DANiL (T1
POST-CLOSURE PERMIT RENEWAL APPLICATION KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI FACILITY
Fluor Daniel GTI Project 101399
ecember 1997
Prepared for: Beazer East, Inc. One Oxfcrd Centre, Suite 3000 Pittsburgh. Pennsylvania 15219
epared by: Fluor Daniel GT) 637 raddock Avenue E Pis5urgh,PA 15112
37 Brcddcc Avenue / Ecst P:t5t;c, F’
12 USA
2 523-5300 FAX (412. 2J.-72 15
3eaze. r’.aoa, Mssssppi Facity Post-C:csure Renewal Application
December1997
CONTENTS INTRODUCTION SECTON B. FACILITY DEScRIPT;DN 8.1 General Description 8.2 Topographic Map B.3 Location Information B.3a Flood Information 8.4 Traffic Control
B-i B-i B-2 B-2 B-2 B-3
SECTION C. WASTE CHARACTERISTICS C.i Chemical and Physical Analyss C.2 Waste Analysis Plan
C-i c-i C-i
SECTION D. PROCESS INFORMATION D.1 Surface Impoundment D.2 Landfills
D-1 D-1 D-i
SECTION E. GROUNDWATER MONITORING E-1 E.1 Interim Status Groundwater Mcnitoring Data E-i E.ia Description of Wells E-1 E.ib Description of Interim Status Sampling and Analysis Procedures E-2 E.lc Interim Status Monitor-g Data E-2 E.ld Statistical Procedures E-2 2.2 General Hydrogeologic Information E-2 E.2a Regional and Site Gecogy E-2 E.2b Identification of Upperrost Aquifer E-4 E.2c Determination of Grou-dwater Flow Direction and Rate within Uppermost Aquifer E-5 E.3 Topographic Map Requiremer.:s E-5 E.4 Groundwater Quality Descripc E-6 2.5 Detection Monitoring Program n Accordance with the Hazardous Waste Management Permit No. 88-543-01 E-6 E.5a Description of Wells E-6 E.5b Description of Sampiirg and Analysis Procedures E-6 E.5c Procedure for EstabHs1ng Background Quality E-7 E.5d Statistical Proceduces E-7 E.6 Continuation of the Detection cnitoring Program E-9 E.6a Description of Wells E-i0 E.6b Sampling and AnaIyss E-10 E.6c Alternate Concentratcn Limits E-11 E.6d Statistical Evaluation 2-11 E.6e Results E-12 E.6f Post-Closure Grounca:er Monitoring Program E-12 2.7 Compliance Monitoring Progra’ E-12
2.8
Corrective Action Program
E-13
SECTON F.
PROCEDURES TO PREVEV —AZARDS
F-i
SECTION H.
PROGRAM TRAINING
H-I
DNi1.GTJ
C
0
C
Beazer Gerada, M ssss:ppi Fac.ty 1 Post-Cosure Renewai Aophcation
sEcT:oN I. 1.1
.2
1.3
1.4 1.5 .6 1.7
December 1997
CLOSURE PLANS, POST-CLOSURE PLANS, AND FINANCIAL REQUIREMENTS Cosure Plan ia Closure Performance Standard .1 b Partial Closure and Final Closure Activities I.ic Maximum Waste Inventory lid Schedule for Closure lie Closure Procedures Post-Closure Plan l.2a Post-Closure Contact .2b Inspection Plan l.2c Monitoring Plan l.2d Maintenance Plan l.2e Post-Closure Care for Miscellaneous Units l.2f Post-Closure Security Notices Required for Disposal Facilities I.3a Certification of Closure l.3b Survey Plat Closure Cost Estimate Financial Assurance Mechanism for Closure Post-Closure Cost Estimate Financial Assurance Mechanism for Post-Closure
..
I-i I-i I_i I-i I-i i-i I-i 1-4 1-4 1-5 i-s 1-6 1-7 1-7 1-7 1-7 1-7 1-8 1-8 1-8 1-8
SECTION J. OTHER FEDERAL LAWS
J-i
SECTION K. CERTIFICATION
K-i
SECTON L. INFORMATION REQUIREMENTS FOR SOLID WASTE MANAGEMENT UNITS Description of Solid Waste Management Units L.i L.2 Information Pertaining to Releases L-3 Sampling and Analysis Description of Solid Waste Management Units
...
FIG U R ES B-i B-2 B-3 E-1 E-2 E-3 E-4 E-5
Site Location Map Site Topographic Map As-Build Final Grading Plan Surface mpoundment Closure First Quarter Groundwater Elevation Contours A Zone January 21, 1997 Second Quarter Groundwater Elevation Contours A Zone May 5, 1997 Third Quarter Groundwater ElevatioD Contours A Zone July 28. 1, 1997 Fourth Quarter Groundwater Elevaticn Contours A Zone October 6, 1997 Monitoring Well Locations -
-
-
-
-
-
-
-
TABLES E-i E-2 E-3 -i
Summary of Monitoring Well Construc:ion Summary of 1997 Groundwater Flcw ‘Ielocities and Hydraulic Gradients Summary of Detection Monitoring Ccstituents Post-Closure Cost Estimate
JCR DN1
QT’
L-i L-i L-2 L-2
C
0
C
Beazer Grenada, Missssppi Facwty Pos-Cosure Renewal Application
December 1997
APPENDICES B-i B-2 C-i E-1 E-2 E-3 E-4 E-5 E-6 I-i 1-2 1-3 1-4
Meteorological and Wind Distribution Data Flood Insurance Rate Map Impoundment Sludge Analysis Statistical Evaluations Well Construction Information Historical Groundwater Elevations A Summary of Historical Analytical Results Sampling and Analysis Plan Statistical Methods Closure Construction Documentation Report From Surface Impoundment Closure Inspection Log Survey Plat Financial Assurance for Post-Closure Care
UOR DANL 071
C
0
0
BeazeriGrenada, Mississippi Facity PostClosure Permit Renewal Application
v Decerroer 1997
INTRODUCTION In accordance with Federal Regulations in 40 CFR Parts 264 and 270 and the Mississippi Hazardous Waste Management Regulations (MHWMR) 264 and 270, this Resource Conversation and Recovery Act (RCRA) Post-Closure Care Permit Renewal Application (Renewal Application) is being submitted for the closed surface impoundment (SI) at the Koppers Industries, Inc. (KII) facility located in Tie Plant. Mississippi, Grenada County (KIl facility). The original RCRA Operating Permit Applicatcn for the SI was submitted to the Mississippi Department of Natural Resources currently known as the Mississippi Department of Environmental Quality (MDEQ) in 1987 by Keystone Environmental Resources. The effective date of the Hazardous Waste Management Permit No. 88-543-01 (Permit) for the SI was June 28, 1988. The MDEQ Permit Board modified the Permit on February 23, 1990. The Permit was modified to reflect Beazer as operator, Kil as owner, include additional detection monitoring constituents in Part IV Groundwater Protection, and to provide Post-Closure Care requirements of the closed SI. The duration of the Permit was 10 years and is set to expire on June 28, 1998. In accordance with Section l.D.2 of the Permit, the Permiffee shall submit a complete application for a new permit at least 180 days before this permit expires. -
The 1984 Hazardous and Solid Waste Amendments (HSWA) Permit is set to expire on June 14, 1998. As stated in the EPA letter to Beazer dated July 17, 1997 and pursuant to HSWA Permit Condition l.D.2 (40 CFR 270.10(h)), and Part I Section l.D.2 of the Post-Closure Permit, the Permittee shall submit a complete application for a new permit at least 180 days before the permit expires. Because the HSWA Permit and the Post-Closure Permit together constitute the full RCRA Permit for the facility, this Renewal Application has been prepared to meet both regulatory requirements. The KIl facility was built in 1904 by Koppers Company, Inc. On November 14,1988, BNS, Inc., an indirect wholly-owned subsidiary of Beazer PLC, completed its acquisition of all the common stock of Koppers Company, Inc. On January 26, 1989. the name of Koppers Company, Inc. was changed to Beazer Materials and Services, Inc. (BM&S). On December 28, 1988, the wood treating facilities, including the KIl facility, were purchased by KH. No changes in operation have resulted from this sale. On April 16, 1990, the name of Beazer Materas and Services, Inc. was changed to Beazer East. Inc. Under the terms of the purchase agreement. Beazer has agreed to remain the “operator” of the RCRA SI. Beazer has also agreed to retain responsibty for financial assurance required in connection with the closure of the RCRA SI and has providec acoropriate financial assurance documentation (reerto Section 1.7). Prior to closure, the SI stored hazardous waste material, KOCi (bottom sediment sludge from the treatment of wastewaters from wood preser rg processes that use creosote and/cr pentachlorophenol). In the summer of 1988. a.i KOOl sludge and visually contaminated soils were removed from the SI and shipped to a permitec off-site disposal facility. Closure accvities for tne SI were initiated in July 1989 which included rercvaI of accumulated rainwater, placement of clean soil
LU D,!NL Q
0
C
Beazer,Grenada, Mississippi Facility Post-Cosure Permit Renewal Application
vi December 997
fill, construction of a soil-bentonite cap and ccver system. Closure activities for the Si were completed by the end of October 1989. The closure cons:ruction documentation and closure certification for the SI were submitted to the MDEQ in January 1990. This reapplication is organized into the follow!rg section with supporting documentation contained in the appendices: • • • • • • • • • • • •
Section A Section B Section C Section D Section E Section F Section G Section H Section I Section J Section K Section L
Part A Application Facility Descnption Waste Characteristics Process Information Groundwater Monitoring Procedures to Prevent Hazards Contingency Plan Training Program Closure Plans, Post-Closure Plans and Financial Requirements Other Federal Laws Certification Information Requirements For Solid Waste Management Units
C
C
C
0
\0
“3
I
-v
0
14)
N
t
‘I
1.9
—J(,
N
Z,,
t.Jf%J
N
£
‘I’
U.
‘tiI
‘
N
e tLwN
0
OOj
0
0
(
p
r
Q
I
•0
a9:
(•44
-i
7
r
0
9)
L.
HO N
04:
(1)0
,Oo [zj:1l E-’ WON
H
•
zcz czi
Z 0
Co Z OH HCO
HH
rzic.)Z Co
•
Coizi
HZ C)
fziE-4 1zlD
WNH tHCo
Cl)Z (0(1)
0E4 E-ICO H
4:ZE-H
Iz1C)
>40 O1DCo OH N E-’ZZE H H
NCo4 Nrx.iP4Z 4:P4 NO
.
-
4
‘
N E4: N
cr1 0
H
S
N
Q)
0
••
E H Co
Z 0 fr
‘5 V.! :.
C
.j
0.. Cl)
0’ C)
0 EC)
ZN P4 0 H
H
4: &
P4
H
P4
C) N
J
..
••
0 N >4
P4 N
F-’ Z N H
P4
0’ N
r
.L
ç
o
V
4
N Co
H
Z Q Cl) 0 ECi N
P4 U)
H
Z
z Cl)
4:
U)
0 Co C/)
C-
‘.iJ
N H Cl)
N
0 (Z
H
0 Ei H (1)
(1)
Z 0 >4
Z 0 0 H
4:
) Ci
,‘ .•
Cl) N H
>
H
4:
C)
0
Fz4 >4
U)
2
)
A-
—
(4J
cL.
o
-
-J
p
I
C,)
z
‘I
o
\—
c
(1)
Z
C) 4:
F-’ 4:
u)c H
‘9
i-
Cl)
EC) Zrii p4
0
11I
C)• Z H
N
EZ
N
NrLIci(z
•• •
4 ri. 0
U)
Z ;
r,J
..
fz
cI)c
O’q O i1
5
t
-
O,
C)
-4CI)
HH -P..
rzlQZ
QZ
HZ
f4EC) fr
OE-i E-4C1)
ZP
U]Z >10 C) EZ HH fz4fr
U)
J Lj
-
i..J -
—
-
0
A -
4
)
-÷
(
t.r
I
—
2 j
z -+
F
lii
C
‘1
z
2. -I
0
H a
&
-
-
0
I
I
51 ‘I
.1
>1
H Cl)
I
I I I
I
II
I I
Z
E-i
C)
Z
p4
HO
0>4 U)Q
‘E EC)
Z OH HZ 1zE4 0 Z OF-i F-ic) C/)Z
>40 1C)
0
Ei
Ed..
C) Z
H
ø
çz
HCi) .
4 Op
1 f
V—
-4-
c
7
nI
0
I
E
U) Q)
.
0
H
C/)
0
F-i
&i
HO
F-4
Z fi op4
‘)
>-
—C)
C
‘
3
>4
F-i
Oi
p4 H
Z
x
p4
•—
2
cI
J
j
>-
&4
H
Cl)
2 U)
U)
F-i
o
Z U)
Cl
I-I
0
>4 C/)
H
Z
0 0
Z 0
0
Cl)
‘
0
E-i
ru H
(Z
H F-i
HH
çi0Z
C/)
-J
Cl)
!)
‘ZC/)p4
frrzH CiHU)
C/)
Ctjci)
‘E-iH
H
H
u)
fi HH
IU) fx NIz,P.iZ
Z 0
6
-
./)
F-i H Cd)
Z 0 Cl)
0
>
-
I
F-i H Cd).J H I
C)
ct:.
H H
H F-i C)
0
>4
I
2-
‘
(j
-4-
,
>
ç
2
w
-
—i
-
—
0
(I’
\-
G.
-)
J
-
0
rp
V
ç
rzI
H
J
C/)
F-i
U)
Z
0
F-i
F-i
C
Cl)
-
r
I.
-,
o
c,
—
r
r
—‘
—‘
V
•‘i
(t
1
\d1’
-
•Ji
U
‘
V’ 1 0
•1’
I’
-
-
.‘
)
-
0
ci
—
N
(-
r
3
I
(I
(
-\
r
C
v
I’
I..
+
(v’
7
4-
r
V
P
0
3 V
0
K
—
ft.
C)
Cl)
‘-3 H
H
J’
-,
-
-\c
Cl)
‘-3
‘
.
z(
H
—
t’i tTJCI)
CflH
.0<
Z()tli
Htxjtlj rjCl)Z’ ‘•tJ-’-3 Cl) HH
H3Z
HtTI
P’Cflt’I
tri1tTi
Z’4N
octi
I-I
I:l
Pi’Z ‘-3
Z Cl)
HO
Z’-4
0
i-3j H
C)
z CHJ
O’<
C)E-’
Zx 04 JI
H
O Cl)c
z
0—Ic-I’’ •‘ & 1 4I
NON
El Z
ci
•
C) Z H
0 .El &4C) ZN
NQZ HH
40 C)
0
H
U) ° N 0 Cl)
N
Q C) El 0 El Z 0 C_)
-
,-
j
,.
-,
J
-
0
V.’
••
N
>
04
El Z H
0’ N
‘.-
i
-
t)
0
7’
-
q
••
N El Cl)
H
Z 0
cri
-
0 El” C) N U)
Z H
v,
U)
U)
U)
V El
.U
o -
•.
U)
N El
H
C 0
N H
H
El
C)
H El
0
0 -‘
11
v q1
0
,
-z
0
—
,
D
C
-
:3
2.
-
)
N
0
_
(LI
El Z N
Ci
>
El
H
El El H
U)
r1
o
Cl)
Z 0
El U) C)
VI
‘j
El Z 0 C) > El H
0’
0
Q
c
>4
.E-H
FzIOZ
Ci)I1 ZZ OH&I
frP4 zC,
IxIE-’
d O C) IzQH I-4
EZ
rz1:D0
.
Cl)
E-
0
Cl)
-
o
\
_•)
-
1: }
‘
‘ii
C ft
19
-
\-
-
-
0
.-)
I
—
(1.1
I
-
cj
A
-)
j
2 15
()
(
1-:
,
0
F -
-
-
/‘
‘A
0
I
Ci)
Z
C)
sO
/71
ii o’
1
oL s’s
L c3)
S
I,
‘Org
oi
0
tiJ-J--tf
/
••
‘-3
L
‘-4
(1)
U
I.
Cl)
‘.3
‘.3
o
LI’
4 v
—I
0
v’
Ii’
“
C-
p
‘.7
>—
—
-
-
i-v
r
1
Cl)
zj
H
H
H
0 ‘-3
0 Tj
Cl)
‘
‘.3
Cl) H
0 Z
Cl)
‘.3
H Cl) H
c,
1
fl
C)
Cl)
‘.3
Cl)
0 t-
0 O Z —
JH
‘S
:;:
I-I
•c:
tT?
‘.3
Cl) H
Z
o
‘.3 0 Cl)
t1
Cl)
Z
a
3
t3
—
11)
C’
—
••
ti
‘-3
‘t
H
tI O
r
‘.
r7
P.
7
C..j
‘
Cl) H
tJ
0
‘.3
C)
‘.3
C) 0
H
‘.3
1:11
‘-3
CD
rn
‘-‘
o
H
‘-3 ‘ ,.g
H
‘-4
C)
‘
‘-3 rj
ti
Cl)
•
I t20trj
frHIt IoL
‘.3
‘-40
JZ tri C) ‘.3 tij
Cl)’.3
zcn
Oti O’<
o
‘.30
OH
til
NfxH
cI)ZH(i
H E4
Z Z 0
0 v
i-tfl sZE-IH HDØCI)
El
I .
7
-
-,,J 2
‘1
0 1’ ‘)
A ,1
0 i
—
—
0
v1
-f-
‘—
—
-
C) C) —
0
I
F
‘
1 V
(1
‘
—
/‘
(1:
,—
A
-
/1
‘
.
•
•
0
ç
F
3
)
C
-
—
-,
—
!.Li
2
7,.
(5 1
I
‘
0
-J
0
I
L
z
El
0
• QE-
z1
HO
0>4 ciQ
0 ‘4El
E-4C) Z1 1z
‘i-il
.01
zw1
fzOf
E-IP1x.. lcocr
C)
Z H
ci
1z CJD
ZZ 01-i HCl)
Z .
HZ 11QZ 0
.H
fxE-l C)
I—Il—I
ODC1)
i4ZE-IH
i-IQCI)
CQ.cH0
fzfrH
HCI)tI)
‘ZCO4
Zø OEE40 COZ >40 C)
c
F
/
:
-..
(7
H
-
L)
—r
4.)
0 C)
—
w
00 H H
H EC.)
114
-,
0/’ >
0
“
0
-
‘ii
J
•/7 .-.i)
—.
2.
ol
—Q
J ) ‘I) 2V
-J
fti
$
4I
I
H
a
Cl, H
‘.3 Cl)
Li
C)
‘-3 ‘-3
0
L)
I’
r
0
(2
r
Li
a.
-\
0
0
C)
Cl)
t
0
tIj
H
Cl)
z
0
Cl,
0
H
H Cl)
Cl,
LII
Cl)
Cl)
‘-3
LII Cl)
0 4 t‘-3
z‘-3
0 0
‘-3
H
p
LII
Cl) I-4
z0
Cl)
z
I
rr
(1
‘I’
0
7:,
.
6
0
tTJ
iO
0
Cl)
H
Lii
‘-3
Cl) H
‘-3
‘
C)
z‘-3
c•) 0
•
‘-3 LII :z;J
0
H
LII
Lxi
‘-3
•..2
(I)
(D
ci
F
2’
F
.3t7
•3
H
‘
H
C)
Li
‘-3
Z
‘
:, I’ “.3
C
i-3C)
OH VZ
Lxi
:r-o
t.4 •
Lii CCl)
(‘.3 ‘-3.
t!Z
t’I
Cl)
z
HO
ZH
-3LxI
0
‘.30
CO’-3
ZCI)
0 O’<
zC)
H
—
tII tic,)
C()
Cl)H
Cl)
‘tCl)ZR’
Cl)cOii
Cl)Cl)cH Hi-3Z> Cl)t,t4 Cl)HCl)
HH
tC
OcH1
OEi
Z
HO
O’ COc
0 i4E4
EC)
Z4
I
HI rzorz1 &lf4FZ..
Qco
C) Z H -
Co Izi 0
z
U)
OH HCO
o
HZ
Co H
H
fr.1C)Z HH
fifyH H
H,..coco
C)
Cl)
0
UCoQ
fIi1z1ø 4cIZ 41
HH
iZE.H
CHC1)
,—iQCi)
‘ZCo4
Co
1z&l
C) 0Ei
ZI &4C1)
CI)Z >‘O C)
0
A
LE
A
Li
r
0
()
.
A
J
sI,
(
0
H
0
IT
I
I
0
11
(>1
9%
C. N
7:
C.
€1
3
()
k
C
3
1
)
H
H
‘-3
“Cl)
0
z
‘.3
I-I
Cl)
z
0
Cl)
‘.3 0
H
Cl)
H
•
V.
-
I .-.,
o
I
o
Cl)
tl•i
t-I
Ci)
0 4 t ‘-3 LII Cl)
0 0
)
I
-L.
H ‘-3 tTJ
Cl)
z
0
Cl)
0 ‘-3 0
‘-3 1<
t1
‘-4
1
z 3’.3
+ C.
I
Cl)
z
‘H
C
C., Lii
H
0
-a
•
••
LII
1<
t7Z o ‘-3
In I’I
Lii
[ Q
1’
)
“.
—
.
r
r
r
U
Lii
(D Cl)
Cl) H ‘.3
‘.3
Lii
C)
Z
I-’.
-
H
0 Z
‘
0 Z
Lii
LII
LII
I
Cl)
Tj
1,
(A
0 0
‘-3
ILIlOtij
,Cn
)
0
OH Z ‘-30
LII
10
Lii
t-q
Cn
‘-3> •
tIIZ
Cl)
HO Z
0
H
0
Z
‘.30
Cn’-3
zø
0 01<
o
‘-I
—
tiICb
CCD
WCl) 1
Z ‘.3
Cl)I-4
1.3
ItOL 3 4 •< 1 t:-
HH
‘tI’
ItCi)ZR’
CflHCl)
Cl)lLlt-l
H’-3>
Cl)c0ii
Cl)Cl)H
Htxl
I0cti1
tl
I
-
LII I
01.3 H
‘I
‘
OH ‘-3 ‘-3
o o
Ztz HO 04
N 0>4
O.
C1)Q
0 ZN ZZ OH
HZ
>0 ZI-I C)
Ztz OE.s Es(s) COZ >40 C)
0
-
0 C) S.
Es
NoNi
0 Z H
rz 0t H(s)
>0. Cs)
HI-I
0
> H Es 0
H
Es
H
N
xQZ
Cl)
Es
COXHU)
U) ‘ZE-4H HCOCs)
EsZE .HH
b1Z404Z
0 -J j
C,
‘U
1
d c1
3 1.
i,J (J
I
z
VI
>
3
.j1 Ii)
U
0
0
V
g II
c)i
I
I’!
/9
(.I
U
C
Q
c
C)
‘2
.-)
N
I
3’-
4
I E.
2
1
cI
E
fJ
J
J
‘SI
i)
>
-S
ct
‘I
Ii
U) Es
0
KEYSTONE ENVIRONMENTAL RESOURCES, INC CONSTRUCTION INSPECTION DAILY REPORT
(cont.):
SUMMARY OF ACTIVITIES
i—c,
+1-
l
Pi\ --
I-1_
‘AS
lcsS
1 L*
v- P-çt2_ -c-s : I::,
/
,
‘(ufrg
DATE: REPORT NO. : j of SHEET r1L BY:
INC.
BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT
( iti
yr) fr’, 1
/
R
.
—--‘
u3j3hAi6
J EZ , 1
Tr
j L
-r4
] 7 j
E1 cs-i
L-L & á — 2 f\ S
C
LLE(\
I
(
j4\ .•
0
ATTACHMENTS:
•S IGN’ITURE:
),
\
----
1
LI
0
1; —“
•
C)&4
zcz
HO
0>4 04:
CI)
pI
Qi
C)
H
Z
I
‘CE-i E-0 Z Z OH HCI)
0r4
HZ
1zE
;El
1z0Z U)
El
ZZ Eicri czuxH COZHU)
0 HH
>40 4:ZE-IH
E.l ZU) 4
z1C)
czo
sHH
0:zco
HDCI)U)
Q
vi
J
0
•-
-
w C)
c -
I
I
-
U)
Z
o rz
El
z
HO
El
Li
rI1
H •. ç
cz
o
iI
I Z
z1 H
i(
ct
‘3
‘I
El H U)
0 U)
I
4
4 VI 0
U)
U) El U)
Z O
El
>4
H
or
4:
0 El C) U)
z H
>-
fi e
U) H
El
H H
C->
b
0
z
0
E
C 0 -
‘1
1Z4
0 >4
I
“
VI
0
VI
z
0
•1
I
2
ct:
‘I)
A
C
qI
cL
C”
‘1
‘U
+
‘4-
r
0
C’
Co
I
0
HO
iC-4
C)
frOZ
-i ‘
Z
HH
HZCI)Cl)
sZE-lH
‘ZCf]4 cxfrH
U)
HU)
Q
E.4bZ H r4 CI)1z1 ZZ fx OH HZ
NE-i C)
Zt OE >40 IzIC) P.a1H HH
Nfx44Z
-%
0 0 U) £4
H
£4
C)
0
U)
‘1
U
ri
A
C\
vi
-
V
—
f
I
-‘
1—
F
V
-
I
V
V
-
(
cL
r
C
V
.
vi
a
ç
r
U
A
c V
-
w —
A V
V
U)
VI
2
A
E 1)
J
r
C
vi
icc
I
C
V
“I
\
H
U)
—
U)
z
C)
£4
0
— -
1J-
-
9)—
-
0.
-
0
2
v
j,.
-
hi
‘))J
—
‘c
L’
IL,
2
UJ
(5
-
0
-
-O
-D
-1
-
SATE
lo ,Jo
0
(c cfA
t-r,ô,J
1OO.c c7
9T< icij
9 c4
S
.-‘
‘if
7
‘Sr.
c5s9
9 I
tO 11
c]sc
1
ic Is
/5
0
_______
KEYSTONE ENVIRONMENTAL RESOURCES, INC. CONSTRUCTION INSPECTION DAILY REPORT BEAZER MATERIALS & SERVICES, INC. SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLNT WEATHER:_
i
o-r
DATE: REPORT NO.: SHEET 1 of I BY:TIj.
4pi
PRECIPITATION: M/4
(inches)
TEMPERATURE: LOWiJ/A_HIGH____
CONTRACTOR PERSONNEL ON SITE:___________________________
‘
EQUIPMENT EMPLOYED:
)a,oe
0 1o
INSPECTORS ON SITE:
QUALITY CONTROL TESTS AND SANPLES:
VISITORS ON SITE:
“-e
SUMMARY OF ACTIVITIES:__________________________________
3 -ro PPe’s
y
cn i ,
3jj
fo
-
Q
--r
7/E
1S7?
