NCD122263825_19870917_JFD Electronics - Channel Master_FRBCERCLA SPD_Hazardous Waste Manifests-OCR

I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12-itch writer ·
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
NCDO 7 0
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4.Generator'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA 10 Number
C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA 10 Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Expires 9-30-88
2. Page 1 Information in the shaded a<eas is not
of required by Federal law, but is by State law.
12. Containers 13. Total Quantity 14. Unit
No. Type 'IN'lr/.
1 D T 2 0 Y
~1,1:r.-:101:rT9f~
\'HE10,o,61fr
~0~~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72352
, e. OENERATOR·s CERTIFICATION: I horeby declare that the contenls ol thls consignment are fully and accurately described above by proper shipping nam• and are cluailied.
packed, marked, and la.beled. and are in all respecls in proper condilion for transpor1 by highway according to applicable International and national government r~ulationa and
the law11 ol 1he State ol Soulh Carolina. · ·
If I am a large quantity generator, I cer1ify Iha! I have a program In place to reduce the volume and toxlcltyol waste generated to the degree I have determined to be oconomlcally
practicable and that I have selected the practicable me!hod ol treatment. slorage, or dlsposal currenlly available to me which minimizes the present and luture throat to human
health and the environment; OR, II I am a smotl quanlitygenoralor, I hove ~ado a good laith effor1 to mtnlml.i:e my waste generetlon and select the beat waate managem•nt method
that la available to me and that l ean afford.
Print"'CAA'm:ES R. HANSEN Month Day Year
0 9 l'.7 S':7
T 17. Transporter 1 Ac;icnowledgement of Receipl of Materials
Printed/Typed Name -A 1'1'1.8 -AN,,
Printed/Typed Name Month Day YeaI
19. Discrepancy Indication Space
20. Facility Owner or Operator. Certification of receipt of hazardous materials covered by this manifest except as noted In ttem 19.
Printed/Typed Name Signalure Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 (Rev. 10/86)1
I
/!,. ~ .... ,.,._ South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Wa,te Mgt.
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone] --
E PRINT or TYPE (Form desl ned for use on elite 12-itch
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
, P. 0. Box 1416, Smithfield, NC 27577
4. Genen,tor'sPhone 919 934-9711
5. Transporter 1 Company Name
'Willms Truckin Co Inc.
' 7. ·"iranspor1er 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6, U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard crass. and ID Number)
a.
C. ,...
d.
.'
0GSX Work Order No. : 72351
'r·:,
Emergency & Holidays: [phone]
Form A roved, 0MB No, 2050-0039 Ex ires 9-30-813
2. Page 1 Information in the shaded areas is not
of required by Federal law, but is by State law.
~tf:F;~~~:-~t:~}:~iW~~!~i.~:;
·:t~a~aft11~iflt!l~tll!i·
,e. GENERA TOR'S CERTIFICATION: I heieby declare that the con1anls ol this consignment are fully and accurately described ■bov• by proper shipping name and are cl__.fled.
pecked. marked, and 18baled, and are In a11 raspecta In proper condition for transport by highway according to appUcable lnternallonal and national govarnmanl regulations and
· tru, laws ol the Slale of Soutti Carolina. ·
111 sm a large quantity generator, I certify th al I have a program In placo to reduce the volume and toxicity of waste generated to the degree I have determined lo M economk:alty
•• practicable and that I have selected the practicable method ol lroalmont. storage, or disposal currently available to me which minimizes the present and luture thr-1 to human
·•• health and tho environment OR, II I am a small quantity ganaralor. I have made a good la Ith effort lo minimize my was le gonerallon and select the best waste management method
•;,j 11'\at la available to me and that I can afford.
: Printed/Typed Name
Charles R. Hansen
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous malerials covered by this manifest except as noled in Item 19.
P~ntedtTyped Nama Signature
Month Day Year
8 ... I ...,_ ....... _._.jibs. • l...,_ ...... ...._...,llbs.
b I pbs d I ilbs
Monlh Dey YNI
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
SE PRINT or TYPE {Form desi ned for use on elite 12-itch ewriter
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 6 o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Gene;atofsPhone 919 934-9711
Manifoet Document No. 0 0 2 2 8
5. Transporter 1 Company Name
Willms Truckin Co Inc.
6. U.S. EPA ID Number
S C D O 7 3 7
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
Form A
2. Page 1
ol
Buraau of Solid & Hazardous Waste Mgt
2600 Bull $tree~ Columbia, SC 29201
Phone: (BOJ) 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnlorm8tion in the shaded areas is not
required by Federal law, but is by State law.
E a Hazardous Waste' Solid' nos ORM-E lf;F,o'ii ,,f,;~
N 1-.::N'..:A:....:9~1~8:,:9~-----------------------l--1--11~D:...J.T:...I..J..J..J.:2:....!.'.0'...!,....;Y:._i:\:J.J~1 E:1 Q::=:1 D::1::6::l~f,ru.i
6 \..b_. _________________________________ _j_.J.-1~~L-i....L..J......J_L-i---l.·.:::'.1!,!':="·'·=i·-=;·-·= .. ==;·==·,.:• .. ,:;.,.~=.-··!.:~;::t);j,
:~1rt' , j · ,· · ,·:r C.
'B, .... ,Jtf
d.
~!~~f:"~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72353.
16. GENERATOR'S CERTIFICATION: I hereby declare that the conlen\.s ollhis consignment are fully and accurately described above by proper ahlpplng nam• and are clasail1od,
packed. marked, and taheled,and are in a11 respects in proper condition lortranspor1 by highway according to applicable lnlernalional and national government rogulations and
the laws cl the State ol South Carolina.
111 am a 1arc;ie Quantity generator, I certify that I have a program In placo to reduce the volume and toxicity of waste generated to the dog,_ t have de1arminod to be economically
praclicable and that J have selected the practicable mothod ol treatmont. storage, or dlspo:,.al currontly available lo me which minimizes the pres.en! and lurura lhreal to human
health and \he environment;OA, ii I am a sma!I quantity gonorator, I have made a good laith effort to minimize my waste generation and select the beal waata management m11thod
thal is available to me and that I can atford,
T 17. Transporter 1 A<.:Knowledgement of Receipt of Materials
Printed/Typed Name /I
m£5 {-I. 1 \CS oJ
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
Signature '
Signature
SC71J
'I'-'-.................
b l'-'-.I...L...&....L
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted ln Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete {OHEC 1988 (Rev. 10/86)]
Month Day Year
9 ( 7 ~7
Month Day Year
" C/ ~
Month Day Year
jibs. C I jibs.
!Jbs. d I !Jbs.
Month Day Year
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Wa,te Mgt
2600 Boll S"ee\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E.x ires 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. Manlloat Document No.· WASTE MANIFEST N c D o 7
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
Generator's Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
1 0 0 2 2
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 72354
2. Page 1
ol
1 D T
Information in the shaded a,eas is not
required by Federal law, but is by State law.
2 0 y
l~:~'.F.:1=1ff·ff'91~~
··:::~1E ,a ,a 1_61%
16. GENERATOR'S CERTIFICATION: I hereby declare that !he coritents olthis corislgrimeritare lullyarid accuralely described abova by proper ahlpplrig riam• ■nd ara clas■ilied.
packed. marked, arid labeled, arid are iri all respects in proper coridition for1rarispor1 by highway according to applicable international and riatlorial government regulatlon■ and
the laws of the State ol Sou!l"I Carolina.
111 am II large quantity generator, r cer1ify that I have a program In place to reduce the volume and loxlclty ofwaategenerated lo the dagree I have determined to be oconomlcally
practicable and that I have selected lhe practicable method cl treatment. storage, or dlspoaal currently avaltable to me which minimizes the present and future thre,at to huma.n
health end the environment OR, ii I am a small quantitygerlerator, I have mado a good faith etlor1 to minimize my waste generation and 1el11c1 the bet! waate management method
that is available to me and that I can atlord.
Signature
T 17. Trans porter 1 Ae;,cnowledgement ol Aeceipl of Materials
Printed/Typed Nam
Printed/Typed Name Signature
19. Discrepancy Indication Space
• I
b I
I ,-,..--::-,.,--,----::------,--,-,-.,-T 20. F acilify Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Re"v. 10/86)]
Month
09
Month
jibs. C I
!Jbs d I
Month
Day
"Day
Year
Year
jibs.
jll>s.
Year
I
E
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generetor'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 6
Form A
2. Pago 1
ol
Bureau ol Solid & Haz.ardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
3. G;~:~:: ~a;;:;dt ~a;i.ng Address :;;j;t~=;;fJEl~tti~Q1i!~(~i~~ii~t~1[~'..
r'"·..:G:::p•::.~:::•:.:r~:::•o::.
0
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2
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7
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5
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7
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7
_______________ t+rf;;;;e1;%~{fl:tlt1l~i~::tmb;Jmtt~~i}~tit1l~
5. Transporter 1 Company Name 6. U.S. EPA ID Number
Willms Truckin Co Inc. S C D O 7 3 · 7
7. Transporter 2 Company Name 8. U.S. EPA 10 Number
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) .12. Containers 13. Tot.al Quantity 14. Unil
No. Type 'MN•
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
J::,~~ ~M:;~~:~~,i!:il!i!]!!l:i,!:l!':':Iit;::s rtl1!l'.'.l~3;;;;:,j;ii1i;:i ii <M:':<:J: :::!:!'::
a.~-I012r7r7r4l-lld1012h<tANiic.L_.1..J-I r r r r 1-1 r r r h+
b. u..J-1 1-1 .... ,, ,fijjj!ittil!~t,+J-J .. , J--:1 r ,,,
15. Special Handling Instructions and Additional Information
GSX Work Order No. : 72355
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16. GENERA TOR'S CERTIFICATION: I hereby declare that the contents of this consignment are lully and accurately described above by proper shipping name and are classified.
r;,ecked. marked, and labeled, and are in all respecls in proper condition for tran:,port by highway according to applicable International and natlonal government r90ulatlon• and
the laws or the State ol Soulh Carolina.
111 am a largo quantity generator, I cortify thal I have a program in placo to reduce thevotume and to.11:lclty ofwaatogenoraled to the dogroe I have delermlnod to be oconomlulty
practicable and that I have selec1ed the practicable method ol treatmenl storage, or dlspoaal currently available lo mo which minimizes the r;,resent and future threat to human
health and the environment; OR, If I am a small quanlitygonerator. I have made a good lalth effort to minimize mywastegeneratlon and select the boat waits management method
tnat Is available to me and lhal I can afford.
Month Day
'7 I 7
ceipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I jibs. C I jibs.
b I jibs. d I jibs.
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifesl except as noted in Hem 19.
Printed/Typed Name Signaluro Month . Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/861)
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 o 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transponer 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a
12. Containers
No. Type
~~r~~~~
15. Special Handling Instructions ~nd Additional Information
GSX Work Order No.: 72356
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holiday~ [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
1 6. GENERATOR'S CERTIFICATION: I hereby declare th al the contents of this consignment are lully and accurately described above by proper shipping name and are classified,
pack ad, marked, and la°beled, and are in aU respects in proper condition for transport by highway according to applicable International and natlonal government regulations and
the laws of the State of South Carolina.
II I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity ol waste generated to the degree I have determined to be oconomlcally
practicable and that J have ,elected 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, ii I am a small quantity generator, I have made a good faith effort to minimize mywastageneraUon and select the best waste management molhod
that is available to me and that I can afford.
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
Month Day Year
' LI .l..J,_._J...L_,jlbs. c .__I ,._._ ...... .....,jibs.
bl jibs d I jibs.
Month Day Yea,
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [OHEC 1988 (Rev. 10/86)1
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE (on a 12-pitch (elite) typewriter] OR USE FIRM POINT PEN· PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owne~s or operators of hazardous waste treatment. I
storage. or disposal ficilities to use the U.S. EPA Form 8700-22 Rev. 9/86 [DHEC 1988 (REV 10/86)] and, if necessary, the continuation sheet U.S. EPA Form
8700-22A Rev.-9/86 (DHEC 1988A) foi both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States from
another country are responsible for completing the manifest Federal and State regulat_ions also requi/e generators and transpor1!:!rS ol hazardous waste and
owners or _operator~ _of haza.rdous waste treatment, storage, or disposal facilities to complete the !allowing information. I
GENERATOR SECTION
l. Generator's U.S. EPA ID Number -Manilest Document Number: Enter the generator's U.S. EPA twel11e digit identification number and the unique fi11e digit
number assigned to this manifest by the generator beginning with 00001.11 your company does not ha11e a U.S. EPA Identification Number, please contact S.C.1 OHEC at [phone] about obtaining an identification number.
2;. Page 1 of: . Enterthe~otal number of pages used to complete this manifest, i.e., the fiist page EPA Form.8700-22 Ae11. 9/86 {OHEC 1988 (REV 10/86)1 plus the
number of continuation sheets EPA Form 8700-22 Re11. 9/86A (OHEC 1988A) if any.
