Appendix 30.  

Read all instructions before completing this form. This form has been designed for use on a 12-pitch (elite) typewriter; a firm point pen may also be used—press down hard.

New York State regulation requires generators and transporters of hazardous waste and owners or operators of a hazardous waste treatment, storage and disposal facilities to complete a manifest (EPA form 8700-22), and, if necessary, the continuation sheet (EPA form 8700-22A) for both inter- and intrastate transportation of hazardous waste. Omissions, false coding or illegibility is considered a violation. All generators are responsible under New York State and Federal law for the proper identification, labeling, manifesting and ultimate disposal of all hazardous waste they generate. The manifest system is designed to track hazardous waste from the point of generation until its final disposal (cradle to grave). In order to accomplish that goal, it is essential that all items on a manifest be properly completed.

Distribution of each copy of the manifest is indicated on the bottom of the form. Additional copies of the form may be required. For example, the generator must make additional copies of the manifest, as necessary, to be submitted by the generator to the generator state and the disposer state. Extra copies of the manifest will be needed if more than one transporter is used. For exports, the transporter must deliver a copy of the manifest to the U.S. Customs when exporting the waste across U.S. borders and mail a copy to the generator. For imports, the TSD must mail a copy of the manifest to the USEPA. For rejected loads, the final receiving facility (generator or TSD), must make manifest copies to submit to the generator state and the disposer state, as necessary. New York State regulations provide 10 calendar days for a generator and 10 calendar days for a TSDF to distribute manifest copies. The disposer's state is the state in which the designated TSD facility is located. The generator's state is the state in which the installation generating the hazardous waste is located. TSD facility is a treatment, storage or disposal facility.

For submittal to the department, mail manifest related documents to: New York State Department of Environmental Conservation, Division of Solid & Hazardous Materials, Manifest Section, 625 Broadway, Albany, NY 12233-7252.

The following statement must be included with each Uniform Hazardous Waste Manifest, either on the form, in the instructions to the form, or accompanying the form:

"Public reporting burden for this collection of information is estimated to average: 30 minutes for generators, 10 minutes for transporters, and 25 minutes for owners or operators of treatment, storage, and disposal facilities. This includes time for reviewing instructions, gathering data, completing, reviewing and transmitting the form. Any correspondence regarding the PRA burden statement for the manifest must be sent to the Director of the Collection Strategies Division in EPA's Office of Information Collection at the following address: U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Avenue NW, Washington, DC 20460. Do not send the completed form to this address."

I. INSTRUCTIONS FOR GENERATORS

Item 1. Generator's USEPA Identification Number—Enter the generator's US EPA 12-digit identification number, or the state generator identification number if the generator site does not have an EPA identification number.

Item 2. Page 1 of _. Enter the total number of pages used to complete this Manifest (i.e., the first page [EPA form 8700-22] plus the number of continuation sheets [EPA form 8700-22A], if any).

Item 3. Emergency response phone number–enter a phone number for which emergency response information can be obtained in the event of an incident during transportation. The emergency response phone number must:

1. Be the number of the generator or the number of an agency or organization who is capable of and accepts responsibility for providing detailed information about the shipment;

2. Reach a phone that is monitored 24 hours a day at all times the waste is in transportation (including transportation-related storage); and

3. Reach someone who is either knowledgeable of the hazardous waste being shipped and has comprehensive emergency response and spill cleanup/incident mitigation information for the material being shipped or has immediate access to a person who has that knowledge and information about the shipment.

Item 4. Manifest Tracking Number—This united tracking number must be pre-printed on the manifest by the forms printer.

Item 5. Generator's Mailing Address, Phone Number and Site Address—Enter the name of the generator, the mailing address to which the completed manifest signed by the designated facility should be mailed, and the generator's telephone number. Note, the telephone number (including area code) should be the normal business number for the generator, or the number where the generator or his authorized agent may be reached to provide instructions in the event the designated and/or alternate (if any) facility rejects some or all of the shipment. Also enter the physical site address from which the shipment originates only if this address is different than the mailing address.