-TO
f? LL-/,.3
1ii -rE -ti-f / *bATTACItMENTS:
rA c-q &-
-r V —rs-r
i 4
frs2
1i
VLi
L-9&jAJ€
4iJD —r4P
csI i
p
2 5P)A L
ev\, ! T’L
-o
T1U’—.
iLrTY
(t’s
SIGN-URE:
1,
-‘-
.
k
v—
KEYSTONE ENVIRONMENTAL RESOURCES, INC CONSTRUCTION INSPECTION DAILY REPORT
WEATHER:
1°iI\J
PRECIPITATION:
?
DATE: REPORT . : SHEET 1 of BY: yPfr —
INC.
BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT
E”),,’-rs
/ iJ
J?i’%J=
TEMPERATURE:
(inches)
0
LOW_HIGH
ilç —
CONTRACTOR PERSONNEL ON SITE:___________________________
EQUIPMENT EMPLOYED:
AC-yE
C
-KTh2
INSPECTORS ON SITE:
QUALITY CONTROL TESTS AND SAMPLES:
VISITORS ON SITE:_______________________________________
SUMMARY OF ACTIVITIES:
j4,,-’ 4ic-&e
ATTACHMENTS:
]‘T/
1
1E S/i’-) &
*1LL)6
S IGN PURE:
—71
0
C)E-i
0>4
Z
Eq
rori
El
.1>i
•
o
e.H
Z H
F4C)
ZN
HO
Ci)fr Z OHN HZ
2•
H
HH
(0C)
N H E-’ZZX
Cl)C/)
ø0 ‘ZE-4H
CQZHCl)
NE cioz 00 HI-i El Ztl)4 NNH
Z ElCl) OZ >40
0
-
—
‘J
VI N El N
21
Ei
U)
0
N H Cl)
Z 0 N 0
El
Ii) Z 0 H El . 0 El El HO
C)
H
fri 7_
Zç 0 C)
3
rO
E.
_c
U
N >4
N
El Z 111 H
0’ N
El H U)
Z 0
o
El C) N Cl)
H
Z
0
U)
C
2
Cl)
0
Cl)
0 El
-)
r)
-
H\-Z
—
1.1
••‘— H
0 N El N El
C)
H H
••
0
El 0
114
Cl)
>4
Z 0
Cl) H
H
0 El
0
El Z 0 >1
El H
01
‘VI
I_I
‘J
1 U C
4)
cD
f)
-:
H
El
N
C)
El El
0
j
o
QE
Z HO CO
(J>
‘Ei
E-C.) Z1z1 Ci)
OH
zZ HZ 1Z&4
(_)
4 ..q-
I
‘cI
..9
Z
HH
E-i
c-CO
C)
a
H
4 ri. 0D HCI)
CO
Cj czIQZ
E-
OCO
HDCOCi2
ZEJ-
1xfIH
‘ZCO
C) fr CQ.HCO
Z
OEi E-Cfl
COZ
>O
E9’ HH
OtXQ
COø
z1DOtZ
4.)
0 C)
-
S
, 1 CO
-.
Ei H
F)
H H C)
0 >4
CO
4-
-
t3
j
r
9
A.
I-
c —
F .J
t -.
9 Li
10
V
()
I
0
11
\W Li
(t
‘
U
1-•-
\L
1’
r1JJ
c-
I
“I
fj
j
J
0
I
H Cl)
CO
a
IJ 1<
I%:\’
j
-Cl) H 0 Z
r
a
r a
p
7
m
-
1,
r’
0
r V
-ç
‘;
7
Li
H
1
z
•.
H
H
H
i-3 Li
Cl)
o
H
Cl)
H
‘-3
0
0
Cl)
CTI
z
Cl)
Li Cl) ‘-3
‘-3
0
‘-3
0
‘-3
H
10
‘-3
—
Lxi
H
0
z
0
‘-3
Lxi
Cl)
H
0
-
cc-
1J
V V
3
Lxi
Lxi
Z ‘-3
H
Li
rTJ.O
0
J
p
(‘1
,
ti
UI .-.
CD
‘-3 Li
H
C) Cl)
I
I
0
z
Z
Li
C!)
ti
H
‘-3
‘
OH ‘‘-
0
i-i
r I
—
I,,
I-
i I I I
I
0
_
r
—
p
r
J
Lxi
•
•
Z
tic)
ij
C0
< ØH
I
•.ti ItiOti
wc’
2 i3
Cl)
Zoti
HH
CflZR’
HLitrI
Cl)HXn
ChCflH HI-3Z> øH
HH’
XCI)Li
ZiN
ti’Pl
G)Cl)W
OLi
OH
iz
t3
1 0< 0 10
—I
0
4-4
I
1-I
••EsZ>1
Z
u: cø 1
0
Z (Jz çx cHD HU)
frlQZ HH U)
‘Zco01 CHU) i-4QU)
1
Cl)
.
o
4 .
I
w
y7 ‘)
(H
.1 Z J
-
ID
—
F
—
-
2
.2
0
0
J_)
0
El Z
0
El
Z
HO Cl)
0
,
IM1 z 1 c, rz1ocx
El
E4fr• Qcic
• H —
U)1z fr HIJ)
Z OH
HZ frWZ HH U)
s•
1’1E4 C) ‘ZCI)ø4 1zzH UHU)
El—
Z(Z OEI ElU)
‘Z&lH H 0(I)
HH
rzQ
10
-
O)U)
>40 fzlCJ
0
<
c.J
••
El 1z4
_
H
rz
.I
%El U) H
C) C) .
I
ol •
0
JZ Z 004 H
El
.
—
... 12
4J
El)’) Z 0 ()
El El HO
C)
04 H
04
I
-
Q
El
z
04 H
01
I I
El H
U)
Z 0
o
El C)
H
04 U) Z
3
U)
U) El
El 0
El 0 >4
El
H
Cl
I i
I
I
Ui
El H
0 Z 0 0 El
H U) H
El
H
H
H El
C)
0 >4
0
4
, D
C
4
‘1;s”
t
_•)
L
I
41
z
H
crj
U)
El Z
C)
El El
0
KEYSTONE ENVIRONMENTAL REUR, INC. CONSTRUCTION INSPECTION DAILY REPORT BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT
SUMMARY OF ACTIVITIES -i
b c’—
ATTACHMENTS:
&3
DATE: lo1?k9 REPORT NO. . SHEET of c? BY: rP&
(cont.):____________________________
SA-t’J b
‘-
Lt4
NON El 04 N..
IhI I _ij -‘a. VIH
• C) Z
H -
U)r N
Z
OH HU) .
HH
N EEZX
N1x04Z
HH
.ZElH HU)Cl)
NNH CiHC0
E-i04 ‘ZCl)04
Cl)
004 NOZ
HZ
NE-I 0 ZZ OEl F-lU) COZ >O çzO
0
—
2
h
.
-
ç’-. >
-
‘I.’ • N El N
0
H
•
N N El N H U)
El
10 Cl)
Z 0
0 El
IZ
0
0
cI •.
H F-i .
El
04
.‘
HO H
•
C) El Z 0 040
A
2 -
-
3
N
2 -
N El I-I U)
Z 0 E Z N
C) N 04
0
U)
04
N
H
H
Z
Cl)
0’ N
0
w N 04 U)
F-I N El ‘-
El Z 0 0 >4
El H 0’
a •.
U) N El
H
H
C’)
>4
0
C)
>
•.
H F-I
N E H
U)
Z 0 Cl)
0 El H C’) H
—
••
C,
L)
ç
•
•
1
.‘
LC
c’
1
t_•
-
J
•
•
0
/
N
Z
U)
H
El Z N
C)
El
KEYSTONE ENVIRONMENTAL RESOURCES, INC. CONSTRUCTION INSPECTION DAILY REPORT BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT SUMMARY OF ACTIVITIES fr1
LOZ
Ijafri : of
DATE: REPORT NO. SHEET BY: TK
INC.
(cont.):________________________
L-f 0
tz
Ho z
Z-4
HZ 0<
CD
‘.30 Z
Ø’.3
ZCi)
CDt 0’<
_____
__
KEYSTONE ENVIRONMENTAL RESOURCES, INC. CONSTRUCTION INSPECTION DAILY REPORT BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT
INC.
DATE: REPORT NO. : SHEET of —i BY:
SUMMARY OF ACTIVITIES (cont.):________________________ T5
—Ns i]2’,l / ,) 6, L-S
Cfh_i-s
T
ATTACHMENTS:
iL,’-c
1s CL.
5OL
c L-SS E -r
-i-’ a,Zi
FeSf-
0
ScL
S1rz(Lc
ir
-
ThE
f\s\jAi L/
f
sL
jv
éI
-2
i_
f’
A,
N
SIGN 1TURE:___________________
______
KEYSTONE ENVIRONMENTAL RESOURCES, INC CONSTRUCTION INSPECTION DAILY REPORT BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT
DATE: REPORT NO.:’1 SHEET 1 of .j..... BY:
INC.
a
WEATHER: PRECIPITATION:
O
(inches)
CONTRACTOR PERSONNEL ON SITE:
TEMPERATURE: LOW_HIGH____ ‘-“‘--t
EQUIPMENT EMPLOYED:______________________________________
INSPECTORS ON SITE:______________________________________
0
QUALITY CONTROL TESTS AND SAMPLES:________________________
VISITORS ON SITE:_______________________________________
SUMMARY OF ACTIVITIES:
.‘.j4q
ATTACHMENTS:
—r-’-’O
11/Lñ)
7.3?D
i4j
1-/GaS
SIGNTURE:
_—S
A
,
L. r .i’’-.-.-----
0
• •
QE’
Z
HO
H
r
L
3IcHI z 0 Es E4. NON s
PCi)U
H
Z O
F-sc) ZN
N
• C-) Z
1Z zC OH HCI)
Es
HZ
Cl)
H
—
acro
N1z
HH
N
ZU)
QCi) .‘ZEsH H 0(l)
UEHcl)
HI-I
czIQZ
-
NE-s C)
C
Z ‘ZCf)4
OEs Esco >O zQ
0
•‘
N Z Es N
oI
:1 H
J7I D-J
Es
fr
2
,u
0
0 Es
P
V
-EU) H Q) Li)
Z 0
H
F-s
Es
HO
)
/
‘
Hiv
C)
Es Z 0 C)
I
I -
‘H ct
A ••
F
(.
r\l >4
4
N
F-s
z
H
N
‘Jj
U
L)
Cl)
+
C
-
Cl)
4
‘ -
-
rz4A
Cl)
>4
0
—
cL
Es( C) ç..J —
H
Es
H
Es
N F-s
0 H Cl) H
F-s
Cl)
0
z
Co
H
Li)
N Es ‘-0 0 C)
‘C
.-
>41
Es H i-
0’
()
c
d
\-
I
F )
j
0
s.f)
-
+
2
-
I
11
0
Z
H
Li) Es Z N
C)
“
Es Es
0
0
0
H
U)
:3
t)
‘
1
‘-)
_v
:iL
C,
V
r
—
C t’
p
0
()
L.A I)
i
-\
-fl
r
V
—
r
P
—
3
..
0
Cl)
H
1-4 i-3
H
0 ‘.3
rj
‘<
Cl)
O,< ZCl)
C1)H
IvW
i
W 0 i
IzI
P
1-4
trico
0 tj
••tJ’t1i-3 i11Otxj ‘-3 I
Z ‘-3
Z0ti
‘l’ •-3 HH Cl)
CflZR
HtxitXi
CflHC1)
ED
‘-30
OH
CCl)
0
tiZ
zz
-40
ZH
3tz
C)
‘-30 Z
Cl)-3
(j H3Z’ 4
Cl)Ci)H
cl)co
H’tri
HH
ZiN
Ør4Cj)W
________
A-r--rA
0
44(E,JT
91-)
lo
SATE
(0
Jo 1
II
/
LI
S tc7
7
0 I IC) I,
i
‘S jLf
‘S
0
/0.1
!3cb
9L1 I0
1
Cl) H
0
(I’
ç
ç)
r
..
0 ..
0
i-3
0
•.
0
0 0 Z ‘-3
H
Cl)
H
(
Cl) H
0 Z
0 Cl)
H
H
H
H
<
C)
00
t
t, 0
0
t’i
Cl) H i..3
Z
0
0 Cl)
0
t’I
Z
H
f\)
r
1.)
V
C,
Z ‘-3
H
iO
0
C
r
C:
I
I
0
1
“
0 Z
H
r
-
L
C
z
Zi-
0<
til
0
°
OH
‘0
0
‘-3>
C) •
tZ
H
HO tJ Cl2ZZ
ca
H
0<
PC)J
H
C) HH
Cl)
Z
‘30
03
0<
Ø ‘C0Za’
0H Øfrn
HH>
>Cl)t’i
HIM
H
I
‘-3
Cl)
ow
c Z L>0 -
? Cl)
d tJ
H
OH
H
ti i
‘-3 ‘.3.. 0>
0
C)
O
KEYSTONE ENVIRONMENTAL RESOURCES, INC. CONSTRUCTION INSPECTION DAILY REPORT BEAZER MATERIALS & SERVICES, SURFACE IMPOUNDMENT CLOSURE KOPPERS INDUSTRIES, INC. GRENADA, MISSISSIPPI PLANT SUMMARY OF ACTIVITIES
&
--riSS p)l
e(v\
-ri,’
t )fr-tc
S
ATTACHMENTS:
-
*f2
I-’- G5T /1NiD3
f44&
i
O.J<
¶
ce
S
tE
io
1
ee
‘s
LT
Th
3Is
FELL
Fi-e
cvq
L 5 4
(cont.):_________________________
i-1
1ftBa,c_
CD
DATE: REPORT NO. : SHEET of BY:
c
c:4ei2c
‘-
kt
INC.
Lf4 ‘/tv
Ty
—iev”. 444L f- c3 ‘
J
1Rr
i
?i
S IGNN’URE:
t
.
s
0
p
•1
H
-
‘P
(7
C
5;
()
0
Cl) H
Cl)
L
<
Cl)
tn
1-4
‘-3
z
•.
H
z
Cl)
0
7J
•.
Cl) C0
‘-3
H
Cl)
0
0 Ct]
C)
CO
H
‘-3
-4
H
-3
0
0 Z
‘-3
H
10
C) 0 Z -3
Co
0
1-3
H
H Cl)
H
1-3
C)
0
Cl)
(73
••
1<
‘
‘-3
txi
d H
10
r
(c
(
0)
3’
c
•-
Li O
rn
‘-3
Cl) H
tn t’ 0 Z
z
Cl) 0
‘ C) ‘-3 0
3
CD
0 Z
I
t’I
‘-3
H
0
tn
‘-3
Cl)
CD
C)
z0
‘-4
‘-3
-‘
C
‘-3••
H
‘
H
C)
ti
‘
CO
..
Z ‘-3
tn
HO ZZ
ZH
,-3tzi HZ 0<
C)
0< ZCI) CO’-3 ‘-30 Z
,‘
‘-30
OH
tn
‘tTjt!j
ZxiN
øCI) OcH’1
•.E-l
•
C) Z
,-4 -
CO1
l:z:1 C)D
HCl)
El Z
cJ)
fr>4
ror I
okII
o
• OE Zx
1-10
coz 0>4
coca Z 0
4EEO Zi:l Zl
HZ
EU) Z OH
C3Q4 1zOZ Cl)
HH
1zE-4 C) C(
‘ZCl)Ci .CZEH H (i)Cl)
HCI)
fH
ElU)
Z >iO H
EZ HH
rzcl)<
1I:zit:
I-.’
21
-
El
0
.4
C)
El
0
z
U)
H
.•
,‘-
-i ••
El
-
U) 0)
r1
C)
H
H
El ‘ El
H
Z
Cf —. .•
1 El
El
Z 0 C)
2
h
A
1_
••
-
\-
‘i
X,L
El
z H
0’
0
,
Cl)
c
Cl)
U)
(I]
H
/
Cl) •.
H
>4
0
o
El
H
0 El
H Cd) H
Cl)
Z 0
H
El
El
•.
El
01
El H
>4
0
El Z 0
0
El
H U)
z
0
4-,
El 0 Cd)
H
Z
4.
‘1
r)
1
I
2
“I
‘I—
0
HO
z E’ EC)
>0 ZH Iz
Z >0 IilC)
o
LrId,-JI
iLiI
C)• Z
>0.).;;l
Zu) 4ZElH HZCI)CJ)
EZE
HH
.
H Ei
El C)
0
J
e
ct.:
g
(.-
-7 -
ii
J 1
U)
3
0 rbj
__)
-j
C) t1_
0
‘f’u
q1
‘I
i.t
‘I
A()
w
(7-
J
0
ql
vi 4’ I
-
I
‘‘
2
J
—
C
I
•‘
‘2
qqc)
u-
ii
&
/L
o
7
\
El
L’S
z
H
Cl)
C,
0
rr
)-)
1
r
9
r
LI
C.
cn
(,A.
z
H ‘.3 H
<
H
C)
t)
r
—\:
c r
1%S
%_‘
0
1<
•.
L’S
Cl) H 1-3
0 Z
Cl)
‘.3 0
H Cl) H
.•
Cl)
‘.3
L’S Cl)
0
0 Z ‘-3
C)
1<
‘-3
‘-4
(r)
LI
n-
C.
PS
Cl) H
0 Z
Cl)
0
C)
Cl)
0
-
-
i
•.
‘.3
H
O
p
&
“
,.
PS
a
d.
iO I
••
0 Z
H
: i_. -f--4_..
‘-
h
Ic,
0
H
“r—
-,
(
fl
C
H
0 Z
L’5
Cl)
t’I
,.
r
‘
.,.
ç.
,-i
‘-3 ‘.3.. 0>
,
H
tI
C
17-
0 Z
cl)o
•
H Z
tTjCfl
t’1
H
Ij
I 4: Sandy, Silty, Clayey
Design Soil
2nd Appi.
Cement (% by Vol.)
1. Section No.
22
577
2. Test No. 3. Date 4. Time 5. Station
/J\
/c-1
6. Location.
/1/it /f/
7. Depth
/1/it
/7/
4/j
$
,c/ çt,7 f’z-w/
/:,A/
8. Sta. Limits Sect. Being Tested 9. Standard Count 10. Moisture Count 11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count >5
15. Air-gap Count(If Used) 16. Density Count Ratio 17. Wet Density, PCF
j
18. Dry Density, PCF
f
19. Mofsture Content, % 20.
I’ p //-
/
/‘ e
,,
/c/3
Density 21 - Standard Curve Number
22. 23.
rt
of
/ 7 7 5_
/O/r4’1
7
/2
9a7
/c’44 7
9ç
75
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot Sum of Lo 26. Dev. from SV No. of Snipis in Lot Uebric im of deviation 27. inpp1iCab1e lots 28. 29.
1 No. of Samples Used g I Dev. applicable lots
=
Distribution: Signed
Title
--“
•7
-
-
--
0
SOIL-BENTONITE LAYER DENSITY TESTS
0
0
____________Block ___________Subbase
_____
MID-SOUTH TESTING LABORATORIES, INC. Grenada,
FIELD DENSITY DATA
2267415
IFj_________
_Frame_,
—
TREATMENT:___________
Soil(Type)
ilt
None
Cia
Base_______________ Sand Clay, Semi-Or., Clay-Ox.
Inches
Depth Measured
Design Soil
Basement Soil
_Course:
—
MATERIAL: (circle one)
COMPONENT: (circle one)_ Lift
n; ‘r’t
Base
Lot Size______
Binder Base
Lime (% by WI.): 1st AppI.
Class_________________________________________ 2nd
Appi._
Cement (% by Vol.)
.Design Depth__________ Inches
Unit of Deviatio
MS
I. Section No.
3
/
2.TestNo. 3. Date
J..71
-
çy
2’/
7-3/ ,çI
5
7j/
‘-3- ç
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Ernb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count C,
10. Moisture Count
.
---
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count
c a
15. Airgap Count(If Used) 16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF
an
57?y’7
7
19. Moisture Content,% >.. .
.
From Standard
20. Density Curve Density 21. Standard Curve Number hi-Place Density 22. % of Standard
/7.5
92
24. No. of Samples in Lot
28.
tat No. of Saniple Used
2f
D?7Dev. applicable tots = Distribution:
J5fr
/.4 /24/i
/CE
lA/L r
DeA-c;l/ i’AAz, A kA,vIcw’
AreA.
,93 /.
P M ID—s )-UT I-I L B Co
25. Algebraic Sum of Deviations in La Algebraic sum of Lo 26. Dev. from SV o of Smpls in Lot £dçbric am of deviation icaote lots
99.7
95
Specified percent of 23. Standard Density
27.
/ ,993
“set.
,//
575
________________Block
___________ _______ ___________
_
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
22f-7415
__Distrjc___________________ Framp
oject
7/
-
TREATMENT:__________
COMPONENT: (circle one)_________ MATERIAL: (circle one)
(‘
Technician
Course:
Lift
Basement Soil
Design Soil
--
Subbase
Inches
Depth Measured
Base
Lot Size_______
2nd Appl.___
Class
1. Section No.
9
7
2. Test No.
7
3. Date
Cement (% by Vol.)
Design Depth__________ Inches
Base.
Unit of Deviation
Lime (% by Wt.): 1st AppI.
Base_____________ Sand Clay. Semi-Gr., Clay-Gr. Binder Base
‘/‘
None______________________
Soi1(Type Sandy, Silty, Clayey
7. 5/
7Y/c
/c’
7/f?
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits.Sect. Being Tested 9. Standard Count C)
.
10. Moisture Count ii. Moisture Count Ratio 12. Moisture, PCF 1.3. Standard Count
>.
a c
14. Density Count is
Air-gap Count(If Used)
C,
16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF u,
..t)-.6
19. Moisture Content, % > .
20. 21.
°
22.
.
C
23.
From Standard Density Curve Standard Density Curve Number In-Place Density % of Standard Specified percent of Standard Density
9j /i’5
7
/c2c.
9-
9ç
24. No. of Samples in Lot 25. Algebraié Sum of Deviations in Lo Algebraic sum of Lo 26. Dcv. from SV No. of Smpls in Lot 27.
M I D SC UT H Li B CO P’
A1ebrtzc zm of deviation icabie lots
28. Total No. of Samples Used 29. Avg 1 Dcv. applicable lots Distribution:
fI. tE,v/c4/’/ 1A’1c1 Signed
/.:;::;//1::; Title
&
-.
______
__________Subbase
_________
__________ ______
________________
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
7415 V
%
Co
.
L
Dxa--t.
—
—
COMPONENT: (circle one)_________ MATERIAL: (circle one) _Course:
Lift______ Depth Measured
Basement Soil
Design Soil
Base_______________ Sand Clay, Semi-Gr., Clay.Gr.
Inches
Lot Size_______
—
.Block Base
Binder Base
None_____________________ Lime (% by Wt.): 1st Appl._ 2nd Appl._
Class Design Depth__________ Inches
Base
Unit of Deviation
Soil(Type)dilt,Ciayey
TREATMENT:_________
Cement
(%
by Vol.)
1. Section No. 2. Test No.
_./22
3. Date
9-/fY
2 3 .jy 2/2 ,ç
/,243
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count C)
10. Moisture Count U)
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count .,
15. Air-gap Count(If Used) C)
16. Density Count Ratio 17. Wet Density, PCF ,.,
18. Dry Density, PCF
CCC)
E
.
20. 21.
°
9
19. Moisture Content, %
22.
.
C)
23.
From Standard Density_Curve Standard Density Curve Number In-Place Density % of Standard Specified percent of Standard Density
,7
7
,2./
9 ‘i 95
/cY5 95
/02.7 ,9ç
,Jo./ ,_-
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot Algebraic sum of Lo 26. Dev. from ...V o of Smpls in Lot Aluebraic m of deviation 27. mpp1icaoie lots 2JE)_No.
of Samples Used
29. Avg 1 Dev. applicable lots Distribution:
/5/-
1k 27 1k 28
/E)-
c2/ 3’1A/a4/ /1 Signed
Title
--
T
__________Subbase ____________________________Design
________
_______________Frae_....
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
226-7415 4Lounty
-
Basement Soil
_Course:
Lift
Block Base
Lot Size
Design Soil
Soil(Typdy,Silt,ClN None
Base_______________ Sand Clay, Semi-Gr., Clay-Gr.
Inches
Depth Measured
TREATMENT:__________
..COMPONENT: (circle one)_________ MATERIAL: (circle one)
/-A4 C
Binder Base
Lime (% by WI.): 1st AppI. 2nd Appi.
Class Cement
Depth___________ Inches
Unit of Deviation
(%
by Vol.)
1. Section No.
/ ?-/2-P
7
2. Test No.
/72/
3.Date
2/2
/7 j/2&
/2 /6;7-1
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count 0
10. Moisture Count
0
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count
..
c
15. Air-gap Count(If Used)
0
16. Density Count Ratio 17. Wet Density, PCF
an
18. Dry Density, PCF
;zf7
.19. Moisture Content, % ,
c
.
c
913’
From Standard 20. Density Curve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard DensIty
95’
9 f1 9ç
-
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lo Algebraic sum of Lo 26. Dcv. from SV No. of Smpls in Lot 27.
.1çbric nni of deviation xcaoLe lots
28. Total No. of Samples Used 29. Avg 1 Dcv. applicable lots L 7 Distribution://$
‘k 1k 28
6Y 7 1A
/-
c9/C
‘IL
Signed
çfr-J/
/ 7/
Title
53
9$
/‘O
JvE
.95’
ubbase ______Block __________S ___________
_________
____________________________________________
___
___________
_______________________________
MID-SOUTH TESTING LABORATORIES, INC.
27415
prU
Grenada, M
FIELD DENSITY DATA
/,
<
-
A
Li..L
1/
Technician
/Zj;, 1.
/7.
_Course:
Li ft
Basement Soil
Design Soil
Base
Lot Size________
None___________________
Soi1(Type), Silty,Clayey Sand Clay, Semi-Gr., CIay.G.
Base
Inches
Depth Measured
TREATMENT:_________
COMPONENT: (circle one)_________ MATERIAL: (circle one)
Lime (% by Wt.): 1st AppI._
Class______________________________________________ 2nd Appl.._.
Binder Base
Design Depth___________ Inches
Unit of Deviation.
Cement (% by Vol.)
I. Section No. 2. Test No. 3. Date
1 ç/2-f?
2 -/2
/ 9, 7
3 4. c
4 Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count C)
10. Moisture Count
.
(
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count
.
15. Air-gap Count(If Used) C)
16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF SC)
f
,
19. Moisture Content, % .20. 21. 22.
C)
23.
From Standard Density Curve Standard Density Curve Number In-Place Density % of Standard Specified percent of Standard Density
/‘)
/5
9p3)
5
/c2
/4f 7
9 77
.
.9 5
Y5’
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot 26. Dcv. from ...V
Algebraic sum of Lo No. of Smpls in Lot
4iebric m of deviation 27. mppiicaoie lots -Total No. of Samples Used vg 1 Dcv. applicable lots Distribution:
/5-7/
)r
1k 27 1k 28 [7/
c’F JA A F7/ Cc,?1/1(7/ic.4.
