS'' _,. _,;; !y l I/ ' 7 I . , / ,._ .?.{:ve ;c~- ... I ~o1 lZ.IlZ.. '·-- .'/ 4'

~ Transporter 2 PrintedfTyped Name Signature Month Day Year

0:: I I I I 1-

1 18. Discrepancy

18a. Discrepancy Indication Space D Quantity DType 0Residue D Partial Rejection 0 Fuh Rejection


~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number ::::; u ~ Faciflty's Phone: I c 18c. Signature of Alternate Facilijy (or Generator) I MonUl I Day Year w

< I z * 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

~)· r- r 14.

20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as naed in Item 18a


1 I I I .. EPA Form 8700-22 (Rev. 3-05) Prev1ous ed11ions are obsolete. GENERATOR'S INITIAL COPY

i I i I I I

I I i

c

--·· .... ·---~

Please print or type. (Form design'ed6or use on elite (12-pitch) ~pewriter.) FonnApproved. OMB No. 2050·0039

UNIFORM HAZARDqUS I 1· ~~I~ N~m~r WASTE MANIFEST M • D 0 r_, :.! 0 8 •i 0 tJ . 3

12. Page 1 of 13. Emergency Response Phone

·! {.9001 4M-4;;30t11 . 14· Mofooc&3ie6 3 3 VES

'· """"""' ""'"~ "''"'""= ~r\:\'CTIIIC C'.l ~~~~~n~~n mailing address) ·. -> .-: . - . '"' t c

A :MAT ALAC( ",JE ~59 -Pl.../l.S1"fGS ft.W . '!59 ... ASl:K~'.~· AVf: r.;lt fT,· ·lei.IJ fJA 0"!?01 PI ,-, i-''"" lrLn t> • O'J2G·t ':'1 ;l 494-fj~'\1<';>6 . I I ' "'' - ~-' ./[ ,'\

Generator's Phone: 6. Transporter 1 Company Name

"" U.S. EPA 10 Number

!JS rJ:JU<: T:~ .I\NSf.;~Qrn 1!'4~;. lp "' D 9 !j '? ' ! '1 I L


I 8. Designated Faciuty Name and Site AddressMI( -:1-1. DiSf~')'SA.l.. WA~TE T~l.fATMF:.N'f U.S. EPA ID Number

oi!P3N1 N 1·94 SERVICE OHIVE .. .:,d() f:~J2-~J ,;·~~~9 9ELLEV!Ll.E, 1,~! 11fH1-i

I ' l i) n (! u ., ,VJ c< .. -~ .. r ;

Facility's Phone:

9a. 9b. U.S. DOT DescripJion Oncluding Proper Shipping· Name, Hazard Class, ID Number, 1 ii .. Containers 11 . Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type >:. •".c;l.u!I.Qii!V~11 · Wt.Nol.

.)( F~-':•..:.v t ·. n•"-l.P,<>:t,:l.)~;::~ "'· ,..··o t ~= . :::.v LJL·, ;1 . .o.: • . ._....~ .. A!f.l., ~ (MERSI.Jr~Y). 9. lli, R0 0

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j{

I w :z: 2. w C>

3. I I ! --

4, --1 -14. Special Handling lnslrucUons and Additional Information t:hf·~;.l 11 ro"t:?-<:',;~!t•t r bUlL. .. :H::tll!~it:l'l . 1 ,l>.l'll:J :..lt'.t'H~ :;:. .f..n ~. liW.t .•

T l ~!.'\l t.IT! 1->iUI-I'[~[:r.~ ·---~3.1.\::::2.&.. .. -.. + !) i\'1.:\!'ERl f>.L f-R.OM Sll.v t:::f-i LP.KE Pf~)JECT. C.iO t~EC'tUIRfi:TI, PP.C'I'tJNG ·3UP ''·.rf M~HE.D PO# ~ ·i ~ i 7;?.i:.~72

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby dedare that the contents of this consignment are fully and accurately de,scribed 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. lf e~port shipment and I am the Primary Exporter. I certify that the contents rJ this consignment conform to the lenns 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 q~an~rator) or (b),(ifl'am _!Small quantity generator) is \r\!E.,.,

"- ~ _,. .. -··· Generator's/Offeror's Prinledfl'yped Name .,--~~~~~0)/J . '···:.) :.·-· ·-· ' .

IM\0 I ,2,_1\y!. F!.C8ERT PAPAU.O (AGENT FTJFt G!i::} •• ~/'<" • " . . . . i'.M~J:..t..~t.. \·-t -~ ~~-;... ~ ·r~~- '"' ..........

....I 16. 1ntemational Shipments 0 Import to U.S . 0 Export from U.S. j:.. Port of entry/exit: ~ Transporter signature (for exports only): Dale leaving U.S.: . a: 17. Transporter Acknowledgment of Receipt of Materials ' II w li: Tr{.poder 1 Prin:0d Nam~. /' / Signature ,1-f .A'' : / ·' \ Month oz. Year 0 - . .J ' f · /1 -.. J -/· I __..~·',.: I '·· ·"'-:~_:-.. ·-- ·- --- -· I tol (' .,tz. 11. ' ·t y ' (../ .:::::. ,.· - - · ~-"' ~.:.-;?.~··.: ·.-i , ·- ---·- ·- -.. ~-rn .._...... ~ .. Jlo .J -

~ Transporter l Printed/Typed Name S1gnature .. ,,;r '- Month Day Year

~ I -"' I 1 l

I 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity Orype 0Residue 0 Partial Rejection 0 Full Rejection

ManWest Reference Number.

i= 18b. Alternate Facility (or Generator) U.S. EPA ID Number :::i 0 it Facility's Phone: I c 18c. Signature of Alternate Facility (or Generator) l Month l Day Year w !;i I :z: ; 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazanfous waste treatment, disposal, and recycfing systems)