Item 6. Transporter 1 Company Name, and U.S. EPA ID Number—Enter the company name and U.S. EPA ID number of the first transporter who will transport the waste. Vehicle or driver information may not be entered here.

Item 7. Transporter 2 Company Name and U.S. EPA ID Number—If applicable, enter the company name and U.S. EPA ID number of the second transporter who will transport the waste Vehicle or driver information may not be entered here. If more than two transporters are needed, use a Continuation Sheet(s) (EPA Form 8700-22A).

Item 8. Designated Facility Name, Site Address, and U.S. EPA ID Number—Enter the company name and site address of the facility designated to receive the waste listed on this manifest. Also enter the facility's phone number and the U.S. EPA 12-digit identification number of the facility.

Item 9. U.S. DOT Description (Including Identification Number, Proper Shipping Name, Hazard Class or Division, and Packing Group)

Item 9a. If the wastes identified in Item 9b consist of both hazardous and nonhazardous materials, then identify the hazardous materials by entering an "X" in this Item next to the corresponding hazardous material identified in Item 9b.

Item 9b. Enter the Identification Number (UN/NA), U.S. DOT Proper Shipping Name, Hazard Class or Division, and Packing Group for each waste as identified in 49 CFR 172 (see section 370.1[e] of this Title). Include technical name(s) and reportable quantity references, if applicable. USDOT requires the word waste before or in the shipping name for all hazardous waste. See 49 CFR parts 171 through 173 (see 6 NYCRR 370.1[e]). Contact USDOT office or visit https://www.phmsa.dot.gov for description assistance.

Item 10. Containers (Number and Type)

Enter the number of containers for each waste and the appropriate abbreviation from Table I (below) for the type of container.

TABLE I. TYPES OF CONTAINERS

BA - Burlap, cloth, plastic, or paper bags

CF - Fiber or plastic boxes, cartons, cases

CM - Metal boxes, cartons, cases (including roll-offs)

CW - Wooden boxes, cartons, cases

CY - Cylinders

DF - Fiberboard or plastic drums, barrels, kegs

DM - Metal drums, barrels, kegs

DT - Dump trucks

DW - Wooden drums, barrels, kegs

HG - Hopper or gondola cars

TC - Tank cars

TP - Portable tanks

TT - Cargo tank (tank trucks)

Item 11. Total Quantity—Enter, in designated boxes, the total quantity of waste. Round partial units to the nearest whole unit. "Do not" enter decimals or fractions. To the extend practical, report quantities using appropriate units of measure that will allow you to report quantities with precision. Waste quantities entered should be based on actual measurements or reasonably accurate estimates of actual quantities shipped. Container capacities are not acceptable as estimates.

Item 12. Units of Measure (Weight/Volume)—Enter, in designated boxes, the appropriate abbreviation from Table II (below) for the unit of measure.

TABLE II. UNITS OF MEASURE

G - Gallons (liquids only)*

K - Kilograms (2.2 pounds)

L -Liters (liquids only)*

M - Metric tons (1,000 kilograms) (2,200 pounds)

N - Cubic meters*

P - Pounds

T - Tons (2,000 pounds)

Y - Cubic yards*

*Specific gravity - may be provided in Item 14. Special Handling Instructions and Additional Information to assure accurate conversion of volumetric units into weight. The value of 1.0 will be used for calculations if no other value is provided.

Item 13. Waste Codes—Enter up to six Federal and State waste codes to describe each waste stream identified in Item 9b. State waste codes that are not redundant with Federal codes must be entered here, in addition to the Federal waste codes which are most representative of the properties of the waste. Examples of State waste codes include New York State "B" codes for PCB waste and the New York State handling code, described under "Item 13 -additional state requirement."