-
A
.-
I
Signed
Title
vj
//-C
t
k se Subba __Bloc _____ _____ _____ __________
___—
_____
_____
______
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
226-7415
6
i 7
/7
Basement Soil
_Course:
Ii f
Depth Meisured
TREATMENT:___________
RIAL: (circle one) COMPONENT: (circle one)_________ MATE
//A4 (
Technician
Frame
Binder Base
Base
Lot Size________
Lime (% by Wt.): 1st AppI.
Sand Clay, Ser’-ii-Gr., Clay-Cr.
Base
Inches
None_______________________
Design Soil
2nd AppI.
Class
Cement (% by Vol.)
Design Depth__________ Inches
Unit of Deviation. 1. Section No.
4,
/
2. Test No.
71
3. Date 4. Time 5. Station 6. Location from Q 7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count a
10. Moisture Count 11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count
,v
14. Density Count 15. Air-gap Count(If Used) a C
#
37
16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF
s 19. Moisture Content a c
.e c
23’
9
From Standard 20. Density Curve rd Density 21. Standa Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
/3’
953
/(c:’
/o/
.95
t’
26-7
26-2
3’
7
9 7
96
95
:.1—
in Lot 24. No. of Samples 25. Algebraic Sum of Deviations in Lot Algebraic sum of Lo 26. Dev. from V No. of Smpls in Lot 27.
of deviation Alebric iam lots icabie
Used 28. Total No. of Samples 29. Avg I D. a1icable lots = Distribution:
1k 27 1k 28
2-4--a’ /
-
8A-1&-I h
Signed
‘1 7,/ C /
Title
5y
$E-: /
________________Course: _________________Block ___________Base __________Subbase ____________________________
___________ _________ _______
______________________
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
7415 p Ai-
c
District.
Z44Cnuntv
/ /‘AAC
Basement Soil
Lift
Design Soil
Base
Lot Size_______
Binder Base
Lime (% by Wt.): 1st Appl._
Class______________________________________________ 2nd Appl._ Cement (% by Vol.)
Design Depth__________ Inches
Unit of Deviation.
None
Soil(Typdy,Silty,ay
Base______________ Sand Clay, Semi-Gr., Clay-G.
Inches
Depth Measured
TREATMENT:_________
COMPONENT: (circle One)________ MATERIAL: (circle one)
if
1. Section No.
7 22YP
2. Test No. 3. Date
//
Jo
P27
P7 p7-P7
J77
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Ernb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count a
10. Moisture Count
a 11. Moisture Count Ratio \J
12. Moisture, PCF 13. Standard Count 14. Density Count 15. Air-gap Count(If Used)
a 16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF sa I .
a °
•
C
,2
19. Moisture Content, % : From Standard
20. Density Curve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
9 j’
/A?
99
77 2$
,1P 5
7
9A?5’
95/
4- 7 I9,
7 95
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot Algebraic sum of Lo 26. Dev. from SV =No. of Smpls in Lot Aigbric im of deviation 7. in ppiicao1e lots
,
2F’”otal No. of Samples Used 1 Day, applicable I ots Distribution:
J
tk 27 1k28
ZAE /c-’/
Signed
Title
T
/oc
: se Course _Block Subba _____ _____ _____ _____ _____ __________ _____
__ __ _____ ____ _____ _____ _____
____
_____
_____
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
226-7415
IA
IA
oject
.Frame
/7
C)—
Basement Soil
Lift
Design Soil
Base
Inches
Depth Measured
Base
Lot Size_______
Binder Base
Soil(Type)Silty,cl Sand Clay, Semi-Gr., Clay.Gr.
None_______________________
Lime (% by Wt.): 1st App!.
Class____________________________________ Design Depth__________ Inches
Base
Unit of Deviation,
TREATMENT:__________
MATERIAL: (circle one)
COMPONENT: (circle one)
/z14-’ C4
Technician
________ 2nd Appi.
Cement (% by Vol.)
1. Section No.
13
2. Test No. 3. Date 4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count u
10. Moisture Count
a
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count 15. Air.gap Count(If Used) a
16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF
,
az
E
a
c
o
c
19. Moisture Content, % From Standard 0. Density Curve rd Density 21. Standa Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
77
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot Algebraic sum of Lo 26. Dev. from SV No. of Smpls in Lot im ol deviation A1bric ica dos —
28. Total No. of Samples Used 29. Avg 1 Dev. applicable lots Distribution:
=
1k 27 1k 28
,j
Title.
_________________________________ _________________Block ________________Course: __________Subbase
_________________
______________
_______
MID-SOUTH TESTING LABORATORIES, INC. FIELD DENSITY DATA
7415 N 6r)iIí)
/AC
COMPONENT: (circle one)_________ MATERIAL: (circle one) Basement Soil
Depth -Measured
Inches
Design Soil
Base
Binder Base
Soil(Type):ndy, Silty, Clayey
None____________________ Lime (% by WI.): 1st Appl.._..
Class______________________________________________ 2nd Appl._ Design Depth__________ Inches
Base
Unit of Deviation
TREATMENT:_________
Sand Clay, Semi-Gr., CIay-Gr.
Base
Lot Size_______
Cement (% by Vol.)
1. Section No. 2. Test No.
4
3. Date
.y/j
.2 YJ2
2
j,
4/ Q/%’
-
P
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested
I
9. Standard Count
C?
10. Moisture Count a
()
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count
c
15. Air-gap Count(If Used)
C?
16. Density Count Ratio 17. Wet Density, PCF
a F >
c °
‘e
C
18. Dry Density, PCF
7c 23
?
19. Moisture Content; From Standard 20.Densjtycurve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
(
,ç72.
9 5’
95
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot 26. Dcv. from SV 27 •
sum of Lo No. of Smpts in Lot
4.lebric im of deviation icabie lots
2Ltal_No.
of Samples Used
29. Avg 1 Dcv. applicable lots Distribution:
d
1k 27 1k 28
-—
-1
Mf
District
/
/. i
Technician
7t’ 4
Cn,rnt
Grenada,
Signed
Title
-
/
77.
—
-
___________________________________Course: ________________________________Block __________Subbase ____________________________
__________
--
MID-SOUTH TESTING LABORATORIES, INC.
oject
-z
17 /‘ 5
Y 1
//
6,7
County
1/
S
Disict
Frame
_MATERIAL: (circle one)
TREATMENT:__________
-
COMPONENT: (circle one)
rechnician
Basement Soil
Lift
Design Soil
Base
Lot
Binder Base
None
Soil(Type):ndy, Silty, Clayey
Clay-Gr. Base______________ Sand Clay, Semi-Gr.,
Inches
Depth Measured
Unit of
Grenada
FIELD DENSITY DATA
226-7415
Lime (% by Wt.): 1st AppI.
Class____________________________________________ Dsian Depth__________ Inches
2nd Appl.
Cement (% by Vol.)
‘“
1. Section No.
7
2. Test NO.
J/*’
3. Date
//
/
,c.
/?
PY
&‘
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count
io. 0
Moisture Count
11. Moisture Count Ratio
y
12. Moisture, PCF
.
L.——1
—
13. Standard Count 14. Density Count ,
15. Air-gap Count(If Used)
0
C)
16. Density Count Ratio 17. Wet Density, PCF CC —4) Cn
18. Dry Density, PCF 1 Moisture Content,%
>,
C
O C
a
From Standard 20. Density Curve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
.
2J ,.
225 2 /j
5__
3’
/J
24. No. of Smp1es in Lot 25. Algebraic Sum of Deviations in Lot sum of Lo 26. Dcv. from sv No. of Smpls in Lot 27 .
AlbrAiC im of deviation ppiicabie lots
28. Total No. of Samples Used 29. Avg I Dcv. alicab1e ls Distribution:
37
d
=
—
1k28
/Ay1-)
-
Signed_.-_
Title_
—
.z
-
__________COMPONENT: ________________Course: __________Subbase _______Block
___________ ______________
_________________
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
15 i
7/
I
Ountv
r
k
7
h
(circle one) Basement Soil
Lift Depth Measured
Fr ,na
MATERIAL: (circle one)
TREATMENT:_________
Design Soil
Soil(Type,Silty,Clayey
None Lime (% by Wt.): 1st Appl._._._..
Base______________ Sand Clay, Semi-Gr., Clay.Gr.
Inches Base
Lot Size_______
Class__________________________________________ 2nd Appl._
Binder Base
Cement (% by Vol.)
Design Depth__________ Inches
.Base
Unit of
District
1. Section No.
/
2. Test No.
/I
3.Date 4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested
t t/t$’7
9. Standard Count a
/13’
7/
/
/‘t j,/ 7
/i
10. Moisture Count
a
[ L’
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count
.‘
15. Air-gap Count(If Used) a 16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF az
E-’ >. °
o
c
7/ 7
19. Moisture Content,-% From Standard Density Curve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
99 y
,95
9/ 9 .5
77
,
9J .9 5__
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot 26. Dev. from V
sum of Lo No. of Smpls in Lot
Alebric im of deviation 27. jnpp11caoLe lots 2YNta1 No. of Samples Used
-h 2
1 Dev. applicable 1 ots=
Distribution:
lk 27 1k28
7 c/ / 76
— —
Signed
•
L//
/ Title
/
v
-
‘
7—
—
k se Subba __Bloc _____ _____ _____ __________
_ ___ _____ _____ _____
_____
__________
MID-SOUTH TESTING LABORATORIES, INC. GrenadaM
FIELD DENSITY DATA
226-7415
Frame
/
‘roject ,
/z.
_Coorse:
Lift
Binder Base
___________ 2nd AppI.
Class____________________________________
Size
Cement (% by Vol.)
.Design Depth__________ Inches
Unit of Deviation 1. Section No.
7
y
/
2. Test No. .
Lime (% by Wt.): 1st AppI.
Sand Clay, Semi-Gr., Clay-Gr.
Base Base
Lot
None_______________________
Design Soil
Basement Soil
Inches
Depth Measured
TREATMENT:___________
one) COMPONENT: (circle one)_________ MATERIAL: (circle
7/2-7
Date
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) S. Sta. Limits Sect. Being Tested 9. Standard Count C)
10. Moisture Count 11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count
t_ /1 1 _
ç
14. Density Count .
15. Air-gap Count(If Used) C)
16. Density Count Ratio 17. Wet Density, PCF —e an F’> >,
18. Dry Density, PCF
20. 21.
.° .
9
.19. Moisture Content, ‘‘7o
22. 23.
From Standard Density Curve Standard Density Curve Number tn-Place Density % of Standard Specified percent of Standard Density
/.
/ci’
/5’
2
2
‘.
2
79
,
/ ôJ. 9
/o/ /
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lo ..Algebraic sum of Lo 26. Dev. from sv No. of Smpls in Lot im of deviation ic oie lots ..7. Albr in ..ppuca 28. Total No. of Samples Used 29. Avg 1 Dev. applicable lots = Distribution:
4i 1/
jk 27 1k 28
/ ,-/7
—
Signed
Title
--
C-
/( T
.1
/c? 75
MID-SOUTH TESTING LABORATORIES, INC. 22’)15
FIELD DENSITY DATA A
.
,,.i,r
—
iA 4’
Technician
(‘
—
COMPONENT: (circle one) Basement Soil
Lift Depth Measured Lot Size
TREATMENT:___________
MATERIAL: (circle one) Design Soil
None
Base______________ Sand Clay, Semi-Gr., Clay-Gx.
Inches Block Base
-
Lime
(%
by Wt.): 1st AppI.
Class____________________________________________ 2nd Appl.
Binder Base
Design Depth___________ Inches
Base
Unit of Deviation
MS
ii
—
t
Grenada,
Cement
(%
by Vol.)
I. Section No.
2
2. Test No.
//
/
-
3. Date 4. Time 5. Station 6. Location from
7.
Q
Depth Below Subgrade(Emb.)
S. Sta. Limits Sect. Being Tested
9. Standard Count a 10. Moisture Count a °
11. Moisture Count Ratio 12. Moisture, PCF
13. Standard Count
fr,, ,l: / 1
15. AirgapCo:t(If Used)
/ //
/
16. Density Count Ratio 17. Wet Density, PCF
18. Dry Density, PCF 19. Moisture Content,
9 9P f
5?24
1
a.
9!?
21. Standard Density Curve Number
-9
22. 23.
Specified percent of
95
4
99 I 9ç
‘
/‘
?/
9
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot 26. Dcv. from SV
sum of Lo No. of Smpls in Lot
27.
klgebric j1m of deviation ln’appllcaoLe lots
28.
1 No. of Samples Used
29. Avg 1 Dev. applicable lots = Distribution:
/
/ /
Signed
Title
:7
s.’-
‘
-
97 9ç
________________________________Course: __________Subbase
____________ ___
__________ __________________________
MID-SOUTH TESTING LABORATORIES, INC. FIELD DENSITY DATA
226-7415
2
oject
JI’ 4 Technician’
-
TREATMENT:__________
(circle one) COMPONENT: (circle one)________ MATERIAL:
-
Design Soil
Basement Soil
Lift
Block Base
Lot Size______
Lime (% by Wt.): 1st Appl._
Class____________________________________________
Binder Base
Tn
Base
Unit of L)eviatiOn
None
Soil(Typeilty,
Base_______________ Sand Clay, Semi-Gr., Clay-G.
Inches
Depth Measured
Frame
Disict
ounty 2 ‘
/
Depth_
2nd Appl._
Cement (% by Vol.)
Inches
—
1. Section No.
.
/7
/
2. Test No.
/2’/
Date
9/2(
2-/2-J
/7
-‘d2
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count
io.
Moisture Count
.
0
11. Moisture Count Ratio 12. Moisture, PCF
/
f/’/t(/
13. Standard Count 14. Density Count ‘
15. Alr-gap Count(lf Used)
0
c C)
// /. 1/,)
13
211
2 4±
16. Density Count Ratio 17. Wet Density, PCF C) 0
>
c
a 0 c a
18. Dry Density, PCF 19. Moisture Content,% From Standard 20. Density Curve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Density
/t’’
—_________
7! ?
25. Algebraic Sum of Deviations in Lot Algebraic sum of Lo 26. Dcv. from SV No of Smpls in Lot 1çbric im oi deviation ppLLcaOLe 10 S
28. Total No. of Samples Used 29. Avg 1 Dcv. applicable lots Distribution:
1/
= lk 1k 28
1
‘PC .1
2 ;c
.2 —
/2 /
/C
24. No. of Samples in Lot
27 •
24-
V
DRAINAGE LAYER DENSITY TESTS
0
0
ubbase _____Block __________S ___________
MID-SOUTH TESTING LABORATORIES, INC.
ir
oject
c
C
/
/
i-”A’z
rechnician
Grenada MS
FIELD DENSITY DATA
226-7415
-t
Basement Soil
Design Soil
Soil(Type): Sandy, Silty, Clayey
Base_._____..____.___.)Clay, Semi-Or., Clay-Gr.
Inches
Depth Measured
TREATMENT:__________
COMPONENT: (circle one)________ MATERIAL: (circle one) Course:
Lift_________
Frame
Base
Lot Size________
Lime (% by Wt.): 1st App].
Class____________________________________________ 2nd
Binder Base
.Design Depth
Unit of Deviation
None_______________________
Cement (% by Vol.)
Inches
1. Section No. 2.TestNo. /t
3. Date
/ /32
’7 9 7c/3
/c-/YP’
6
4’
3’
Appl.
/ ,j2%
//J’2’
/a-/7
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count a
10.. Moisture Count
a 11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count >..
14. Density Count 15. Air-gap Count(If Used) 16. Density Count Ratio 17. Wet Density, PCF
18. Dry Density, PCF .19. Moisture Content, % >.
/cP. ç 7
/ô
/ 7/
9. 9
ç/
f 7
From Standard 20. Density Curve Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23 Standard Density
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot sum of Lo 26. Dev. from V No. of Smpls in Lot A1gebric im of deviation 27. mpp1icabie lots
28. Total No. of Samples Used 29. Avg 1 Dev. alicabIe lots =
/“
Signed
Title
42’
‘
7
/c.
_________________Block
MID-SOUTH TESTING LABORATORIES, INC. 2 3415
FIELD DENSITY DATA
/ A , ,44t/5 LA’9,’4/
i-’ HI
I—
4z
Techn,-;.,.,,
CE
.COMPONENT: (circle one) _Course:
Depth Measured
/ -t .4 t’7/l
Inches
Basement Soil
Subbase
Lot Size_______
Base
Design Soil
Grenada, MS
fljq
n. 2 Pr
MATERIAL: (circle one)
TREATMENT:__________
Soil(Type): Sandy, Silty, Clayey
Base_______________ Sand Clay, Serni-Gr., Clay-Cr. Binder Base
Unit of Deviation
Lime (% by Wt.): 1st AppI. 2nd Appl.
Class Design Depth
None_______________________
Inches
Cement (% by Vol.)
1. Section No.
‘7
2. Test No.
cP
/-/$‘-‘?
3. Date
/,-/5y
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested g. Standard Count a 10. Moisture Count a °
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count
>..
14. Density Count 15. Air-gap Count(If Used) 16. Density Count Ratio 17. Wet Density, PCF C)
18. Dry Density, PCF E’ >, ..
I
19. Moisture Content, % 1’rom Standard 2C. Density Curve 21. Standard Density Curve Number In-Place Density 2 2. % of Standard Specified percent of 2 Standard Density
-
4, -______________
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot 26. Dcv. from SV
sum of Lo of Snipis in Lot
Algebraic sian. of deviation 27. innppilcable jots 28. Pkl No. of Samples Used 29.
Dcv. applicable lots =
28
Signed
7 Title
0
COVER SOIL DENSITY TESTS
0
0
MID-SOUTH TESTING LABORATORIES, INC. 2
415
Grenada, MS
FIELD DENSITY DATA
)roitJ/f/é/f
/A,9cc--
A
County
4
COMPONENT: (circle one) Lift
Basement Soil
_Course:
Depth Measured
Tnrh.c
Design Soil
Soil(Type): Sandy, Silty, Clayey
Base______________ Sand Clay. Semi-Cr., Clay-Cr.
Subbase Block Base
Lot Size_______
TREATMENT:__________
MATERIAL: (circle one)
Binder Base
Unit of Deviatio
None Lime (% by Wt.): 1st AppI. 2nd Appi.
Class .Design Depth
Inches
J
4
Cement
(%
by Vol.)
1. Section No.
/
2.TestNo. 3. Date
/c
-
-i
/c-?c
/&
c
2
-P
/&
/t
‘
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Einb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count a
10. Moisture Count
C .-,---‘
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count .,
15. Air-gap Count(If Used) a 16. Density Count Ratio 17. Wet Density, PCF 18. Dry Density, PCF C
19. Moisture Content, % >.
C
c
c
20. 21. 22.
.
23.
/5
From Standard Density Curve. Standard Density Curve Number In-Place Density % of Standard Specified percent of Standard Density
/t
/
7
/6 t /oti
7
/, /t’t.
7
99
/7-
9c
9
4z
7
/44 /c 7
/o.)
/‘i/
/‘( / /U.
9c’
25. Algebraic Sum of Deviations in Lo sum of Lo No. of Smpls in Lot
A1uebric sirn of deviation ..7. inppi1caoLe lots 2f\1_No. of Samples Used 29.
1k 27 1k 28
Dcv. applicable lots
L 157
9”
iF7t
cf Signed
(Ci-k
-
cI/
/ Title
99,’ 9 ‘
24. No. of Sam,ples in Lot
26. Dcv. from ..,V
/5 /‘6
(‘E ;7
_________________Design ___________ ubbase _____Block __________S ___________
__ ___________
MID-SOUTH TESTING LABORATORIES, INC.
A
ojec
41 1
//Az
rechnician
Grenada,,,M
FIELD DENSITY DATA
226-7415 7-
-e1
Design Soil
Basement Soil
_Course:
TREATMENT:___________
MATERIAL: (circle one)
COMPONENT: (circle one)
Lift
Soil(Type): Sandy, Silty, Clayey
Base______________ Sand Clay, Semi-Gr., Clay-Gr.
Inches
Depth Measured
Frame
i
/i4
Base
Lot Size________
Binder Base
43
7
2. Test No.
/c-2&-g
‘3. Date
2nd AppI. Depth__________ Inches
L Section No.
Lime (% by Wt.): 1st AppI.
Class
Base
Joit of Deviation.
None________________________
J-29
Cement (% by Vol.)
9 /if2
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested
9. Standard Count C)
10. Moisture Count
.
11. Moisture Count Ratio 12. Moisture, PCF 13. Standard Count 14. Density Count .:‘
‘ C C)
15. Air-gap Count(If Used) 16. Density Count Ratio 17. Wet Density, PCF
an -‘
>. .
c °
18. Dry Density, PCF
/4 3’ /-t’er- 7
.19. Moisture Content, % 20: 21.
22.
C
23.
From Standard Density Curve Standard Density Curve Number hi-Place Density % of Standard Specified percent of Standard Density
/&. 7
/cc-
7
/
-1 9c2
24. No. of Satples in Lot 25. Algebraic Sum of Deviations in Lot sum of Lo 26. Dcv. from No. of Smpls in Lot
sv
Im o deviation Alebri aoie 10 s inppncc —
28. Total No. of Samples Used 29. Avg 1 Dev. applicable lots
//
=
1k 27 1k 28
9”
‘-
‘
/ c7/
Signed 1’”
Title
_____Block _______________Course: ___________
_______ -__________
MID-SOUTH TESTING LABORATORIES, INC. Grenada, MS
FIELD DENSITY DATA
7415
2
1/ /Zi4
Fechnician
A A
V
gCountv
District
I-
C
I
Basement Soil
Lift_____ Depth Measured
Base
Lot Size_______
Binder Base
None_______________________
Soil(Type): Sandy, Silty, Clayey
Design Soil
Lime (°)1 by Wt.): 1st Appl._
Base______________ Sand Clay, Semi-Gr., Clay-Or.
Subbase
inches
TREATMENT:__________
MATERIAL: (circle one)
COMPONENT: (circle one)
2nd AppI.
Class Cement
.Design Depth___________ Inches
(Jail of Deviation
(%
by Vol.)
1. Section No. 2.TestNo.
3. Date
? /
/‘
j - 3;-P /c
-
/c
/
-
4. Time 5. Station 6. Location from
Q
7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count a
10. Moisture Count ii. Moisture Count Ratio
—
12. Moisture, PCF 13. Standard Count
>.
14. Density Count 15. Air-gap Count(If Used) 16. Density Count Ratio 17. Wet Density, PCF .18. Dry Density, PCF
I’ >.
From Standard 20 Curve Density 21. Standard Density Curve
22.
// ( /c’c’ 7
/3’
19. Moisture Content, %
/c
r7
//ó /c’2-
7
/,a-
,7
/t’-I
/o-
.-
Number
17tY
I
///. /
Specified percent of
44
/oi
90
24. No. of Samples in Lot 25. Algebraic Sum of Deviations in Lot sum of Lo 26. Dcv. from SV No. of Smpls in Lot 41ebric sum of deviation 27. inapplicabie lots 284l No. of Samples Used
29’.l Dcv. applicable lots
4-c/
?‘7’ii’
Cecr ì1-
, Signe4
Title
I’
T
1.
/oo
__________Subbase ___________________________________Course:
-_____________
MID-SOUTH TESTING LABORATORIES, INC.
Oject
Grenada,
FIELD DENSITY DATA
226-7415
j75
IA 9c
MS
h
County
//
‘echnician
/ZA-
TREATMENT:___________
COMPONENT: (circle one)________ MATERIAL: (circle one) Basement Soil
Soil(Type): Sandy, Silty, Clayey
Base_______________ Sand Clay. Semi-Gr., CIay-G.
Inches
)epth Measured
Design Soil
Block Base
..ot Size
Binder Base
Lime (% by Wt.): 1st AppI. 2nd AppI.
Class
Cement (% by Vol.)
Design Depth__________ Inches
3nit of Deviation
None________________________
1. Section No.
7
2. Test No. 3. Date 4. Time 5. Station 6. Location from Q 7. Depth Below Subgrade(Emb.) 8. Sta. Limits Sect. Being Tested 9. Standard Count a
10. Moisture Count
a ii. Moisture Count Ratio 12. Moisture, PCF
——cD—
13. Standard Count >‘
14. Density Count 15. Air-gap Count(If Used)
a 16. Density Count Ratio 17. Wet Density, PCF an
18. Dry Density, PCF 19. Moisture Content, %
a
0
C
From Standard Density Curve 2 ° Density 21. Standard Curve Number In-Place Density 22. % of Standard Specified percent of 23. Standard Densfty
/e:’c ‘7 /c2. c’
9c’
l4. No. of Samples in Lot 5. Algebraic Sum of Deviations in Lo Algebraic sum of Lo 6. Dev. from SV =No. of Smpls in Lot AIebr.ic im of deviation ica cbs 8. Total No. of Samples Used 9. Avg I Dcv. applicable lots
97 kk 28
/V1
91t
L 7/ / 1 7 Signed
TitLe
,7/
‘—
(%)
U
APPENDIX C Waste Manifests for Sludge Removal
0
0
No//ins Eilv/rdnm8nt8/ S8rvitws fF51 /nc
(ne Rollins Plaza. P.O. Bo 2349, Wilmington, Delaware 19899 ,302)4?9-2920
® J Rollins
U
August 26, 1988
Mr. Jack L. Stephenson KOPPERS COMPANY, INC. 801 Koppers Building Pittsburgh, PA 15219 Dear Jack: Please find corrected invoices for the Flor ence, SC, and Grenada, MS plants. Sorry for the confusion. Yours Very Truly,
C. Robbins, P.E. cc:
Koppers Company, Grenada Plant Koppers Company, Florence Plant
JCR:jch
0
*
0
INVoICE
*
KC)PPERS COMPANY, GRENADA, MS CUSTOMER: 14-8-50523 CUSTOMER ORDER NC). : AUGUST 25, 1988 DATE:
ITEM DESCRIPTION
QUANTITY 1
MOBILIZATION
UNITS LS
8187 PROJ NO.: SALESMAN: GANCE/ULEKOW 089/041 SALESMAN
UNIT PRICE
AMOUNT
$7,835.00
$7,835.00
3031.47
TONS
$32.09
$97,279.87
800.71
TONS
$38.36
$30,715.24
PRIMARY DISPoSAL (CWM)
3031.47
TONS
PRIMARY TRANSPORT
3031.47
TONS
$29.90
$90,640.95
SECONDARY DISPOSAL (PDC)
0
TONS
N.A.
$0.00
SECONDARY TRANSPORT
0
TONS
N.A.
$0.00
STABILIZATION ADMIX USED
$125.19 $379,509.73
TOTAL $605,980.79
DATE 14-Jul—88 15-Jul-88 16—Jul—88 17-Jul-88 18-Jul—88 19—Jul—88 20-Jul-88 21-Jul—88 22—Jul—88 23-Jul-88 24-Jul-88 25—Jul—88 26-Jul—88 27—Jul—88 28—Jul—88 29-Jul—88
0
ADMIX (LOADS)
ADMIX (TONS)
DISPOSAL (LOADS)
DISPOSAL (TON)
4 4 5 3 3 3 4 5 1
103.42 97.62 122.77 75.06 75.64 75.5 98.2 127.5 25
l0 12 14 17 14
250.4 301.8 379.56 434.08 339.6
25 9 9 9
647 57 235 66 215.42 227.38
119
3031.47
32
800.71
.