1. r r r· 1

20. Designated Facmty Owner or Operator: Certification of receipt of hazardous materials oovered by the; manifest ~xcept as nded in Item 1Ba

Printed/Typed Nan)l! Signature Month Day Year

I I I I .. EPA Fonm 8700·22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete . GENERATOR'S INITIAL COPY

Appendix G-6

Hazardous Waste Manifests for the Off-Site Transport of RCRA-/TSCA-/High VOC-Regulated Materials to the Veolia Facility in Port Arthur, Texas

Table

Number

Shipping

Date Load Weight (kg)

Shipping Document


1 9/7/2012 21,390 000527114 VES Port Arthur, TX2 9/7/2012 21,620 000527115 VES Port Arthur, TX3 9/10/2012 21,100 000527116 VES Port Arthur, TX4 9/11/2012 22,390 000527117 VES Port Arthur, TX

Total 86,500



RCRA-/TSCA-/HIGH VOC-REGULATED MATERIALS

4/15/2014G:\GE\GE_Silver_Lake\Reports and Presentations\2014 draft Final Completion Report\Appendix G\G-6\0841411214_SilverLakeRCRA-TSCA-HighVOCs-DisposalLog.xlsx Page 1 of 1

Waste Manifests

----==_,

G~ase print or type. (Form designed for use on elite (12-pitch) typewriter.)

UNIFORM HAZARDOUS ,1. Generator ID Number

Form Approved. OMB No. 2050-0039

WASTE MANIFEST .,... ., " .• _ , " ,. .. 1

2. Page 1 of ,3. Emergency Response Phone 1'4. Manifest Tracking,; umber •l

., ,.,.,._,~ .... "" 0 0 0 5 ~ 711 '4- VES

r:x: 0


. 7. Transporter 2 Company Name

8. Designated Facility Name and Site Address VE(;-!.16.. ES~fECHil.~tC,~t 'iXX.'..ffiON~ H!Ot-!VIJAY 73 3-5 MILES W. OF T.~YLOH'S f:lfl.YOIJ

Facility's Phone: ~.;._, "136·lH2·1 ''l(lRT ARTHUR, TX nf.ir'!(l

9a. 9b. U.S. DOT Description (including Proper Shipping Name. Hazard Class, ID Number. HM and Packing Group (H any))

;,:: 1

· HAJi; ·r ;-:. t·~t..Z.AJ~f)\)V$ V'\fAS'rE\ SOtJf.!. n. n ,~ . tF'~:a·~~;

Gimerato(s"Site ll:d<lress (If different than mailing address)

GENER.t.~L ELECTRIC CD ~59 !=''1 ... 1\STICS AVE

I '7!"' -, c·>: J""l r) 1.·· II ,... ... ,,.,., • ~ ' -.. )• f.... • ··· · ~~ r • -.. .~ J $. \. ~

1 0. ·Containers

No. Type

U.S. EPA ID Number

l n -~·-·o" 1"" .... :..,f ..,. r.)

·I U.S. EPA ID Number

U.S. EPA ID Number

11. Total Quanti~

12. Unit Wt.Nol.

· "!~ - ·~ "('-•

l.E,L:..C;.. 8 m RO flf: ,~D. F\...tl'S) !;;( ' MT -

13. Waste Codes

(}tJTG r:x: , ·~· ~~~-~~-1"2.-----------------------------------------------------r-------i----~~~~~q---~r-----~----+---~ w (!)

3.

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I 14. Special Handling Instructions and Additional Information

!::.17(-':3 rn P(::£1 :SC'!L. SEC!!MENT, ~~-I'D DEBf'?IS'. OTLI.?~~i 27~~- PCf:1'S <·t <)c_

.! q.'\!LER r-..J\.IME!Ef.l ~-a -.5.... PCB REMC~1ED ~'HGI\,1 SE:R\' !G::C P/- n: 8/29120 1:2 SRfl a ·; ·16f.f-';::-• + _,)

15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents o(lhis consignment are fully and accurately d-escribed 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. ~export shipment and 1 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.

Generato~s/Offero(s Printedffyped Name

....1 16.1ntemational Shipments 0 ~ ~~~M !!!!: Transporter signature (for exports only):

D Export from U.S. Port~entry/exit: -------------------Date leaving U.S.:


~ Transporter1,'!'·ci~:~ypedNJe ,- i; ,_·:-r i ~ ,- I Signature -~/ 7~:./~::'--- l';9t;llfeZ

~ ~T~ra-n-spo~rt-er~2~P~~~-n~te~d~~y-p-ed7N~a~m-e----~~~--~~----------------------~~S~ig-n~at-ur-e~~------~~~~~------------------~~M=on~th~~D~a~y~~~~e=ar~

g J I I I

D Quantity 0Type D Full Rejection

118. Discrepancy

18a. Discrepancy Indication Space 0Residue D Partial Rejection

Manifest Reference Number: ~ 18b. Alternate Facility (or Generator) U.S. EPA ID Number ..... C3 ;f Facility's Phone: ~ 18c. Signature of Alternate Facility (or Generator) , - .

A . ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

I .~ Month I Day Year

I ~ 1.