ITEM 13 - ADDITIONAL STATE REQUIREMENT

If the receiving TSD facility is not providing a hazardous waste management method code in Item 19 that reflects the ultimate disposal method for the hazardous waste, the generator must provide a State waste code to designate the ultimate disposal method of the waste using one of the following State codes:

L = Landfill

B = Incineration, heat recovery, burning

T = Chemical, physical, or biological treatment

R = Material recovery of more than 75 percent of the total material.

If the receiving TSD facility uses hazardous waste report management method code for "storage, bulking, and/or transfer off-site - no treatment/recovery, fuel blending, or disposal at this site" in Item 19 of the manifest form, and the generator has failed to provide the ultimate disposal method in Item 13, the ultimate disposal method is deemed landfill (L).

Item 14. Special Handling Instructions and Additional Information.

1. Generators may enter any special handling or shipment-specific information necessary for the proper management or tracking of the materials under the generator's or other handler's business processes, such as waste profile numbers, container codes, bar codes, or response guide numbers. Generators also may use this space to enter additional descriptive information about their shipped materials, such as chemical names, constituent percentages, physical state, or specific gravity of wastes identified with volume units in Item 12.

2. This space may be used to record limited types of federally required information for which there is no specific space provided on the manifest, including any alternate facility designations; the manifest tracking number of the original manifest for rejected wastes and residues that are re-shipped under a second manifest; and the specification of PCB waste descriptions and PCB out-of-service dates required under 40 CFR 761.207.

Item 15. Generator's/Offeror's Certifications

1. The generator must read, sign, and date the waste minimization certification statement. The date is the date of receipt by transporter. In signing the waste minimization certification statement, those generators who have not been exempted by statute or regulation from the duty to make a waste minimization certification under section 3002(b) of RCRA are also certifying that they have complied with the waste minimization requirements. The Generator's Certification also contains the required attestation that the shipment has been properly prepared and is in proper condition for transportation (the shipper's certification). The content of the shipper's certification statement is as follows: "I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name, and are classified, packaged, marked, and labeled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and national governmental regulations. If export shipment and I am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent." When a party other than the generator prepares the shipment for transportation, this party may also sign the shipper's certification statement as the offeror of the shipment.

2. Generator or Offeror personnel may preprint the words "On behalf of" in the signature block or may hand write this statement in the signature block prior to signing the generator/offeror certification, to indicate that the individual signs as the employee or agent of the named principal.

II. INSTRUCTIONS FOR INTERNATIONAL SHIPMENT BLOCK

Item 16. International Shipments. For export shipments, the primary exporter must check the export box, and enter the point of exit (city and state) from the United States. For import shipments, the importer must check the import box and enter the point of entry (city and state) into the United States. For exports, the transporter must sign and date the manifest to indicate the day the shipment left the United States. Transporters of hazardous waste shipments must deliver a copy of the manifest to the U.S. Customs when exporting the waste across U.S. borders.

III. INSTRUCTIONS FOR TRANSPORTERS

Item 17. Transporter Acknowledgment of Receipt. Enter the name of the person accepting the waste on behalf of the first transporter. That person must acknowledge acceptance of the waste described on the manifest by signing and entering the date of receipt. Only one signature per transportation company is required. Signatures are not required to track the movement of wastes in and our of transfer facilities, unless there is a change of custody between transporter. If applicable, enter the name of the person accepting the waste on behalf of the second transporters. That person must acknowledge acceptance of the waste described on the manifest by signing and entering the date of receipt.

IV. INSTRUCTIONS FOR OWNERS AND OPERATORS OF TREATMENT, STORAGE, AND DISPOSAL FACILITIES

Item 18. Discrepancy

Item 18a. Discrepancy Indication Space.

1. The authorized representative of the designated (or alternate) facility's owner or operator must note in this space any discrepancies between the waste described on the Manifest and the waste actually received at the facility. Manifest discrepancies are: significant differences (as defined by sections 373-2.5[b][1][i][e] and 373-3.5[b][1][i][e] of this Title) between the quantity or type of hazardous waste designated on the manifest or shipping paper, and the quantity and type of hazardous waste a facility actually receives; rejected wastes, which may be a full or partial shipment of hazardous waste that the facility cannot accept; or container residues, which are residues that exceed the quantity limits for "empty" containers set forth in section 371.1(h)(2) of this Title.