.
______ __________ ,
.ü.
-
i.
HAZARDOUS.
MANIFEST
WASTE
s RçLd Cy The Alabama Department of Environmental Management) Form Approved. 0MB No. 2050-0039.
(Form des!gned fr use on elite (12’p.’tc/s) t,pewri1.r.) 1. Geneiator’s US EPA
tnifest
M HAZARDOUS1 D WASTE MANIFEST jj$lDj OLOI 71 012171 5141310 i°OflTl°i iip Addre.
4.
P. 0. Box [60 Tie flant, Ms. Generators Phone ( 601 )
5.
1ransporter 1
Company Name
a.
R
A
required by Federal
101 HIDIOIO 19181 615181215
Transporter 2 Company Name
US EPA ID Number
8.
Designated Facility Name and Site Address
IllIllIllIll 10.
.
H. 1 D A L 1 O 010
a
6121 2 12.C
a
No.
Type
RQ Hazardous Waste,Solid N.0.S.(K-001) ORM—E NA-9189
Total Quantity
—
CWM Profile NumbeREs_H_53976
‘
F. I
US EPA ID Number
11. US DOT Description (Including Proper Shipping Name. Hazard Class and ID Number)
E N E
is not law.
US EPA ID Number
6.
CHEMICL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163’ EmeIIe.A1abama35459
0
information in the shaded areas
1
38960 226—4584
: ‘
of A.z
-
Dart Transportation Co. ‘7.
2. Page 1
’Il.ZIc2I 1 01011 P11 4
p
b. CWM Profile Number
I
I
I
I
I
I
I
I I I
I
I I I...
.—
—
CWM Profile Number
I
WM Profile Number
I I
cJ.
Adtt0fl3I Uescrip:ionS toT Materials Listed Above
J.
Work Order No. 880718029 RES P.O. No. 28—063i Eineruency Contact (601) —
15
I
K. Handling Codes for a.
c.
b.
d.
226—4584
htd been dded to the bovr. vi’ql c winr Ii I rnr hei nq .1 nud f i 11 (?d When hind iJnci wea r eyc ,1.( p:oh i hi f. I protection ann pro[ctive equipment such as impervious clothing an glove
S?ecII 4lprii
O 1 t 9 nstp
t7Olj
a
.
,
16GENERATORS CERTIFICATION; I hereby declare tfra the contents of this consignment are fully and accurately described above by proper shipping name end are cIasiIied, packed, marked, and labeled, and are in all respects in proper condition for transpoil by highway according to applicable international arid national government regulations, If I am a large quantity generator. I certify that I have a program ri place to reduce tire volume and toxicity of waste generated to the degree I have determined to be ecnomically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimixes the present and future threat to human health and the environment; OR. if lam a small quantity generator. I have made a good faith effort to minimize my waste generation and select Ihe best waste management method thaI is available to me and that I can afford
Signature
PntedfYPedCNfytnn
Month
Day
Year
IE) P II fl I R A
1 7.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
,
N S
P 0 R 1 E R
,1
‘—“
Signa ,
7
Month
Day
Year
Month
Day
Year
..
-
-
4’itraiiporiem, Acknoedgement of Receipt of Materials Printed/Typed Name
-
‘
,-“
tgnature
I
I
I
I
I
I
IF
ij
1 9.Discrepancy Indication Space
20.Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printedfliyped ‘9nty
A
5igna5re
Monrt Day
Vt. Z
I
Vèàr
lJl/l(i
)
___________ ____
__________________________________________
_____________________________________ ________________________________________________
Ctri’mic.iI W.ish .i.iitr’m.nl
_____
_______ ________
--
-
-
H” AZARbOUS WASTE MANIFEST
>
(As Required By The Alabama Department of Environmental Management) print or type.
I-
i’Fcr,n dssigned for use on elite (72-pit chJ typewriter.)
UNIFORM HAZARDOUS
1
ID
WASTE MANIFEST
3.
P. 0. Box 160 Tie Plant, Ms. 4. 5.
0
2 V
17 0
aRlucg AdIrps
Generator’s Phone (6 01 ) Transporter 1 Company Name
5 4
B
DLycioeiN,
®
Form Approved. 0MB No. 205O-OO9. ExpIres 9-30-88 Information in the shaded 2. Page 1 I:.nbt required by Federal of
area”1
Manifest
1.Generator’sUSEPAIDNo.
A. State Manifest Document Number
6.
US EPA ID Number
C Sti Traht(er’s ID
IH D 0 W 9 8 16 5 8 Z 5
Dart Transportation Co. Transporter 2 Company Name
8.
I
US EPA ID Number
Designated Facility Name and Site Address
I
I
I
I
10.
CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 EmelIe, Alabama 35459
I
Ejransporter’s là --
I I I I I I
US EPA ID Number
G. State Facility’s ID II.
A
L
0
0
0 01 6
I
2
2 4 64
21.
6 S N E
A T 0 R
•
87O2b. .:
RQ Hazardous Waste,Solid N.0.S.(K—00l) ORM-E NA-9189 CWM Profile NumLRES_H_53976
13. Total Quantity
•
Type
ai
:
205/652-9721
(Including Proper Shipping Name Hazard Class, and ID Number)
No.
L1
.
-‘
:.
-
Facility’s Phone
12. Containers
11. US DOT Description
-
v’
0. Tteflspdrter’S Phbñe 1
—
6i
-
‘
14 1.7, Unit ! WIJV0________________ -
.
101010
b. CWM Profile Number
I
I
-A-
I I
CWM Profile Number
I I
J
I I I I
I I
._..j....
I
a.
)
CWM Profile Number U;
Auclitional Descriptions tor Materials ListbU Above
.:Wkodr 4o., 880718029 No 28—0631 RES Thrgency Contact (601) .
15.
pe
9
Ad
....i..”
‘
I
K. Handling Codes for Wastes Listed Above
ii.
a.
C.
b.
d.
.
226—4584
iflq’ton
had been added to the above waste which When handling wear eye would prohibit it from be:i ng land filled. protection and prc)I:ective equipment such as impervious ci.othing and gloves
16 GENERATORS CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects n proper condition for transpoit by highway according to applicable international and national government regulations.
Ill am a large quantity generator. I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which minimizes the present and future threat to human health and the environrnent OR. ill am a small quantity generator. I have made a good laith effort to minimize mywaste generation and select the best waste rnanageiçt_iethod that is available to me and that I can afford Signature,j’ Year Month Day
:2::.;’ (‘‘2.
II A
2 T
17.Transporter 1 Acknowledgement of Receipt of Materials Name -
A
/),S-V5’/Z dO/kiEvL/ “l-gTransporter 2 Acknowledgement of Receijt of Materials rr,nsea, lypea Name
.
L7jct_ 9 I I -
ature
Signature
(1 71
Ii
$I RI
(}
L...—”
9
L—’
E
Month
14
71
Day
Year
1 R RlU
Month
Year
Day
I 11111
.
,J19.Discreanc Indication Space
20.Facility Owner or Operator: ,Cortificotion of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Name S,gnatur //
114 ii /,.//-;
I
I
38960 226—4584 -.ie,.
7.
-
/ -f
Month
Day
-
yeb;
_______ _____
*Y\ • Cri’rrrr IV, lslc•’ cJnl•
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
I’Iease print or type.
(Form des ,gned For use on elitu
0
Form Approved. 0MB No. 2050-0039. Expires 9-30-i
UNIFORM HAZARDOL WASTE MANIFEST
nation in the shaded areas is not required by Federal law. it.
4. 5. 7
P. 0.. Box it’0 Tie Plant, Ms. Generator’s Phone ( 601
Transporter 1 Company Name
)
38960 226—4584
lOT HIDIOIO 19181 615181215
Transporter 2 Company Flame
8.
I
Designated Facility Name and Site Address CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
io.
us EPA ID Number
I
I I I I I I I us EPA ID
A L 1 1 1 D 01010
Number
I 6I
61212
No. a.
E N E ,,
CWM Profile
NumbeRES_H_53976
Type
01011 jg 12IOL3IO
CWM Profile Number
I
......L.
I I I I
I I
..._L
I
C.
CWM Profile Number
r CWM Profile Number
Work Order No. 880718029 RES PO. No. 28—063l Emergency Contact (601) -
1_. Unit Wt/V
..E —
)
I I
IIJIIII
LdjflonaI DescriptionE. for MaterIals Usted Above -
1. Total Quantity
RQ Hazardous Waste,Solid N.O.S.(K—’OOl) ORM—E NA—9189
b.
.J,
I ‘1’i
12. Containers
ii. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) G
-
us EPA ID Number
6.
Dart Transportation Co.
)
K. Handling Codes for V
a.Dj
c.
b.
d.
226—4584
had been added to the above waste which from When handling wear eye would prohibit St beinq land filled. protection and protective equipment such as impervious clothing and glove 16
GENERATOR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable inl.’rnatlonal and national governmenl regulations. If lam a large quantity generator. I certify that I havi a program in place to reduce the volume and toxicity of waste generated io the degree I have determined to be economically practicable and Ihat I have selected the practicable method of treatment. storage, or disposal currently available tome which minimizes the present and future threat to human health and tire environment, OR. ill am a smntl quantity generator. I have made a good faith eflort to minimize my waste generation and select the best waste management method that is available to me and that I can afford -
Pted/Ped(re. T 3 t T A 0
Signature
or
1 7.TranspoFter 1 Acknowledgoment of Receipt of Materials rinted/Typed Name
// 8.Transporter
A/’/
2
re
Year
Month
Day
Year
Day
Year
y Signature
Month
E
111111
.
1 9.Discrepancy Indication Space
D
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/ typed Na e Signature
1
Day
(..-.“
Signa
.
2 Ackncwe grrert of Receipt of Materials Printed/Typed Name
Month
—‘7
,-
.,.-.,
1 Montl
Day
u S J 1 i
-z
q•
Clii’mir,iI W,isle’
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
rift or type.
°
(Form designed (or use on elite (1
2. 0. Box 160 Tie Plant, 1s.
1 of
38960 226—4584
b.
7.
fansporter2 Company Name
9.
Designated Facility Name and Site Address
US El’A II Number
b.
Dart Transoortation Co.
101H1D10I019181615181215 8.
i I 10.
CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle,A1abama35459
US EPA ID Number
I
I
I
a.
N
E A A 1’
I
F Transporter’s Phone
2i—38—7O2O
H.Facilhty’s Phone 1 L A 1 1 D 01
01016121 2
RQ Hazardous Waste,Solid N.0.S.(K—001) OPM-E NA-9189 CWM Profile NumbeRES_H...53976
205/652—9721
i
614 12. Containers
010 Ii
b. CWM Profile Number
I
C.
13 Total Quantity
Type
J.T ......L...
Ii7i
I
CWM Profile Number
I
AGOltioflal tJescr.ptIons br Materials Usted Above
Wo±k- Order No. 880718029 R.ES P.O. No. 28—0631s Emergency Contact (601) 15.
I
iO
14 Unit Wt/Vo
-
.Ei
I
CWM Profile Number
—
4,
G.State FacIlity s ID
No.
E
-.:.
E.State Transporters ID
us EPA ID Number
11. US DOT Description (Including Proper Shiopin Name. Hazard Class, end ID Number) G
Information in the shaded areas is not required by Federal
1
-I
Generator’s Phone 601 ) iransporter 1 Lompany Name
4.
Form Approved. 0MB No. 2050-0039. ExpIres 9-30•88
UNIFORM HAZARDOL WASTE MANIFEST rnr.,n’’. Y’ ; b r’ t m
I
I I
K. Handling Codes for Wastes Usted bo
226—4584
:‘
dd
had been added to the above wnst.e whi ch would prohih.i. it- frnm being land filled. When handlinq wear eye protection and protective equipment such as impervious clothing and glove
S e 9 ci
15 GENERATOR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are cIassifed. packed, marked, and labeled, and are in all respects in proper condition for transport by highway accorthng to applicable international and notional government regulations
If toni a large quantity generator. I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economicatty practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment. OR. 1ff am a small quantity generator. I have made a good faith effort to minimize mywaste generation and select the best wasie manaoement method that is available to me and that I con afford
’Pr 3 lted/jyPed Nar?e T B
A N
S P 0 B
17.TransØorter I Acknowledgement of Receipt of Materials Printed/Ty d Name
i’=r/ 1 8.Trensporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name
E
Signature
,,,51
“ Signature
/‘
J 2
/% 1-
Month
Day
Year
Month
Day
Year
Month
Day
Year
-
Signature
111111
.—,-.‘
.Discrepancy Indication Space F A 1. V
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Na signa
7 )l.f7/
Month I
Da
free?
_________
-
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management) (Form designed to, use on elite (12-pitch) typewriter) UNIFORM HAZAHDOUS Fl. Generator’s US EPA ID No.
I-lease print or type.
WASTE MANIFEST
mJ’4Ia Addr,
3.
I i SIDI
01 (ii
Dl 2171 51 4I3i0O
226—4584
601
Generators Phone
5.
Transporter 1 Company Name
C. St8te
US EPA ID Number
6.
101 FE DIOlO I 9181 61 5181215
Dart Transportation Co. Transporter 2 Company Name
US EPA ID Number
8.
I
9’ Qhsignated Facility Name aiid Sai Address CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 1(33 Emelle, Alabama 35459
10.
I
I I
I
I
a.
E
N
‘‘
E.State Transporter’s ID
j -
..
.
‘f.
219—938—O2
H. Facility’s Phone
.
205/652-9721..
A 1 1 L 1)101010161212 41614
12.Containers
US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
..?
.4 II
.
13.
Total Quantity
Type
WWVo
RQ Hazardous Waste,Solid N.0.S.(K—00l) ORM-E NA—9189
E A 1’
Phone
6. Stete FacIlity’s ID
US EPA ID Number
No. 0
D Transporter
F. Transporter’s Phone
I
I
‘“
-
4i352..Z’i
B State
38960
4-
11
Form Approved. 0MB No. 2050-0039. Expires Information in the sha 2. Page 1 is not required by of law. AState Manifest Document Number
,CWMA
P. 0. Eox 160 Tie Plant, Ms.
7.
‘
Manifest
010 LI, J.’J i’iIiThV.L
CWMProfileNumbqEsH_53976 b.
0
I
.....L..
I I I
I I
....J.....
I I I
CWM Profile Number
R
C,
CWM Profile Number
.-.
d.
I..
I. CWM Profile Number
T” Additional Descriptions
I
for Matori&ls Listed Above
Work Order }o. 880718029 RES P.O. No. 28—0631 Emergency Cortact - (601)
I
4._t’ I I K. Handling Codes for WaStes Listed Abó
...........
a
)JI
c
226—4584 b
d
i)d
had been added to the above waste whi. rh would prohibit it from being land filled. When handling wear eye protecti.on and protective equipment such as impervious clothinq and glove. 16
GENERATOR’S CERTIFICATION: I hereby declare that tile contents of his consignment are fully and accurately described above by proper sh:pping name and are classified, packed, marked, and labeled, and arc in all respects in proper condition for transpolt by highway according to applicable ;iitermiationol ant national government regulalions
Ill arri a large quantity generator, I certify hI ott I have a pm oqrimii ii place to rcrcl,ice tl, vol urno awl toxicity of was IC qr’ni.l ,ilcf to the degree I have deter mined to be economically practicable arid that I have selected the practicable method of treatment. storage, or disposal currently available to me which minimizes the present and future threat to human health and the environrrient. OR, ill am a small quantity generator. I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford
Signature ,
Month
/ -
‘j
t—
Signature
Printed/Typed Name
/t,1/ J 1 4
(
,‘-/
-
,.
Day
Month
.,
/
18.Transporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name
0
-
g
7
(J
17.Trartsporter 1 Acknowledgement of Receipt of Materials
T
0 1 1 Month
Signature
E
I 1 9.Discrepancy Indication Space
I
Year
Day
8 Day
I
Year
I
Year
I/N
-
F A L
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed 4.ame Signature /f.
“ -
-
.//
-
it-
Month
Day /eer
)
(I
/
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
for use on elite (I 2-nitch) tynewriter.)
Forni Approved. 0MB No. 2050-0039. Expires 9-30-88
EPA ID No.
I
Information in the shaded areas is not required by Federal
C
P. o. Box 160 Tie Plant, Ms. Generator’s Phone ( 601
4. 5.
Transporter 1 Company Name
7.
Transporter 2 Company Name
)
38960 226—45A 6.
Dart Transportation Co.
l0IHIt)IOhfIIIRIfISIRI2I 8.
US EPA ID Number
I
II
Designated Facility Name and Site Address
10.
CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 EmeIle,AIabama3S459
—
US EPA ID Number
I
II
I
I I
I
US EPA ID Number
A L 1 1 0 0 1 D
06I2j 2
411614
12. Conltiners
11. US DOT Description (Including Proper Shipping Name. Hazard Class. and ID Number)
No.
Type
13. Total Quantity
RQ Hazardous Waste,olid N.O.S.(K—001) ORM—E NA-91.F’9
‘
CWM Profile ç 7 Numbrq_fl_t Q
n In h
1, Iqi
‘/i I2IRlO
P
CWM Profile Number C.
CWM Profile Number
CWM Profile Number F&drnonal liescriplions br Materials U5tCO ove
f.
Work Order No. 880718029 ‘RES P.O. No. 28—0631. Emerq C 5 onta ency ct (601) 226—4584
I
I
I
I ..
I’
-
b. 15. SfeciaIeHodl t a inf rS
b1naIcfrrnn
had bee!’
to the above waste which When handling wear eye pre,t:ection and proctve equipment such as impervious clothing and giove
would prohibi. L i [
r3
from being land fill ed.
16 GENERATOR’S CERTIFICATION: I hereby declare that liii, contents of tins consignment are lully and accurately described above by
proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations
Ill am a large quantity generalor I certify rat I have a progririrl iii place to rlnilui:(! tIre vol urine toil toxicity of waste geiier at ed to It un degree I have deter inured to be economically practicable and that I have sehrcterl the practicable nietliod of treatriuiniut. ;torage. or disposal currently available to me which minimizes the present and future threat to human health and tire environment. OR. ill am a small quantity generator. I have made a good faith short to minimize my waste generation and select the best waste manaqement method that is available to me and that I can afford ,
Signature
PntedvPecjaItQ!l
.
z.
Month
Day
Year
T R A N
1 7.Transpàrter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
Signature
Month
Day
Year
S
,,. 18.Transporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name
Signature
Month
Day
Year
P
0 R
T E R
zj, —
‘‘N
I
iscrepancy Indication Space
I
I
I
F A
1’
V
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed ame tgnature .
/l(7/-’
I
Month
Day
I
[
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management) (Form designed for use on elite (12-pitch) typewriter.) UNIFORM HAZAR DO US I 1. Generator’s US EPA ID No.
I-lease print or type.
II-1I SIDi UI Ui
WASTE MANIFEST
I
Manifest
012171 51 43 IOi5imaP)il
ddTc
4. 5. 7. •
P. 0. Box 160 Tie Plant, Ms. Genorators Phone ( 6 01 )
Form Approved. 0MB No, 2050-0039. ExpIres I Information in the shar 2. Page 1 I is not required by of law. I MaiiiSt. C
38960 226—4584
Transporter 1 Company Name
US EPA ID Number
6.
101 U1D101019181 615181215
Dart Transportation Co.
transporter 2 Company Name
US EPA ID Number
8.
I
I
1 A L 1
1 D
I
Designated Facility Name and Site Address CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Markor 1(3 EmeIIe,A1abama35459
10.
I
I
I
US EPA ID Number
°l
01016121 2
j 614
‘3. Total Quantity
11. US DOT Description (Including Proper Shipping Name. Hazard Class and ID Number) No.
G S N
a.
RQ Hazardous WztsteSolid N.O..S.(K—001) ORM-E NA-919
E
R A T 0 R
Type
.
P
01011
CWMProrileNumbeRES_H_53976
b. CWM Profile Number
I
CWM Profile Number
I I
I
I
I
I
C
I I I I
d. CWM Profile Number
Additional
I
Work Order No. 880718029 RES P0. No. 28-0631 (601) Emergency Conbact -
I
I
K. Handling Codes 1_.
Descriptions tor Materials L,stad Above
C.
226—4584 b.
ar
d.
hal-i been added to the above waste whi ch When hand liriq weu eye wou].d prohibit. i.t: from being land fii led. protection and prnLeetive equipment such as impervious cothi.ng and qlove
15. CiL
16
slrflj9c
frI
0Ofi
4ddql
GENERATORS CERTIFICATION: I hereby declare that l)te contents ol this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transpott by highway according to applicable international and national government regulations If lam a large.quantity generator. I certify that I have a program in place to reduce the volume and toxicity of waste 9eirerated to the degree I have determined to be economically practicable and that I have setected the practicable method of treatiiient. storage, or disposal currently avaitabte to me which minimizes the present and future threat to human health and fhp environment, OR. ill am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford
Signature
0 Prnted4JYPedNprzje,j.
,
Month
Day
Year
Month
Day
Year
—:--
T
1 7.Transborter I Acknowledgement of Receipt of Materials Printed/Typed Name
N 0 R i’ E
/,/‘
I
Signature’
c
s
p
18.Transporter 2 “Acknowledgement of Receipt of Materials Printed/Typed Name
It
1 9.Discrepancy Indication Space
f
Sign ature
Day
Month
I
I
I
Year
I
F A
C
-
L .
“
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Na e Signature /‘
j ‘2
-
Month
‘
Day
lice,
_____________________
(Form designed for use on elite (72-pitch) typewriter.)
UNIFORM HAZARDOUS WASTE MANIFEST
•
8 P.
m ? 4 t 0. Box ).()
Tie Plant, Ms. 4.
Generator’s Phone (
5.
Tfnspor1er 1 Company Name
601
Adde,
Ti. Generator’s US EA ID No.
Manifest
I t-IISII)i 0101 71 012171 5141310
E
E R
A I
Form Approved. 0MB No. 2050-0039. Expires 930•88 2 Page 1 Information in the shaded areas required by Federal of 1
38960 ‘,
I
226—45 84
..
Dart Transportation Co.
Tiansporier 2 Company Name
9
Designated Facility Name and Site Address
US EPA ID Number
8.
-
...
,,
.
US EPA ID Number
I
I
I
i
i
i
I
I
US EPA ID Number
io.
H.FlitYEPhOfl A L 1 1 D 1 0 01016121 2
4jj4
2081682-912i
12. Containers No.
CWM Profile NumbeRES_H_53976
b.
13. Total Quantity
Type
01011
CWM Profile Number
CWM Profile Number
14. Unit
I’
Wt/VoI
PL 4641; J
C.
Th
Tdflb& *4,:
IOIHIDIOIO 19181615181215
a. RQ Hazardous Waste, Solid N.O.S.(K—00i) ORM—E NA-9189 .
4
_,-
w
6.
7.
I I
I
I I I I ,
CWM Profile Number
J.
I I
Additional. DescriptiOns for Materials Listed Above
‘Work Order No. 880718029 ItES P.O. No. 28-0631 iergeflvy COntact (601)
I J_.., K. Handling
I I
I
-.-
Codes for Wastes Listed AbO 6”.
a.DJ
226-4584 b.
lb.
16
‘
çWMA, 4i358
11. US DOT Description (Including Proper Shipping Name. Hazard Class, end ID Number)
N
_____ _______ ___
AStatê MahifEsi DOcument N nberc
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
C
____
_________________________
(As Required By The Alabama Department of Environmental Management)
rint or type.
-‘
__________
____
FIAThRDOUS WASTE MANIFEST
n
I.)E(
_____ ________ ____
becia,l 9SIr9 ar
.
had been added to the above w t.
wh.i, c:h would prohibit i.t from beinq land filled. When handling wear eye protection and protective equipment such as impervious clothing and glove.
GENERATOR’S CERTIFICATION: I her”by declare that the contents at this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations If lame large quantity generator. I certify that I have a program in place to reduce the volume and loxicily of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment, OR. if lam a small quanlily generator. I have made a good faith effort to minimize my wasle generation and select the best waste manaaement method that is available to me and that I can afford ar”.
I
PntedvPedryton
I R A N
I (
1 7.Transpôrter 1 Acknowledgement of Receipt of Materials
0 I
S
.
—
I1
vY ,.)‘
U
‘
L
D. (i
1)
Printed/Typ d/Name
I Signaturet
I
S
p
Signature
1 8.1 5isporter 2‘noweg eme t of Receipt of Materials 4 Printed/Typed Name
t) Signature
Month
u
Day
Month
p y Month
Year
116 8 8 Day
Year
Day
Year
‘
It
111111
,joiscrePanc Indication Space
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. rrin,ea, lypea eme Signature
62/1
%‘r
I
‘i-i/
Month
Day
èèî
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
Form Approved. 0MB No. 2050-0039. Expees 9Information in the shaded are’ 1 is not required by Federal law. 1
(Form designed for use on due (72., UiirUHM HAZARDOUS 1 1.
Hease print or type.
WASTE MANIFEST
State Manifest Document Number
3’
P. 0. Box 160 Tie Plant, Ms. Genorator’s Ptone 601 ) transporter I Company Name
4. 5.
CWMA43 58 L
st,
38960 226—4584
:
1tL%.
iOiLlDiOIOi9I8I 5ii2i5
Dart Transportation Co.
7.
c stats rta
US EPA ID Number
6.
Transporter 2 Company Name
8.
Designated Facility Name and Site Address
10.
US EPA ID Number
11111111111 -
-
US EPA ID Number
CHEMICAL WASTE MANAGEMENT, INC Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
G E N E A T 0 R
a.
.: ;z.’
H.FSàiftty’s Phone,
O5/652-9f21
A 1 1 L DI 01 01 0161212 41614 . 12. Containers 11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number) Type No.
-
:
13.
14.
Quantity
Wt/Vo
•-
-
RQ Hazardous Waste,Solid N.0.S.(K—001) ORM-E NA—9189 CWM Profile
NumbeRES—H—53 976
01011
ci.7iro
b. CWM Profile Number
I
I
11
I
I
CWM Profile Number
I
I
-J_
I
I
I
C.
d. CWM Profile Number
1 Il_Lull
AuOllfonaI UescriptiOns to, Matertats ListeC ADove
.1.
-
Wor) Order No. 880718029 RES P.O. No. 28-0631 (601) mergency Contact —
I
K. Handling Codes for Wastes Listed
—
a.
C.
226—4584 b.
-
d.