A:. Slate Manifest Document Number': .. Leave blank.
B: State Generator Identification Number: Lea11e blank.
3. Generator's Name and Mailing Address: Enter the name and mailing address of the generator who will manage the returned manilest lorms.
4. Generator's Phoiie Number: Enter a telephone number wilh area code where an authorized agent of the generator can be reached in the e11ent of an
emergency including nights. weekends. and holidays.
5. Transport 1 Company Name: Enter the company name of the first transporter who will transport the waste.
6. U.S. EPA 10 Number: Enter the U.S. EPA twel11e digit identification number of the first transporter identified in item 5.
C. Slate Transporter's ID Number:. Lea11e blank:
I
I
0. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the first transporter can be reached in the e11ent of
an emergency including nights, weekends, and holidays. I
1:. Transporter 2 Company Name: If applicable, enter the company name of the second transporter who will transport the waste. If more than 2 transporters will
be used, use a U.S. EPA Form 8700-22A Re11. 9/86 (OHEC 1988A) continuation sheet and list the transporters in the order they will be transporting the waste.
8 .. U.S. EPA ID Numbor:11 applicable. enter the U.S. EPA twel11e digit ID number al the second transporter identified in item 7.
E.. State Transporter's ID Number: _ Lea11e blank. I
F:. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the secorid transporter can be reac;:hed in the
event al an emergency including nights, weekends, and holidays.
9.. Designated Facility Name and Site Address: Enter the company name and site address ol the treatment, storage, or disposal lacility designated to recei11e the
waste listed on this manifest The address must be the site address. which may differ from the mailing address. :
10: U.S: EPA ID Number: Enter the U.S. EPA twel11e digit identification number of the designated treatment. storage. or disposal facility identified in item 9.
G:. Slate Facility's 10 Number: Lea11e blank.
H;. Facility's Phone Number: Enter a telephone number including area code where an authorized agent of the facility can be reached in the event of an
I
emergency including nights, weekends, and holidays. I
11'. U.S: DOT Descriptions: Enter Rroper shipping name, hazard class and 10 Number (UN/ NA) for each waste as identifie~ in 49 CFR 171-177. If additional space
is needed. use a U.S. EPA Form 8700-22A Re11. 9/86 (OHEC 1988A) Continuation Sheet.
12.. Containers (no. and type): Enter number al containers !or each waste and the appropriate abbre11iation from Table I (below) for the type of containers.
TABLE I
OM.= Metal drums. barrels, kegs TT= Cargo tanks (tank trucks) CM= Metal boxes. cartons. cases. roll offs
OW = Wooden drums, barrels, kegs TC = Tank cars CW= Wooden boxes. cartons. cases I
OF= Fiberboard or plastic drums. barrels. kegs OT= Dump truck CF= Fiber or plastic boxes. cartons. cases
TP = Tanks portable CY = Cylinders BA = Burlap. cloth, paper or plastic bags
Total Quantity: Enter total quantity ol waste described on each line. relati11e to the units used in item 14.
Unit (weight/volume): Enter the appropriate abbre11iations from Table II (below) for the unit of measure:
13 ..
14. I
Table II
P = Pounds L = Liters · K = KilogramS T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (liquid only)
I.. Waste Number: Enter hazardous waste numbers as specified in South Carolina Hazardous Waste Management Regulation A.61-79.261 Subparts C and D to I
identify the hazardous waste on each line.
J. Additional Descriptions for Materials Listed Above: In the spaces pro11ided, enter the authorization number(lrom the S.C. OHEC Authorization Request Form)
!or each waste stream listed in section 11 above. Note: Before any hazardous waste can be accepted for treatment. storage or disposal In South Carc;,lina, !he
generator must obtain prior authorization lrom the treatment. storage or disposal facility. I
K. Handling Codes lor Wastes Listed Above: Lea11e blank.
15 .. Special Handling Instructions and Additional Information: Generators may use this space to indicate special transportation, treatment. storage or disposal
information or Bill al Lading Information. For international shipments. generators must enter in this space the point of departure (city and slate) for those
shipments destined lor treatment, storage. or disposal outside lhe jurisdiction of the United States. I
16. Generator Certification: The generator must READ, SIGN (BY HAND IN INK), and DATE the certification stat7~e~t. If a,m?~e oth~r thafl high.w_ay i~ ~sed, the
word "highway" should be lined out and the appropriate mode (rail, water.or air) inserted in the space below. lt'anothet'moOe in addition to the highway mode is
used, enter the appropriate a.dditional mode (e.g.,.and. rail) in the space below.
TRANSPORTER SECTION
11: Transport~r 1 Acknowledgement: Enter th.e name ol the person accepting the waste on behall al the first transporter.
acceptance al the waste described on the'manifest bY signing (BY HAND IN INK) and enlering the DATE of receipt.
That person must acknowledge I
18. Transporter 2 Acknowledgement: Enter. if applicable, the name of the person accepting the waste oii behalf 01 the second transporter. That person must
acknowledge acceptance ol the waste described on the manifest by SIGNING (BY HANO IN INK) and entering the DATE al receipt I
FACILITY SECTION
19. Discrepancy Indication Space: The authorized representati11e of the designated facility's owner or operator must note in this space any discrepancy be!ween
the waste described on the 'maiiilest and the waste actUalty recei11ed at the facility. Owners and operators of facilities who cannot resolve signilicant
discrepancies within 15 days recei11ing the waste must submit to the Department a letter with a copy of the manifest describing the discrepancy and attempts to I
reconcile il The treatment, storage. or disposal facility must enter the actual weight al waste i_n pounds in the spaces pro11ided if the amount 11aries any from that
specified by the generator in item 13 or ii the generator uses a unit al measure other than pounds.
20. Facility Ownei-or Operator Certillcalion: Print or type the name al the person accepting the waste on behalf of the owner Or operator of the facility. That person
must acknowledge acceptanc·e of the waste described on ·the manifest by SIGNING (BY HAND IN INK}° and entering the DATE of receipt. I
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATMENT, STORAGE, OR DISPOSAL FACILITY DESIGNATED TO
RECEIVE THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WE!'YDftYS FROM 8:00 am TO 5:00 pm.
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
l Generator's Name and Mailing Address
Channel Master
ewriler
1. Generator's U.S. EPA ID No.
N C D O 7
P. O. Box 1416, Smithfield, NC 27577
Generalor'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
Form A
2. Page 1
of.
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Number) 12. Containers 13. Total Quantity 14. Uni!
No. Type 'MNrJ
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
~~~:~iMi~~i~ii1il!i1l~,\llili~iiill1l;lfli~!IJ~!lf:;::::1
a 1£..ilij-l0 12 , 7 17 14 1-111 l 10 I 2 l:im;n1+. c. LLJ-1 1-... I_.____._.__,
b. u...J.=1 1-1 · .... 1i!~iii!i'i1iiii'il~w.=.1.
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 72357
1 D T 2 0 Y
:ll~F/6\ifg"i'~
l~IF 10JOI61ff
16. GENERATOR'S CERTIFICATION: I hereby declo.rethal lhe contents of this consignment are lully and eccuratelydescrlbod above by proper shipping name and are clasadled,
packed, marked, and labeled. and are In all respects In propercondilion lorlransportbyhlghway according to appllcab1e lntamallonal and national governmant re,gulatlon1 and
tha laws ol the State ol South Carolina.
II I am a large quantity generator. I certify that I have a program In place to roduca the volume and toxicity ol waate generatod lo the deg,_ I have datermlnod lo be economlcally
precticabte and that I have selected the pract!cable method ol treatment. atorage, or dlaposal currently evalleble to me which mlnlrnl~aa lhe praMnt and future tt'lrNI to hu~n
health and the environment;OR, lrt am a small quantity generator, I have made a good faith effort to minimize my waste generation and se1ectttle beat waata management method
that is available to ma and that I can afford.
Signature Month Day Year
0 "J /J ?.i'
17. Transporter 1 At.:Knowledgement ol Receipt of Materials
Printed/Typed Name Signature Month Day Year
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signalure Month Day Year
19. Discrepancy Indication Space
• I pbs. C I pbs.
b I jibs. d I jibs.
20. Facility Owner or Operator, Certiricatlon ol receipt ol hazardous materlals covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Edllions arc Obsolete (DHEC 1988 (Rev. 10/86))
I
E
T
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA 10 No.
N C D 7 0
P. 0. Box 1416, Smithfield, NC 27577
Generalor's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facitify Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
a
Form A
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
b ..
C.
d.
~2>°'.~~:1~:( ~;~1!!'.;:i:!i;!!1,!l:1;1t1]:lr,~~1:t11:1~:f ;!~];:)f';1f /';r!:1riliff 11j::r!f;!1l\it1!:
a lf...ll:LI-IO 12 17 17141-11Jl1012 l!Mc'1!i!N!ii<-u..J-I 1-1 Eb
b. u..J-1 1 1 1 1 1-1 1 1 11:llll,!1lJ1fl~w:J 1 1 1-1 .1 __ 11f:
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72358
Buroau ol Solld & Haznrdous Was!• Mgl
2600 Bull Streel Columbia. SC 29201
Phone: (BOO) 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ire, 9-30-88
lnlormation in the shaded Meas is not
required by Federal law, but is by State law.
2 0 y
f :=.,-~:.·f·~)-,~~
,p;
16. GENERATOR'S CERTIFICATION: I horobydeclare lhat tho contents ol this consignment are fully and accurotelydncrlbed above by proper 11hipplng name and are clauilled,
packed. marked.and ta.beled, and are In all respects in proper condition !or tr1msport by highway according to applicable lnternaUonal and national government re,,;.ulatJon• aM:I
the laws of the S1.a1e ol South Carolina.
If I am II large quantity generator, I certify lhat1 have a program In placo·10 reduce the volume and toxlcltyol waste generated to the di,gree I have determined to be oeonomlully
practicable and Iha! I havo selected the practicable method ol treatment, storage, or dlspou.l currently available to me which mini ml.res the present and future throal to human
health and tha environment OR, If I am a small quantity generator, I have mado a good faith effort to minimize my waste generation and :,elect the beat waate managemonl method
that ia available to me and that I can afford.
ransporter 1 AcKnowledgement of Receipt ol M te·~ials
Typed Name -
o c'------J
rter 2 Acknowledgement ol Receipt of Materials
Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I 111>,. C I Pb,.
b I !lbs. d I Pb,.
20. Facility Owner or Operator. Certification of receipt of hazardous materials covered by this manifest except as noted in llem 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700•22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev, 10/86)1 -~ _,_
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Manlteat
Document No. WASTE MANIFEST N c D o 7 6 o 1 0 0 2 3 4
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,. Generator'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
Form A
2. Page 1
ol
Bureau of Solid & Haz.ardous Waste Mgl
· 2600 Bull Stree~ Columbia. SC 29201
Phone: (SOJ) 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 e:,p;res 9-30-88
Information in the shaded areas· is not
required by Federal law, but is by State law.
DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Conta;ners 13. Total Quantity 14. Una
No. Type 'MNrJ
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72359
1 D T 2 0 Y
iil;f';'o·,1,gf~~
yj1E1D1Q161ff
1 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol _this consignment are fully and accurately described above by proper shipping name and are cleaailled.
packed, marked, end 111.beled,and are in all respects in proper condition for transport by highway according to applicable International and national govemmenl r9guletlona and
U'le laws ol the State ol South Carolina.
111 am a large Quantity generator, I certify that I have a program In place to reduce the volume and to"lcltyol waste generated tothadogr-I have dater mined to be economically
practicable and that l have setocted the practicable method of treatment, storage, or dlsposal currently available to ma which minimizes tho present and future U'lreat to human
health and the environment OR. ii I am a small quantitygenoralor, I hove made a good lailh eNortlo minimize my waste ganerallon and select the beat waate manage men! method
that is available to me and that I can attord.
P1inted/T~ Name CHAt<LES R. HANSEN
Signature & L.,
Month Day Year
71 I 7 ~)
T 17. Transporter 1 Ac.;Knowledgement of Receipt of Materials
Printed/Typed Nam;/
;&~41'£..
Printed/Typed Name
19. Discrepancy Indication Space
Signature
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manrfesl except as noted In Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Prev;ous Ed;1;ons are Obsolete [DHEC 1988 (Rev. 10/86)]
a!....,__.L..L..,_._
b l....,__.L..L..,_._
Month Day Year
Oq I '7 7
Month Day Year
!lbs. C I !tbs.
!lbs. d I l'bs.
Month Day Year
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stroot Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. Manife11t Document No. 2. Page 1 Information in the shaded a<ees is not
N C D 0 1400235 ol required by Federal law, but is by State law.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Irie.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number)
..
C.
d.