12. r

120. Designated Facility Owner or Operator: Certification-of receipt of hazardous materials covered by the manifest except as nded in Item 18a ~P~ri~nt~ed~~~y~p~ed~N~a~m~e~------~--------------~------------------~--J'S~ig~n~at~ur=e~--------------------------------------~~--~~~~~

r· Month Day Year

I I I EPA Form 8700·22 (Rev. 3-05) Prevrous editions are obsolete. GENERATOR'S INITIAL COPY

G e print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 11. Generator ID Number 12. Page 1 of ,3. Emergency. ~ponse Phone r Mtrooc5g2u~ri 1.5. VES WASTE MANIFEST M ,'\ Ll t1 (! 1 0 ~ '' (i $) .;· • mam "2.·-t-~noo 5. Generator's Name and Mailing Address

~fi:~~f-~r~.f~i? Gfl~or~~f.:i!~.(rm~r~n{&an mailing address)

·~ I 1:: '' • _c, \.., .) 159 Pi..ASTK~S AVE

i 00 P!.J\.~T!CS AVE

1-'l'lfSF!E.'U.o Mf· O'i::0111 ,...,.!., .,, .. ,.·u· · ~· ~ 0~2G1 Generator's Phone:

·iL ; .;,H .. -.. .. !J ... -!:lfl I_ t 'H I f • ..:J.f 1... r : , .-t ,f:.'

6. Transporter 1 Company Name U.S. EPA ID Number ~ lS BtJL t<. -rr~Af'~sr:\)RT tt-4G.. lp •l r j' ~~ . (; ' 3 •1

.. ,,, j .. 7. Transporter 2 Company Name • U.S. EPA ID Number

1 8. Designated Facility Name and Site Address VE<)L!A es TE.CHNlCt-\L SC)'~l. lil(ll-!~1 U.S. EPA ID Number

H!~~WAY r:~ 3.5 Mil~ W >:,)F T.4.'!'L\>R'S 8 11 YOl...J

~'>l'tj\f; ...- J;). ,!_{j,i ~ Pn rr r i~R'fi-JUR. T}': 7-:'1>'10 1 I ,. u 0 \) (J f-11 [? p .. <:; ; '· Facility's Phone:

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Un~ 13. Waste Codes HM and Packing Group (H any)) No. Type .:1. 1'1t12nli~ .... .lAit.Nol.

v 1J'Ii ' ,; .. ,' · , !-lr I ~'tl_V\~'\)'1,) ~"> '.J\(J .,;;... ~ C',, :::i\..,b,.J! ,1, n !if, ~ ', I , ,_J~ ,•..;.,. ., ,..... !A J' •• h 0::

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0

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3.

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~ 14. Special Handling Instructions and Additionallnfonnation !::H<~ · ! I !-'· .• ti '::::{.lh •. !::i!:'UfMt:;,, , f, ~P~U Utl:!Hih !·' I .~ :. 1;! 1~. 1-'f..;t•''i, < !o/1

TP .• \ !l.EP 1\}.t ~ ~.'l.'£1.4> .. . ~-:::.1 ____ P'.-::8 REt>H~VEt'l t:'H1JM SH~vV::'E Df,n: Bi:>•n:~Qi;,t $!~ 0 t 1 605(1 ·! 'l ' -)

~.1 -~· 1Eq!flL F ··~O~l ~'i l!..'.fER. LAKE f~G"If-:C: T Cif) q,t:•')U!f..tF.D f..\/~.c~:n'K=' (,;up "'· rr .~Cttt:P P\.1# 11 ~ 1 ?' ·1 92-'~

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, marlled and labeledlplacarded. 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 confonm to the tenms of the attached EPA Acknowledgment of Consent. 1 certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quan~nerator) or (b).~~ a ~ntity generator) is true.

-~-.. -,_

Generato~siOfferor's Printedffyped Name

~~N:C~~~~ ,~,&~~tz, ~~~~.tf~ t ~r! F'y L~J ' ~ t..t (., .a~~3FNT •· Ot:l r:,~:; I

...J 16. International Shipments D Import to U.S . D Export from U.S. ...... .~

P~ of enlly/exit: t-~ Transporter signature (for exports only): Date-leaving U.S.:

0:: 17. Transporter Acknowledgment of Receipt of Materials w ~ Transporter 1 Printedffyped Name Signature

~91old~ 0 '• I , ~ ...... ..., a.. .. U)

Transporter 2 Printedffyped Name Signature Month Day Year :z <

J I I I 0:: .....

r 18. Discrepancy

18a. Discrepancy Indication Space D Quantity 0Type 0Residue D Partial Rejection D Full Rejection


E; 18b. Alternate Facility (or Generator) U.S. EPA ID Number ...J 0 Lf Facility's Phone: J 'f') Signature of Alternate Facility (or Generator) I Month I Day Year

( I ~ 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) UJ 1. ,2. r r· 0

l 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as naed in Item 18a

Printedffyped Name Signature Month Day Year

1 I I I .. EPA Form 8700-22 (Rev. 3-05) Previous ed1t1ons are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Form designed for use on elite (12-pitch) typewriter) Form Approved OMB No 2050-0039 ~IFORM HAZARD.OUS 11. Generator ID Number

( )'ASTE MANIFEST -~ "' n " . ,., " f. •:l 1

2. Page 1 of 1 3. Emergency Response Phone 14. Manifest Tracking Number

.. I tllM\ n>~. f.YU'lf) I QQQ52711 :3 VES r:r.f;enerator's Na me and MaHing AddresS · · -· Geiierato(s Site Adaress {if different than mamng address)

GENEP.Ai. ELECTRIC CO ,_. ·, • ~~ Flli\ST!CS AVF

Generato(s Phone: 4'1 :> 494·6358 I n t-rT.r.-r:!'.,.-1 n ''"A ,.,1."' '1 ' • ;.-:.~, 1 .... ~ '-• J=t{. u "'·\l


'_1 :~·. fJUU•:. T~o!'{::;F'(il':tT INC I p _i.; Cf 9 c ? ~~ .t!, ~ ::; • j t ,

] .. Transporter 2 Company Name

8. Designated Facility Name and Site Address VEOUA ES TECH!'ltG,<\t .. -SOU.JT!OHS HiGHW.A V 7:.1 .:..5 MILE$>-'N. >:;;~ Tl•YLOR'S 8AYOU

u.s. EPA ID Number

l U.S. EPA ID Number

Facility's Phone: ·'109 ;·Ji;..;eez·t oc.~RT .~.~.TI-tUR. T~t 77640 I r x D o 0 a a ~ 6 & fi ~

D:: 0

9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, HM and Packing Group {if any))

10. Containers

No. 11. Total · 12. Unit

Type Ouantitv. Jlolt.Nol. 13. Waste Codes

iJO!J8

~ l 0 'T 12.1Ja> w~-1~--------------------------------------------------~t-------;------Pma~=-~-----r-----r-----+----~ z 2. w (.!)