..
which had been added to the above eye wear handiinq When would prohihi t it. from hei ng 1nd f.i lied. and glove clothing protection ‘ind protective equipment such as impervious
15. STci.
16
wtste
GENERATOR’S CERTIFICATION. I l,rrr’by cfr’clare that the contents of this consignment are fully and accurately described above by prbper shipping na me and are chissif red. jacked. iriarked. and labeled. an(f are in ll respects in proper condit inn for transport by highway according to applicable inter rintional and n lionril goverrimeirl regulations It I am a large gualility generator. I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined lobe economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which minimizes the present and future threal to human health and the environment. OR. ill am a smII uiintity generator. I have made a good faith effort to minimize mywaslegeneratron and select the best waste management method that is available to me and that I can afford,
Prjtted/fyPed
T R A
N S
a
P 0
1 7.TranSporter 1 Acknowledgement of Receipt of Materials Prid/Typed Name
/ Yz
/7
Signature
(IytOfl
00
c
I
Day
Year
10 i 1118
/ Sign I
-...—
r
1B.Trertsporlar 2 Acknowledgement of Receipt of Materials Printed/Typed Name
Month
,_J,r,f
Month
Day
Year
0 i 1118 Signature
Month
Day
Year
IlIIl 1 9. Discrepancy Indication Space
2OFacility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typeç Name Signature ,
-///
Month
Day
r
_________
Ctwmr,,I Wish’
WASTE MANIFEST
iJme’n
l-lef
“int or type.
HAZARDOUS (As Required By The Alabama Department of Environmental Management)
(Formdesignedlor_use on elite (72-pitch) typewriter.)
UNIFORM HAZAR DOUS WASTE MANIFEST
1. Generator’s US EPA ID No.
7.
P. 0. Box 6() Tie Plant, Ms. Generator’s Phone ( 601
‘Liansporter 1 Company Name
3
38960 226—4584
,
6.
US EPA ID Number
Company Name
8.
US EPA ID Number
I I
US EPA ID Number
i
614 No.
J -
CWM Profile Number —
LIStOP MOove
I I
strcoJ
anp,,
dç
i
-
I
I
_...L...
.,
-
j
j
P
I I I
I I I I
K. Handling Codes for WastöS Listed Above
.
C.
226—4584 -
tpi
ha been rd ed t.o t:be above W t’C? wh’t ch wr,11r1 prohi hi t i t I i:cwi bei. nri nc3 fi..i led . When handi lnq weil eye prot.ecti on nd p’ ‘ci:ive nrui.pment such as impervious clothing nd qiove
16 GENERATOR’S CERTIFICATION: I hereby declare that the contents oh this consignment ore fully arid accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for tionspoil by highway according to applicable international end national government regulations If lam a large quantity generatnr, I certify that I have a program in place to reduce tIre volume and toxicity of waste geneiatert to the degree I have determined lobe economically practicable and thai I have selected the practicable method of treatment, storage, or disposal currently availahte to me which minimizes Ihe present and future threat ho human health and th environment, OR, ill ciii a small quantity gener;ilor. I have made good faith effort to minimize my waste generation and select a the best waste manaoement method thi’ is available to me and that I can afford
Pited/jrcPed tjtme
T R
A N S p 0 Pt
Signature
t
17.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
‘
4I4
•‘
2 Acknowledgement of Receipt of Materials Printed/Typed Name )iscrepancy Indication Space
,,,J_4
I
..,s’
jí4
Signature
Month
Day
Year
Month
Day
Year
ji 8 Month
Day
liii
P? Year
II
J 20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Name signature .1 / I, —-
I
.1I
ç;
14. Unit Wt/Vo
a.V.,
j
I
,
I I I I
b. lb.
13. Total Quantity
Type
01011 DIT 47iIi’
CWM Profile Number
-
j
i
.
—
976
CWM Profile Number
Work Order No. 880718029 RES P.O. No. 28—0631. Emergency Contact (601)
.1
;. .
‘
205/652-9721
12. Containers
C.
.
-
H. Facility’s Phone 1 L A 1 1 D Oi 01 016 21 2 I
b.
-
—
.f ---
CWM Profile NumbeRES_H_53
ivwierteis
-
G.State FaclIfty ID
RQ Hazardous Wte,oiid N.O.S.(K—00l) ORM—E NA—9189
Tor
,‘
219- 938-102L
-
ieacripuons
-
-.
E.Stete Transporters,ID F. Transporter’s Phon8
I I I I I
10.
11. US DOT Description (including Proper Shipping Name, Hezard Class, and ID Number)
ou.uonat
.-
CStet’Traftep
,,...II
l0IHDl01019181 615181215
CHEMICAL WASTE MANAGEMENT, INC Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
4.
.
.
Designated Facility Name and Site Address
a
Form Approved. 0MB No. 2050-0039. Eaplres 9-30-88 2. Page 1 Information in the shaded areas is not required by Federal of law. I & State ManhlOSt Docutñent Number I
cwMA.413s-82..
Dart Transportation Co.
Transporter
Manifest
o12j7L5L4.I3joi0O1mI t
at oi 71
Add
4. 5.
____ ___________ _____ ___________ ____ ___________ ___________ _______ ___ ______
Month
01
Day
ear
d(i
___
_ _____
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
Hease print or type.
(Form designed for use on elite (1 2.pitch) typewriter.) 1. Generators US EPA ID No. HAZARDOUS
JIFOKM WASTE MANIFEST
fljS)DI 0)0)
‘
Manifest Do urn nt No
0)2)7) 514I3401O) ãIIJ
Addrk,
P. 0. Bo 1f) Tie Plant, M. 4.
Generators Plicne ( 601 ) Transporter 1 Company Name
389O 226 —-4584 US EPA ID Number
6.
IOIHIDIOIO 19181 6) 51812 IS
DartTransportaLio’tCo..
7.
Form Approved. 0MB No. 2050-0039. !nformation in the shaded is not required by Federal of law. j A. State Manifest Document Numbet , 2 Page 1
us
s.
Transporter 2 Company Name
io.
Designated Facility Name ancFSlihddress CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Markcr 103 Emelle, Alabama 35459
I
I
I
I
I us
E.Stme,Transporter’S ID
EPA ID Number
I
I
I
I
I
I
G.SteteFacffity’a ID,
i87o2’
..
21 j _205/652-97 j 4 _
11. US DOT Description (including Proper Shipping Name. Hazard Class. and 10 Number)
13. Totai Quantity
Type
No. •
E
N a R A T
“:
ftFeCilItys Phone 12 Containers
C
RQ Hazardous Waste,Solid N.O.S.(K—001) ORM-E NA-9189 CWM Profile
Numbes_H_53976
-,
-.
-
EPA ID Number
A L 1 1 0)0)0)6)2)2 1 D
-.
,-,
Tranportar’s Phone
‘‘.;
.‘
14. Unit Wt/Vo
I’
--
Lf1Igc
0)0 Ii
b. CWM Profile Number
IIJIIII.
CWM Profile Number
iijiii_Lm.
CWM Profile Number
I I
C.
aurnonai uescrpnons ior MaeriaIa ustea Moove
Work Order No. 880718029 kES P.O. No. 28—0631 (601) hnèrency Contact —
15. Sci1ari
JnstrJctoçrs
prchi.lri t 1 protection m WOI•iir
16
it p’r’l
_._L_.
i 1 I I
I
K Handling Codes for WaStes Usfed a.
c.
b
d
226—4584
rl been idc1ed to the above wst. wh i. eli When han1.1J.nq wear eye 1 ann f I .Icr1 nq ‘ cm h2 e;t.ve quiorqent such as irnterviou clothing and q1ove .
L’j—
D
1(P1- ‘zi’4 1)
-
GENERATOR’S CER tiFf CAT ION: I hereby declare that tire contents of this consignment are fully arid accurately described above by proper shipping name and are classified, packed. marked. nd labeled, anti are ri aft respects in proper condition for transport by highway according to apphcable international and rralional government regulations
Ill am a large quantity generator, I certify ifiat I rave a Irrogr;irrr in place to rmndrir:rr th volume and toxicity of waste generated to tire degree Ilmave determined to be economicallypracticable arid hat I have selected tire practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and tire environment. OFT, ill am a small quantity generator, I have made a good faith effort to minimize mywaste generation and select the best waste manaoement method that is available to me and that I can afford
nature
.217_
74
17.Transporter 1 Acknowledgement of Receipt of Materials Printed/type Name
Month
0 7
Day
Year
B $ 8
Month
Day
Year
Month
Day
Year
-
0 T
18.Transporter Z”Acknwledgement of Receipt of Materials Signature
Printed/Typed Name
E
R
IIlII
.
-
19.Discrepancy Indication Space
20.Facility Owner or Operator: Certification of receipt of hazardous materials red by this manifest except as noted in Item 19. Signa)OrJ rriieaI,ypeo Name J,, 4 -i i / Y /i / / f f)/J)J]i’
/ ) -/.-
-,
/
i’! A-
Month
Day
i/
/i
p
_____
_________
______________________________________________________________________ _________________________________
_________________________
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management) or
type.
(Form designed
for
Form Approved. 0MB No. 2050-0039. Expires 9-30-88 2. Page 1 Information in the shaded areas ;:n0t required by Federal of
use on elite (1 2-pitch) typewriter.)
IIFORM HAZARDOUS WASTE MANIFEST
1.Generator’s US EPA ID No.
Manifest
MIS ID I 01 01 71 01 217 I 51 413 10
A3tat Manifast Dbcurn8nt Nümbe
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone 6 01
4. 5.
iransporter 1 Company Name
‘WMA.415R .4 B
38960 226—4584
SaGenetatqr S
6.
Dart Transportation Co.
7.
C
IOIHIDIOIO 19181 615181215
Transporter 2 Company Name
8.
US EPA ID Number
I I
11
1-acuity Name and rte Address
10.
CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 1(3 Emelle, Alabama 35459 11. US DOT Description
US EPA ID Number
I
Phoflê
E. State F. Transpoi’ters
I I I
I
Ste 1 Tmflp
T o :a
US EPA ID Number
2
G.State FaclIltys ID\,.
219-9382th! H. Facility’s Phone 1 L A D 01 1 1
p 01 0
6
2
2
4
6
I
4
12. Containers (Including Proper Shipping Name.
13. Total Quantity
Hazard Class, and ID Number)
No.
-.
‘205/652—9721, Type
14. Unit Wt/Vo
RQ Hazardous Wste,So1ia N.0.S.(K—00l) ORM-E NA-9189 CWM Profile
s—.—
NumbeRES_fj_53976
b.
CWM Profile Number
I I
C.
CWM Profile Number
CWM Profile Number
I I
—.
J.
,iuuiiu
DescrIptIons for MMerIas Usted Above
1 _ I
SI2.i CISC
01011
L
I
-J
I
__..,.j_.,.,.
I I
-
.
.
:‘w..
‘4
-
‘;
I I I
I
I
I
0’
I
K.HendIingCodStorWasdAb
-
Work Order No. 880718029 RS P.O. No. 28-0631 Emergency Contact (601) -
)—J
a
c
226-4584 b.
d.
15. 5,eciai1fI
had been added to the bov waste which would prohi.b3t: it from being Jmd filled. When handlJPQ wnar eye protection rind prnl ‘cti.ve eqniprnent such as impervious clothing nd qiove. f) ( p 1) p F)d (j)
16
GENERATOR’S CERTIFICATION: I hereby declare tht lire contents of this consignment are lully aifd accurately destribed above by proper shipping name and are classified. packeii, marked, arid labeled, and are in all respects in proper condition for transpoit by highway according to applicable international and national governrneit rcqufalinns
I
are a large qua 0111 y genera br, I cer lily I lie I I have a pr nqrilrri ri place to rerlrice I lii: vol urire a i-rd toxicity of was IC qener alerl to If-re degree I iave determined to be economically practicable and I ball have ye led ed the pr act ice ble net find of lrOat ii Slit. ‘;lor age. or clisposa I currently ave table lii me wlr cli minimizeS the present and future threat to human health and the vi .,r’Jnrnent OR. ill rim a small r uantity generator. I rave mode a good faith effort to minimize roy waste generation and select 1 the best waste manaaemenl method that is available to roe and that I can afford Signature PntedvPed..N!re t”nrt Month Day Year It I
J,,,
‘
1 7.Transpt,rter 1 Acknowledgement of Receipt of Materials Printed/Typed Name —
—
-
-
)/ ekk”91 p
i.h
..
-‘
-—
I
Sign
,, I —
/
—
(—i’/
J
“
Month
Day
Year
Month
Day
Year
n-
I—
18.Transporter 2 Ackrlowledgemeni of Receipt of Materials Printed/Typed Name
E
Signature
R’N ‘
U V Ii B
II
) Discrepancy Indication Space
1111
Fl Al
CI I
LL Ii
1 T
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. -fl.unreoi jypea name (i9natu7Z ...
V
-
17 /)1’A
.--
Month
Day
Year
HAZARDOUS WASTE MANIFEST of Environmental Management) (As Required By The Alabama Department
I-lease print or typo.
Form Aeproved 0MB No. 2050-0039. ExpIres 9. Information in the shaded areas is not required by Federal
ch) typewriter.) (Form designed for use on elite (72-pit ors U (enerat 1. -
--
UNIFORM HAZARDOUS WASTE MANIFEST
11S1D1 0I0
Numbel’
-
--
,,.
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone 1 601
4. 5.
—
)
6.
tion Co. Dart Transporta Name
lOt BIDIOIOI9I8t
s Designated Facility Name and Site Addres INC NT, CHEMICAL WASTE MANAGEME Emelle Facility Alabama Highway 17 at Mile Marker 163 EmeIIe,A1abarna35459
10.
*e-
US EPA ID Number
D 01 01016121 2 1 1 A L
I
N. Feoil
‘S Phone
-
12 Containers
CWM Profile
NumbeRES_H_53 976
qi
01011
‘
-
‘
Quartity
Type
No.
.-.
-
?21 4I6t4LO/6529 14. 13.
d N.0..(K—001)
N S
-
raflipOrt& i FT I stato FacThiyê
I i i i i i
RQ Hazardous WsLr,oli ORN-E NA-9189
a.
-
E.
US EPA ID Number
8.
Shipping Name. Hazard Class, and ID Number) 11. US DOT Description (Including Proper 0 S
aStateGetereto?s ID
US EPA ID Number
transporter 1 Company Name Transporter 2 Company
7. W
I
38960 226—4584
P
5.
A T 0
L
CWM Profile Number
P
I
I I
C.
J
I I
CWM Profile Number
I I I I
d. CWM Profile Number —
III) ..J.... K. Handling Codes tar WeSt* Uéd
I
als bated Above 3• Adcht,onaI Uescrtpttons to.’ Materi
Wórk Order No. 880718029 R.EB P.O. No. 28-0631 (601) 226—4584 emergency Contact
-
a.
o-’( :
d.
b.
—
ve wa c’ ihi rh had been added to the abo When handling wear eye J.nnd filled. would proh hi. t-.it trorn being clothing and gJ.ove ipment such as impervious protection and prntectjve equ eci
15
—
16
t a jr rfJ 1 lst o
Add.jlp
tJ9qp?o
P cRA 3tWrc-fl
are ft,lly and accurately described above by declare tlirit tire contents of this consignment y GENERATOR’S CERTIFICATION: I hereby ts in proper condition fr transport by highwa respec all in are arid , labeled rind , marked , pioper shipping name and are classified, packed l qovarr’inenr regulations according to applicable rIOT I ‘cl,onal arid nationa
ined to be toit to the degree I have determ r the volume anrl toxicity ol waste qirrora that I rave a program in plric to rerluci which minimizes the present and me to le availab tly curren al ill am a large quantity genuiritor, I certify ent. storage, or dispos tion and select selected tire pr;rcticablc rnetlrid cii treotirr hriit it pun, t toni inimize my waste genera economically prcctrcabte rind that I hay.’ ill ii iii a cmii ii I line mit it y go rem itor I have made a good Ii and t liii clvi ron acre, OR. heaP human tto threa future A a lfimal Year I li;il is ilyri i latile to rio and tlta t I can Month Day tie best waste manaGement method Signature,, / 5 PniedfypedcN!re. f 9 -
I P A
0
t of Materials 17.Transporter 1 Acknowledgement of Receip
-_-
f
L’ re
’inted/Typed Name .4
Qk’cf%/’ als Y/’2J V t of Materi 1.Transporter 2 Acknowledgement of Receip
P
Printed/Typed Name
r E
I.
Signature
Month
Day
Year
Month
Day
Year
I I I
P 1 9.Discrepancy Indication Space F
A C
T
19. d by this manifest except as noted in Item co e of hazardous materials 7 ci Owner or Operator: Certification of receipt ty 5 2O.F i Ignat e-’ 7 — J-
printed/Typed Name
/
c7 ) ‘; 1, -
J__.
d)J)
‘/
/-/t7L.1 i
-
Month
qay
Jp8c.
iQ7i/ii
HAZARDOUS WASTE MANIFEST
-‘;
(As Required By The Alabama Department of Environmental Man agement)
,int or type.
3.
(Form designed for use on elite (72-pitch) typewriter.)
UNIFORM HAZARDOUS WASTE MANIFEST
sm4 Addeffr
I 1. Generator’s US EPA ID No.
4. 5. 7.
Dart Transportation Co. Transporter
9.
orter 1 Company Name
E It
A
a.
I Information in the shaded areas i is not required by Federal
1 I
law.
3960 226—45 84 6.
US EPA ID Number
IOIHIDIOIO 19181 6151812 i5 8. US
2 Company Name
EPA ID Number
Iii
Designated Facility Name and Site Addres s CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 EmeIIe,A1abama35459
10.
I
I
I
I
I’
i
614
CWM Profile NumbeRES— H—53976
I
12.Cont.....ars No.
RQ Hazardous Waste,Solid ?1.0.S.(K—001) ORM—E NA-9189
b.
I
US EPA ID Number
A L 1 1 D 1 0 0101 6121 2 11. US DOT Description (Including Proper Shippi ng Name. Hazard Class, and ID Number) 8 E N
2. Page 1
TIV of
IMISID I 0101 71 Ci 2171 51 4j3 10
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone ( 601 ) Transp
Form Approved. 0MB No. 20500039. Expires 93O-88
Manifest
Tvoe
010 Ii
C
I
0 I1
CWM Profile Number
C.
I
—
CWM Profile Number
CWM Profile Number ,j.
FWQWOflI ueacr,psions so’-
aiertais ust
ye
K. Handling Codes for’
Work Order No. 8807 9(&f’) RS P.O. No. 28—0631 knergency Contact (601) 226—4584 —
16. Srecial
J)Zl ac1dd to the above watc t’1i rI’t prohi hi. ii. I rom being land filled. When handling wear eye protection nd prc’:ective equi,pme ft such as impervious ctqthing and glove
w’iI.d
.
PEk
C./Q
16 GENERATOR’S ,ERTlFtCATt0N: I hereby declare that lie contents of this consignment are fuTly and accurately escribed above by prober shipping name and are classified, packed , marked. anti labeled, and are in all respects in proper conditioi for transport by highway according to applicable international anti hationa f government regulatiorr If lam a large puantity generator. I certf that I have a progi am in place to reduce the volume and toxicity ol waste generated to the economically practicable and that I have selecte degree I have determined to be d the practicable method o 1 treatment, storage, or disposal currently availab future threat to human health and the enviro le tome which minimizes the present and nment. OR. ill ziin a small quantity gerinritor. I have made a good faith effort to minimize my waste the best waste management method that is availab generation and select le to me and that I can afford. Pted/,ped Signature
(N1tytofl
1’
7)
1 7.Transpbrter 1 Acknowledgement of Receipt of Materials
a
i
9)
Signtttf
A4 iP/V /1’/) (J 6/
Month
Month
I
V
20.Facility
P
Signature
)Discrepancy Indication Space
.
Year
cA”
18 Transporter 2 Acknowledgement of Racer 1 of Materials Printed/Typed Name
Year
,,,./
/
Printed/Typed Name
Months
I
Day
I
Year
I
Owner or Operator: Certification of receipt of hazardous materials covere d by this manifest except as noted in Item 19.
r’rinteo/ lypeB r’tarpe
hA
Signature
,
iY)
A
Month A”
.7
)
Day,,. ,Ydar /1’ / I V
ANIFEST S WASTE M HAZARDOU ental Management) Alabama Department of Environm (As Required By The
Ilor use on elite (12
rase
°A ID No.
cWMA
160 P. 0. Ms. nt, Tie Pla ) Generator’s Phone ( 601 Box
4.
38960 226—4584
5.
transporter 1 Company Name
7.
nsportation Co. Dartter Tra 2 Company Name
101111D101019181615181215 ,
,,
US EPA ID Number
8.
I Address Designated Facility Name and Site T, INC. MEN AGE CHEMICAL WASTE MAN Emelle Facility er 163 Alabama Highway 17 at Mile Mark Emelle, Alabama 35459
I I 10.
I I I I
ii
4iai I
Esie
I
H:Fao;utys P1Oñ
CWM Profile
I
* 2O5/613.2-9?21 14.
1 01 DI 016121 2 1 D A L 1
12. Containers
4
01011 DT
NumbeRES—H—53976
Unit
Total Quantity
Type
N&
lid N.0.S.(K—00i) RQ Hazardous Waste,So ORM-E NA-9189
I
GSfltö
US EPA ID Number
and ID Nurnberj Proper Shipping Name. Hazard Class, 11. US DOT Description (Including a.
I
c. sia
US EPA ID Number
6.
Transpor
.
Expires 9-30Form Approved. 0MB No. 2050-0039 ed areas shad the in ation Inform I is not required by Federal law. I A. Stat6 ManlfeS DocUment Number
‘:‘
-
-;‘
.
-
W74fiO
b.
I
L
CWM Profile Number C.
I I
CWM Profile Number
1
lilt
J
I I
E CWM Profile Number .1.
Abov K. Handling Codes far Wastes Listed -
--
rtats LISt iwamonai uescripttons tor Mate
) Work Order No. 8807J€02Y&p 1 063 28RES P.O. No. (601) 226-4584 Emergency Contact
d.
b.
—
icf the above wrtte wh haa been u1ded to eye e w .ng dii When han in glove m being land filled. imper,ious clothing would prohhit it Fro as J s’ic mn j.p equ fective pQq(c/) above by protection nd pio
trc n ns 1 e 9 S 15. a
PERKcR
fully and accirately descriled
of this consignment are I hereby declare that the contents on for transport by I iqhway 16 GENERATOR’S CERTIFICATION: irf, etckucI. iriarke&f, &iriil taboh,tl. antI or i., in alt r,,Spirct S in proper conditi lassilii c are rid a proper shipping name regulatiors. mined tobe national and national government rated to the degree I have deter according to applicable inter volume and toxicity of waste gene nt and m a progra in place to reduce the to me which minimizes the prese le have I availab lit tly certify . I curren rator al gene dispos select t, storage, or If lam a large quantity minimize my waste generation and practicable method of treatmen the to ted effort selec faith have I good that a and made . able ;itnr I have
—.
-
economically practic ft am a small quantitygener h and the environment. OR. future threat to human healt le to tire and that I can afford availab is that method ent aaem the best waste man Si9nature9
Prited/fjmped tNr
7t
A
ent of Receipt of Materials 17.Transporter 1 Acknowledgem Printed/Typed Name
0
ent of Receipt of Materials 18.Transporter 2 Acknowledgem
I
R
ft
i
1?
or
9;d
Printed/Typed Name
I
Signature
1
Signature
Year
Month
tO 17
2
I
‘I
Month
i7 I
E ft
I
Year
Day
Month
I
I
I
L
1 9.Discrepency Indication Space
d in Item 19. covered by this manifest except as note cation of ieceipt of hazardous materials 20.Facility Owner or Operator: Certifi signature Printed/Typed Name / -
.
/
,
-
-,
/z
Month
Day
r
__ ______ __ __________________
______________________ __________ ___________ ___________ ___________ ___________ ___________ _ _____ _____ _____
.e
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
‘V -
-
—
-
Form Approved. 0MB No. 2050-0039. Expires 9-30-88
(Form designed for use on elite ((2-
I-leâie print or type.
!nformation in the shaded areas is not required by Federal law.
1
— —
UNIt-OHM
HAZARDO
WASTE
MANIFEST
I
A. State ManIfest Document Number
.
,,
P. 0. Box 10 Tie Plant, Ms. Generator’s Phone 1 601
4. 5.
-
Transporter 1 Company Name
C.Stata
US EPA ID Number
6.
10 i HI DIG 10 918 I 61 518 12 15
Dart Transportation Co.
US EPA ID Number
8.
I
I
I
I
D. Tr8naportar’ Phone
•.
-
E. Stat’ Transporter’s ,ID
G. State Fcility’e ID
-
-
-.
“
.
.
.:
,..
.219—93 —7020.
CHEMICAL WASTE MANAGEMENT, iNC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
H. Facility’s Phone
205/652-9721
D 01 01 016121 1 1 1 L A 2 4 6 — 12. Containers Class, and ID NumbEr) 11. US DOT Description (Including Propec Shipping Name. Hazard it Type No. -
RQ Hazardous Wate,So1id N.0.S.(K—00l) ORM-E N1\—9189
CWM Profile NumbeflES._FI_53976
14.
13.
-
a.
‘‘‘aD’’
-
F,TranspOrter’s Phone
US EPA ID Number
10
W Designated Facility Name an Site Address
5 N S
‘ “‘
‘‘:
Transporter 2 Company Name
1.
413589.
CWMA
38960 226—4584
-
‘total
Unit
Quantity
Wt/Vo
Waite
0l0I9I(
R
A b. T
0 R
CWM Profile Number
I
I I
I
I
I
I
.
—
—.
.
—
—
C
I CWM Profile Number
I
CWM Profile Number r
I
-J-
I
Additional Descriptions for Materials Listed Above
I I I I
L
K. Handling Codes for Wastes Listed Above
p’)
Work Order No. 8B074)29((3 ES P.O. No. 28—0631 (601) 226-4584 Emergency Contact
Jr .‘
-
C-
—
d.
b.
hr1 been added to the above waste hich When andlinq wear eye it frdm being land filled. would prohibi as impervious clothing and glove, such ent protection and pioective eauipm
15. SeCiaf
PR
—
16
cp gqg -‘)
GENERATOR’S CERTIFICATION: I hereby declare that the c ntonls o this co’isignrniint aref
proper shipping name and are clas,f,ed, packed, marked, and labeled, and are in all respects 1 accordlng to applicable internalionI and nalirnial goveriririent reutfllions
ly and accurately described above by
iii proper condition for transport by highway
and toxicity of waste generated to the degree I have determined lobe 111am a large quantity generator, I certify that I have a program in place to reduce the volume or disposal currently available to me which minimizes the present and economically practicable and thol I fiavi selected the practicable method of treatment, storage, mywaste generation and select OR. if lain a small quantity generuilcir. I have made a good faith effort to future threat to human health and Ilur’ A anii that I can afford the besi waste management method that is available to minimize
environment,
me
--
°c!’tjton
Year
Month
ature,,,,/ Si n 9
.