12. Containers
No. Type
11~~,~~~~~;~1~~!!1r1!li!~i:;~!lir:}1!1!!lf'!1!llll:l~l1IJ1lijl~l1,l!!:1i1•1:1:1:1112:~!0i~:!'.l;;
a. l.tJlij-!O 12I7I7141-1 Id IO I 2 hi%f1id:+ c.LLJ-1 1-1 !:A
b.W.:.1 I. I I I 1-1 .. , '· I i[!!;!!li1l!lllli!d:W.:L, ... I,, .J:). ..... .rfm
15. Special Handlir)g Instructions and Additional Information
GSX Work Order No.: 72360
16. GENERATOR'S CERTIFICATION: I hereby declare that Iha contents ol ihlsconslonmentarelullyand accurately described above by proper shipping name and are clasaili.-c:t,
packed. marked, and raheled,and are in atl respects in proper condition tor transport by highway according to applicable International and nation at government r~ulations and
the laws ot the State ol South Carolina.
!fl am a large quantity generator, I car1ify that I have a program ln placoto reduce the volume and toxlcltyol waataganaratodtothadogroe I h•vo dot•rmlnod to be oconomicaJly
pr•cticable and that I have selected the practicable method of treatment. slorage, or dlspoaal currently available lo me which minlmlzn the present and lulUra threat to human
health and the environment: OR, 111 am a small quantity generator, I have made a good lalth effort to minimize mywaslo generation and selecl the beal waate management ~lhod
tha1 la available to ma and !hat I can afford.
T 17. Transporter 1 Aumowledgement ol Receipt of Materials
Printed IT yped Name
Printed/Typed Name
19. Discrepancy Indication Space
Signature
20. Facility Owner or Operator; Certificalion of receipt of hazardous materials covered by !his manifest except as noted In Item 19.
Prinled/Typed Name Signalure
EPA Form 8700-22 (Rev. 9/86) Previ~us Editions are Obsolete (DHEC 1988 (Rev. 10/86))
a I
b I
Year
S'?
Month
Month Day Year
pbs. C I !lbs.
!Jbs d I pt>s.
Monlh Day Year
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
EASE PAINT or TYPE (Form desi ned for use on elite 12-itch ewriter
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAtDNo.
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
~-Generato(sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of sc; Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Cfass, and ID Number)
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E.x ires 9-30-88
2. Page 1
of Information in the shaded areas is not
required by Federal law, but is by State law.
12. Containers 13. Total Quantity U. Unit
No. Type WtJV~
IN
E a Hazardous Waste, Solid, nos ORM-E !iPffo'f!(tf;'~~:
NA 9189 1 D T 2 0 Y ·J, E ! Q IQ I 6 hr
!6
: ~b.__:::::_.:.::.::..:... ________________ _j.......1......Ji.:._i:::...t.:..J._1._l_J.::..l::...J.--_'.__j.2'ij.::::.,,,=. "'==.,M==cs:=~,:::",.::.lci
' c_
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72361
\~ I I/): d <.,
=:,ii ,:jf:
=·:••:_::,;-~=:·/··;· ·1 •,,,,:-.•:-:;:;--,,::?:·
\\1 ~ ~~~~J1·=·,<• I~~
1e. CENERATOR'S CERTIFICATION: I horobydoc1aro that tho contents ol thlscons~nmentarofurtyand accuratelydascrlbed above by proper shipping name and are clasadied.
packed. marked, and la'beled, and are ln all respects in proporeonditlon !or transport by highway according to applicable lnlornallonal and national government r9gulatlona at'\d
tho laws ol tho Stale ol South Carolina.
111 am a large quantity generator, I certify that I have a program ln place to reduce the volume and toKlcltyol waste generated to tho degree I have determined lo be economically
practicable and Iha! I have selected the practicable method of lrealmenl storage, or disposal currently available to me which minimizes !he present and luhJre truNI to hu""'n
health and the environment.: QR, II I am o smalt quantitygonoralor, I have mado a good laith effort to minimize my waste generation and select the be,t wa,10 management method
that is available 10 mo and Iha! I can afford. ·
Signature
17. Transporter 1 Ac.:1mowledgement of Receipt of Materials
19. Discrepancy Indication Space
• ... I .._._......._ ....... l'bs. ' l ....................... ~l1bs.
b I !lbs. d I !lbs.
20. Facility Owner or Operator: Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Street Columbia. SC 29201
Phone: [phone]
SE PRINT or TYPE (Form dest ned for use on elite 12-itch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generalor'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No,: 72362
Emergency & Holidays.: (603)734-542•
Form A roved. 0MB No. 2050-0039 E.x ires 9-30-88
2. Page 1 Information in the shaded .weas is not
ol required by Federal law, but is by State law.
12. Containers 13, Total Quantity 14. Unit ·tUW&lt11t'Nufflbeir:;o:+
No. Type 'M/Vr). hfr}%"~\+:H}a¥ff?{
16. GENERATOR0S CERTIFICATION: I horoby declare that the con1en1s olthls consignment are fully and accurately described above by proper shipping name and are clan,ried,
packed. marked, and l8beled, and are in all respects in proper condition for transport by highway according to appUcable lnlernational and national government re,gulatlona al'\d
the laws ol lhe State ol South Carolina.
II I am a large Quantity generator, I certify that I have a program tn place to reduce the volume and toxicity of waste generated lo the degree I have determined to be 6Conomlcally
practicable and Iha! I have selected the practicable method ol treatment, storage, or disposal currently available to mo which minimizes the present and lutura threat to human
health and the environment; OR. II I am a small ciuantitygeneralor. I have made a good laith effort lo minimize mywastegeneratlon and select Iha beat waste managamenl method
that is available to me and that I can afford.
Signature R
Month Day Year
69 ,, 'l ~,
T 17. Transporter 1 A<.:1<nowledgement ol Receipt ol Materials
Printed/Typed Name
04'~// /:tr7.;;;_. Signature lj_,.,~ Month Day Year
Printed/Typed Name Signature Monti, Day Year
19. Discrepancy Indication Space ·
a I jibs. C I Jibs.
b I pbs. dJ pbs.
20. Facility Owner or Operator. Certification of receipl ol hazardous materials covered by this manifest except as noled In Item 19.
Printed/Typed Name Signature Month Day Year
.EPA Form 8700·22 (Rev. 9/86) Prf:vious Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
I
E
South Carolina Department of Health
and Environmental Control
SE PRINT or TYPE (Form desi ned for use on elite 12-itch ewriter Form A
UNIFORM HAZARDOUS 1. Generator's U.S. EPAID No. Manlleal 2. Page 1
WASTE MANIFEST N c D o Document No. of 1 4 0 0 2 3 8
3. Generator's Name and Mailing Address
Channel Master
P.· 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
C D O 7 3
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
a.
b.
C.
d.
Hazardous
NA 9189
Waste, Solid, nos ORM-E
15. Special Handling Instructions and Additional Information
GSX Work Order No,: 72363
1 D T
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street, Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: (8-03)734-5424
roved. 0MB No. 2050-0039 E, ires 9-30-Ba
Information in the shaded a<eas is not
required by Federal law, but is by State law.
2 0 y
18. GENERA TOR'S CERTIFICATION: I hereby declare that the contenls of this conaignmenl are fully and accurately described above by proper ahlpplng name and are claa.1fled.
packed, marked, and labeled, and are In all respects In proper condition for transport by highway according to appUcab1o lnternallonal and natlonal government ra,gulatlon• and
the laws of !he State ol South Carolina.
111 am a large quantity generator, I certify that I have a prcvram In place to reducethovolume and toxlcltyofwasitegenerated lo !he ditgr-I have determined to be economically
practicable and that I have selected the practicable method ol treatment. storage, or dlsposal currently available to mo which minimizes tho present and future lhraal to human
health and tho environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my wasla genorallon and select the be1I wa1to management method
that is available to me and that I can afford.
HANSEN Signature Month
0
T 17. Transporter 1 AcKnowledgement ol Receipt of Materials
Printed/Typed Name Signature Monl/l Day Year
18. Transporter 2 Acknowledgement ol Receipt ol Materials·
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I !lbs.
b I pbs. d I pbs.
I 1----,,-------,-----,---,--,--T 20. Facility Owner or Operator: Certification of receipl of hazardous materials covered by lhis manilesl except as noted in Item 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete {DHEC 1988 (Rev. 10/86)]
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE {Form desi ned for use on elite 12-itch ewriler
UNIFORM HAZARDOUS 1. Generator's U.S. EPA 10 No.
WASTE MANIFEST N c D o 7 6 o l
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416,
4. Generator's Phone 919
5. Transporter 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7 .. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
SCD070
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bult Street. Columbia, SC 29201
· Phone: [phone]
Emergency & Holidays: [phone]
roved. OMS No, 2050-0039 Ex ires 9-30-8&
Information in the shaded Meas is not
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID N.umber) 12. Containers 13. Total Quantity U. Unit ,'i.twat:l'"NUfflbeif/(
No. Type 'MIVQ i/{\\i:J/#t,1N(Wt'
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
~~~~~~-~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72364
2 0 Y
;~'rf Yff;i'Nt~z
<!IE ,a ,a 16 ,~i:
16. GENERATOR'S CERTIFICATION: I horebydoclerethat the cont9nts of this conalgnmenlarefully and accurately described above by proper ehlpplng nam• and are clasa,fled,
packed, marked, and 1a·beled, and are in au respects In proper condition tor lransportbyhlghwayaccording to appUcable lnternallonal and national governm•nl ra,gulatlon, al"ICI
the laws ol the State or Soulh Carolina.
If I •ma large ci\Jantity generator, I cor1ify that I have II program In place to reduce the volume and toxlcltyol waategenerated to !he degree I have delermined lo be economic.ally
prac1icable and that I have selected the prac1icable melhod ol treatmanl, storage, or dlspoaal currently available to me which minimizes the present and lutura t:hr-1 to human
health and the environment OR, 111 am a small ciuanlity generator, I have mado a good faith eHor1 to minimize my waste generation and select Iha best waste management molhod
that Is available lo me and lh11t I can oHord.
Signalure Month Yea,
17. Transporter 1 Aumowledgement ol Receipt ol Materials
Printed/Typed Name
, J) C""r -:e LJ Month Day Year
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I pbs. C I pbs.
bl !lbs. d I jibs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700•22 (Rev. 9/86) Prev_ious Editions are Obsolele [DHEC 1988 (Rev. 10/86)}
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
ewriter
1. Generator's U.S. EPA ID No.
N C D 0
ManUeat Document No. 0 0 2 4
P. 0. Box 1416, Smithfield, NC 27577
4. Generalor'•Phone [phone]
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Numbe;
SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
Bureau ol Solid & Haz.ardous Waste Mgl
2600 Bull S•ee\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
e a.. Hazardous Waste, Solid, nos ORM-E :iifi'Ji'io~f1'9"1},~
N NA 9189 l D T 2 0 Y •;j1E1P1P161i
'~b_._·-----------------------------------jf-L.L+...1-1-LL.L...l.-J---l-·:~l!l:::~=··'·=~-==:!,='=··=·:.:~;:.1:;ii
.·-. ..:.· •. -~--••' ti ~1 ~~~~J·;·~~> C.
15. Special Handling Instructions and Additional 1nlormalion
GSX·Work Order No.: 72365
'.lf_ I !Jfr
-•;;•,; ;,, ... :.:..:::~:-':•·':••::,,,.,. /(~i~~~~j
16. GENERATOR'S CERTIFICATION: I harebydaclarftthal the contenls ol this consignment are fully and accuratelydascrlbed above by proper ehipplng name and ara claHilled.
packed, marked. and ie:ba1ed, and are In all respects in proper condition !or transport by highway according to appllceble lntarna1lonal and national government r9Qulatlon1 at'KI
tho laws Ol lho State ol Soulh Carolina.
111 am a large quantity generelor, I certify that I havo a program In place to reduce the volume and toxicity of waste generated lo Iha de,groe I have dotormln&d to be economlea.tty
pr11ct1cable and that I have selected the practicable method ol treatment, storage, or dlspo&al currenl1y available lo ma which minimizes the present and lutur• throat to human
health and the environment;OR, lfl am a smoll quantity generator, I have modo a good faith eftor1 lo minimize my waste ganerallon and select the beat waa\a managam•nt ~thod
that it available to me and lhat I can afford,
Signature
Materials
Signature
Signature
19. Discrepancy Indication Space
'I
bl
20. Facility Owner or Operator; Certification of receipt of hazardous malerials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsole1e (DHEC 1988 (Rev.10/86)(
pbs.
Month
a
Month
C I
pbs. d I
Month
Yaar
Day Yaar
pbs.
pbs.
Day_ Yw
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generalor's U.S. EPAID No.
WASTE MANIFEST N c D o 7 6 o 4 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone · 919
5. Transporter 1 Com·pany Name
Smithfield,
934-97i 1
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7
8, U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
Form A
2. Page 1
ol
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x ires 9-30-88
Information in the shaded areas is not
required by Federal law, bul is by Stale law.
DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity 14. Unit :L\,waste·Ntdbei--:C-:+
No. Type 'M/Vrj /i}if<\{f,tti~}f_t{
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additiolial lnlo~matlon
CSX Work Order No.: 72366
1 D T 2 0 Y
,e. CENEAATOA"S CERTIFICATION: I herebydeclere that the contents ol thlsconalgnmenterolutlyand accurately described above by proper shipping nama and ara clasailltld,
packed. marked, and la"beted,and are In all respects in proper condilion for transport by highway according to applicable International and naUonal governmanl ra,gutatlons and
trie laws of the Stale ol South Carolina.
111 am a large quantity generator. I certify that I have a program In place to reduce the volume and to11lcltyol waste generated to the degree I have determined to be economlcally
practicable and lhal r have selected the practicable method ol treatment, storage, or dlspoaal curranUy aVo.itable to me which minimizes the preaent and future thrMI to hunwin
health and the environment OR, lfl am a small quantity generator, I have made a good faith effort lo minimize my waste generation and selec1 the beat waste managamanl metr'IOd
that ls available lo me and that I can afford.
cR1:i:WrfseR. HANSEN Signature %_,,,t( Month Day Year
~ ( ~
T 17. Transporter 1 Aumowledgement ol Receipt of Materials
Prinled/Typed Name
J. ~.(
Prinled/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
'I Jibs CI Jibs
b I jibs d I Jibs
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted In Item 19,
Printed/Typed Name Signalure Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions'tre Obsolele [DHEC 1988 (Rev. 10/86)1
I
South Carolina Department of Health
and Environmental Control
Form A
UNIFORM HAZARDOUS 1. Generalor's U.S. EPAID No.
WASTE MANIFEST N c D 1
2. Page 1
ol
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4, Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7
10. U.S. EPA ID Number
11. U.S. DOT Description (incfud_ing Proper Shipping Name, Hazard Class, and ID Num_ber)
C.
d.
ti~~;~:~~:~i~u\iiltl,:l!rl!lllrlitu!ltll~llllWitlllif llllll\1ll!lii
a.lLJRj-!0,2,7r7,4!-!1,1,o,21;;;:;!i)ilJc.LLJ-1 I I J I ,-, I I J l\1i
b. LLJ:1 ,-, __ ,!lir.1!!/::;!:~!!fr~w:J.! .. ! .. '-----.J:J ........ ,t~;!
15. Special Handling Instructions and Additional 1nlormation
GSX Work Order No.: 72367
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded ateas is nol
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I harabydac1ara that Iha conlants ot lhlsconslgnmantarefullyand accurately described above by proper ahtpplng nam• and are claWlled.
packed, marked, and laholed, end are in all respects in proper condition tor transport by highway according to applicable International and national government regulation• aM
the laws ol the Stale ol South Carolina.
111 am a large Quanlity generator, I certify that I have a program In place to reduce the volume and 10,dcltyol waste generated to the degree I have determined to be economically
practicable and that I have selected the practicable method of treatment, storage, or dlspoaal currently available to ma which minimizes the present and lul\Jr• lhreat to human
health and the environment: OR, ii I am a small quantity goneralor, I have made a good laith eNort to minimize my waste generation and select the boat waata management m-ethod
that is available to me and that I con afford.
Printed/Typed Name RO,CER [ COAT$ Signature Month Year
0
T 17. Transporter 1 Ac.:Knowledgement of Receipt of Materials
Printed/T ped Name
.9,C a,,('.,( 77o,.. Signature ~ ~, Month Day Year
Printed/Typed Name Signature Month Day Yea,
19. Discrepancy Indication Space
I I jibs. C I jibs.
b I jibs. d I Jibs.
I
T 20. Facility Owner or Operator; Certification of receipt ol hazardous malerials covered by this manifest excepl as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolole (DHEC 1988 (Rev. 10/86)1
I
. '·'='-,
11;:!!ll!~.•,-C
South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columb;a, SC 29201
Phone: [phone]
Emergency & HoUdays: (803)73-4-5424
Form A roved. 0MB No. 2050-0039 E.x ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
Manlleat 2. Page 1 Document No. of 1400243
Information in the shaded areas is not
required by Federal law. but is by State law.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
S. Tninsporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC,. Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
,,. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers 13. Total Quantity 14. Unit
No. Type 'MN<I
::~t7f'*!i:~~11!!1i]/t1;~!~:~~•(:~1!~1j!t~1iwlll!r~!r:1! ,!l!!)!iJ:iJ~~i
b. LLJ-1 1-1. i Jti1f1!!1ll~l!{dLLJ-i,11 i __ J-1 i .. J~,~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72368
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents olthls consignment are lullyand accuratotydoscribed ebove by proper ahlpplng name and are clasaifi-.d,
packed, marked, and laheled, and are In all respects in proper condilion for transpor1 by highway according to applicable International and naUonal government rogulatlona and
the laws of the Stale of South Carolina. ·
111 am a large Quantity generator, I certify that I have a program in placa to reduce thevolumeand loxlcltyolwastagoneraled to the dogrM I have determined lo be economically
practicable and that I have selected the praclicable method ol treatmant. storage, or dlspoaal currenlly available lo mo which minimizes tho present •nd luturo lhr-1 lO human
r-.ealth and ttle environment: OR, ii I am a small quantity generator, I have made a good laith t1Nortto mlnimlH mywasle generation and select the boil w111te management method
Iha! ls available to me and that I con afford. '
?rinted/Typed Name RO'.CER L COATS Signature
/A.)'
aterials
Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operalor; Certilicatron ol receipt ol hazardous malerlats covered by this manifest except as noted In Item 19.
?rinted/Typed Name Signature
Month
(J
Year
'1
Month Day Year
Month Day Year
E?A Form 8700•22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12-itch ewriler
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. Manifest
Document No. WASTE MANIFEST N c D o o l 0 0 2 4 4
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
Form A
2. Page 1
al
1 D T
~,~~~:0~~~~~l1!l!!i!!!~l~!l:!:l:i:;i:i!l~1~l_l~l!l~2!il!:::Jil;!:~:11::1'.:;f::::A1il;1/i~:~![~
alP__iHJ-lo,2,7,7,41-lld,0,2Lnitm\1%c.LLJ-I I 1 1 1 1-1 1 I I hw,
b. LLJ-1 1-1 1lll~ll!~t~w:J .......... J.:L ... 1 • .i~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72369
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a,eas is no1
required by Federal law, but is by State la'#.
2 0 Y
~lfF .. ·-{O~i:'t"Jgf~
yj1E1a,016r~r
16. GENERATOR'S CERTIFICATION: I hereby declare th al the contents ot this consignment are fully and accuretely described above by proper shipping name and are clasailied.
packed. marked.and 1a'beled, and are ln all respects in proper condition !or transport by highway according to applicable International and national government regulation• and
the laws cl the SI.ale ol South Carolina.
II I am a large Quantity generator, I certlty that I have a program In place to reduce the volume and toxicity cl waste generated to the degree I have determined to be economically
practicable and lhat I have selected !he pracllcabte melhod ol lreatment, storage, or dlspoaal currently available to me which minlmlz11111 the present and lutura throe.I to human
health and the environment OR, If I am a small quantity generator, I have made 11 good ta Ith eNort lo minimize my weste generation and selecl the be al waata management ff'ltlll"lod
thal is available to me and that I can aNord.
Printed/Typed Name RO.GER L. COATS Signature
T 17. Transporter 1 Ac;1enowledgement ol Receipt of Materials
Typ~ N::; '}c;,.J.__ t7
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I libs. C I Jibs.
bJ pbs. d I pbs. ,,_ _____________ _
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 Signalure Month Day Year
EPA Form 8700~22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi writer
Manifest Document No. UNIFORM HAZARDOUS
WASTE MANIFEST
t Generator's U.S. EPA ID No.
NCDO 760 1400245
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. GeneratofsPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name. Hazard Class, and 10 Number}
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
fs. Special Handling lnslructions and Additional Information
GSX Work Order No.: 72370
Form A
2. Page 1
of
l D T
Bureau of Solid & Hazardous wa,te Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.xpires 9-30-88
lnlormation in the shaded areas is nol
required by Federal law, but is by State law.
2 0 Y
, 8. GENERATOR'S CERTIFICATION: I horoby doc1are that the contents of this consignment are fully and accurately described above by proper shipping name a rod are cl•saified.
packed, marked, a rod laheled, a rod are lro au respects in propor eorodition tor trarosport by highway according toapplicabla International and national govemment regul•tions and
the laws of the State ol South Carolina.
111 am a largo quantity generator, I cortily that I havo a program In placoto reduce the volume and toxlcltyol wastegeneratodtothodogroe I hove dotormlrood to be oconomlcally
practicable and that I have selected the practicable method ol treatment, storage, or disposal currently available to mo which minimizes the proe.erot 1md future ll'\roat to hum.an
health and the erovironmerot; OR, If I am a small quantity generator, I have mado a good faith oNort to minimize my waste goroaratlon and select tho best waste manogemant method
that is available to me and that I can aNord.
Printed/Typed Name
T 17. Transporter l Ac.:Knowledgement of Receipt ol Materials
Printed/Typed ~ . ,~ ar, ~-
18. Transporter 2 Acknowledgement ol Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
} Signature
'(7,._/
Signature
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
• IL...L.J...J...J...,L
b IL..L..WL..L.J.
Month Day
CJ
Monlh Day Year
i!? 9 /i
Month Day Year
jibs. C I jibs.
pbs d I 111>s.
Month Day y..,
p
South Carolina pepartment of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Boll Stree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
SE PRINT or TYPE (Form de,1 ned for use on elite 12-itch wriler Form A roved. 0MB No. 2050-0039 E.r ire, 9-30-68
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D l
Manife■t 2. Page 1 lnlormelion in the shaded a<eas ia not 8os,,m.,nt4No, ol u L O required by Federal law, but is by State law.
3. Generator's Name and Mailing Address
Channel Master
P, O. Box 1416, Smithfield, NC 27577
4. Generatofs Phone 9 l 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
B. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
~l;t!;=;~,'.~i:::]J:;;::;~::~;I:i(:J~{:C(S.
iai~~;f? l~t~~~~Jt~~:;1~:}'.(:t:~~1¾m:~i;~~lr
12. Containers 13. Total Quantity 14. Unij
No. Type 'M/Vo
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T
:;;;~yf::•,;'[f{ff~ir?ii
2 a y l,f,a,a,5,I
t§P~~!~
15. Special Handling Instructions and Additional rnrormalion
GSX Work Order No.: 72371
, e. GENERATOR'S CERTIFICATION: I hereby declare that !he contents of this consignment are fully and accuratoly daacrlbed above by pro?(lr ahlpplng name and are classified.
packed. marked. and labeled, and are in e11 respects In proper conditlol'l lor transport by highway according to applicable lnlernational and national govern men I regulations and
the laws of the State ol South Carolina.
111 am a large ciuanlity ganerat0r. I certify that I have a program tn place to reduce tho volume and loxiclty ol waste generated to tho degree I have determined to be oc:onorniully
practicable and thal I have selected lhe practicable method or treatment, storage. or disposal currently available lo me which minimizes the present and luturo threat lO human
health and tho environment: OR. If I am a small Quantity generator. I have made a good lailh eNort to minimize my waste generation and select the beat wa1te management methOd
that ia a\'ailab1e to me and that I con aNord.
Printed/Typed Name R0:CER LtOA S
17. Transporter 1 Ac,mowledgement ol Receipl of Materials
Printed/Typed Name
.,7 V",,,..._
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
F a I I b~, ~ Pb& CI Pb&
jibs. d I l'ba.
I
T 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete fOHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generalor"sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
Manlre11t Document No. 1400247
6. U.S. EPA 10 Number
S C D 0 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
S C D 0 7 0
Form A
2. Page 1
ol
Emergency & Holidays: [phone]
roved. 0MB No. 2050.0039 Expire$ 9·30·88
Information in the shaded .weas is not
required by Federal law, bul is by State law.
!~'.~!~l:~:~t'::::\tli'.'.;iil'i'.it}ifi:t
iillt~t~t{11:l)It~t~~1t~t1:iW!;lif ;~~,~~:~~
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit
No. Type 'M/Vri.
a
C.
d.
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 72372
1e. GENERATOR'S CERTIFICATION: I hereby declare thal Iha conlents of lhlsconslgnmenlare lullyand accuralely described above by pro~r ahlpplng name and are clasaiflod.
packed. marked, and 18beled,and are in a11 respects in proper condition !or transport by highway according toappUcable lnlernatlonal and natlonal government regulatlons and
the laws ol the State ol South Carolina.
111 am a large quantity generator, I cer1ify thatt have a program ln place to reduce the volume and toxlcltyolwastegeneratod lo the degr&e I have da1armlned to be economically
practicable and that I have selected Iha practicable method ol lraelment, storage, or dlspoaa1 currenlly available to me which mlnlmlta1 the praNnt and luture threat to human
health and the environ men!; OR, 1ft am a small Quantity generator, I have made a good talth eHort to minimize my waste generation and Hlecl the beat wute management methOd
thal is available 10 me and lhal I can afford.