3.

4. ,.

~ r(. Special Handling lnstJ:uctions and Additionallnfonmatio~ pr_:-s SOIL. ";ED ; r~! E't>..1T. ; f',;[\ OfEf.JRIS

r r::A!IEP ~.~~. ''l!:SEn._2~(::i2-..-:S.&.. .. P<::e !~HA·::~vFc FRO!,;! SERV!ct:· r>l•TE SI29.!21H :~ , s~J·) ·H:.;os·:~ !· '! 1

t,A u n -::p !Jl, l r- ~"1:0..: :-'~ !I ,;;:::q ! i~loC!= PQ('_\, ~~ C''f ·~J'"! ~Ft1! Hf.'I'Ffl Pt.Ct<.iN(.; "'I ff.l .a. If At"":l-J~O P .:''lft 1 ·' 1 171 <.:n.<l

~----~----~~-----

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, am are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable inlemational and national governmental regulations. If export shipment and 1 am the Primary Exporter, I certify that the contents of this consignment confonm to the tenms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27{a) {if! am a large quantity generator) or {b) {if I am a, small quantity generator) is true.

Generato(s/Offeror's Printed!Typed Name

....1 16. International Shipments 0 US j:- lm~rtto .. 2!::: Transporter,.signature {for ~xports only):

D Export from U.S. '-"' Port ~f entry/exH:. -----------------------------------Date leaving U.S.:

f5~1;7~.T~m~n~s~~rte~r~A~ck_n~o;wl_ed~g~m~en_t_m_R_ece~i~ __ m_M_a_te_ria_ls ____________________________ ~~~----~---,~--~--~4--------~----------~~--~~--~--~ t;: Transport,er 1 Printed!Typed Name Signature / · .: / ' · ,.

11

.M ~~onth_ . D~a()y I fY2_ear 0 , I . ~ I l .... . . ./ T _,!: __.;!.... ........ (

5; ·~./, · ./ ~> { I_. i t ~i ;. ._<~-:'_,>· "i;".J --""'f ".,rJ: -:- ,._ ;};~·· ,. ~ Trans~rter 2 Printed!Typed Name · Signature

~ 1 -


118. Discrepancy

~ 18b. Alternate Facility {or Generator) ::J u ~ Facility's Phone:

D Quantity

fi:l 18c. Signature of Alternate Facility {or Generator)

0Type 0Residue


1 r __,/. Hazardous Waste Report Management Method Codes {i.e., codes for hazardous waste treatment disposal, and recycling systems)

D Partial Rejection

U.S. EPA ID Number

J

Month Day Year

..1 I I

0 Full Rejection

I Month I Day Year

I

14.

Month Day Year

I I I

~ 1. 12. ,3.

1 ~2;0~.D:e;s~ig~na=re~d;F;ac;il=i~~Ow=:n=e~ro=r~O~~=ra~t=or.~· ~Ce=rt=ifi=~=ti='o=n =m~re=c=e~ip=to~f=h~==ar=d=ou=s~m=a=te=ri=als=co~~=r=ed=b~y=th=e~m~a~n~~~st~e=~=e~p=ta=s~n=ct=ed_i_n_lte_m~18~a--------------------------~~--r;.~~v.=71 PrintedfTyped Name Signature

I EPA Form 8700~22 (Rev. 3-05) Prev1ous editions are obsolete. GENERATOR'S INITIAL COPY

Please print or type (Fonn designed for use on elite (12-pitch) typewriter) Fonn Approved OMB No 2050-0039

~NIFOR_P/1 HAZARDOUS 11. Gen~ra~ ~~, N~~~r 1

-r· Page 1 of J 3. Emergency Response Phone r Manifest Tracking Number

~l ' 0 p ; l ~1':100} rf2:4l$30Q o·oos~27117 _ vEs WASTE MANIFEST M ,)}, u •,, ,. .t. ,'J " , .

~- Generator's Name and Mailing Address r-,::.NERAI F; ft"rr.~!r' : ·.-·. ~f*"~~lf'l~~l!n mailirigadd~ss) • ·• y ;·

i'·i·Tl"N~ ·nc·~>L ,..,_ ~'"ill";·· ~... . . ... ,.) I • f ..... ~ A.C .. " '- .i\ST!CS AVE . i59 ~ STICS IWf' i . ~ _.., _ . 0 .... - .• P .rrs -tt:-U.) MA .. ~ ;;n, nn"f<''"l~'l..[- '.i ~ 0. :201

Generator's Phone: 413 494·t'nns I I 'l. lt t.... • ..) , <- ' lr.. ..,

6. Transporter 1 Company Name U.S. EPA ID Number US ['UU< T1~Al'!lf<Pf)h1T IN\'; lp .4. !J ,IJ -~ 2 t'j 7 ':i 'I ~-.. .. 1


J 8. Designated Facility Name and Site AddressvEOU-!\. ES TECHNIC.A.L '20U.IT!ONS U.S. EPA ID Number

HIGHWAY73 :~. 5 Mlt£$W. OFTA''t'LOR'S B!>.Y()lt

4(1il f:li.J .. 28.t. l fl(~'Y Af{iHUR, <X ?-:tf: .. t!) I '~ X 0 0 Faci~ty's Phone:

(i a ~~ ,,j s r:. 9 B

Sa. Sb. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. cOn)ainers J 11. Total 12.Unil 13. Waste Codes HM and Packing Group (If any)) No. Typ · WtNol.