T R
A
17.Transporter 1 Acknowledgement of Receipt of Materials
My’ (
0
R T
7 A(i (
‘18.Transporter 2 Ackn4edgemen
of Receipt of Materials
I 7W14y
p
I
i
-
Year
v u>w v
Month
Signature
Printed/Typed Name
i 9 ii
Month
Signature,,
Printed/Typed Name
I
I
Day
Year
I
I
Day
Y*ar
19.Discrepancy Indication Space
IA
lc I,
20Facihity Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Sign ature Printed/Typed Name
/
(
/‘ ‘1
i2----
Month
____
_______
____
HAZARDOUS WASTE MANiFEST (As Required By The Alabama Department of Environmental Management)
I-lease print or type.
Form Agproved. 0MB No. 2050-0039.
(Form designed for use on elite (7
,
se
rrn
,
P. 0. Box 160 Tie Plant, Ms. Generators Phone 601
4. b.
Transporter 1 Company Name
7.
Transporter 2 Company Name
)
101HD101019181 615181215 US EPA ID Number
8.
I 1i_I 10.
Document NumbeTT,
CWMA
4i3S8E
I
I
I
I
I
I
I
I
L State TICISØOtfC C P.Tranporter’s Phonb
‘i-2
6. State FacllIts ID
US EPA ID Number
‘ , , 205/652-9721,, 219 91B41,
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle.A1abama35459
O
H. Fecifttys Phone
I
1 1., D 01 0,016,21 2 A
12. Containers
ii. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
a.
State Manifest
c. state
US EPA ID Number
6.
Designated Facility Name and Site Address
Federal
State GCnera*bt C
38960 226—4584
Dart Transportation Co.
G E N E R A T
Information in the sht is not required by law.
1
UN WORM HAZAHUOI. WASTE MANIFEST
•
RQ. Hazardous Waste..Solid N.O.S.(K—001) ORM-E NA-9189 CWM Profile NumbeRES_fl_53976
)
No.
Unit
Total
Quantity
Type
010 Ii P1
,
14.
13.
-
-
r
3ø P
b.
I I
CWM Profile Number
-J
I
I
I
C.
v “k,,
CWM Profile Number
I
a--—
I
CWM Profile Number
J.
1
I
I
I I I -J Hendling Codes for Wastes LIsted bO8I’ K.
Additional Descriptions for MaterIals UstfAbove
Work Order No. 88O7.WO2’CrP) 280631 (601) 226—4584 ‘H emergency Contact
a.
:.1S P.O. No.
.
-
‘5-
& ch wh.i ws.t oslrtP: ? ‘, had been added to the above -7e’r cye When handl.ing would prohhi.t it Urorn being 1aid fiLled. protection n’ p’ot ct:ive equipment such as impervious clothing and glove. b.
1Pdi
‘cP4oOI-I)
16
by GENERATORS CERTIFICATION: I hereby declare that the contents of thIs consignment are hilly and accurately described above proper shipping name arid are classified, packed, marked. arid libeled. ard are in all respects iii proper condition for transport by highway according to applicable ntrnational and national government regulations to the degree I have determined lobe If lam a large quantity generator. I certify that I have a progrrirn in place to reduce tire vol nine and toxicity of waste generated available tome which minimizes the present and economically practicable and that I have selected tire practicable method of treatment, storage, or disposal currently to minimize my waste generation arid select future threat to human health and the environment: OR. iii mr a small quantity generntor. I have made a good Iithr effort the best waste management method that is available to me and that I can afford
Signature
‘
/
Month
T p A
0 p r S
18.Transporter 2 Acknowledgement of Receipt of Materials
Year
/19
Year
U
.
17.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
Day
Month
8 P
Day
Month
I Signature
Printed/Typed Name
I I
.1
I
I i
1 9.Discrepancy Indication Space
Year
i.—
)
F A C L “
20.Facility er or Operator: Certification of reipt of hazardous materials covered by this manifest except as noted in Item 19. I Signature Printed/Typed Name 7 ,
it’i o/%’
I
L >‘
-‘
Month
i
Day
1
IJ
HAZARDOUS WASTE MANIFEST (As Required By The A’abama Department of Environmental Management)
for use on elite (12-pitch) typewriter.) 1. Generator’s US EPA ID No.
1DOUS WASTE MANIFEST P. 0. Box 160 Tie P1.ant, Ms.
MISIDI 0101
ö’1 m 012171 5I4I3l0ii
38960 —4 Rd
b.
Generator’s Phone ( 01 ) Transporte1 1 Company 14me
7.
Transporter 2 Compahy Name
9
Designated Facility Name and Site Address
4’
‘
221
-
flart TranspQrtation Co.
us EPA ID Number
6.
-
Form Approved. 0MB No. 2050-0039. Expires 9-30-88 2. Page 1 !nformation in the shaded areas is not required by Federal of •I law.
Manifest
l0lHDlOI0I9l8l 615181215 8.
US EPA ID Number
I I io.
CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marki’r 163 Emelic, Alabama 35459
I
I
1 L A 1 1 D
I I I I’• us EPA ID Number
°I 01
01 6 2
11. US DOT Description (Including Proper Shrpping N8me. Haza(d Class, and ID Number)
2
205/659721
4
12. Continers Nd.
a.
13. Total Quantib.
Type
RQ ITazardo Waste,Solid N.O.S.(K—001) ORr4-E NA-9189 CWMProfileNumbeREs_H_53976
b.
‘I39t:
OlOll
“ 14. Unit Wt/Vo
-“-
-
‘
We
e
CWM Profile Number C.
CWM Profile Number
I
l
J...,
,
CWM Profile Number MuUIiJolIaI
iz
Descriptions tot- Matedals Listedbove
K. Handling Codes for WodteS USt&.
Work Order No. O 88 J 7 021GP) RES P.O. No. 28—0631 :‘
mergency
Contact
-
15. SeciaI Han.!in9lnstrtcj!ons 1 and Additioi
(601) 226—4584 r.oq1t
hr1 been added to the bovn wite hi i.fli
would prohibit it. 1mm be’irig Thnd filled. !ect pnt . 1 pr o 7 protection nr
When handling wear impevious ,ylyth ng and glove
GENERATOR’S t,.cn I irii..ATION: I hereby declare thai the content sol this consigihuent are fully and accuatel described abbve by proper bipping name and are classified, packed, marked, and labeler!, and are in all respects in proper condition for transpoit by highway
16
according to applicable international and national government rejlnlions
-
I cei tify that I havc a program iii Place to reduce the volume and losicity of waste qneralef to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to rue which minimizes the present and future threat to human health and the environment. OR. if lain a small quantity generator. I have made a good faith effort to minimize my waste generation and select If tam a large
quantity generator.
the best waste management method that is available to me and that I can afford Prifjted/JPed Signature
T’yton
1 7.Transpqrter 1 Acknowledgement of Receipt of Materials lirinted/T)PeJ Name
A
I I I I
E R,,,. I
-
-
-
I Signatu/e
18.Trensporter 2 Acknowledgemt of Receipt of Materials Printed/Typed Name
0
/1 :z;: ;’
Month
lO j7
Year 4*
i8
Month
Da/4
Month
Day
/ ( Signature
Year
II II II
Indication Space
-
F A
C L. ‘
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Namel Signature
A
f
J.-’•
Monik Day
YAar
I -
_________ i.
ff’_
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
Hease I
for use on elite (12-pitch) typewriter.) 1. Generator’s US EPA ID No.
iE MANI
Form Approved. 0MB No. 2050-0039. ExpIres 9-301 Information in the shaded areas is not required by Federal I law
of
Manifest Document Number
i
P. 0. Box 160 Tie Plant, Ni. Generators Phone f 601
4.
Transporter 1 Company Name
.
CWMA
38960 1
us EPA ID Number lOIHDIOl09l8I 6)5)8)215 6.
Transporter 2 Company Name
“9E
S.
I I io.
Designated Facility Name and Site Address CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
I
I
I
E. State Transporter’s
I I us EPA ID Number
F. Transporter’s
I
1 L A 1 01 01 01 1 D 612
2
4) 6)4 12. Cont
CWM Profile NumbeflES—Ij—53976
CWM Profile Number
CWM Profile Number
I
d.
I
CWM Profile Number
15.
-
-
-.
•.
-
205/652-972t.. Total Quanttty
Type
00 1 J!
C.
-.
Unit Is, £Ac5lL Wt/Vo
5ij’ibD I
I
I
I
I
—
I
LJJ L
ye
.
_‘
I
IC Handling Codesfor We
sUctedAbov
-
,,Wörk Order No. 8807IS(’GP) RES P.O. No. 28-0631 Eñiergency Contact (601) 226-4584 -
ctni 1 stricpp,s .
C
en?f ddL19II
Iid been added t. the above t•mt wh, cit wouj.d prohibiL .‘i From heinq Jand fiJJed. When handiinq wear eye protection arni proLctiVeqPflt impe u 7 s rv yythin and alove .
rca5
16
GENERATOR’S CERTIFICATION I heroby declare unit I iii contents of I us cniisigriiiiiin t are fflhly and accurately described above by prope, shipping name arid are classified, packed, marked, and labeled. aórl are in alt respects in proØer condilirin for Iraiispoit by highway according to applicable international and national government regulations If lam a taige quantity generator. I certify that I havo a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be and that I have selected the practicable nillmocl of IrCaIrlienI, storage, or disposal currently available to me which minimizes the present and luture threat to human health and thr’ emmvirunhiment. OR. ill ann a sun-ill quantity qeumimr;itni . I have made a good faith elfnrl to minimize my waste generation and select the best waste management method that is available to me and that I can iiffoncl PriEed/yped economically practicable
ton
T R A
1 7.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name —
N
S p 0
R T E R
/1 1 8.Transporter 2 Acknowledgement of Printed/Typed Name
‘.1
Signature
Month
Oat
19.Discrepancy Indication Space
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Name Signature .,
1 ) jt
I
2l9—938—7Q2O,
b.
:‘-
‘j:’
,.
.
‘.‘
RQ Hazardous Wate,Solid N.O.S.(K—0O1) ORM—E N?\— 9 1 89
Aitional Descriptions for Materials Listed
:
.D’
G. State Facility’s ID
No.
t’
C. State Transporters ID D. Trenspotters Phone
US EPA ID Number
11. US DOT Description (Including Proper Shipping Name. Hazard Class and ID Number) a.
:..,•
•.-
226—4584
Dart Transportation Co.
7.
413588..:...
S. State Generators ID
i-fL-
I
j i-i.
Month
Day
Y er
J ,;/
e’ ,...
p•
ij 1-IAZARDOUS WASTE
V
(_N
(As Required By The Alabama Department of Environmental Management)
)int or type.
He&
(Form designed for use on elite (T2.pitch) typewriter.)
fi. Generators US EPA ID No, Manifest 27 5 13 ioirt lrsIDl 001 Addiç
UNIFORM HAZARDOUS WASTE MANIFEST .
e
P 0. Box 160 Tie Plant, Ns. Generator’s Phone ( 601
4. 5
Transporter 1
)
Company Name
Designated Facility Name and Site Address
.
.
I
F.Transfrteisfliofl
I
I I I
I
us EPA ID Number
A
4grn. ,,
.,
,.
,..
G.StatO F
Ij* ID,
84o22
219—
1 L A 1 1 D
°I 01 °l
.
612
&
2
i 614
..
205/652—9721
12. Containers I. No Type
13. Total Quantity
14. Unit Wt/Vo
RQ Hazardous W5t9rSOl1d N.O.S.(K001) 0RM—T NA-9189
E F R
Stat
.
1 1. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
N
‘.
HFaeilIty’s Phone
.
a.
A.Statd M8nlf6t DOcurnem Number
c
at
.
;:.ub0t
us EPA ID Number 101 HDl0I0,9l8I 615181215 8. us EPA ID Number 10.
CHEMICAL WASTE MANAGEMENT. INC ErnelIe Facility Abama Highway 17 Mile Marker 163
Information in the shaded areas required by Federal
1
of
WMA419Z 6
Transporter 2 Company Name
‘-‘-“—
Fomi Approved. 0MB No. 205O0039. Espires 930.08
2. Page 1
38960 226—4584
Dart Transportation Co.
7.
MANIFEST
CWM Profile
NumbeRES—H—53976
‘b.
E
5OILit
01011 J!
1
,
T
0
CWM Profile Number
It C.
CWM Profile Number
I
___,/
J
I III
......L
I I I I
CWM Profile Number
j
Additional Descriptions for Materials Listjbave.
•Z’ndling Codes to?WaSte
Work-Order No. 8807’02(3.P’) ‘ RES P.O. No. 280631 Emergency Contact (601) 226-4584
,
a.
C.,
b.
15. Seci%
iStr
êd
.;‘‘
.
,
‘,‘:‘,
‘
-
.
‘
d.
“, 5,,
anAddIcf’jy9fi
had been added to the ahovt waste which would prohibit ii .Irot heinq land filled. When htndii.nq eye prot’ecti.on and pi nectiv equi.pment çh as imprvious clothing nnd glove wear
.1cffoflU’fc-i)
—
16
GENERATOR’S CERTIFICATION: I hereby declare that the contents of this ci nsigninenl 5 e fully and 5 ccurately desc ed above by proper shipping nare and are clnsiIied. packed. marked, tind labpled. and omm all respects n proper condrlion,for transport by highway according to applicable internatiorilit and natibniil government regulationsl ‘
lam a large quantity gerieirioi. I certify that have a program economically practicable and that I have snlrrcted the practicable future threat to human health and the environment. OR. ill am a the best waste management method thai is available to me and
Pted/jFyPedNIro,fyt T p A N
,
ri place to reduce lire voluirre and toxicity of wCsle qnrated to tIre degree I have determined to be method of treatment. storage, or disposal currently available tome which minimizes the present and sniill quantity generator. I have made a good faith eftnrt to minimize my waste generation and select that I can afford
Signature
—‘-...
./, /
17.Transporter 1 Acknowledgement of Receipt of Materials
Printed/Typed Name
,,,,,,
Month
i- ioi’ i 7
Signa
T E
Printed/Typed Name
i
of Receipt of Materials
I
P
biscrepancy Indication Space
fr-*
-
Month Year
P
lpoe1
S 0 It
Year
Signature
I
Month
Day
Year
11111!
F A
T
V
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Name J/I signature— ,
ff’
Month II
Day
-
______
____________
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
UNIFORM WASTE MANIFEST P. 0. Box 160 Tie Plant, Ms. Generators Phone ( 601
iilsL 0101 7 012171 5i4,3,0i5i91
Of
.1.
A state MãnhfOSi Doourneiit NIiàab
i9Iv.ij øWM4 ätêr*tO
; B
38960 I
$
.yç-
226—4584 US EPA ID Number
6.
transporter I Company Name
4
IOIHIDIOIO 98 6151812,5
Dart Transportation Co.
7.
Transporter 2 Company Name
8.
US EPA II) Number
W
Designated Facility Name and Site Address
io.
US EPA ID Number
i_i i
I
I
I
I
-r.
.i
-‘-.
i*lI
‘-‘
‘
E. S1tê : F. TrenSpDers Phone, ttye1D:..;,i, G.StefoFadli H. FaciIitys Phbns
A L 1 Dl
01
0 0 62
,
-
O5f652921
2 41614 12. Containers No.
Type
13. Total Quantity
CWM Profile Number
II
I
1111
CWM Profile Number
IIJIIII
CWM Profile Number
I I
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number) a.
Tie
‘,
j
CHEMICAL WASTE MANAGEMENT, INC Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
G E N E R A
Information in the sha is not required by law.
2. Page 1
Manifest
Addqe
3.
4. 5.
Form Approved. 0MB No. 2050-0039. Expires
(Form designed for use on elite (12-pitch) typewriter.) 1. Generators US EPAID No. HAZARDOUS
I-lease print or type.
14. Unit Wt/Vo
RQ Hazardous Wste,Solid N.0.S.(K—00l) ORM-E NA-9189 CWM Profile NUmbeRES—H—53976
0.
T 0 R C.
d.
L
Additional Descriptions tor Materisis List
._L_
I I I I
I
K. Handling Codes tai WasteS
-‘
work
Order No. 8807ZTSfy RES P.O. o. 28—0631 (601) 226-4584 nergency Contact -
h a ri be en added l-o the aiove w’ste wtI1 When handling wear eye i I- F rorn bi ng land f Illed. pro-ecLhie eal1.iprnnt such as im ervious clothinq and glove
ctp4s an 4dd!Tp Wc ns r T5. S écitnliiq- t 9
would pt’chiH proction ‘it3 ‘
16
fR RR f ZDf
fc-/’
GENERATOR’S CERTIFICATION: I hereby declare that the content of this consignment are fully and accurately scribed above by proper shipping name arid are classified, tiackerl, riiarlced, anrl labeled, arid are in all respects ii proper condition fpr transport by highway according to applicable international and national government eguletiohs If tarn a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined lobe and economically practicable and that I have selected the practicable method of treatment. storage. or disposal currently available tome which minimizes the present future threat to human health and the environment. OR, itt am a small quantity generator. I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me tmnd that I can afford Year Month Day Signature
T
17.Transporter 1
A
Printd/T
a
Acknowledgement of Receipt of Materials Name
f
.
,,j)
Signatuee
Month
Signature
Month
Year
.
1 8.Transporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name
0
Day
1111
Year
1,1—’
19.Discrepancy Indication Space
-
20.Facility Owner or Operator: Cetificalon of receipt of hazardous materials covered by this manifest except as noted in Item 19. rrinlea, lypea Nom 4 Signature 4,&’
Month
Day
V Ør.
i
_______
_________
___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ _____ ___________ ________ ___________ ___________ _____ ____
:
CIwmr.iI W.is’
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
(Form designed for use on elite (12-pitch) typewriter.)
print or type.
UNIFORM HAZARDOUS WASTE MANIFEST
Form Approved. 0MB No. 2050-0039. Expires 9-30-88
1. Generator’s US EPA ID No.
4 lDI UI UI
Manifest Docume
f 2171
2. Page 1 ,
41 ‘Ifl I fli U
4.
kansporter
5.
I
Company
Transporter
.
Designated
2
Company
Name
6.
and
Alabama Highway
a.
E N C A
by
areas
Federal
.
Site
I
US EPA ID Number
Address
I
I
I
10.
I
I
I
I
I
I
I
..‘..
INC.
17 at Mile Marker
.H.Facilltys Phoió
163
35459
US DOT Description
A
I I
L
D
0
I
I
0
I
0
I
6
j 2 416 4
2
12. Containers
(Including Proper Shipping Name. Hasard C/ass, and ID Number)
No.
,
‘.2O5/652a972j: 13. Total Quantity
Type
1.j
14. Unit
‘‘
Wt/Vo
RQ Hizardous Wastc,Solid N.O.S. (K001) ORM—E NA—9189 CWM Profile
b.
NumbeRES_H_53976
010 Ii Ji cckc
p
1’
0 R
CWM Profile Number
I
L
I
I I
_L
I
I
,,_..j.__,_
I
I
C.
CWM Profile Number
I
I
—I,
i:’
I
CWM Profile Number
O0fliOflSI Descriptions toi’ Mateflals
1
List
Woric Order No. 8807(eP)(i RES P.O. No. 28-0631 Emergency Contact (601) 226-4584
I
I
I
I
K. Handling Codestor Wastes UStedAbo’!’..
—
.t-’.
a.
b. 15 Secl
d.
a
had been added to the aboqe whi.c h would prohibit t from being land fi] led. When handling wear eye protection and protective equipment such as impervious clothing and glove
15
P/
c.
R
-
now
rc--
1)
GENERn.TOR’S CERTIFICATION: I hereby declare that tire contents 01 hits consignmtrnl are lully and accuratel described above by proper shipping name and are classified. packed. marked, and labeled, and are in all respecls in prop’er condition for Iranspuit by highway according to applicable international and na(ionl government regulations. If lam a large quantity generator. I certify that have a program in place Icr reduce tire volume and toxicity of waste generated to the degree I have determined lobe economically practicable and thai I have selected the practicable method at treatment. slorage, or disposal currently available to me which minimizes the present and future threat to human health and the environment. OR. ill am a small quantity generator. I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford flIed ed,tfl
Month/tr,t
1 7.Traj,sporter 1 Acknowledgement
Receipt
of
Materials
Signature
Name
Year
U?
Receipt of Materials rrtntea/ I ypeo
Year
U ‘1 of
Month
Month
Day
Year
111111 pace
materials
covered
Signatur
coa
C,.,,,.
e,rrn’v,
I
I
US EPA ID Number
•.
G
shaded
Facility
Emelle, Alabama
11.
the
US EPA ID Number
8.
CHEMICAL WASTE MANAGEMENT. Emelle
in
required
IOIIJDIOIOI9I8I 615181215
Name
Name
not
38960
I Facility
,S
226—4584
Dart Transportation Co. 7.
Information
1
law, A State ManliOSt Document Number
Addr
P. 0. Box 160 Tie Plant, f1s. Generator’s Phone ( 6 01
of
in....
n____.,_
by
this
manifest
except
as
noted in Item 19. Month
Day
____ _______ cv’/
•
____________
WASTE MANIFEST
HAZARDQUS
(As Required By The Alabama Department of Environmental Management) (Form designed for use on elie 12.pitch) typewriter.) 1.Generator’s US EPA ID No. iruiii4 HAZARDOUS
f-lease print or type.
N1sDIoIo7oI2I7I5I43I0i51u1%t
WASTE MANIFEST 9tjp 1 am
P.
Manifest 1,
raaiec
Fo Appved, 0MB No. 2050-0039. Expis 9. Information in the shadid areas 2. Page 1 is not required by Federal 1 of .1. law. A. State Manifest DoCument NumbBi’s
Box 16()
0.
Tie Plant,
eat6D
3B60 226 4584
4. 5
Generator’s Phone ( 601 ) Transporter 1 Company Name
Dart Transportation Co.
i0i1Di0i0i9i8,6i5i8i2i5
7.
Transporter 2 Company Name
8.
US EPA ID Number
Designated Facility Name and Site Address
10.
US EPA ID Number
6.
.l,
US EPA ID Number
I
j
-
I
,. ,
962O _4._
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
H.Facillty’s Ph6ne
I
1 L A 1 D 1
01 01 01 6
11. US DOT Description tincluding Proper Sh,ping Name. Hazard C!ass and ib Number)
2
2
I
6 4
.
a.
RQ ITaardous
-
-
-
14. Unit Wt/Vo
13. Total Quantity
Type
lNo
--‘
205/652-9?2I
12. Containers
riI
‘
-
‘.
te,o1id N.O.S.(K—001)
ORM-E NA—9189 CWM Profile NurnbeflES—H—53976
010 ii DiT
-S1L I IIb__4’I
—
b. 0
CWM Profile Number
A C.
CWM Profile Number -
CWM Profile Number Descriptions br
Listed Above
k 880719029
15.
I
I
I
I
L
I
I I
-—
I I I I J K. Handling Codes for
j
-
Wastes Listed Above
.1,4
Work Order No. a. C. RES P.O. No. 28-0631 226-4584 iergency capt-b. d. I’4- i’ R i fr-I ‘C/” fI”4j\ SeciaIntIip strc . and 9 1 .AdditQçt çups ha1 ‘heezt ‘arded to tile above wn I n wn 1 I1 being land filled. When hawili.nq ilear :‘ye woitid prnhih t ri’ohr’tc;1:ive imprvious clothinq and q)ove such as equipment protecf’i.on and
r
-
‘
16 GENERATOR’S CERTIFICATION: I hereby declare that tire contents of this consignment are buy and accurately described above by proper hipptng name and are classified, packed, marked, and labeled, and art) in all respects in prope cond lron for transpoil by highway 1 1 according to applicable rmernationl and nationt government reputations: llama large quartity generator, I certify that I have a program in 1)10cc to educe the volume and toxicity of wasl generated to the degree I have determined to be economrr.ally pacticable and that I have selected tire prectcxbIe method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health ar.d the environment, OR. if lam a small quantity generator. I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford. 4 Signatd Month Day Year Pr(1ted/&PedNr,ey
t:on
—½ T R A N
S P 0 A T
.—‘
/7
13.’ranspprter 1 Acknowledgement of Receipt of Materials Name
.thv’d
,
ri 11 II 9
L—” /
Signatu,re
j
//,_JJ
A.”/ 2 ,11,’c
1.Transporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name
0
“‘
(
f
/>“
Signature
E A
Month
10
Day
Year
17 1119
Month
II
Day
Year
IlIfr
1 9.Discrepancy Indication Space F A
T V
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. I rifltd/Typed Name Signature) (-. ) ] I— 1.1-’-I..-’
Qf
y
/
( i/ / (,( 1 ///
ç
Month
i/il
Day
Year
i.JO)i
)
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
-
(Farm designed for use on elite (12.pitch) typewriter.) HAZARDOUS Ti. Generator’s US EPA ID No.
MANIFEST 1t?
Manifest
hilsiL) 10101 7i 0i2 I? I5i4i3
4.
P. 0. I3ox 160 Tie Plant, Ms. Generator’s Phone (601
5.
Transporter 1 Company Name
7.
Transporter 2 Company Name
W
Designated Facility Name and Site Address
$)1T7!I
Form Approved. 0MB No. 20500039. Expires 93O-88 I Information in the shaded areas is not required by Federal of 1 law. A.’ ‘e Maflltest.C 2. Page 1
I
3890
226—45 84
I
us EPA ID Number
6.
Dart Transportation Co.
IOIHIDIOIO 1 2 5 6 i 8 I 9
us EPA ID Number
8.
I
I I
I
I
10.
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
I I I us EPA ID Number H.
-
LL
1 01 LI D
j 01 0
2O5I652-
6
13. Total Quantity
1 2. Containers
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
No.
Type
PQ Jiazardous Waste,o1id N.O.S. (K—001
B
ORM-E NA-9189
ck9i() 2
010
P.
CWM Profile Number
I
I
I
I
I
I
CWM Profile Number
I
I
I
I
I
I
I
I
I
I
I
I
CWM Profile NumbtRES—H—53976
DIT
b.
C.
CWM Profile Number J., MItIOflhi uescrtpuons to,
atenats jsteg P.oove
Work Order No. 880719029 RES P.0. No. 28—063]. (601) Emergency Contact -
226-4584 b.
i-
i. I-
16
I
d.
wh I sI 1tit’l ben aJded to the above Then hanril i.nq wear eye I a-nm being land f 1 J.e . such as impervious c).othi rig nd glove.
cjddi 9 9 .pstrJition a 15. SeciaI He,Ii
wo”ii prohiIi t prnt-ect ion iad
I
K. Handling Codes for Wastes Listed i.
“
atr.icfmjj9n
1< 1-s C / :i 30LJC1 (c
-
I
GENERATOR’S CERTIFICATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked. and lapeled, and are in all respects in proper condilioçi for transport by highway according to applicable international arid national government regufation Ill am a large quantity generator. I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment. OR. ill rim a small quantify generator, I have made a good faith effort to minimize niy waste generation and select the best waste manaoement method that is available to me and that I can afford.
signature
Pjnied3YPedmeyt,.