2. For rejected loads and residues (section 373-2.5[b][1][iv], [v] or [vi], or 373-3.5[b][1][iv], [v] or [vi] of this Title), check the appropriate box if the shipment is a rejected load (i.e., rejected by the designated and/or alternate facility and is sent to an alternate facility or returned to the generator) or a regulated residue that cannot be removed from a container. Enter the reason for the rejection or the inability to remove the residue and a description of the waste. Also, reference the manifest tracking number for any additional manifests being used to track the rejected waste or residue shipment on the original manifest. Indicate the original manifest tracking number in Item 14, the Special Handling Block and Additional Information Block of the additional manifests.

3. Owners or operators of facilities located in unauthorized states (i.e., states in which the EPA administers the hazardous waste management program) who cannot resolve significant differences in quantity or type within 15 days of receiving the waste must submit to their Regional Administrator a letter with a copy of the Manifest at issue describing the discrepancy and attempts to reconcile it (40 CFR 264.72[c] and 265.72[c]).

4. Owners or operators of facilities located in authorized states (i.e., those states that have received authorization from the EPA to administer the hazardous waste management program, such as New York State) should contact their state agency for information on where to report discrepancies involving "significant differences" to state officials. For facilities located in New York State, upon discovering a discrepancy, the owner or operator of the facility must attempt to reconcile the discrepancy with the waste generator or transporter (e.g., with telephone conversations). If the discrepancy is not revolved within 15 days after receiving the waste, the owner or operators must immediately submit a letter to the generator state and the disposer state describing the discrepancy and attempts to reconcile it, and a copy of the manifest or shipping paper at issue.

Item 18b. Alternate Facility (or Generator) for Receipt of Full Load Rejections. Enter the name, address, phone number, and EPA Identification Number of the Alternate Facility which the rejecting TSDF has designated, after consulting with the generator, to receive a fully rejected waste shipment. In the event that a fully rejected shipment is being returned to the generator, the rejecting TSDF may enter the generator's site information in this space. This field is not to be used to forward partially rejected loads or residue waste shipments.

Item 18c. Alternate Facility (or Generator) Signature. The authorized representative of the alternate facility (or the generator in the event of a returned shipment) must sign and date this field of the form to acknowledge receipt of the fully rejected wastes or residues identified by the initial TSDF.

Item 19. Hazardous Waste Report Management Method Codes. Enter the most appropriate Hazardous Waste Report Management Method code for each waste listed in Item 9. The Hazardous Waste Report Management Method code is to be entered by the first treatment, storage, or disposal facility (TSDF) that receives the waste and is the code that best describes the way in which the waste is to be managed when received by the TSDF.

Item 20. Designated Facility Owner or Operator Certification of Receipt (Except as Noted in Item 18a). Enter the name of the person receiving the waste on behalf of the owner or operator of the facility. That person must acknowledge receipt or rejection of the waste described on the Manifest by signing and entering the date of receipt or rejection where indicated. Since the facility certification acknowledges receipt of the waste except as noted in the Discrepancy Space in Item 18a, the certification should be signed for both waste receipt and waste rejection, with the rejection being noted and described in the space provided in Item 18a. Fully rejected wastes may be forwarded or returned using Item 18b after consultation with the generator. Enter the name of the person accepting the waste on behalf of the owner or operator of the alternate facility or the original generator in Item 18b. That person must acknowledge receipt or rejection of the waste described on the Manifest by signing and entering the date they received or rejected the waste in Item 18c. Partially rejected wastes and residues must be re-shipped under a new manifest, to be initiated and signed by the rejecting TSDF as offeror of the shipment.

INSTRUCTIONS—CONTINUATION SHEET, U.S. EPA FORM 8700-22A.