Printed/Typed Name RO.GER L. COATS Signature
T 17. Transponer 1 Ae;1mowledgement of Receipt of Materials
~~hTyped Name f\ H rf\ · .1-1 ~ K'\ a ,J-S
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
20. Facility Owner or Operator: Certification of receipt ol hazardous malerials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolele (DHEC 1988 (Rev. 10/86)(
Month Day Year
a ... I .L.J....L..L-'-'pbs. c I ....... .L.J......__,!lbs.
b I pbs. d I !lbs.
Month Day Yw
I
I
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi ewriter
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. Manlfoat
Document No.
3. Generator's Name and Mailing Address
Channel Master
N C D O 7
P. O. Box 1416, Smithfield, NC 27577
•.Generato~sPhona 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7 .. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 2_55
Pinewood SC 29125
1400248
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
Emergency & f-!olidays: [phone]
Form A roved. 0MB No, 2050-0039 Ex ires 9-30-88
2. Page 1 lnfOrmaUon in the shaded areas is no!
ol required by Federal law, but is by State law.
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Uni! -~~t"~~~\½i
No. Type WtJVa n1?M}Vt?:J;Ji,@f;{
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
i~,~~~i~i;~;
a. lE.iliJ-10 ,2,717141-11, 1,0,
b W::: 1-1 1 r r J;!!1'':''';/:'::1d:W:::J.
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 72373
1 D T 2 0 Y
I I I 1-1
16. GENERATOR'S CERTIFICATION: 1 hereby declare that the contents olthis consignment are lullyand accurately described above by proper ahipplng name and are clasailied.
packed, marked, and laheted.and are in all respects in proper condilion lortranspor1 by highway according to appUcab1e lntarnatlonal and national government reoulatlon• and
tna laws ol tha State_of South Carolina.
Ill am a large Quantity generator. I certify that I have a program In placo to reduce thevotumeandtoxlclty ofwaalegenera.tod lo the dogr-1 have determined lo be economlcally
pra.clicabla and that I have selected the practicable method ol treatmont. storaga,"or disposal currently available to mo which minimizes the pres.ant and future throat to human
health and Iha environment; OR, II I am a smo.lt Quantity generator. I have made a good faith effort to minimize my waste generation and select the t>eat waata management rMtthod
that ia available to ma and ttJat I can afford.
Printed/Typed Name ROGER L COATS Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
Month
0
Month
0
Month Day Year
8 IL...L.J...L...1-'..J!Jbs. C 1 .................... _,Pbs.
b I !Jbs. d I jibs.
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 Month Day Year
EPA Form ~700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)}
I
.-A-·.
'"""''"'.'-')~
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi
UNIFORM HAZARDOUS
WASTE MANIFEST
1 Generator's Name and Mailing Address
Channel Master
writer
1. Generator's U.S. EPA ID No.
NCDO 760
Manifest Document No. 140024
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name an"d Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name. Hazard Class, and ID Number}
a.
C.
d.
Form A
2. Page 1
of
~~~~:~~~
15. Special Handling lnslructions and Additional Information
GSX Work Order No.: 72374
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ire, 9-30-88
lnlormation in the shaded Meas is not
required by Federal law, but is by State raw.
, e. GENERA TOR'S CERTIFICATION: I hereby declare that the contents cl this consignment are fully and accurately described above by pro par shipping name and are claWlleod,
packed. marked, and 1a·beled,and are in all respects in proper condition for transport by highway according to applicable International and national government r.-;;iulatlons a~
the laws ol the Slate ol South Carolina.
111 am a large quanlity generator, I cer1ity that I have a program In place to reduce the volume and 10-.lclty of waste generated to the dog roe I have datermlne,d to be economically
practicable and 1ha11 have selected the practicable method of treatment, storage, or dlspoaal currenlly available to ma which mlnlmlzea the present and lutura throat to human
health and the environment;OR, 111 am a small quantity generator, I have made e good laith etfortto minimize mywasla generation and select the best waste management mothod
that is available to ma and that I can atford.
Printed/Typed Name RO.GERL. COATS Month Day Year
a
T 17. Transporter 1 Atacnowledgement ol Receipt of Materials
Pri ,;x ,fiJ}J/ 1
18. Transporter 2 Acknowledgement ol Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
· EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsoloto (DHEC 1988 (Rev. 10/86))
a!~.._._..__..
bl~ ...............
Month o,q
Month Day Year
jibs. C I I jibs.
pbs. d I !lbs.
Month Day Year
I South Carolina Department of Health
and Environmental Control
E PR.INT or TYPE (Form desi ned for use on elite 12· ilch ewrller
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o 7 6 o 1
3. Generator's Name and Mailing Address
Channel Master
P •. Q. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7 0 9
8. U.S. EPA ID Number
10, U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
GSX Work Order No.: 72375
Form A
2. Page 1
ol
12. Containers
No, Type
1 D T
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x ires 9-30-88
Information in the shaded areas is not
required by Federal law, bul is by State raw.
~~jf:F··-(cii'ifgt~
2 O Y a1F1010161~
16. GENERATOR'S CERTIFICATION; I hereby declare that tho contents of this consignment are lully and accurately described above by proper a hipping name and are clasailied,
packed, marked, and la.boled,and are in all respects in proper condition lortranspor1 by highway according to applicable International and national government r~ulation.1 al"ld
Iha laws ol tha Stale of Soulh Carolina.
Ill am a large Quantity generator, I certify tho! I have a pro,..ram In place to reducethevolume and toxicity ol waategeneratad to the degr-1 have determined to be aconomlcally
practicable and that I have selected the practicable method of treatment. storage, or dlspoaal currently available to ma which minimizes the present and future U"lr-1 to human
health and Iha environment: OR, Ur am a small quanlitygenerator, I have made a good faith atfor1 to minimize my waste generation and aelact Iha beat waata managemanl method
that ia available to ma and that I can atlord.
Printed/Typed Name ROGER L COATS Signature Month
0
gement of Receipt of Materials
0
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I !lbs.
bl !lbs. d I !Jbs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
~rioted/Typed Name Signature Month Doy Year
EPA Form 8700-22 (Rev. 9/88) l',evlous Editions nre Obaotata [OHEC 1888 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12· itch wriler
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
NCDO 760 1
P. 0. Box 1416, Smithfield, NC 27577
4. GeneratofsPhone 919 934-9711
5. Transporter 1 Com·pany Name
Willms Truckin Co Inc.
7. Transporter.2 Company Name
6. U.S. EPA ID Number
S C D O 7
Manifest Document No. 0 0 2 5 1
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
Form A
2. Page 1
of
1 D T
¥~~~~.~
b.W:L. 1-1 ..... 1/iiiiiFifa~:W:J LJ-:1 .......... ,.1,.,le
15. Special Handling Instructions and Additional lnlormalion
·GSX Work Order No.: 72376
Bureau of Solid & Hazardous Waste Mgt
2600 Bull S~ee\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays:_ [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded Meas is not
required by Federal law, but is by State law.
2 0 Y
t}!¾:F','Oll1'9T~~
~t!IE1D1b161\i
,e. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are lullyand accuratelydoscribod above by proper ahlpplng name and aroclas-ifiod,
packed, markod, and 1a·beled, and are in all respects in proper condition for transport by highway according to applicable International and national government r~ulatlons and
the laws of the State of Soulh Carolina.
111 am a large quantity generolor, I cortily that I have a program In place to reduce thavotumo and toxicity ofwasloganerated to the degre111 I have determin&d lo be economically
practicable and lhel I have 11elected tho praclicable method ol treatment, slorage, or dlspoa.e,I currently available lo mo which minimizes tho present and lutura lhr-1 to human
heallh and !he environment: OR. ii I am o small quantitygonoralor, I have mado a good laith ettor1 to minimize mywastegonoratlon and selocl the beat wa1to management mothod
that is available to me end thnt I con olford. ·
Printed/Typed Name ROCER L. COATS Signature
T 17. Transporter 1 At;,cnowledgement of Receipt of Materials ·
Prinled/Typ~e /
· Pn/1 S C!!Cf',f?/7£
18. Transporter 2 Acknowledgement of ReCeipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator: Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Slgnelure
EPA Form 8700-22 (Rev. 9186) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
Month Day Year
a '-I .L...L..L..1-...,_,!lbo. c !L..L...L...1...L..1.-'pt,,.
b I !Ibo. d I !Ibo.
Month Day Year
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (B03)734-5424
Form A roved. 0MB No. 2050.0039 Ex ires 9·30·88
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. Manlleat Document No. WASTE MANIFEST N c D o 7 o 0 0 2 5 2
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generato~sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Descriptio~ (including Proper Shipping Name, Hazard Class, and ID Number)
15. Si>ecial Handling Instructions and Additional Information
GSX Work Order No.: 72377
12. Containers
No. Type
Information in the shaded a<eas is not
r_equired by Federal law, but is by Stale law.
13. Total Quantity 1 ◄. Unil VW&SIINuniberch
WtNd '.::)?(t\rt:tmf.!NJ:tr
1 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are clusilied,
packed, marked, and labeled, and are in a11 respecls in proper condition tor transport by highway according to applicable International and naUonal government regulations and
the laws of the State ol South Carolina.
II I am a large quantity generator, I certify that I have a program In place to reducelhevolume and toxlcltyol waatogeneratedtothodogree I have determined to be oc:oRomleally
pract1cable and that I have selected tho practicable method ol treatment, storage, or dlapoaal currently available lo me which minimize, the present and future thr-t to human
health and the environment;OR, lfl am a small quantity generator. I have mode a good lailh eHortto minimize my waste generation and select the beatwaate management method
that fs available to me and that I can afford.
Printed/Typed Name RO.GER L. COATS'
Signature
T 17. Transporter 1 Ac.:1mowledgement of Receipt o! Materials
Printed/Typedwm 1 ,.--/'. I
' I I '
Signature
18. Transporter12 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by !his manifesl eiccept as noled in Item 19,
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolele [DHEC 1988 (Rev. 10/86))
Month Day Year
8 !......_.....,_........__,/1bs. C ._/ ,L.J..-'--'-..L..J/ibs.
b I pbs. d I /lbs.
Month ,Day Year
I
-d!P.1 .. '=°'b..
,!fi},I
-. ·~ -··
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
writer
t Generator's U.S. EPA ID No.
NCDO 7 0
Manifest
Document No. 1 4 0 0 2 5
P. 0. Box 1416, Smithfield, NC 27577
4. Generatofs Phone 9 1 9 9 3 4-9 711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Description {including Proper Shipping Name, Hazard Class, and ID Number)
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72378
12. Containers
No. Type
Bureau of Solid & Hazardous WMte Mgt
2600 Boll Stree\ Columbia, SC 29201
Phone:. [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnlormalion in the shaded a<eas is not
required by Federal law, but is by State law.
13. Total Quantity 14. Unit 1,l',W,...lu11b01\{
'MJV,j. \t:W'.ff9?!&ft%]!}ft
16. GENERATOR'S CERTIFICATION: I harabydac1ara that th a contents olthls consignment are fully and accurataly described above by proper shipping name and are classified.
packed. marked, and ta"belcd.and are in all respects in propor condition lor lranspor1 by highway according lo applicable international and natlonal government regulatlons and
the laws ol the Stale ol South Carolina.
111 am a large Quantity generator, I cer1ify that I have a program In place to reduce the volume and toxicity of waste generated to the dog roe I have determined to be oconomlcalty
practicable and that I have 1t1lected the practicable method ol treatment, storage, or dlsposal currently available to mo which minimizes tho present and lutura throat to human
heatlh and the environment OR. II I am a smnll Quanlitygenerator, I hove mode a good laith eHor1 to minimize mywasteganeratlon and select the best waste management methOd
that is available to me and thnl I con ollord.
Printed/Typed Name ROGER L. COATS Signature Month
<'.l
Year
T , 7. Transporter 1 Aumowledgement of Receipt of Materials
Printed/Typed Name ;;/
'lrLE £ /f,vffrTt2~Y ?c
18. Transporter 2 Acknowledgemenl of ~eiptOI Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item i9.
_Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous E.ditions are Obsolete [DHEC 1988 (Rev_ 10186)]
Year
8,/
Month Day Year
' l~......,...._._~l'bs. c IL...J...'--'-..L...L.Jl1bs.
b I pbs. d I !lbs.
Month Day Year
I South Carolina Department of Health
and Environmental Control
E PRIHT or TYPE (Form desi ned for use on ellle 12-itch writer
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Manlloal Document No. WASTE MANIFEST N c D o 7 o. 1 0 0 2 5
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
Form A
2. Pago 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Str .. t Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.xpires 9-30-88
Information in the shaded &<eas is not
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, H~ard Class, and ID Number} 12. Containers 13. Total Quantity 1t Unit /(1.wutl!Nlinbe,\{;,
No. Type VMrJ. '.GW?Hi)%,·f!f!Ji?[f{
a.