Month -
‘r
R A N 0 R t E
17.Transpqrter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
-‘-.
Day
Year
V V
Cl
L.—’ Signature
Month
Day
Year
I Signature
Month
Day
Year
—“‘
1 8.Trensporter
Acknowledgement of’ Receipt of Materials
Printed/Typed Name
R
liii II
i
(,,_)iscrePencv Indication Space F A
C
I. .
20.Facility Owner or Operator: Certification of receipt of hazardous materials Covered by this manifest except as noted in Item 19. rid/Typed Signafu
/.(/)/
-
“%I
Sn...
4)/J)5
/(ai/ I
/)/A
Month
Day
Year
--
Clii’r,,c.iI
W.ite
>
E MANIFEST HAZARDOUS WAST Department of Environmental Management) (As Required By The Alabama
I-lease print or type.
(Form designed for use on elite (12-pitch) typewriter.) I 1. Generators US EPA ID No.
UNIFORM HAZARDOUS WASTE MANIFEST
Addrp.
eq
3.
P. 0. Dcx 160 Tie Plant, tls. Generators Phone ( 601
4. 5.
I
m SIDI 01 Ui ,1 01 2171 51 41 3l01°ö1
US.EPA ID Number
6.
Dart Transportation Co.
101 1DIOl0I9l8l 615181215? US EPA ID Number
8.
Transporter 2 Company Name
10.
Designated Facility Name and Site Address CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Eme)le,AIabama35459
I
I
I
I
I
I
Ii ii...,
1 Dl Oj 01016121 2 A L 1
I J_ 4 I 6 12.
RQ Hazardouts WasterSolid N.0.S.(J*001) ORN—E NA—9189 CWM Profile NumbeREs_H_53976
A T 0 R
IC
US EPA ID Number
11. US DOT Description (Including Proper Shipping Name. Hazard Cless. and ID Number)
a.
tte Mölfest DóoUment
3960 226—4584
)
Transporter 1 Company Name
7.
Form Approved. 0MB No. 2050-0039. Information in the shaded areas 2. Page 1 is not required by Federal of law.
Manifest
• a.
S
No. f1
Type
Total Quantit
oio a
I2J3.
giiiC
b. CWM Profile Number
I
I
CWM Profile Number
I
I
CWM Profile Number
II
I
14. Unit WtJVo
£
I
I
C.
Jz, Additional Descriptions for Materials Listed Above.
Work Order No. 88071902Q RES P.O. No. 28-06U Emergency Contact (601) -
a9
qIl.atz9n
I ptch i hi he i rotertit,n irtr rirc’’;tive
woiiJji
16
226—4584
I
I
I
I
I
K. Handliflg Codes for Wastes LiSted i a.
C.
b.
d.
h3d been z’dded to the ,o wt-c -1ii ch inn f.i 1 1 When nnc1 11 n’w’ r T11pmen t Slid) as .i pevicus c1 othing Fjn1 ?r7Xf f’’ \
ni
q)
GENERATORS CERTIFICATION I hereby decibre that tim contents of this cniisqnmrrlrt are f[iliy and accurately descri d ah b proper Shipping name and are classified. packed. marked. tind lebeleit. end are iii all respects in proper condition for transpoit by highway according to applicable iniernticirtbl intl nitinii;rl clovernnieril rei,latirins, be fl am a large quantity generatnr, I certify that I have ti tiroqra!ii iii pttic lii rieliii:e Iii: voltittie anti toxicity of wOstO rj,ni,r,itnd to tin— degree I have determined to present and economicaflypracticable and that I trove selected the prcticablc method itt treCtirielit. storage, or disposal currently availat,Ie to me which minimizes the generation and select future threat to human health and the environment. OR. ft run a titi;illqutuiitity genirr;utor.l have made a good faith effoi Ito minimize my waste the best waste manaoemenl method that us available to me and that I can afford •.
Month
Sg nature
.a T R
A
A T
(h -)
Day
Year
I di d
17.Transporter 1 Acknowledgement of Receipt of Materials P ‘nted/Type
i 7 /%
7’
IJame
J/L’’-c MknowIedderent of Receipt 18.&O42
Month
ih
Day
Year
I di
of Materials
I I
Printed/Typed Name
S
ft
Month
Signature
Day
11111
1 9. Discrepancy Indicadon Space
Year
( )
F A
C I. ..
20.Facility Owner or Operator: Certfication of receipt of hazardous materials covered by this manifest except as noted in Item 19.
P ‘nted/Typed Name
/.
/////
/ / / /)/1,
Month
I Signature
I
/‘i
t ;‘
Day
Year
i 7 6 i i
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
t
or type.
(Form designed for use on elite (72-pitch) typewriter.) viruiiM HAZARDOUS T’i. Generator’s US EPA ID No.
WASTE MANIFEST
myp Add
4. 5. 7.
‘
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone ( 601
-
Manifest
I N1SIDjOl0I’I 0L2!71 51 4l3I0OOfm.O
A
A1i’J
38960 226—4584
1
Transporter 1 Company Name
6
Dart Transportation Co.
US EPA ID Number
1
I0I1DI0I0I9l8I 615181215
Transporter 2 Company Name
8.
US EPA ID Number
I I
Designated Facility Name and Site Address
I
10.
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
1 LI D A 1
I
01
I
I
US EPA ID Number
2
0! 01 612
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and 10 Number)
4
I 4
12. C ,
-
1.
No.
‘
a.
Form Approved. 0MB No. 2050-0039. Expires 9-30-88 I Information in the shaded areas 2. Page 1 is not required by Federal of law. 1 1 A. State Maflhfest Document Number
Type
TotI Quantity
IJ’tit WI/Vo
•
,,.
ROTlazardous Waste,Solid N.0.S.(K—001) r)RN—E NA— 9189 CWM Profile
NumbeRES_H_53976
01011
b. 0 R
CWM Profile Number
I
C.
I 7iC J 4 J.T 5i ......L._
CWM Profile Number
I
CWM Profile Number
II
Adamonal Lescr,puons tot Materials usma ove
,.J.
-
-
15.
I I
II
I I
II
K. Handling COdes
Work Order No. 880719029 RES P.O. No. 28-0631 Emergency Contact (601) 226—4584
I
tOr
a.
C.
b.
d.
-
S e 1 cinl strQ an
would prohih t it
protection and
d been added to the above waste Which riorn being lanitill.od_ When handHng war eye oetive,, eqip- such as impervious clothing and glove.
R
1<
(• / /y
16 GENERATOR’S CERTlFlCATI0N I hereby declare that the cdntents of ties consignment are fully and accurately described above by proer shipping name and are classified, packed. marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulittionk
,
Ill am a large quantity generator, I cerufy that I have a program in place to reduce the volume and toxicity of wCSte generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me wf,icfi minimizes the present and luture threat to human health and the environment. OR. ill run a small quantity generator. I have made good faith a effort to minimize my waste generation and select the best waste management method that is available to me rind that I can afford
Signature
Month
Signature
Month
I
Ij /
,,,.
/
Day
Year
111111
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. -.-‘ rrited/JYped Name Signatu,e j j — ),, , k ,‘ /1!) / C ü .
KL
Year
II
18.Transporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name biscrepancy Indication Space
Day
Month
114.
-
Year
Ii
1 7.Transpàrier 1 Acknowledgement of Receipt of Materials Printed/Typed Name
bstL(s
Day
/
Month
Day
Year
i1 j,2 1 S
_______
___
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
Fo Apped. 0MB No. 2050-0039. Expires 9 O,fl 3 , Information in the shaded areas 2. Page 1 is not required by Federal of law A State Manifest Document Number,..’.,
tic, use on elite (72-pitch) typewriter.) 1. Generator’s US EPA ID No.
4. 5. 7.
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone ( 6 01
CWMA )
30960 226 4584
6.
Dart Transportation Co.
l0lHIDl0l0I9l8l6l5I8I2
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
US EPA ID Number
I
I
D
L
0
0
I
0
I
6
2
13. Total Quantity
1Z. Containers “
Type
No.
14. Unit Wt/Vo
!4,> .5
RQ Hazardous Waste,Solid N.O.S.(K—0Ol) ORM-E NA-9189
E N E
‘
2
11. US DOT Description (Including Proper Shipping Name. Hasard Class, and ID Number) U
I
.
H. F8culity’ Fhone A
I
!Tt4.
11111111
10.
Designated Facility Name and Site Address
‘
‘
I
US EPA ID Number
8.
liii 9
‘:
US EPA ID Number
transporter 1 Company Name Transporter 2 Company Name
41 3? Li
e.Gn&atorS IOç5.
:%‘
-
q’
5LcIolI.C
010 ji
CWM Profile NumbeRES_H—53976
b CWM Profile Number
L
I III
CWM Profile Number
L
I III
C.
d.
i’4 j’ ..5
CWM Profile Number
liii. _J._. IC. Handling Codes for WasteS listed AboetS
II
J.. AaitlOflaI Descriptions for Matenals LIste Above
Work Order No. 880719029 ‘RES PaO. No. 28-0631 ñiergency Conta
pr nlt’i hi. 1. :t.-1 prntect.ion and p 1(1
)
c
b. ‘
hc1 been dt’JeJ to the ;hovE’ wa t:e wh rh 1 ‘Vd When hndi inq wety eye hej nq i’in’1 I Ofl alove. impervious cloUiing as l-r!cive equipment such
s ag AdditioI, nstrJ Q 1 t 15. Sectai l1a9dlt, 9 WOlf
aOI
fPIon
r
and
consignment are fully and accurately described above by 16 GENERATORS CERTIFICATION: I hereby declare that tire contents of this 7 for transport by highway and are it all respects in propr conditro proper shipping name and are cIasified. packed. marked, anti laeled. according to applicable international and tialionl government requtstion lobe volume and toxicity of waste goner .,ted to lhe degree I have determined If I am a large guantily generator. I certify that I have a program in place to reduce the storage. or disposal currently available tome which minimizes the present and economically practIcable and that I have selected the vacticabfe method of treatment. select generator, I have made a good faith effort to minimize my waste generation and Itilure threat to humanheatth and tire environment, OR. ft am a small quantity afford the best waste management method that is available to me and that I can Year Month Day Signatur Prnteded,.t — 0 ‘) ,.
I R A N S p 0
1_I
L_—”
1 7.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
Signatur
.
e42
,4/7/cj / ‘ ,4 A / C 1 8.Transporter 2 Acknowledgement of Receipt of Materials
Day
Year
9
p Month
Signature
Printed/Typed Name
Month
Day
Year
JlII() .
1 9.Discrepancy Indication Space
F A in Item 19. 20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted — Signet r) rintd/Typed Name
fC’flJ I,
I
1
Month
:
Day
c 2 1 7
Year
_____________________________________ _______________________ ___________________________________________________
r:KAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
(Form designed for use on elite (12-pitch) typewriter.) 1 Generator’s US EPA ID No UNIFORM HAZARDOUS
li-i print or type.
WASTE MANIFEST
SWI
Addrps.
:3. Box
0.
P.
01
I
33960
ris.
5. 7.
Transporter 2 Company Name
8.
W
Designated Facility Name and Site Address
10.
226-- 4584
6.
Transportation
Dart
3loo6m1
A. State Manifest Document
Generator’s Phone ( 6 01 1 Transporter 1 Company Name
4.
41
01 2171
Form pproved. 0MB No. 2050-0039. Expires 9-30-68 Information in the shaded areas 2. Page 1 required by Federal of
160
Plant,
Tie
01
Manifest
US EPA ID Number
l0IHDI0I0I9l8I5I8l2I5
Co..
E Suate Tanepoitet S ID
US EPA ID Number
I
I
I
I
I
I
I
I
I
I
US EPA ID Number
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
H. Facility’s hA1&--
2O5/6$29ti
2 41614 6 0 D L A 1 12. Containers 11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number) No. Type 5
E N E A T 0 p
a.
RQ
Hazardous
ORM-E
Waste,Solid
14. Unit Wt/Vo
13. Total Quantity
,
.
-
N.O.S.(K-O01)
NA-9189
CWM Profile
01011
fliT
6’Qii/ I. •‘‘f
i(
b. CWM Profile Number C.
IL
CWM Profile Number
-‘
I I
-4.
CWM Profile Number .3.
nuu.inn,a,
wcsnn ip.an. tot Jyraja. laiD LiSted
A
Emergency
Contact
-
a. .çs,
(601)
I
I I
I I I I J K. Handling Codes for Wastes Usted AbQS
ye
Work-. Order No. 8807 • kES P.O. No. 28-0631 •
L
226—4584
.J(
b.
.
C.
d.
and Adthtio lrkjrrrt iop 1
wonl.d proli.thit protection Dncl 15
ii-
r
had been added to the shove wrtte which When hartdl.inq wear eye fiorn }winq land f.11ed. ious cJ othi.ncT nd glove 5 tch as iper 4 ,
GENERT0RS CRTIFlCATtON: I hereby declare thai tire contents of this consignment are tulty and accurately described above by proper shipping name and are classifipd. iacked. marked. nd labeled, and are in all respects n proper condition for transport by highway ovi’rrimirrrt regulations 1 according to applicable Trier rational and ruitirurul i Ill am a large quantity generator. I crtif’ iliat I have a f)rograin ifl 1)10CC to TCdiICi) the volume and toxicity of waste generated to The degree I have determined tobe economically practicable and that I tiavi. selected the practicable method of treatrirvi.!. storage, or disposal currently available to me which minimizes the present and future threat to human health and the environrilent. OR. ill urn a small quantity generator. I have made a good laith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford
Prted/YPedl!reyt
T
B Year
Month
Signature
Lt-19--R 8
$4 5 0
MonthQ
(,,../
17.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
:
Signature
18.frensporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name
V I
‘N 19.Discrepancy Indication Space 2
Year
Day
Month
Signature
I
I
I
I
F
A
.
‘‘
20.Facility Owner or Operator: Certificatioit of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed N roe Signature
/1 “-S
fl..5
A
Month
Day
Near
IJ,A)
______
___________
____________
_______
•0
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management) (Form designed or use oh elite (1 2.pitch) typewriter.)
IFORM HAZARDOUS WASTE MANIFEST
Form Appwved. 0MB No. 2050-0039.
1. Generator’s US EPA ID No.
HSIDI 0101
‘
2 Page 1
Manifest 0 urn ntN
012171 51 41310 lI 21??
Information in the shaded areas is
of
not
required
by
A. State Manliest Document Number
P. 0. Rox 1E0 Tie Plant, Ms. Generator’s Phone 1 601
4. 5.
CWMA 4123 Genrtór’s ID,
6.
US EPA ID Number
c.St V
Transporter 2 Company Name
8.
Designated Facility Name and Site Address
10.
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
US EPA ID Number
I
I
I
I
I
I
I
I
ID
“
‘
H.Facillty’ Phone A L 1 1 DI 0101016121 2
41614 12. Containers Type
13. Total Quantity,
01011
p1
c”o
CWM Profile Number
I I
-J-
CWM Profile Number
I I
No.
•.
14. Unit Wt/Vo
f”
‘
I
PQ Hazardous Waste,Solid ?‘LO.S.(—00l) ORM—E NA-9189
N E A
I
US EPA ID Number
11. US DOT Description (Including Proper Shipping Name, Hazard Class. and ID Number)
a.
pãrte?
101HD101019181 615181215
I
0 E
‘,,.
-
226 4584
)
Dart Transportation Co. ‘W’
.
BState
38960
Transporter 1 Company Name
7
Federal
law.
CWM Profile
NumbeRES—fl—53976
.
1’ 0 R C.
0.
CWM Profile Number
I
JAdditional Dóscriptions for MbteiiCls lJsted A
Wérk-Order No. 8807 RES P.O. No. 28-0631 Emergency Contact i601) —
‘.‘70U1c1 pUOltJ 1-ri protection mc9
I
I I I I _,_j..,...
i
—
I
:
‘
K. Handling Codes for Wastes Listed Abóe a.)f
c.
b.
d.
226—458.4
(PEgC?24(-/))
9Jcf\oI anJ, ddi;lp t 0s
I
1ñ”t Ue boy e w—’t L e wit i cii rcrm hinq lnncl fi ‘I J.od !“lhen hndIi n ‘r ce t ptol octive ipment such as impervious olot.h.inq and qiove. 9t?a1ip, fr’tr
rrr
.
‘
GENERATOR’S CERTIFICATION: hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for tiansport by highway according to applicable international and iatioral government regulations
16
P I am a large quantify generator. I certify I fiat I have a tir Cyril iii iii pince to r nilni;’, II to vol ii ice and toxicity cit wCst ci gene, atnd to tire tlegr no I have deter mined to be economically practicable and that 1 liavp sidecleri tIm practicable nilliiid of treCtii’irirf. ctorage. or disposal currently availtile to roe wInch minimizes the present and future threat to human health and the environment, OR, ft ant a smelt quantity generator. I have made a good faith effort to nr,nimize my waste generation and select the best waste management method thi5t is available to me and that I can afford
Signat,,,,7
Pedqreddljmaeyton T R
A
0 R
17.Transøorter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
H
Month,
I4
-.
I Signature
:j
17 I’’
Year
U
Month ‘) Year
18.Transporier 2 Acknowledgement of Receipt of Materials
I I I
Printed/Typed Name
E
R 1 9.Discrepancy Indication Space
Signature
Month
Day
Year
11111
)
.
F A C L ..
‘
—
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/T d Name n 9 JSi /
J/
,.-
Month
Day
Ye4-
_______ ____
___
______
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management) I-
print or type.
(Form designed for use on elite (12-pitch) typewriter.)
I
UNIFORM HAZARDOUS WASTE MANIFEST
Form Aeproved. 0MB No, 2050-0039. ExpIres 9-30-88
1. Generator’s US EPA ID No.
I
0
Manifest
4l3Ioi0OimO1l
012171
rntLIIp k00rC
.
o. Box 160 Tie Plant, Ms.
3960
Generator’s Phone ( 601 Transporter 1 Company Name
7.
-
a.
A T
101H1D101019181615181215
Transporter 2 Company Name
8.
I
10.
US EPA ID Number
I
I I
I I I
F.iiOYteesPhonHe
NL
J
Work.,Order
‘
.“
,.
.
13L$U’Ø
I
1 L A 1 Oj
01 DI
01 61 2
614 12. Containers -
No.
Type
13. Total Quantity
CWM Profile Number
I I
L
CWM Profile Number
I I
-J
111L
I
J...,.
I I
No. 8807 RES P.O. No. 28-0631 Emergency Contact (601)
---“-
-
Unit
,.
‘;rn.l ti
Wt/Vo
it,iO 9 5ili
01011
d5°
.
‘-‘
205/652-9721
2 4
CWM Profile Number Additional Descriptions for Materials Us
,
G. StSte FltIty’s ID
H.FeCilIty’s Phdne
C.
I
-
—.
Dt*$Phofle
b.
R
-
EataflspotersJD
US EPA ID Number
RQ Hazardous Wiste,So1id N.O.S.(K—001) ORM-E NA—9189 CWM Profile NumbeRES_H_53976
0
.-
‘;L
Dart Transportation Co.
-
C
.—
US EPA ID Number
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
N E
.
.
6.
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama l-lighway 17 at Muir Marker 163 Emelle, Alabama 35459
0
-
‘
226—4584
Designated Facility Name and Site Address
W
of
-‘:cWMA. .4 I 2.36 8 s.taw Ginerators to’;
P. 4. 5.
I Information in the shaded areas I is not required by Federal Ilaw. A. State Manifest Document NUmber
I 2. Page 1
I I
I I
I I
.
K. Handling Codes forWestôsLb,
-
-
-
226—4584 b.
15. Sped
d.
‘-
wh.i ch. added to the nb4’vp would prohiH t. it. frrin bei iig land f lied. When hand.l mg wear eye prot-ection and prective equtpnent such as impervou clothing and 9Ijn!1psir
PIi 1 C f f -zfn U 1
qiove.
16 GENERATORS CERTIFICATION: I hereby diclare that thoniirts of this coiisig iiiT1are fully aid accurateiç described above by proper shipping name and are classified. pncked. marked, nd labeled, and are in all respects in proper condition for Iranspoit by hqhway c&ding to applicable iniernational and nalionl government regulations
fl am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined lobe economicatlpracticable and that I rave selected the practicable method of treatment, storage, or disposal currently available tome which minim.zes the present and future threat to human health and the environiiienr, OR, It am a small quantity generator. I have made a good faith effort to mnni,ze my waste generation and select the best waste manaoement method thaI is available to me and that I can afford
Signature T
Mont,
:2D
,
17.TranSporter 1 Acknowledgement of Receipt of Materials Prp*ed/T pa
Name
Signature
Mont
I 0
Year
g g
1 8.Transporter Z AckncvIedgement of Receipt of Materials Printed/Typed Name
Year
h,Dö
g c7’
I Signature
Month
I I
C
Day
Year
111111
)19.Discreianci Indication Space 1 F A
C I.
. ‘
—
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Name Signat,.
T(j
‘
I
,
.14::-
--.,/_—-
Mont,))ay
I
I
-
I
Cli’mic.il W,,sl, .icli.mtlnl.J
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
Form pproved. 0MB No. 20500039. Expires
(Form designed for use on elite (72’pitth) typewriter.) 1. Generator’s US EPA ID No. UNIFORM HAZARDOUS
I’Iease print or type.
WASTE MANIFEST
i.
4, 5.
ep
LISIL)I 0101
012171
P. o. Box ]60 Tie Piant, ‘3S.. Generator’s Phone 601 )
of
38960 226—4584
Transporter 1 Company Name
6.
US EPA ID Number
101 IDl0I0j 918161 5181215
Transporter 2 Company Name
8.
uesignatea i’acility Name and Site Address
US EPA ID Number
1111111111
us EPA ID Number
10.
CHEMICAL WASTE MANAGEMENT. INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
F. Trnspon .
A L 1 1 01010161212 4j 614 1 D
state
205/652-
12.Containers
.—.—
1 1. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) ‘
.No.
.
.
G C N C R A T 0 R
1
A. S!etO Manifest Ooóument
I .
Manifest
4I3Ioio6mLIo/
Aadrrj(.
Dart Transportation Co.
7.
‘
Information in the shaded a is not required by Federa’ law.
2. Page 1
Type
13. Total Quantity,
U Wt/”d
te,So1id N.O.S.U—001)
RQ Raardous T ORf—E Ni\—9189
CWMProfileNumbeRES_Jj...53976
01011
b. CWM Profile Number
I I
CWM Profile Number
I
!JI DriiL .....L..
.E’
I I
C.
CWM Profile Number 3,
tOl’
Work’ Order No. 880’Za RES P.O. No. 28—0631 (601) Emergency Contact —
15.
I I I .1...... K. Handling Codes fOr WaStes L..._ a.
C.
b.
d.
226—4584
ad ‘‘ri ridded t:o t.he abov “te :1ii ch When handlinq wear eye filled. land wc’i1d prcThi.}’tit: i [ f’roin bei nq lmpervieus clothing and glove as such prLectiv euipinent prcecion nd
fPP/ ?Oo(-I
-.
16
I I
Materials Uste AQ
I I I
GENERATOR’S CERTIFICATION: I hereby declare that the content of ths consinnienl are lully and accurtely described above by proer shipping name and are classified, packed, marked, and labeled. and ore iii all respects in proper condition for transport by highway according to applicable internationat and national government regulatibns. Ill am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined lobe economically practicable and that I have selected the practicable method of treatment storage, or disposal currently available to me wfiich minimizes the present and future threat to human health nd the environment. OR. ill rim a small iluiinlity gener;itor. I have made a good faith effort to minimize my waste generation and select the best waste manaqement method IliCi r available to me and that I can afford
, Signature , 9 .
T
IT A N S p 0
,
Mont h_€ 3
Year
flUIRU8
-,_-1)
17.Transporter 1 Acknowledgement of Receipt of Materials
I Signature
Printed/Typed Name
/,Y I
-
a
/‘zl/4
1 8:transporter 2 Aknowledgement of Receipt of Materials Printed/Typed Name
C
IT
i-”
I
Month
Year
V
$
Month
I Signature
Day
Year
11111
I
)
1 9.Discrepancy Indication Space F A C L .
.t•
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed; Name — Signature,
.i11 //r
ti”.,_i. 4 ‘:.L
isr.-€df
Month I
I
Day
Veal
-
-
--
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management) HeaOnt or type.
(Form designed for use on elite (I 2-pitch) typewriter.)
UNIFORM HAZARDOUS WASTE MANIFEST 3.
4. b.
Jrn’
1. Generator’s US EPA ID No.
SIDI 0
Addrp.
ij17
Manifest
2171 51
Form Approved. 0MB No. 2050-0039. ExpIres 9-30-88 Information in the shaded areas is not required by Federal
2. Page 1
43ioii ô m ’’
A. State Manifest Document Number
CWMA 41RF
P. 0. 13rx .6(1 Tie Plant, i1s. Generator’s Phone ( 601 )
38960 226—4584
transporter 1 (ompany Name
6.
.*ii.r 1 ø.
US PA ID Number
C. State Transporters ID
-
7.
Jart Transportation Co.
Transporter 2 Company Name
101 IDI0I0I9f 81 8.
i
Designated Facility Name and Site Address CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility AlabamaHighway l7atMiieMarker 163
10.
5181215
US EPA ID Number
I
I
I
I
I
I
US EPA ID Number
a.
b.
-
E.Stat8Trensponer’s ID
.
F.Trlnsporter’sPhone
I
.
6. State Facility’s. ID
“
21,8—7O2O.
.
-
H.Facility’S Phone A L 1 1 D 01 01016121 2
205/652—9721
4j 614
12. Containers
11. US DOT Description (lnctuding Proper Sh,pping Name, Hazard Class, and ID Number) C E N C
-
D.Trehsporiai’s Phone
No.
RQ Hazardous Wiste,Sc,1id N.O.S.(—001) ORM-1 NA-9189 CWM Profile NumbeES_Ij_ 53976
13. Total Quantity
Type
14 Unit Wt/Vo
-
-
010 Ii
(1171017 lIE
E. I.
..
CWM Profile Number
I
I
......L...
I
I
I
CWM Profile Number
I
I
,..J...._
I
I
I
I
J_ J_ I K. Handling
I
CWM Profile Number J Additional. Descriptions for Materials List%Avk.
I
.