,.it 1. •v•"".J{ , , O'lf ..,_.~u~.Lfo'·~O < ~,-,>.;:, I \::, ·~·' '" '-!'- · · . ·1. 0 . : • ., 1 ' v!:J ;:, , ·' -r- vvuo

"' u.-t~Cii . G. Hl RC{L£.~0. PCB':;>} 0

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2Z.~ I) K MJ\\i.2 our,.; .:il.iltf _l . w

z 2. w C)

3. '

I•· 4. ..

I . Special Handling Instructions and Additional Information !:.K' ., : ·. · · r"L.tj .-::.UIL, :-;t:,UIMt.::Nf, ; :'IlL.' L.onmt~. r- 1 .'\ .• '!1..! f ~· t"';...~ :;:, ..-. ·J~o

!H.t-, !L.CH •·lL' ~,~f..lf:..F/. ___ ~52-_. PCEl REMOVED FROM 5ERI.J1C£ DATE l'i'2912012 ~11~05,. + 1l

M.•\TERlP.L Ff·11:-)M SILVER L4.KE PR.':)JEC1. ClD RI:.:()I..'IRED. Pft.C'KtNO SUP AITil,CHED. PO#'! -t11719.24 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fuRy and accurately described above by the proper shipping name, and are classified, packaged,

marked dnd labeledlplacalded, and are in an respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and 1 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 was111 minimization statement identified in 40 CFR 262.27(a) (if I am a larga quan~tor) o.w_b) !lf I a~ )I~~ g~or) is_ !rut A..- "....,.,... 1 ,....

Generator's/Oiferor's PrintedfTyped Name

~ ~~~~i~ \1 !12 ROE..·lERT P.(l.f.:t,LL() f -~GENT FOH GE)

...1 16.lntemational Shipments 0 Import to U.S. 0 Export from U.S . Port of entry/exit: f-.· ...

3!: Transporter signature (for exports only): Date leaving U.S.: -......... -.·-

~- 17. Transporter Acknowledgment of Receipt of Materials • , ... _ .... - ·- ·""")r'- ..,1 Signature //\:·· ,.._., _ ......

,~t\,~ a: Transporter 1 PrintedfTyped Name 1 \ ·" · I

/L \/1.. '----··- · 0 \ :·., -~·-: ( \ ~ - (;) -r I .. / \ _,_.. ~- t:.:/ .. '-p " . ~ ~ . , .

""'" ~ ~ Transporter 2 PrintedfTyped Name Signature Month Day Year

a: I I I I t-

l 18. Discrepancy

18a. Discrepancy Indication Space 0 Quantity 0Type 0Residue 0 Partial Rejection D Full Rejection


~ f8b. Alternate Facility (or Generator) I,J.S. EPA 10 Number :::i u

l if Facility's Phone: Q 18c. Signature of Altemale Facil'rty (or Generator) I Month I Day Year w ~ I

1-l ) azaldous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)

~ !f. 12. 13. r· 1 20.-''"'"'"""'"-"' """"oo•~~--~ m'"'"""""" .,.,,__ ~ """'" """'~ Printed/Typed Name . S1gnature • 1 Month Day Year

I I I. I .. EPA Fonn 8700-22 (Rev. 3-05) Prev1ous ed1t1ons are obsolete . GENERATOR'S INITIAL COPY

Appendix G-7

Hazardous Waste Manifests for the Off-Site Transport of Liquid-Containing Drums to the Veolia Facility in Port Arthur, Texas, and to Chemical Waste Managementôs Chemical Services facility in Model City, New York

~-?.!'-tease print or lype. (Form des~ ned for use on elile (12-pilch} lypeWrffar.}

UN FORM RAZARDOUS ~- Ganeralor 10 N1Jn!ber

WASTE MANIFEST ~ A n , , ~ ,1 'L ~.

6. Transportar 1 ~Name

TONAWANOATANKTRA~S~RT 7. Tl'3f1S!IMSI1 Compa~ ttarne

'J

9a. 9b.li.S. OOT ~lie~ {1rduding f'n:9er Sttilll*lg Name. Hazard Class. ID Numbe-,

IX 0

HM an:!~ Gw.Jp(hny))

~ . I •.1112 _. ' Jt Pn!" ·r:r ' I 1~ l MIXT • ~ If! RO

c

1 D. Ccnlainers

No. T\'1)11

Fonn Approved. OMS No. 2050-0COO

U.S. EPA 10 Nt.robar

I ·~ '( BY;..;.--~----~·--~· U.S. EPA lD Number

I U.S. EPA ID NU'Tlber

l ' • I

~~-Total

Ouanbly

J j

l

•

~ ~~-+2~J-N3 __ 4_3_2-. -~-.--Y-t-'i_L_(_f~-~~--~-r-r-,--,,--,--~J--, -~--- ---[-, ------------~~----~~--~--------~--~-~--~ ------~----~

~ .ncr~. $; Ill. RO -- --_l

3.

4.

I

1~- Special Handling lnslruclions and Additional lnfonmatlon ·- E - tf::_r P.'-:A (."'N' 1 ,. r, r ~ I'' )I If I I' 1¥-~ov_o -.y s-R\.'"~= > .... s .J I I p ~"' I..) -';I Jr-- ~ , ,j:. I " . -•) 0£2RIS 't'.'lTH ~e' ~ "1 ,.,, T7!? •3 ~-l • 1 21 f II ~ q"'; ~<;t: '' • ''C-l ) 2\ ~J1 ,

I' / {

~ ~

15. GENERATOR'SlOFFEROR'S CERTlFTCATIDN: I hereby dec!ara t.a: :1-.e oontenls ollhis coos~r-rr-ent are full)• ar>d <a:uralell' l!esttilled abo1'6 by !he proJlEf shipping nore, srd aru dassrned, pad<Bged. martad 8M lal:eladlp!acareed, and are in all respects in XOPBf co'ld.'tlon for transp:11t aa:o.rt!Mg to appicable illernalionaJand national goY81llmenlal ~at!ons. If~ sh·pmen: ard I am tile Primary Elpaler, I cartify thai lila contes1ts of Ills oonsigmlent oo.~M to '.he terms of the attached Ef'A,II.cllnow!ed!Jnen a/ Ca1 sent. I certi~ thai lie wasla rinlmizat!on slalamen11denlif.e<: in 40 CFR 262.27(a) frt J a, a taiga IJIBIIIill' genera1or) o; (b) (ill am a sma" qua 1tty generaiO!) is lnJe.