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T 2 0 Y
F
b;.
d.
b. Lu_:I 1-1 l'(;;'.1i'.'1;;!d:W:1 1-1 I J!1!
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72379
16. GENERATOR'S CERTIFICATION: I hereby declare that Iha content, ol this consignment are fully and accurately describod above by proper a hipping name and are clas.iliod,
packed. marked, and 1aheled, and are in a11 respects in proper condition tor transport by highway according to applicable lnternaUonat and national government regulations al"ld
lha laws ol the Slate ol South Carollna.
111 am a largo quantity generator, I certify that I have a program In place to reduce the volume and toxlcltyol waste generated to the degree I have determined to be oconomlcally
practicable and that l have selected the pracllcabla method of treatment, storage, or dlapoaal currenlly avallable lo me which minimizes the pre11ent end luture thrNI to human
health and the environment; OR, 111 am a small quantity generator, I have made a good lailh errort to minimize my waste generation and selecl the beet wa1te management mothOd
thal 11 available to me and that I can afford.
Printed/Typed Name RO.CE~ L. COATS
ledgement of Aeceip
19. Discrepancy Indication Space
Signature Month Day Year
a IL...L...,_,_-'-'-_,pbs. c ... J .,_,__._._.....,jibs.
bl jibs d I jibs.
~ 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifesl except as noted In Item 19.
Prinled/Typed Name Signature Month Day Yea,
PA Form 8700-2~ (Re\/. 9/86) Previous Editions a.re Obsolele (DHEC 1988 (Rev.10/86)}
I
r ',·· -
;'
IOC~A<O.:.fi'..-.,:·
South Carolina Department of Health
and Environmental Control
Bu~eau of Solid & Hazardous Waste Mgt
2600 Bull S~ee\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,_-Generato~sPhone 919 934-9711
S. Ti'ansporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
Manlleat Document No. 1400255
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. ~OT Description (including Proper Shipping Name, Hazard Class, and ID Number)
C.
d.
15. Special Handling Instructions and Additi~nal Information
GSX Work Order No.: 72380
2. Page 1
of Information in the shaded areas is not
required by Federal law, but is by State law.
, 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment ere fully and accurately described above by proper shipping name end are cla.,.aHl«i.
packed, marked, and t8beled,and are In all respects in proper condition lor transport by highway according to applfcable lnternatlonel and national government re;ulaliona af'\d
the laws ol the State ol South Carolina.
111 am a large quanlity generator, I certify that I ht1vo a program In placo to reduce th• volume and toxicity of waste generated to the da,_r-1 have determined lo tMo economlcally
. practicable and that I have aelected the practicable method cl truatment. storage, or disposal currently available lo me which mlnimlz:os the present and lutur• threat to human
• health and the environment OR, ii I am a smn11 quantity generator, I have made a good faith effort to minimize mywastageneratlon and select the best waste management method
that is available to me and that I can afford.
Pri~ted/Typed Name iROCE::. L, COAT~
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I Jibs C I jibs
b I Jibs d I Jibs
20. Facility Owner or Operator: Certificallon of receipt of hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
~~:
I , -
• • •~v
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. Manlteat
Document No. WASTE MANIFEST N c D o 7 o 0 0 2 5 6
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone 9 1 9 9 3 4-9 711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Co~pany Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
Form A
2. Page 1 of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columb;a. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a<eas is n01
required by Federal law, bu! is by Sla,te law.
11. U.S. DOT Description (including Proper Shipping Name. Hazard Class, and ID Number} 12. Containers 13. Total Quantity 14. Unit \°L\Wutll't.iisbtiff{
No. Type Md f)HhWff;;?Qf?rf
L
.Hazardous Waste, Solid, nos ORM-E
NA 9189
b Lu-I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72381
l D T
~i;:1::r,to~1+=;;~~~
2 0 Y ,,F1Q1Q161I
16. GENERATOR'S CERTIFICATION: I her~by declare Iha! the contents ol this conalgnment are fully and accurately described above by proper shipping name and are cluaifled.
pacl,,ed, marked, and l&beled, and are in oll respecta in proper condition for transport by highway according to appUcable lnternatlonal and natlonat government reQulatlon• and
. the laws of the State ol South Carolina.
If I am a large quantity generetor. I cer1ify that I have a program In place to reduce the volume and to1dclty ol waale generated to the degree I have determined to be economlcalty
practicable and that I have selected lhe practlcable method ol lrealment, storage, or disposal currently available to me which minimizes the present and lutura threet to human
health and the environment OR, 111 am a small quantity generator, I have made a good faith effort to minimize my waste generation and selecl the best wa1te menagement method
that Is available to me and that I can afford.
Printed/Ty~ Name Signature ~~~
~ 17. Transponer 1 AcKnowledgement of Receipt of Materials // /"'i
. .;f:>rinted/Typed Nam;7 f Si~"j~~/2-; 1 / ./2 /.
..._I,_ ,P.;..,.,Pfi-.:;...:t;P'!-'----'Mt'--"7/,'""'J1M='il,<"'-/---'-'.= lf?IJ,?"-.. ___ .,_.I,..:,. Y~) ~ 1/ /X
18. Transporter 2 Acknowledgement of Rece;pt of Materials -/ //
Printed/Typed Name Signature f/
19. Discrepancy Indication Space
20. Facility Owner or Operator. Certification ol receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 87DD-22 (Rev. 9/86) Previous EdlUons are Obsolete (DHEC 1988 (Rev.10/86))
Month Day Year
o c;, f?.h
Month Day, Year
/7,9i/ Pi,P,1
I
Month Day Year
Month Day Year
I
I
I
I
y ·~. ','--h
-~ .. '
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull str .. l Columbia. SC 29201
Phone: [phone]
P EASE PRINT or TYPE · (form desi ned for use on Ii e 12· itch writer
UNIFORM HAZARDOUS . Generator'sU.S.EPAIDNo.
WASTE MANIFEST c D O 9 7 6 O 4 7 1 4
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 91 9
Smithfield,
934-9711
5. Transponer 1 Company Name
Willms Truckin
7. Transporter 2 Company Name
Co. Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7 0
8. U.S. EPA ID Number
10. U.S. EPA ID Number
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1 Information in the shaded a<eas is not
ol 1 required by Federal law, but is by State law.
~~~~:o!d B~~ ~;i 25 s C D O 7 0 3 7 5 9 8 5 ~1:;:;~;=:11:~P~t/:U;:g~!'.i:zi~~~B11:1:
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) i~
0
~onta~;~ 13. Total Quantity 1~:1 i{:\ti1!t;;~t~~
·G• ~~z;~~~us Waste, Solid, NOS ORM-E
1
C M
2 0
y i[l:)::'~:·"~:/4!i E I ~ ~b-. _:'..'.:_..:_~.:__ _________________________ ~_JL~~.J!~.L..L...L~~-!..._ki~if:s¢._,:l,~;:,;·~=.,;,~::,,~,~)4'~1
01-------'------------------__j__l_.L..j--1.._j_.LJ--1.._l_4--__j_L';::±::!:::!:=z:!1 I
I
I
I
I
I
I
A C. :\
F
d.
~~p~~
15. Special Handling Instructions and Additional Information
GSX Work Order No. : J 2. '-/ S-2
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents at this consignment are fully and accurately described above by proper shipping name and are clasaified,
packed. marked, and la'beled, and are in all respects in proper condition tor transport by highway according ta applicable International and natlonal government regulations and
the laws of the State of South Carolina.
II I am a large quan1ity generator, I certify that I have a program In place to reduce the volume and toxicity of waste generated ta the degree I have determined lo be ec:onamlcally
practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to mo which minimizes tho pres-ent and luturo throat to human
health and the environment: OR, ii I am a small quantity generator, I have made a good faith etfort lo minimize my waste generation and select the best waste manegemenl method
that is available to me and that I can afford.
Signature
Month Day Year
19. Discrepancy Indication Space ·~ • I I I pbs 'I l'bs
bl I -I pbs d I l'bs
•1----------------T 20. Facility Owner or Operator: Certlficallon of receipt of hazardoUSJTlaterlals covered by !his manifest excepl as noted In Item 19. Vt----'-..;.___.c...c.._;:_:..;._ __ ;_ ____ ....:.cc:..;:c..c._..;._--'--~---.;.__:....;_'--'---'------'-'-=:C..:;:.c=.::cc;.;,c:c:;..;.:,;_ ______________ ~
·'::~::-P-r-in-,ted""/"T'"y"ped.,,-,,:N-•m_•,_,,,.,,,..,,.-,--,,.,,.,..---,,.,..--,--,,,,.,,S,-ig,-n_•.,tu_r_• ___ ,..,,_,,,_----------------'---•..L--''-.I..-'--'-'
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
Month Day Year
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardouc '.Vaste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
3. Generator's Name and Maiiing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling lnslructions and Addilional Information
GSX Work Order No.: 72509
1 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this conslgnmenl are fully and accurately described abOva by proper ahlpping name and are clasaifled,
packed, marked, and laheled, and are In all respects in proper condition for transport by highway according to appUca~le lnternallonal and national government regulations and
the laws of the State ol South Carolina.
111 am a large quantity generalor, I certify that I have a program In place lo reduce tho volume and toxicity of wastoganeraled to tt'lo degree I have determined to be oconomlca.lly
practicable and that I have :selected the practicable method ol treatment, :storage, or dl:sposal currently available to me which minimizes tt'lo present and future threat to human
health and the environment; OR, If lam a small quantity generator, I have made a good laith effort 10 minimize my waste generation and select tt'le boat waata management method
that is available 10 me and that I can afford.
Printed/Typed Name ROCER L. COATS ' ,
Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Own·er or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 87DD-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
Month Day Year
a ... I ......._...__._....__.jibs. c ... I ......._........_....__.llbs.
b I jibs. d I !lbs.
Month Day Year
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST
IMPORTANT: TYPE [on a 12-pitch (elite) typewriter] OR USE FIRM POINT PEN -PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owners or operators ol hazardous waste treatment.
storage, or disposal ficilities to use the U.S. EPA Form 8700-22 Rev. 9/86 {DHEC 1988 (REV 10/86)] and, if necessary, the continuation sheet U.S. EPA Form
8700-22A Rev: 9/86 {OHEC 1988A) for both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States from
another country are responsible !or completing the manifest Federal and State regulations also require 'Qenerators and transporterS of hazardous waste and
owners or operator~ al haza.rdous waste treatment, storage. or disposal facilities to complete the following information.
GENERATOR SECTION
1. Generator's U.S. EPA ID Number -Manifest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unique tive digit
number assigned to this manifest by the generator beginning With 00001_. If your company does not have a U.S. EPA Identification Number, please contactS.C.
DHEC at (803) 734:5200 about obtaining an identification number.
2: Page 1 of: Enter the total number of pages used to complete this manifest. i.e .. the first page EPA Form 8700-22 Rev. 9/86 [ciHEC 1988 (REV 10/86)] plus the
number of continuation sheets EPA Form 8700-22 Rev. 9/86A (DHEC 1988A) ii any.
A: Stale Manifest Document Number: .. Leave blank.
B: Slate Generator Identification Number: Leave blank.
3. Generator's N8me" and Mailing Address: Enter the nam8 and mailing address of the generator who will manage the returned manifest forms.
4. Generator's Phol1e Number: Enter a telephone number with area code where an authorized agent of the generator can be reached in the event ol an
emergency including nights, weekends, and holidays.
5. Transport 1 Company Name: Enter the company name of the first transporter who will transport the waste.
6. U.S. EPA 10 Number: Enter the U.S. EPA twelve digit identification number of ihe first transporter identified in item 5.
C. Slate Transporter;s ID Number: leave blank. ·
O. Transporter's Phone Number: 'enter a telephOne number including area code where an authorized agent of the tirst transporter can be reached in the event of
an emergency including nights, weekends. and holidays. 1: .. Transporter 2 Company Name: 1f applicable, enter the company name ol the second transporter who will transport the waste. !f more than 2 transporters will
be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) continuation sheet and fist the transporters in the Order they will be transporting the waste.
8.. U.S. EPA ID Number:11 applicable, enter the U.S. EPA twelve digit ID number of the second transporter identified in item 7.
E.. State Transporter's ID Number: Leave blank.
F:. Transporter's P:hone Number: Enter a telephone number including area code where an authorized agent of the second transporter can be reached in the
event of an emergency including nights, weekends, and holidays.
9.. Designated Facility Name and Site Address: Enter the company name and site address ol the treatment, storage, or disposal facility designated to receive the
waste listed on this manifest The address must be the site address. which may differ from the mailing address.
10: U.S: EPA ID Number: Enter the U.S. EPA twelve digit identification number al the designated treatment. storage, or disposal facility identified in item 9.
G:. Slate Facility's ID Number: Leave blank.