Work Order No. 8807’ RES P.O. No. 28—0631 Emergency Contact (601) 226-4584
a
c
b
d
-
j IS. SFrcial Hanifl9{Instritcjionsf and AdditiaIirfofrc1atio?
would pi ‘‘hi hi 1. 1 1: ! rirotFct1 (n r” p n[
t:o f.h ‘tbovc t- Whi ni “m 1’@ n’.i iitid fi 1 When hanrili ng •v; r c:1,ye eq’. imert such as imperp mis 1othinq tid qiove h’J ) 1 een
f-’/iR” (‘I%/
-‘.‘l’ied 1 ts1 -
?r1i’ f-’J
16 GENERATOR’S CERTIFICATION: I hereby declare that the corrtertsf this consighméhi re fully and accurately described above by propr shipping name and are classified, packed, marked, and labeled, and are in all respects n proper condition for transpoit by highway according to applicable international and nalional government regulations If I am a large quantity generator. I certify diat I have a program in place to reduce tire volume and toxicity of waste generated to the degree I rave determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently avainhte to me which min,rn,zes the present and future threat to human health and tire env,roniirent. OR. ill rim a smrill quantity gener;itor. I have made a good faith effort to minimize my waste generation and select the best waste manaoement method that is available to me and that I can afford Signature
Printed/fPed,met
T It
A
17.Transpoher 1 Acknowledgement of Receipt of Materials d77j t Pfl
//
N S p
0 II
1 8.Transporter 2 Acknowledgement’ of Receipt of Materials Printed/Typed Name
4)
t o M h t. n Year iT
7nu
1017 Signature
Month
,jDiscrepancy Indication Space
2O.Fecility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Name. 7 9 Signatj / ;
.7 /
Day
Year
hull
,‘
-
_/
/
/ (
(
/(i-
/
.?44/
____
____ ________
CIii’rn’r,tI V/. isle
>
________
HAZARDOUS WASTE
__________
MANIFEST
(As Required By The Alabama Department of Environmental Management) me print or type.
Form Approved. 0MB No. 2050-0039. Espires
(Form designed for use on elite (72-pitch) typewriter.) Manifest Ti. Generators US EPA ID No I DocumentNo.....I ri SI DI 01 01 0 21 71 9 41 3101 DI 0f_j
UNIFORM HAZARDOUS WASTE MANIFEST
of
‘
A.
3.
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone ( 601
4. 5
Transporter 1 Company Name
7. •
)
.t8te GaOioSID,.
6.
US EPA ID Number
Transporter 2 Company Name
8.
US EPA ID Number
Designated Facility Name and Site Address
10.
US EPA ID Number
“‘
i i i I
ID
G.Stet
,,
-
9a8—7o2LL 2O5/6529721, :
HFeciHtys Phoni
I A I L I DI
.
0 0 0
6
2
464
2
12. Containers -
RQ Hazardous Waste,Solid N.O.S.(K—001) ORM—E NA—9189 CWM Profile NumbeREs_H_53976
No.
Type
13. Total Quantity
-
14. Unit
01011 Pit I f7C
5.
2t
I
I
CWM Profile Number
I I
L
CWM Profile Number
II
_L_
I I
I I I I __.K.,.LHandling .,_ I Codes for Wastds LiSted Ab6O
CWM Profile Number
AdditIonal Descriptions for Materials Listed .Aboim—
L
FTranepoiIersphone
-‘
ii. US DOT Description (Including Proper Shipping Name. Hazard Class, and lb Number) .
‘
“2
Dart -Transportation Co.
—
1
Sta* Manifest Document Number
,9WM4. 4iaas.L.
396fl 226—4584
CHEMICAL WASTE MANAGEMENT, INC. EmelIe Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
9.30.880
Information in the shaded areas is not required by Federal law.
2. Page 1
I I
I
!‘
-r
lilt
Work Order No. -
lb.
RES P.O.. No. 28-0631 (0!) Emergency Contact -
226-4584
had been added to t.he above wast- which When handling wear eye would prohih’it it. fe’m being land fi.ilecl. protection and prot-ec’ivo equipment such as pervlnus ciothinq and qiove
P/ikrRf oO’-1c-/)
.
-
16 GENERATORS CERTIFICATION: I hereby declare that tire contents of this consignment are fuliy and accurately described above by proper shipØrng name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government requlatinns Ill ton a large quantity generator. I certify tlrtit I have a tirograni economically practicable and that I hiavir selecld tire practicable future threat to human health and the environment. OR. ill ciii a the best waste management method that is available to me and Pntedjyped(trnt
ri plnce to ririfuce the viiliiiiie arid toxicity of waste geiwritirif lii tIre degree I have determined to be nicihod of treatment. Storage, or disposal corrently availahle to rue which minimizes the present and sniell quantity generator. I have made a good faith effort to minimize my waste generation and select that I can afford Signature Year Month,Qr _.y/J____._42.,. ....-,--...
7_ .i
gA,c 4’’ 1 18 ransporter
-‘1
Signatur
14
A
Month
L)a
Year
Month
Day
Ye8r
l_
Acknowledgement of Receipt of Mate .als
Printed.’Typed Name
7J 1
L_.—’
1 7.Transporter 1 Acknowledgement of Receipt of Materials Printed/Typed Name
—P
‘
— Signature
II
II
I
I
19.Discrepancy Indication Space
20.Facility Owner or Operator: Certification or receipt of hazardous materials covered by this manifest except as noted in Item 19. Printed/Typed Nam Signet -
Month
Day
Yer
C
__________
( I-IL.
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
‘
j,rint or type.
(Form desi,gned f3r use on elate (12-pitch) typewriter.) 1. Generator’s US EPA ID No. UNIFORM HAZARDOUS
Form Aggroved. Ofaf B No. 2050-0039. Expires 9-30-88
-
WASTE MANIFEST
Manifest
012171
MISIDI 001
1
1” 38960
4. 5.
Transporter 1 Company Name
7.
Dart Transportation Co. Transporter
I
226—4 584 6.
US EPA ID Number
101 NIDIOIOI9IBI 615181215
2 Company Name
8.
I
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
10.
US EPA ID Number
I
I
Lj
I I
-
I
I
I
I
US EPA ID Number
2 L L 0 I _ L !
‘1
No.
a a. RQ Hazardous Waste,Solid N.O.S.(K—001) E
a 4
61
12. ConI
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
1 I. Total Quantity
liners
Type
V
ORI”l-E NA-9189
N E
A T
!nformation in the shaded areas is not required by Federal
,.Stete j
Designated Facility Name and Site Address
P
of
5I4I3IOi0öm04t
Addc
P. 0. Box 160 Tie Plant, Ms. Generator’s Phone 1 60 1
2. Page 1
CWM Profile NumbeREg_H,...53 976
b.
0 P
01011 DIT
CWM Profile Number
I
C.
(
I
CWM Profile Number
CWM Profile Number
L.
WorkOrder No. 8807.Q’. RES P.O. No. 28--0631 emergency Contact (601) —
I
K. Handling Codes
c.
226-4584 b.
15.
would prohi bi ‘ it Ci protect i.on and pm! 16
I
Additional Descriptions for Materials Listed Above
-n
d.
hsd ber lddFac1 to the above wte wh rh h I ug I anr f [1 ted . When hand linq wen r eye eeim c 7 h entq as impervious clothing tnd glove
GENERATOR’S CERTIFICATION: I hereby decline that the contents of this consignment are fully and accurately described above by prober shipping name and are classified, tracked, marked. and labriled, and are in all respects ri proper condition for transport by higliwey according to applicable international rind national government regulations B lam a large quantity generator. I certify that I have a prograro in place to reduce the volume and toxicity of waste generared to the degree I have determined lobe economically practrcable and that I have selected tIre practicable method of treatment storage, or disposal currently available to me which minimizes the present and luture threat to human health and tire environrrierrt. OR. ill run a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and thaI can afford.
Printed/Typed me t. T p A 0 P T E
(
Signatore
.
1 7.Transpiorter I Acknowledgement of Receipt of Materials Printed/Typed Iame
z2
ó’/ A/ /
18.Transporter 2 AdifowIedgemnt of Receipt of Materials Printed/Typed Name
I
I I I
,....j :.
Signature.....,
4 Signature
Month)f
Year
KJ 17 L179-B 8 Mont
/z ..Z
Year
LN9- B .
Month
II
,.Discrepancy Indication Space
Day
I
Year
II
F A
C L
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. l”r,nseai i4’péd iñé 17 Signature z
Month Day 1 L,.yI1.y.
____
___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___ ________ ___________ ___________ _____ ___________
Clir’mc.il Wish’
1(AzARD0us WASTE MANIFEST
>
(As Required By The Alabama Department of Environmental Management)
I-lease print
(Form designed for use on elite (72-pitch) typewriter.)
or type.
UNIFORM HAZARDOUS WASTE MANIFEST
Ti.
Form Approved. 0MB No. 2050-0039. Expires
Generator’s US EPA ID No.
I MC SIIJI
01
Manifest I ‘1 CI 217 51 413 loiim.l
CI
2. Page 1
1 m e1i3iv. Addr
.
P. 0. Box 160 Tie Plant, is. Generator’s Phone C 601
4.
A. State ManifOst Document Nuiiiber
3960 2 26—4584
Transporter 1 Company Name
5.
2
Company
-::i
ID
-
-
6.
i4..
C. SteteIránSDiêJDr..
US EPA ID Number
,
-
Transporter
Gertômtor’s
‘a.statj
Datt Transportation Co. 7.
Information in the shaded areas ;.not required by Federal
1
of
,.
‘..‘
.
W
8.
I
10.
I
I
I
I
I
I
I
.
G. State Facility’s ID
11. US DOT Description
Marker
H. Facility’s Phone.. 163
I
A
I
L
I
D
I
0
I
0
0
6
I
2
I
2
i 614
.
12. Containers
(Including Proper Shipping Name. Hazard C/ass, and ID Number)
-
.-
13. Total Quantity
CWM Profile
E
R A T 0
NumbeRES_Jj_53976
b.
CWM
A
Profile
01011 Pi ,iOiSi’r I
Number
I
C.
CWM
Profile
CWM Profile Number
I I
Additional Descriptions for Materials List
Work Order No. 8807 RES P.O. No. 28—0631 Emergency Contact (601) 226—4584
.%LL ‘:
‘f
‘ -
...
P
-,
...:
L J
Number
.
14 Unit WI/Vo
RQ llazart’lous Waf-c,So1id N.O.S. (K—001) OR!1-E na—9H9
E N
..
2O5/65297: Type
G
.
219—98-UZO..,.
Facility Mile
-
F. Transporters Phone ,,_5.,-._._.,._
I
I
US EPA ID Number
CHEMICAL WASTE MANAGEMENT, INC. Emefle
.I
E. State Transpóttr’s ID,
US EPA ID Number
I I
Designated Facility Name and Site Address
Alabama Highway 17 at Emelle, Alabama 35459
‘i :v.iI.1
101 Iii DIOlOl 9181 615181215
Name
I
I
I
—
I I I I
f
-
K. Handling Codes for Wastes Listed Above
.a..:f/
c.
b.
ri
-.
5.
—
iS 9 S e cta
Han!I1-i lnstrcpons an
would
ddoal,
°im had )-‘een 3ddc’d to the above whirh prc’hi1i t i I-. from being land filled. When handling wear eye
protection
—
clothing and
and
GENERATOR’S CERTtFICATION: I hereby declare that shipping name and are classified. tracked, macken.
16
pr’oper
according
to
applicable ,nli,rnaliøn;,I nniil
Iiahi(iidim!
glove
this consiqni1int re fully and accurately described above by labeled, and are in all respects in proper condition lw Iranspoit by highway ulnlinin:; 1 flOv’rnuinl ren tire conlents of mnit
If I am a large quantity qeneralor. I cerlify that I fdCvi2 tnngir,i in place to reduce the volume and loxicily of waste generated to the degree I have determined lobe economically practicable and that I have selected the practicable nnrelliod of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment. OR, ill am a small quantity generator. I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford
Printed/Typed fame 3. Ti. (..laytol’i
.
I
A A
17.Tranporter
1 Acknowledgement
Receipt
of
,
Signature
Materials
Printed/Typed Name
1_f_c 0 A T E A
I of
Sig
,17.
18.Transporter 2 Acknowledgement of Receipt of Materials Printed/Typed Name 19.Discrepancy Indication Space
Month
Year
10 17 I MonthJ
Year
1017 I I Signature
Month
I
-
I
B Day
1111
Year
iC
F
A C t. 1’
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. E”rmflteof I ypea eme —
//ii 7
I
I I
.
.
-
iw.-’-w.’
-
p
.-
1
Month)
9
,,
/
HAZARDOUS WASTE MANIFEST
/
(As Required By The Alabama Department of Environmental Management)
‘—7
FIeasei or type.
for use on elite (12 ‘pitch) typewriter) 1. Generator’s US EPA ID No. of
Form Approved. 0MB No. 2050-0039. Expires 9-30-88 Information in the shaded areas is not required by Federal 1
ooiument Number
0. Box 160 Tie Plant, Ms. Generator’s Phone (601
A
P.
4. 5.
-
Iransporter 1 Company Name
I
22 —
—4
—
—
R4
-
IOIHIDIO 10 1918161518 (25
Transporter 2 Company Name
8.
I
Designated Facility Name and Site Address CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
I
10.
A
-
US EPA ID Number
I
I
I
L
0
0
I
I
US EPA ID Number
0
0
6 i 2
2
I
I
I
614_ 12. Cont liners
11. US DOT Description (Including Proper Shipping Name. Hazard C/ass, end ID Number)
No.
13. Total Quantity
Type
RQ Hazardous Wste,.oiir1 N.O.S.(K—0O1.)
‘
ORM-E Th-9l89 CWM Profile Ii
-
‘
us EPA ID Number
6.
-
Dart Transportation Co.
7.
1
38960
NumbES_H_53976
e
0(0 U. DJ ‘tik’i/O
5 CWM Profile Number
I I
-J
CWM Profile Number
I I
L
I
L
II
C.
I I I I I
,
CWM Profile Number
I I
Additional Descriptions for Materials Listed Above
3.
I
K. Handling CodeS far West
Work Order No. 88079 RE$ P.O. No. 28—0631 Emergency Contact (601) 226-4584
a.
C-
b.
d.
-
15. Special Haling. Instructions and Additioj’ial Information ri,rr-hppt
J (-rt’1.J:y Ln’ had been. ;vlded to the abovi .c wh. ch 1 wrnld prohi bit I L f om hej nq I mid fill ‘d. When hnc33J.ncj weEtr eye protection mvl T’rnctive ‘TuipTnent such s impervious ci,othnq n’i ç lov fflh.4 ‘
?noq,-’/i7
SigIMufe
,(
1 c>
,.
j J // /j//
Month
-ia-i
L-
Day
Year
,O 2f5
I1AZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
Hease print or type.
(Form designed for use on elite (12-pitch) typewriter.)
UNIFORM HAZARDOUS WASTE MANIFEST
-—
1 Generators US EPA ID No.
11 SI DI Dl Dl
Manifest Docume,U14o.
4. 5.
of
II 21 71 ! 41 310 ( flf
A. Stat& Máñifast Doumbnt Number
k009
P. o. Box ].60 Tie Plant, Ms. Generator’s Phone C 601
CWMA )
Iransporter 1 Company Name
6.
us EPA ID Number
7.
Transporter 2 Company Name
8.
US EPA ID Number
9
Designated Facility Name and Site Address
.
I
I
I
I
10.
I
I
I
Vi
-
J-’
-.
I
I I I I
US EPA ID Number
SFats -
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
.,
4jj
flelebra
B
38960 226—4584
Dart Transportation Co.
-
i998fl2D
H. FaclIlty Phoiê A L 1 1 1 D
01010161212
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
41614
Type
RQ Hazardous Wriste,Soiid N.O.S.(J HAZARDOUS WASTE MA Environmental Management)
Clii’m.c,rl W,n,lr
St
.
(As Required By The Alabama Department of
ch) typewriter.) (Form designed for use on elite (12-pit 1. Generators US EPA ID No.
I-lease print or type.
UNIFORM HAZARDOUS WASTE MANIFEST P. 0. Box J0 Tie Plant, Ns. Generators Phone ( 6 01
4. 5.
MIS IL) loft) 17 101217 151413
r 3 mqa4lj9. Add
qecr
.
)
ioi7(’Y1
-
ID
S. State Geflestots
3J96() 226—4 5 8 4
-
‘
etó TrlnsportwS ID
US EPA ID Number
6.
P1e PhOflA 10 IHIDIO (01918(6(5(82 iS PS EState Transporter’s ID
Dart Transportation
10.
s Designated Facility Name and Site Addres INC NT, GEME CHEMICAL WASTE MANA Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
‘
US EPA ID Number
8.
Transporter 2 Company Name
I I I
I
I
1
1
I
I
I
‘,,
j’
‘.‘
,
GStatU, Fduit%”s D
US EPA ID Number
H. Facility’s PhonS
I
A
I
L
I
D
0
I
0 O 6
2
I
205/652-9721
2-
l 614 12. Containers
ng Name. Hazard Class and ID Number) 11. US DOT Description (including Proper Shippi
‘
14. Unit Wt/Vo
13. Total Quantity
‘
Tye
No.
d NO.5. (K’-OOl) RCIV\ Hazarciou Jcte,So1i NA 9i.39 ORM—E CWM Profile Number RES—I{—53976 ) lOll
a.
l 9 f 4 Q 3 .
cwMA :41 4:t
.,
Transporter 1 Company Name
7.
Manifest
s Fo Approved. 0MB No. 2050-0039. Expire areas shaded the in ation Inform 2. Page 1 is not required by Federal of law. A. State MañIfèS( DOCumen$umber
D 1 LL ‘,i’7i?C
W L
...
;(:¼;s;
‘
b. CINM Profile Number
LJ.
CWM Profile Number
I
......L
I
I
I
—
C.
I
I
I
d. CWM Profile Number
L
j 4 . K Handling Codes for Wastes UdJd4W
Above Additional Descriptions for Materials Usted
J.
WorkOrder No. RES P 0. No. 28—0(31 (601) Eittergency Contact ‘-
-
:
226—4584
Ir’formation Additional r)T nq- Instructions and 15. Soecial Handli , j)r r n-tr r,_i I !.
p.oh hi
ear eye
i t
fii’m
ii
-
—
h
When haprliinq 3004 (C—-i) 1mperviou nr1 rtttcH-ve ee.liiiprncnt such as
t-r-j nq
s:rbi1I
‘‘
‘7”
—-
iir1ci
PFRR(T?1
f
j’1o-1-hina ;n(3 a1ov(s. here!’ declare that
tely described above by tire contents of this consignment are fully and accura proper condition for transport by highway in 6 GENERATORS LtN I Irii.u i iur’J: ts all respec in are , and labeled and . ctassrlied, packed, marked proper shipping name and are l government regulations according to applicable internattorral and nationa the degree I rave delermined to be volume and toxicity of waste generated to that I have a program in place to reduce the I certify tor. which mlntmizes the present and me to le genera availab tly uantity large curren 111am a , or disposal
ent, storage selected the prirct cable niethod of treatm generation and select economically practicable and that I have made a good faith effort to rrrinim,ze nt waste I OR, ill mu a small quantity gener;itor. have nment. enviro the and health human lirlure threat to afford can I that and Year that is available to me Month Day the best waste management method Signature Printed/Typed Name
(
1
C1,nn Receipt of Materials 17.Transportar 1 Ackn6wledgement of Printed/Typed Name
.1
T R A
fl
/ J/zJ /,(./A7c %/2% als r 2 Acknowledgement of Receipt of Materi
0 R T E
18.Transporte Printed/Typed Name
I
I748 IS
-
Day
Year
I7I,cI8 I Signature
I
I
R
Month
—‘1
Month
Day
I
I
Month
Day
Year
1 9.Discrepancy Indication Space
as noted in Item 19. of hazardous materials covered by this manifest except 20.Facility Owner or Operator: Certification of receipt Signature .,a. Printed/Typed Name -t 12 / / ,.;f -J-_ — -
—
kl7
Year
’g 1
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
‘for use on elite (12 -pitch) typewriter.) rGenerator’s US EPA ID No.
Form Approved. 0MB No. 2050-0039. Expires 9-30-80 Manifest 2. Page 1 information in the shaded areas DocumentN. is not required by Federal I of law. ol nI/ I/I’5 A. State Maflifest Document Number
ous -
U.--,
T
Ni sin! UI nIl! 01217 I I 4!
Add s 1 s 11
I
I
cwMA.41414p:.:.,
P. 0. Box ,1.0 Tie F1ant, t-1,
I
3396O ( 6Q1 ) 226—4R4
4. 5
Generator’s Phone Transporter 1 Company Name
7.
Transporter 2 Compantj Name
6.
IOIHIDIOIUI9IRI6ISIRI2R DTsperS
jJrt Trnsparttion
8.
Designated Facility Name and Site Address
‘
US EPA ID Number
10.
Phone, L State i ansporter’s ID -exe
US EPA ID Number
I
I
I
I
US EPA ID Number
I
I
G.Stete FadliltyS ID
1 1 A L DI 01 0! 0! 6
2
2
05/652—9721
i 614
12. Containers’ No.
tTz13B J
;
..
2I4—1-4R211L
. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
ORM—E
I
-
H.Facillty’s Phone -
N E
-
-
-
ErneIIe Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
G a.
--\I
e;;
,,,--.‘.
CHEMICAL WASTE MANAGEMENT, INC.
11
-
tc’,Sn1ii’1 T1.fl.S.
.,
13. Total Quantity
14. Unit Wi/Vo
5i8iiit’
i—’
Type
-
(K—00] )
I11\ 91.89 CWM Profile Number
-
-
H— Y t g76
A b.
-‘.‘ -
o
..
mu
-.
.
‘
,,,
CWM Profile Number
Q
I
CWM Profile Number
I
CWM Profile Number
r Additional
I
Descriptions for Materials Listed Above
Q72Osf/ Work Order No. 88 RES P. 0. No. 28—0631 Emergency Contact (601) 226-4584
-
......L
...J...,_
I
I
I
I
I
I
I
I
1
‘
-
I I I I jL
-
K. Hs,.Wing Codes for ‘F..Stes Listed Aboè
.
-
a.iJ
c.
b.
d.
.
-
—
15. Special Handling Instruc;ions and AdditioQal lrfomation rj’ ,.roi:oer1t I. ce’r tify t nit -
been t’1’ed to the
har
hem hr— ‘ig iElncl f:i 3 prohibit I eye prot ect’ i’’ti nI p1 ‘.‘t iC’ t
1 _ ed
.
PT”lPCPA 3004
bO’7r)
( (-- I )
Ft which won 1 (i h;int-11 i nq
JIiep
VC ({fl iptflCfl [ Bucil fl B fllP V’’.71 fl’JS r1-h’riq nd qlt’Vt7i 16 GENERATOR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by propei shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for tronspoit by highway according to applicable international and national government regulations If lam a large quantify generator. I certify that I have a program in place to reduc., the volume and toxicity of waste generated to the degree I have determined lobe econornicatlypracticable and that I hove selected the practicable method of treatment. storage, or disposal currently rivailahie to ore wlrifi minimizes the present and future threat 10 human health and the environment, OR. ill am a small quantity generator. I have rTiade a good faith effort to minimize niy waste generation and select the best waste management method that is available to me and that I can afford.
Printed/Typed Name t
T R A
Signature
1 7.T’nspoiie 1 AJk4tent of Receipt of Materials ’Typed Name 4 9rinted
1/
L-
f’
Si
a
re
0 1 1é.TransportT 2 Ackn wiedgement of Receipt of Materials R Printed/Typed Name ER:
I
Signature .
iN-., 4 screpsncy Indication Space
20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. t”rintea/ lypea Name Signature /
/
//__-
Year
Month
Day
Year
Month .
-.
Day
In I71?I
‘
/ _J)./,
Month
‘)
I
K.
I
Day
Year
I I. I I
Month)
58.
(7ar
I
HAZARDOUS WASTE MANIFEST (As Required By The Alabama Department of Environmental Management)
lease print or type.
(Form designed for use on elite (12-pitch) typewriter.) I 1. Generators US EPA ID No.
UNIFORM HAZARDOUS WASTE MANIFEST 3.
(OIf 4 . m e( a J3I 1
7 Addr?s,, lrq
1k 15 ID
Form Approved. 0MB No. 2050-0039. Expees 9-30-88
Manifest
—
Olt) 17 I 012 7 I 914 I I flIflI?I/
:.--.
Dart Transportation
US EPA ID Number
C State Transporter’s ID
1011111)1010191816151812 15 8.
I
Designated Facility Name and Site Address
‘
CHEMICAL WASTE MANAGEMENT, INC. Emelle Facility Alabama Highway 17 at Mile Marker 163 Emelle, Alabama 35459
10.
US EPA ID Number
I
I
I
I
I
71 9—QIR—7fl?fl
A L 1 D 1 Oj Dl 01 61 2
2
6 4
13. Total
Type
Quantity
WV
(K—O0l
CWM Profile Number ppq
‘
b.
i3 i
In Ii
97
CWM Profile Number
I
I
......L..
I
CWM Profile Number
I
I
,.....j.....,
I
-
C
CWM Profile Number
I
AdditIonal Descriptions Tor MaterIals Listed Above
-
-
205/652’9721
12.Container No.
3
-
6. State Facility’s ID H,Facility’s Phone
RC.R2\ hazardous tJat-c-’, oJ.id. N. u.S. oRrl—E NJ 91.89
.
Phone
F Transporter’s
I
‘
-.—.—--——__________ __________
D.Transporte’
E. State Transporter’s ID
US EPA ID Number
11. US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number) a.
-
.
6.
Tansporter 2 Company Name
4 14 14 9.i
B,State Generator’s ID
transporter 1 Company Name
7.
Information in the shaded areas is not required by Federal Iaw. A. St8te Manifest Document Number of
CWMA
P. 0. Box 16(1 3(H’.f) Tie Plant-, FIcI. Generator’s Phone ( 6 01 ) 226—4 5 8 4
4. 5.
r
2. Page 1
K, Handling Codes f,
Work Order No. 88 °‘)$O”/? RES P. 0. No. 28—0631 emergency Contact (601) 226-4584
a.4/L)
C.
b.
d.
—
15. Special Hartdlinq Instrpqlions and Additiopal Irformatiop .t. ‘-ct t..i j. V tt;’.: Ii ‘t’l’ lict1 h,id poh i.I,it 1 t- frCiIfl l’(j JH. J. aidJ .1.
16
—
hcn 1c to the ahov ‘iaste which ‘ou ld J.ed. P11WCRI 3004 (C—i ) When handling wear eye protection tid proteti.ve equipment such as impervious 1 rai h j nn nr1 1 GENERATOR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed. marked, and labeled, and are in all respects n proper condition for lransporl by highway accordina to applicable international and rialiotiel government regulations.
ff1 am a large quantity generator. I certify Iliat I have a program in place to reduce lire volume arid toxicity of wasle generated to tire degree I have determined to be economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which minimzes the present and future threat to human health and the environment. OR, ill am a small quantity gener;itor.l rave made a good faith effort to nimnmnrize my waste generation and select the best waSle management method that is available to me and that I can afford
Printed/Typed Name
Signature
-
-
‘1tcr
‘-‘-
17.Transporter’ 1 Ackndwledgement of Receipt of Materials Printed/Typed Name
])‘-141,
( Sitre
/ .
....
‘•(/