~ l &..lrternalio'lal 5 ~;~nls 0 Import to U.S.

:!: Transporte• signsbJre (fur e~ only~ ffi tT. Tcansportec Adtnll'.....,.l!le(l.t of Retelpt o' Ma!elials

~ lra1SllQIIeJ' 1 Pr!ntei'TJ'ped Name

~ tt./JW!tn1 £AliJtF :i TranspOrter 2 PrintedfT)'POO NB(!Ie IX 1-

t :~~=:: looiQition ~ D ~Ja1~ I - ' / ... ") I I

•,} , " , 11 I ~ 1 1 1 r1 1 1 'o-< r •

EPA Form 8700-22 (Rev. 3-35) Pre111ous editiOns are obsolete.

Da~ v-j lt\ l 1 1 ..t..

0 Export: lnm u.s. Port ofentryiexit ----------------Oate lsa'llng u.S.:

- '~ ; \ 0Residue

. hl(l · ' _, ' / ." r

Mii"nilesl Referenwttum!)e-:

/ /

l.bllh Day Year

l /f I 1l I Oa~ Yaa·

I I

0 Palfal Rejection I ) :" ~ ', ) ....

I , ... lf Ll S. EPA ID Nurrbef

I

l.lonlh Oay l'&ar

I I I DESIGNATED FACILITY TO ENERATOR

;;:.- e 61 f.o5?oubl/ nifest Continuation Page Page 2 of 2

lanifest Number: 000631579VES

b ate Shipped: I0/11/2012

PCB Removed

Profile from Service PO Line 11 Drum# Number Date Description WT Units line#

1 Atl430 T79730 5/23/2012 Debris with PCB's <1% 268 KG 7 A5415 T79730 7/16/2012 Debris with PCB's <1% 262 KG 7 A5416 T79730 7/16/2012 Debris with PCB's <1% 305 KG 7 A5413 T79730 7/17/2012 Debris with PCB's <1% 292 KG 7 A5414 T79730 7/17/2012 Debris with PCB's <1% 291 KG 7 A5410 T79730 • 7/17/2012 Debris with PCB's <1% 218 KG 7 A5406, T79730 7/18/2012 Debris with PCB's <1% 305 KG 7 A5408 T79730 7/18/2012 Debris with PCB's <1% 250 KG 7

1 A6006 T79730 7/18/2012 Debris with PCB's <1% 283 KG 7 1 A6010 T79730 8/2/2012 Debris with PCB's <1% 52 KG 7

~1 A5418 T79730 7/19/2012 Debris with PCB's <1% 104 KG 7 1 00730 T79730 8/16/2012 Debris with PCB's <1% 330 KG 13

A5402 179730 7/26/2012 Debris with PCB's <1% 322 KG 7 A6011 T79730 fl/12/2012 Debris with PCB's <1% so KG 7 A5401 T79730 7/27/2012 Debris with PCB'S <1% 53 KG 7 A6038 T79730 8/30/2012 Debris with PCB's <1% 122 KG 7 A6012 T79730 8/7/2012 Debris with PCB's <1% 62 KG 7 A6034 T79730 8/23/2012 Debris with f'CB's <1% 47 KG 7 A6040 T79730 9/5/2012 Debris with PCB's <1% 80 KG 7 A6041 T79730 9/12/2012 Debris with PCB's <1% 140 KG 7 A5428 T79730 8/22/2012 Debris with PCB's <1% 48 KG 6 A6031 T79l30 8/23/2012 Debris with PCB's <1% 57 KG 7 A6042 T79730 9/12/2012 Debris with PCB's <1% 47 KG 7 A6050 T79730 9/20/2012 Debris with PCB's <1% 47 KG 7 A6044 T79730 9/13/2012 Debris with PCB's <1% 47 KG 7 A6052 T79730 9/27/2012 Debris with PCB's <1% 51 KG 7 A6032 T79730 9/11/2012 Debris with PCB'S <1% 65 KG 2 A6043 T79730 9/19/2012 Debris with PCB's <1% 72 KG 7

Total : 4300 KG

2 F4967 BH5510 8/212012 Filtercake with PCB's < 1% 617 KG 3 :? F4968 BH5510 8/6/2012 Filtcrcake with PCB's < 1% 645 KG 3 2 F4969 BHSSlO 8/11/2012 Filtercake with PCB's < 1% 518 KG 3 2 F4970 BHS510 8/14/2012 Filtercake with PCB's < 1% 670 KG 3 2 F4971 BH5510 8/16/2012 Filtercake with PCB's < 1% 717 KG 3 2 F4972 BHS510 8/20/2012 Filtercake with PCB's < 1% 565 KG 3 2 F4973 BH5510 8/27/2012 Filtercake with PCB's < 1% 637 KG 3 2 F4974 BH5510 8/30/2012 Filtercake with PCB's < 1% 638 KG 3 2 F4975 BHSS10 9/3/2012 Filtercake with PCB's < 1% 574 KG 3 2 F4976 BH5510 9/4/2012 Filtercake with PCB's < 1% 612 KG 3 2 F4977 BH5510 9/10/2012 Filtercake with PCB's < 1% 599 KG 3 2 F4432 BH5510 9/14/2012 Filtercake with PCB's < 1% 647 KG 3 2 F4433 BHSSlO 9/16/2012 Filtercake with PCB's < 1% 740 KG 3 2 F4434 BH5510 9/20/2012 Filtercake with PCB's < 1% 698 KG 3 2 F4435 BHSSlO 9/21/2012 Filtercake with PCB's < 1% 649 KG 3 2 F4436 BH5510 9/27/2012 Filtercake with PCB's < 1% 694 KG 3 2 F4437 BH5510 9/29/2012 Filtercake w ith PCB's < 1% 690 KG 3