H;. Facility's Phone Number: Enter a telephone number including area code where an authorized· agent of the facility can be reached in the event of an
emergency including nights, weekends, and holidays. .
11: U.S: DOT Descriptions: Enter Rroper shipping name, hazard class and ID Number (UN /NA) for each waste as identified in 49 CFR 171-1 77. If additional space
is needed. use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) Continuation Sheet.
12.. Containers (no. and type): Enter number ol containers !or each waste and the appropriate abbreviation from Table I (below) for the type or containers.
TABLE I.
PM = Metal drums. barrels, kegs TT = Cargo tanks (tank trucks) CM =-Metal boxes. cartons. cases, roll otfs
OW= Wooden drums, barrels, kegs TC= Tank cars CW= Wooden boxes. cartons. cases
OF = Fiberboard or plastic drums, barrels, kegs OT = Dump truck CF = Fiber or plastic b6xes. cartons. cases
TP = Tanks portable CY= Cylinders BA= Burlap, cloth, paper or plastic bags
13 .. Total Quantity: Enter total quantity of waste described on each line, relative to the units used in item 14.
14. Unit (weighl/volu_me): Enter the appropriate abbreviations from Table II (below) !or the unit of measure:
Table II
I
I
I
I
I
I
I
I
I
I
I
I
P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (liquid only)
I.. Waste NuiTiber: Enter hazardous waste numbersasspecifie_d in South Carolina Hazardous y,taste Management Regulation R.61-79.261 Subparts C ar:d D to I
identity the hazardous waste on ea.ch line.
J. Additional Descriptions lor Materials Listed Above: In the spaces provi.ded, enter the authorization number (from the S.C. DHEC Authorization Request Form)
for each waste stream listed in Section 11 above. t«>te: Belore any hazardous waste can be accepted for treatment, storage or disposal in'South Carolina. the
generator must obtain prior authorization from the treatment, storage or disposal facility. , I
K. Handling Codes !or Wastes listed Above: Leave blank. ·.
15 .. Special Handling Instructions and Additional Information: Generators may use this space to indicate special transportation, treatment. storage or disposal
information or Bill or Lading Information. For international shipments. generators must enter in this space the point ol departure (city and state) for those
shipments destined for treatment. storage, or disposal outside the jurisdiction ol the United States. I
16. Generator Certification: The generator must READ, SIGN (BY HANO IN INK), and DATE the certification statement. II a mode other than highway is used. the· ·
word "highway" should be lined out and the appropriate m0de (rail, water .or air) inserted in the space below. II another mode in addition to the highway mode is
used, enter the appropriate a~ditional mode (e.g.,.and_ rail) in the space below.
TRANSPORTER SECTION I
17: Transport,er 1 Acknowledgement: Enter ,the'.1name 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 (BY HANO IN INK) and entering the DATE ol receipt.
18. Transporter 2 Acknowledgement: Enter. ii applicable, the name al the person accepting the waste on behalf of the SeCond transporter. That person must
acknowledge acceptance of the waste de.scribed on the manliest.by SIGNING (BY HANO IN INK) and entering the DATE of receipt: I
FACILITY SECTION
19. Discrepancy Indication Space: The authorized representative of the designated facility's owner or operator must note in this space any discrepancy between
the waste described on the ·manifest and the waste actUally received al the facility. Owners and operators of facilities who cannot resolve significant
discrepancies within 1 S days receiving the waste must submit to the Department a letter with a copy al the manifest describing the discrepancy and attempts to I
reconcile il The treatment. storage. or disposal facility must enter the actual weight of waste in pounds in the spaces provided ii the amount varies any tram that
specified by the generator in Hem 13 or if the generator uses a unit of measure other than pounds.
20. Facility Ownei-or Operator Certmcalion: Print or type the name ol the person accepting the waste on behall ol the owner Or operator of the facility. That person
must acknowledge acceptance of the waste described on the manifest by SIGNING (BY HAND IN INKfand entering the DATE al receipt. 1 IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATMENT, STORAGE, OR DISPOSAL FACILITY DESIGNATED TO
RECEI'" fHE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm.
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE (Form desi Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Generato(s Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
2. Page 1
of
12. Container,
No, Type
Information in the shaded areas is not
required by Federal law, bu! is by State law.
13. Total Quantity 14. Unit :L\wa:ita·,.,,_y,
'MNrJ hfflftt*~A5sf(}@'
i'iTf ',O',T,''1,'¼
E Hazardous Waste, Solid, nos ORM-E d !F
N ~~N~A_9::;l:;8:.:9:__ ____________________ _j_.L~l+DJT.:+-1...L..C2.t0:'...j....:Y:.....j,::ill~lf:::::I P:::::1 P:!1:::fi:.'*Zl;:
6 ~b-----~------------------------------i-..L-1~i-L+J....1_j_L.j..;_4;L~!2~~=.=·''""'!:t===:=•::··;::·-=···;!.~;:,:j~
r1t·i~=t·'·;•·7·1··~ C.
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 72510
\1 !il ::lJ, I , I ,~~ i.=,~ .... • .. ,._ . ., .. , .. ~--"-, ... ,~,-
16. GENERATOR'S CERTIFICATION: I herobydoc1are that the contents ot thlsconslgnmontarefully and accuretolydascrlbed above by proper ehipplng name and are cl-...ifled,
packed. marked, and r9beled, and are In all respects in proper condition !or transport by highway according to appllcablo lnlarnallonal and natlonat govemmant r~ulatlona and
the laws of Iha State ol South Carolina.
If I am a large quanlity generator, I certify that I have a program In place to reduce the volume and toxicity ol wriate generated to the dagree I have determined to be oconomlcally
practicable and that I have selected the practicable method of treatment, storage, or dlspoaal currently available to me which minimizes the pra.ent and future threat to human
health and Iha environment: OR. ii I am a smafl quanllty generalor, 1 have made a good faith eHortto minimize myweste generaUon end select the boat waate management methOd
that la available to me and that I can aHord.
Printed/Typed Name RO.GERL. COATS Signature
T 17. Transporter 1 Ac:1mowledgement of Receipt of Materials·
Printed/Typed Nare ( I I ,;;-f) (I .s Signature Year
F--;:.
Printed/Typed Name Signature Montll Day Year
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification of receipt of hazardous materials covered by lhis manifest except as noted In Hem 19.
Printed/Typed Name Signature Montll Day Yea,
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Str .. \ Columbia, SC 29201
Phone; [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
l Generator's Name and Mailing Address
Channel Master
2. Page 1
of lnformalion in the shaded Meas is not
required by Federal law. bul is by State law.
,. !~er~~r•,!~o~e 14 ~~9 Sm~~~=~;i1' NC
27577 i~ll~,~~~sr,t$~~~;!0t~f'.1~f1f~~~~f~;~~::fi~;~u~ 'r==.:...:..c=:..,,_....<...:c"'-'---'"'--'--"-''-=--"---------------FF,,
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
SCD070
11. U.S. DOT Descriplion (including Proper Shipping Name, Hazard Class, and ID Number)
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 72511
12. Containers 13. Total Quantity U. Unit :Fwasllf'Nldl>er\i
No. ·Type 'M.NrJ. ·:Ji"/((f};()?/?W/g{
16. GENERATOR"S CERTIFICATION: I hereby declare that !he contents ol this consignment are fully and accurately de1crlbed above by proper 1hlpplng name and are clauirled,
packed, markod, and libeled, and are In all respects in proper condillon for transpor1 by highway according to appllcablo lnlarnallonal and n,ittonal government regulations and
the laws ol tho State of South Carolina.
111 am a large Quantity generator, I cer1ify that I have a program In place to reduce the volume and toxicity of waste generated to the degree I have determined to be economM:ally
practicable and that I have selected the practicable method ol treatment, storage, or disposal currently available to me which minimizes the pres.on! and lutura throat lo human
health and the environment OR, Ill am ·a small Quantity generator. I have made a good faith etfor1 to minimize my waste generation and select tho beat waata management method
th.Ill is available to me and that I can of1'ord.
Prinled/Typed Name ROGER [ COATS Signature
17. Transporter 1 Ac:Knowledgemenl of Receipt ol Materials
Printed/Typed Name ',//_.,., /
Y2 ,',??V ,? /~ ~
Signature
18. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
,,._ _____________ _
T 20. Facility Owner or Operator. Certification of receipt ol hazardous materials covered by this manifest except as noted in ttem 19.
Printed/Typed Name• Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 (Rev. 10/86)1
Month Day Year
Month Day Year
i ... I ........................ Pbl. C .... , ...................... l1b1.
b I pbs. d I jibs.
Month Day Year
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardou, Wa,te Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer
UNIFORM HAZARDOUS 1. Generator", U.S. EPA ID No. Manlreat
Document No. WASTE MANIFEST N c o o 7 6 o 1400261
3. Generalor's Name and Mailing Addr~s.s
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator", Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route,_ l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA 10 Number
SCD070
Emergency & Holiday,: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1
ol lnlormation in the shaded a,eas is no1
required by Federal law, but is by State law.
11. U.S. OOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unil \t\Wata· Nlambeifr\
No. Type 'MN~ \:'.{}~V(t:-/-:i:}~fk~tw
C.
d.
GSX Work Order No.: 72512
16. GENERATOR'S CERTIFICATION: I hereby declare lhal the contents olthls consignment are fully and accurately described above by proper •hipping name and are clasaifiod,
packed, marked, and labeled, and are in all respects in proper condlllon fortranspor1 by highway according to appllcabla lntarnallonal and national government r~ulatlon1 arid
tria laws ol lhe State of South Carolina.
111 am a large quantity generator, I certify lhat I have a prcoram In place 10 reducathavolumaand toxlcltyofwaalaganeraled to the dat.1roa I have determined to be economleally
practicable and that I have selected the practlcable method ol treatment. storage, or dlsposal currently available to ma which minimize, Iha pres.en! and lutura threat to human
health and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my was ta generation and selecl the beat wa1te management method
that is available to me and that I can afford.
Printed/Typed Name ROGER L. COATS Signature ~
T 17. Transporter 1 Ac;Knowledgemenl ol Receipt ol Materials
rinled/Typed Name .,.--
~
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification of receipt of hazardous materials covered by lhis manrfesl except as noted In Hem 19.
Printed/Typed Name Signature
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
Month Day
a I ........................ Pbs. c 1 ........ ....._..__. .... llbs.
b I !fbs. d I !lbs.
Month Day Year
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12-itch writer Form A
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 6
Manliest
Document No. 0 2 6 2
2. Page 1
of
1 Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generato(s Phone [phone]
5. Transporter 1 Company Name.
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
L
t.
d.
201L~i½~~:~~;~!~~l[;;l!'i~~:~'!::l:'[:~:2f:!:i'.I1::11~1!ll!::!!1!~1:1j1!!r:;j~~i!!i~~
a. lP..lli.J-lo, 2, 7, 7, 4 1-11,11 o 1 2 L@Mii!ihYiJ 0-LLJ-I 1-1 Im
b.L,+.J-1 1 I I I 1-1 1 I I 1~1!!1°:lil~:':i!d:LLJ-1 1-1 J[!!
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72513
Bureau of SoHd & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnlormation in the shaded areas is not
required by Federal law, but is by State law.
1 G. GENERATOR'S CERTIFICATION: I hereby declare !hat the conlenls cl this conalgnmont ara fully and accurai.ly dHcrlboct"abova by proper ahlpplng nama and ara clualfled,
packed, marked, and 18belad, and are In all respects In proper condition tor Iran sport by highway according to applicable International and national government r19ulatlon1 and
the laws ol tha Stale of South Carolina. ·
111 am a large Quantity generator, I certify that I have a program In place to reduce the volume and toxicity ol waste generated to the degree I have determined to be economlcalty
. practicable and the! I have selected the practicable method of treetment, storage, or dispose! currenUy available to me which minimizes the present and lutur• thrNI to human
health and the environment; OR, ii I am a small quantity generator, I have made a good laith eNort to minimize my wast.a generation and se1ectthe beat waata manegemant method
that is available to me and that I can afford,
Printed/Typed Name RO.GER L coAi:S.
17. Transporter 1 At;Knowledgement of Aeceipl of Materials
Printed/Typed Name
J'l//7d
18. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
Signature
a ._j .L.J....1...1..1.
b ._! .L..L.L.L...l
Month Day Year
Month Day Year
Month Day Year
!fbs. C I jibs.
!fbs. d I !fbs.
11---------------T 20. Facility Owner or Operator; Certification ol receipt al hazardous materials covered by this manifest except as noted in hem 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions nre Obsolete (OHEC 1988 (Rev. 10/66)]
I ,,.,~· .. . ~ ·~ . -~...,. .~ ·-
South.Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columb;e. SC 29201
Phone: [phone]
Emergency & Holiday~ [phone]
wriler Form A roved. 0MB No. 2050.0039 E.x ires 9.30.sa
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
N C D 0
P. O. Box 1416, Smithfield, NC 27577
4. GeneratofsPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10, U.S, EPA ID Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
e.