Read all instructions before completing this form. This form has been designed for use on a 12-pitch (elite) typewriter; a firm point pen may also be used—press down hard.

This form must be used as a continuation sheet to U.S. EPA Form 8700-22 if:

- More than two transporters are to be used to transport the waste; or

- More space is required for the U.S. DOT descriptions and related information in Item 9 of U.S. EPA Form 8700-22.

State regulations require generators and transporters of hazardous waste and owners or operators of hazardous waste treatment, storage, or disposal facilities to use the uniform hazardous waste manifest (EPA Form 8700-22) and, if necessary, this continuation sheet (EPA Form 8700-22A) for both interstate and intrastate transportation.

GENERATORS.

Item 21. Generator's ID Number - Enter the generator's U.S. EPA twelve-digit identification number or, the State generator identification number if the generator site does not have an EPA identification number.

Item 22. Page _ - Enter the page number of this continuation sheet.

Item 23. Manifest Tracking Number - Enter the Manifest Tracking number from Item 4 of the Manifest form to which this continuation sheet is attached.

Item 24. Generator's Name - Enter the generator's name as it appears in Item 5 on the first page of the Manifest.

Item 25. Transporter—Company Name - If additional transporters are used to transport the waste described on this Manifest, enter the company name of each additional transporter in the order in which they will transport the waste. Enter after the word "Transporter" the order of the transporter. For example, Transporter 3 Company Name. Also enter the U.S. EPA twelve-digit identification number of the transporter described in Item 25.

Item 26. Transporter—Company Name - If additional transporters are used to transport the waste described on this Manifest, enter the company name of each additional transporter in the order in which they will transport the waste. Enter after the word "Transporter" the order of the transporter. For example, Transporter 4 Company Name. Each Continuation Sheet can record the names of two additional transporters. Also enter the U.S. EPA twelve-digit identification number of the transporter named in Item 26.

Item 27. U.S. DOT Description Including Proper Shipping Name, Hazardous Class, and ID Number (UN/NA) - For each row enter a sequential number under Item 27b that corresponds to the order of waste codes from one continuation sheet to the next, to reflect the total number of wastes being shipped. Refer to instructions for Item 9 of the manifest for the information to be entered.

Item 28. Containers (No. And Type) - Refer to the instructions for Item 10 of the manifest for information to be entered.

Item 29. Total Quantity - Refer to the instructions for Item 11 of the manifest form.

Item 30. Units of Measure (Weight/Volume) - Refer to the instructions for Item 12 of the manifest form.

Item 31. Waste Codes - Refer to the instructions for Item 13 of the manifest form.

Item 32. Special Handling Instructions and Additional Information - Refer to the instructions for Item 14 of the manifest form.

TRANSPORTERS.

Item 33. Transporter—Acknowledgment of Receipt of Materials - Enter the same number of the Transporter as identified in Item 25. Enter also the name of the person accepting the waste on behalf of the Transporter (Company Name) identified in Item 25. That person must acknowledge acceptance of the waste described on the Manifest by signing and entering the date of receipt.

Item 34. Transporter—Acknowledgment of Receipt of Materials - Enter the same number of the Transporter as identified in Item 26. Enter also the name of the person accepting the waste on behalf of the Transporter (Company Name) identified in Item 26. That person must acknowledge acceptance of the waste described on the Manifest by signing and entering the date of receipt.

OWNER AND OPERATORS OF TREATMENT, STORAGE, OR DISPOSAL FACILITIES.

Item 35. Discrepancy Indication Space - Refer to Item 18. This space may be used to more fully describe information on discrepancies identified in Item 18a of the manifest form.

Item 36. Hazardous Waste Report Management Method Codes - For each field here, enter the sequential number that corresponds to the waste materials described under Item 27, and enter the appropriate process code that describes how the materials will be processed when received. If additional continuation sheets are attached, continue numbering the waste materials and process code fields sequentially, and enter on each sheet the process codes corresponding to the waste materials identified on that sheet.