Total: 10910 KG

WAST£ MANAGEMENT

GE COMPANY ATTN: !-IATT CALACONE MAD002064093 159 PLASTICS AVE . P:TTSFIELC MA 01201

CWM CHEMICAL S ERVICES, LLC 1550 Balmer Road Model City, NY 1410 7 (716) 286 1550 (716) 286-0211 Fax

E3~: ___________________ _

CERTIFICATE OF DISPOSAL

CWM CHEMICAL SERVICES, L.L . C . 1 EPA ID: NYD049836679, has received waste material from GE COMPANY on 10/12/12 as described on Shipping Document number 000631576VES Sequence number 01. CWM CHEMICAL SERVICES, L . L . C. hereby certifies that the above described material was landfilled in accordance with the 40 CFR part 761 as it pertains to the land disposal of polychlorinated biphenyl contaminated materials .

Profile Number: T79730 CWM Tracking ID: 8165606401

cw.M Unit #: 1*0 thru 28*0 Disposal Date: 02/02/13

Under civil and criminal penalties of law for thQ mak~ng or submission of false or fraudulent statements or representations (18 U.S.C 1001 and 15 U.S.C. 2615) I certify that the information contained in or accompanying this document is true accurate and complete. As to the identified section(s) of this document for which I cannot personally verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons acting under my direct instructions, made the verif · a io ljJ t :Y1 imc o=a tion is true accurate and complete .

. ~ MICHAEL D MAHAR DISTRICT MANAGER Certificate # 363845 02/06/13

For questions please call our Customer Service Dept. at (800) 843-3604

~ ~

(.l)nerator' nona 6. Tra~poricr 1 Company Name

1. T ransporier 2 Company Name

FaCility's Phofl6.

9a. 9b U.S. DOT Oescnption (Including Proper Shipping Nan>.e, Hazan! Class, 10 Number. HM an<! Packing Group Q.f any))

s,(!i11IYL

-

- l 11

10. Conlelners

No. Type

I f

·' r ··' ...J.

lJ.S. EPA 10 Nurnbel

11. Toll!l Quantity

12. Unit WI.Nol.

13. Wasta Codes

~~-4~2-~~~~~~~~~~~~~~~~~~~~~-------------r-------4------t--------t----4-~~-t~t~~----~ w Cl

• 3.

4.

14 SPecial Handl:ng lnstrucfions and Addijionallnformation

"I .. , 1" [10"1. . , ~

15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment ere fuHy an<! accurately described above by the proper shipping name. am are classified, packaged, marl<.ed and labeledlplaauded, and are in al respects m proper condiUon for transport acconilng to applicable International and national govemmenll!l~egulations. If export sh1pmen1 and I am the Plimary Exporter. I certify mat the contents o11his consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify lhal the waste min.mization silltement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (ill am a small quanflly generator) is true.

ffi 17. Transponer Acknowledgment of Receipt of Materials

:Z: Transporter 1 Printedfryped Name

~ /'ff, j) :i ~

r \8. Discrepancy


/: 1Sb. Alternate Facility (or Generator) ::l u

D Quantity

0 Export from u.s.

Slgnaturll

Drvpe 0Residue 0 Partial Rejection

Manifest Reference Number. U.S. EPA 10 Number

Month Day Year

Month Day -Veer

/ j Year

0 Full Rejection

~ Facility's Phone: @~1~87c.~S~~=na~ru~~~o~f~~~a=m7.a~~Fa~~~-~~~r~~n=e~~ro~~~l----------------------------------------------------~~----------------~~--~~~Y~e~ar~

~ ~~------~~--~----~~~--~--~~~------~----~--~--------~--------~--------------L---~---L--~ ~~1~9-.H~aza~rn_o_~~w_a~s-te_R~e~port--M_M_a~ge_m_~_nt_M_e_~ __ Codr._~_ -es~(~i-~~-·-cod __ es_f_or_h_aza __ ro_~ __ w~as_te_~ __ am __ en_t.~d-i~~~~·~a-nd_~~y-di~ng~s~y~ste~m~~~l-------------~--------------------------~ ~ 1 . ( . l . 2. \ .\ 3. 4.

j -J.__'_--r' l \_.., 20 Designated Facility Owner 0( Operator: Certificatiun of receipt of hazardous materials covered by the manifest except as naed mltsm 18a PrintedfTypj!d Narpe Signature 1

. ' ___!_ ,_

EPA Form 8700·22 (Rev. 3-DS) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR

Manifest Summary Page (}) Manifest Number: 000774061VES Date Shipped: 07/08/2013

Profile Accumulation Start PO Line# Drum# Number Date Description WT Units Line#

1 C4081 PTA586707 4/3/2013 Coal Tar ONAPl 5 KG 1

5 KG

2 F6043 PTA586707 4/19/2013 Coal Tar DNAPL 20 KG 1

2 F6052 PTA586707 519/2013 Coal Tar DNAPL 80 KG 1



185 KG

3 A6309 PTA586733 5/21/2013 Vapor Phase Carbon 123 KG 1


3 A6312 PTA586733 5/21!2013 Vapor Phase Carbon 11B KG

3 A6308 PTA586733 5/2112013 Vapor Phase Carbon 127 KG


570 KG

4 A6266 PTA616546 4124l2013 Non-Regulated Decon Water 214 KG 1

4 A6264 PTA616S46 4/24t2013 Non-Regulated Oecon Water 217 KG 1

4 A6262 PTA616546 4/24/201.3 Non-Regulated Decon Water 223 KG 1

4 A6263 PTA616546 4124/201J Non-Regulated Decon Water 225 KG 1

4 A6267 PTA616546 412412013 Non-Regufated Decon Water 149 KG 1 4 A6265 PTA616546 4124/2013 Non-~egulated Decon Water 217 KG 1

1245 KG

5 82951 PTAS86781 4/9/2013 Non-Regulated Well Development Water 2 KG 1

2 KG

6 82464 PTA586731 3/26/2013 Asbestos Decon Water 148 KG

148 KG

G VEOLIA

ENVIRONMENTAL SERVICES

GENERAL ELECTRIC CO 159 PLASTICS AVE PITTSFIELD, MA 01201-0000

ATTN: ACCTS PAYABLE

Veolia ES Technical Solutions, L.L.C. Federal EPA ID: TXD000838896 State EPA ID: 50212-001 Highway 73, 3.5 miles W. of Taylor's Bayou Bridge Port Arthur, TX 77643 (409) 736-2821

CERTIFICATE OF DESTRUCTION

Veolia ES Technical Solutions, L.L.C. has received waste material from GENERAL ELECTRIC CO (Fed EPA ID- MAD002084093) on 7/10/2013 as described on [State Manifest or Uniform] Hazardous Waste Manifest number 000774061VES.

Sequence 1

Profile Number: PTA586707

Veolia Tracking ID: 698082-01

Veolia Unit ID Treatment Date l nter-ComQan~ # Date CD Was Issued

1 7/20/2013 L01821692003001010 C \{D!(I - 7/26/2013

Sequence 2

Profile Number: PTA5B6707


Veolia Unit 10 Treatment Date lnter-ComQan~ # Date CD Was Issued

1 7/18/2013 L01821692003002010 f~t 'f) ... 7/19/2013 2 7/18/2013 L01821692003003010 r'o ')~ .... 7/19/2013 3 7/18/2013 L01821692003005010 ft;,O <;1 7/19/2013 4 7/18/2013 L01821692003006010 fLo6~ 7tl9/2013

Sequence 3



Veolia Unit ID Treatment Date lnter-ComQan~ # Date CD Was Issued

10/7/2013 L01821692003008010 .+ b ~i)~ ~ - 10/10/2013 2 10/7/2013 L01821692003009010 ,f [J JlO 10/10/2013 3 10/7/2013 L01821692003010010 .4~ H Jr

- 10/10/2013 4 10/7/2013 L01821692003011010 IH \ ~:x ..... 10/10/2013

5 10/8/201$ L01821692003012010 Ab ~0 7 - 10/10/2013

Sequence 4

Profile NuiJlber: PTA616546

Veolia Tracking 10: 698082-04

Veolia Unit ID Treatment Date lnter-Qgmgan~ # Date CD Wa~ Issued

1 7/16/2013 L01821692003024010 /] ~ )..b) _.... 7/19/2013

2 7/16/2013 L01821692003025010 I) b'~ ~ 7/19/2013 3 7/16/2013 L01821692003026010 lr ~ )-p- : 7/19/2013 4 7/16/2013 L01821692003027010 ,4~ rb). 7/19/2013 5 7/16/2013 L01821692003028010 }!. H 7 ~ 7/19/2013 6 7/16/2013 L01821692003029010 /H J.-(,( J 7/19/2013

Sequence 5



Veolia Unit 10 Treatment Date lnter-Com12an~ # Date CD Was Issued

1 7/20/2013 L01821692003014010 ~)..11)\ 7/26/2013

Sequence 6



Veolia Unit ID Treatment Date lnter-Com(;lan~ # Date CD Was Issued

7/16/2013 L01821692003007010 ~}~bJ _. 7/19/2013

Sequence 7


Veolia Tracking 10: 698082-07

Veolia Unit 10 Treatment Date lnter-Com12anx: # Date CD Was Issued

1 7/1612013 L01821692003013010 Ac,r-n ~ 7/19/2013 2 7/16/2013 L01821692003015010 ib?--l q J.- - 7/19/2013 3 7/16/2013 L01821692003016010 L J-1\ q J • 7/19/2013 4 7/16/2013 L01821692003017010 I) J-1.{" ~ ,... 7/19/2013 5 7/16/2013 L01821692003018010 G)-?i<\ - 7/19/2013 6 7/16/2013 L01821692003019010 ~)..711 - 7/19/2013 7 7/16/2013 L01821692003020010 ( )-~ rJ. - 7/19/2013 8 7/16/2013 L01821692003021010 (;)..is-7 ,.. 7/19/2013 9 7/16/2013 L01821692003022010 f"~}J.tb .... 7/19/2013 10 7/16/2013 L01821692003023010 p .5)"15 .; 7/19/2013 11 7/16/2013 L01821692003030010 'li-'-?q}- 7/19/2013

I certify, on behalf of the above listed treatment facility, that to the best of my knowledge, the above-described waste was managed in compliance with all applicable laws, regulations, permits, and licenses on the date listed above. Management of wastes includes pretreatment blending and subsequent incineration per standardized handling code H040, "Incineration- thermal destruction other than use as fuel", reference 40 CFR Part 262, Appendix Item 19, {TCEQ 30 TAC § 335.10).

Paul V. Conrad Mate rial Services Manager

+d]dugrxv :dvwh 0dqlihvwv iru wkh 2ii 6lwh … · appendix g-4 +d]dugrxv :dvwh 0dqlihvwv iru wkh...

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