12. Containers
No. Type
Information in the shaded a<eas is not
required by Federal law, but is by State law.
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T
;~1r;co~,1wr~1:
2 0 Y a•E1Q1Q161I
b.
C,
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72514
i6. GENERATOR'S CERTIFICATION: I hereby declare that the contents olthl11 conslgnmentarefultyand accurately described above by proper thlpplng name and arecluaifled.
packed, marked, and 1a'beled, and are in all respects in proper condition for transpor1 by highway according to applicable International and national government r~ulatlon1 and
the lews ol lhe State ol Soulh Carolina. 1
111 am a large quanhty generator, I cer1ify Iha! I have a program In place to roduca the volume and toxlcltyol wattaganeratod to Iha degrN I have determined to be eeonomlcally
practicable and that I have aeleclad tha pracllcable method ct treatment. slor&Qe, er dlspoaal currently available lo me which mini ml us the praNnl and luture !hr-I to human
health and Iha environment OR, If I am a small quantity generator, I have made a good lallh effort to minimize my was le generation and select the beat waate management method
Iha! Is available lo ma and thal I can aNord.
Printed/Typed Name ROGER L COATS
11:nowledgemenl ol Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
a I
b 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 Slgnalure
EPA Form 8700-22 {Rev. 9/86) Previous Editions ::ire Obsolete [DHEC 1988 (Rev. 10/86)1
Month
0
Month
Jlba. C I
pt,,, d I
Month
Year
Day Year
Jlba.
11ti,,
Day Year
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N r. n o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125 SCD070
Manifest Document No.
0 0 2 6 4
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x ires 9-30-88
lnlormation in the shaded a<eas is not
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Uni /Liwa:ilaNtimber\+
No. Type 'MN~ ii'!:f«(DJibLti)Jt{/fi
Hazardous Waste, ·solid, nos ORM-E
NA 9189 1 D T
~~~m;~
1
:ffl~;~~,~1:~, ,::~,~,111~1JJ1111~11,i~,1~(~!11111~i~
b.w,-::1 1-1 1.ti~:1,i1::;;fiJt~:W:J 1 ... J 1-:-111 1.J11!
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72515
2 0 Y
16. GENERATOR'S CERTIFICATION: I hereby declare thatlhe contents olthls conalgnmenlarefutlyand accurately described above by proJMr ehlpplng name and are clHaillod,
packed. marked. and labeled, and are in all respects in proper condition for transport by highway according to applicable lntarnatlonal and national government reQulatlona and
the lawS of the State ol South Carolina.
111 am a large quantity ganera1or, I certify that I have a program In place to reduce the volume and toxicltyol waste generated 10 the degree I have determined to be economically
practicable and that I have selected the practicable method ol treatment, storage, or dlsposal cui-renlly available to me which minimizes the present and luturo throat to human
health and the environment; OR, 111 am a small quantityganarator, I have made a good lailh eNortlo minimize my waste generation and select the beal waala management method
ttial is available 10 ma and that I can aNord.
Printed/Typed Name RO.GER L COATS Signature .
17. Transporter 1 Ae;Knowledgement of Receipt of Malerials
Printed/Typed Name //vi , I . . f 110,,[~Cv~ (,j,,e(!,1t
18. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or.Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Signature
a I
b I
Month
0
Monlh
Month
jibs. C I
!lbs. d I
Month
Year
Day Year
jibs.
!lbs.
Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [OHEC 1988 (Rev. 10/86))
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,. Generato~sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
. 9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
C.
d.
15. Special Handling Instructions and Addilional Information
·GSX Work Order No.: 72516
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Str .. ~ Columb;a, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a<eas is nol
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol thlsconslgnmenlarefully and accuratelydascrlbed above by proper ahlpplng name and are cJa.uifled.
packed, marked, and 1a'beled, and are in all re9pects in proper condition !or transport by highway according to applicable lntarnatlonal and national government r~ulatlona and
the laws ol the State of South Carolina.
111 am a large quantity generator, I certify that I have a program In place to reduce the volume and toxicity of waste generated lo Iha degree I have determined to be oconomlcalty
practicable and that I have selected the practlcable method of trealment, storage, or dlspoael currently avallable to me which mlnlmir.ea the present and luture lhroot lO human
health and the environment: OR, ii I am a small quantltygenerator,I have made a good faith eNor1 to mlnlmlt.a my waste generation and aelectthe beat waata managamantm,ettsod
that la available to me and that I can afford.
Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipl ol hazardous maleria1s covered by !his manifest except as noted In Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Re'-'. 9/86) Previous Editions are Obsolete [DHEC 1988 (Re,... 10/86))
Month Day Year
a 1......,......,_._,Pbs. c ... I ......,...._...,jibs.
b I jibs. d I llbs.
Month Dey Yw
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA 10 No. Manuoat Document No.
3. Generator's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4.Generator'oPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
0 0 2 6 6
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
Form A
2. Page 1
of
Bureau of Solid & Haz.ardous Waste Mgt
260q Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded Meas is not
required by Federal law, but io by State law.
11. U.S. DOT Description (incf11ding Propor Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Uni I
No. Type . "M/Vrj
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 I D T 2 0 Y
b. LL.]-!
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72517
16. GENERATOR'S CERTIFICATION: I hereby declare that the contenls of this' consignment are lullyand accuratolydoscribod above by proper shipping name and are cla.uilied,
paci..ed, marked, and lahaled, and are in all respects in proper condition !or transport by highway according to applicable international and national government re,gulationa an-d
tr'u!I taws of the State ol Soulh Carolina.
If I am a large Quantity generator, I certify that I have a prOQram In place to reduce the volume and toxicity olwaalageneratod tothed8,;3r-1 have determined to be economlcally
practicable and lhal I have selected the pracllcable malhod ol treatment. slorago, or dlspoaal currenlly available lo me which mlnimlzo11 tho prosonl and lutura lhr-1 to human
heallh and tho environment; OR, If I am a small quantity generator, I have made a good la Ith effort lo minimize my was ta generation and select tho best wa110 managemeMt tNtthOd
ttiat Is available 10 mo and that I eon afford. ·
Printed/Typed Name ~ Year
T 17. Transporter 1 Ac.:1<nowledgement of Receipt of Materials
Printed/Typed Name
Printed/Typed Name Month Day Year
19. Discrepancy Indication Space
a I !lbs. C I pbs.
bl jibs. d I jibs.
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 Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holiday,: (803)734-5-424
E PRINT or TYPE (Form desl ned for use on elite 12-itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-8.'!
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
NCDO 760
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC _27577
4. Generator's Phone 9 l 9 9 3 4-9 711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
B. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, tfazard Class, and ID Number)
C.
d.
Hazardo.us Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72518
2. Page 1
ol
l D T
Information in the shaded a,eas is nol
required by Federal law, but is by State law.
2 0 Y
~llYF·:1:·o~;:1·,;91~~
~ilf1Q1Q161)W
16. GENERATOR'S CERTIFICATION: I horeby declare thatlhe contents olthls consignment are fully and accurately described above by proper •hipping name and are clasaifiad,
packed, mark&d. and 18beled.and are in all respects in proper condition !or lranspor1 by highway according to applicable International and national government r&Qulatlon,al"ld
the laws ol the State of South Carolina.
111 am a large quantity generator, I certify that I have a program In place lo r&duce the volume and toxicltyol waateganerat&d to the degree I have dalermin&d to be economically
practicable and that I have selected Iha practicable method of treatment, storage, or dlapoaal currently avaUable to ma which minlmlr.aa the present and lutura thrNt to human
health and the environment: OA.11 l am a small quantity generator, I have made a good lailh effort to mlnlmlt.a my waste generation and select the be•t wuta management mett,od
that is available 10 ma and thal I can attord.
Printed/Typed Name RO.GERL COATS Signature 6d Year
T 17. Transporter 1 Ac.:Knowledgement of Receipt of Materials
Printed/Typed Name , Signature
Iv, 1-, .,,,,., [,.,,
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I pos. e I l'bs.
bJ jibs. d I 1 Jibs.
20. Facility Owner or Operator: Certification of receipt of hazardous materl3Is covered by this manlfesl except as noted In llem 19.
Printed/Typed Name Signature Month Day Year
EPA. Form 8700•22 (Rev. 9/86) Previous Editions are Obsolele (DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull S>ee\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5-424
E PRINT or TYPE (Form desi ewriler Form A rove<l. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generat6r's U.S. EPA 10 No.
C D O 9 7 6 0 4 7 1 4
ManHeat
Document No. 0 0 2 6
2. Page 1
of 1
Information in the shaded areas is not
required by Federal law. but is by State law.
3. Generator's Name and Mailing Address
Channel Master
,i,:~'.~iifiiiii@,,iio,il~i
P. O. Box 1416,
4. Generator's Phone 91 9
Smithfield,
934-9711
5. Transporter 1 Company Name
Willms Truckin Co. Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA 10 Number
S C D O 7 3 7 0 9 2 9 7
B. U.S. EPA 10 Number
10. U.S. EPA 10 Number
S C D O 7 0 3 7 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
a.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72519
,, .. , ··::::
16. GENERATOR'S CERTIFICATION: I hereby declare that the contentsolthls consignment are fully and accurately described above by proper ahlpplng name and are cla..sa1fied.
packed, marked. and 1a·beled,and are in all respects in proper condition lor transport by highway according to applicable lnlernalional and national government r~ulatlon, a/'\d
U'\a laws ol the State of South Carolina.
111 am a large quanlity generator, I certily that I have a program In place to reduCe the volume and toxlc,ltyol waste generated totha degree I have determined 10 be economically
praclicabLe and that I have selected the practicable method ol treatment, storage, or dlsposal currenUy available to me which minimize, tbe present and future three! to human
health and the environment; OR. II tam a small quantitygeneralor, I have made a good laith aNortto minimize my wasle generation and :1e1ecl the beat waate management method
that is available to me and that t can aNord.
Printed/Typed Name RO~ER L COATS Signature (k Year
T 17. Transporter l Ac;Knowledgement ol Receipt of Materials
Prinled/TyRed NamJt__, v-.J . Je=.. v>-, vi
Sign~
0
Month Year
)
18. Transporter 2 Acknowledgemenl of Receipt ol Malerials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I fibs. C I /lbs.
b I pbs. d I pbs.
20. Facility Owner or Operator; Certification ol receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions nre Obsolete [DHEC 1988 (Rev, 10/86)}
I
E
South Carolina Department of Health
and· Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull $tree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE {Form desi ned for use on elile 12-itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. Manifest
Document No. WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generalor's Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and ~ile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
1 0 0 2 6 9
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including 'Proper Shipping Name, Hazard Class, and ID Number)
a
b.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15, Special Handling Instructions and Additional Information
GSX Work Order No.: 72520
2. Page 1
of
1 D T
Information in the shaded areas is not
required by Federal law, but is by State law.
2 0 y
···,~;,;('•,_;,.,,,.,,-fcj,
f}'-i .....J.....JL....'-.JI f 4.
f::=?
1 6. GENERA TOR'S CERTIFICATION: I hereby declare that the contents of this consignment are lully and accurately described above by proper shipping name and are c:ta.sainod,
packed, marked, and la"beled, and are in atl respects in proper condition tor transport by highway according to applicable International and national govemment r9'ulatlons and
the laws ol the State ol South Carolina.
111 am a large quantity generator, I certify that I have a program In piece to reduce tho volume and toxicity ofwa!lllogenerated to the d~roo I have determined to be economically
practicable and lhat I have selected the practicable method ol tre6tment, storage, or dlsposal currently available to mo which minimizes the present and future thr-l to hvman
health and the environment: OR. It I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the bfl11t wa111e management method
tl'lat is available to me and thal I can afford.
Printed/Typed Name/ C/2~-e.1~
Printed/Typed Name -a o 11 5@ e/4'--e.5
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
Signature
20. Facility Owner or Operator; Certification ol receipt ol hazardous malerlals covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
• I
bl
Month Day Year
c:)922 ~7
--#-g'.::,
Month Year
Month Day Year
iJbs. C I l'bs.
pbs d I !Jbs.
Month Doy Year
EPA Form 6700-22 (Rev. 9/66) Previous Edilions are Obsolete IDHEC 1968 (Rev. 10/86)1
I . --=-~?· IL"'s~ ....
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1, Generator'sU.S.EPAIDNo. Manlteet Document No. WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box. 1416, Smithfield, NC 27577
•.Generator'sPhone 91.9 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
1400270
6. U.S. EPA ID Number
S C D 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
2. Page 1
of
1 D T
~;~;~,~~~:~:Ji:1!!~11
"!1i!~ll!i':1;~i!1~!i!l'~!!tl!!!~~!!!f~!~il~~~i!!!!l!l(!t~!'!1!
a.lI..ili.J-I0,2,7,7141-lli110121Mdikdfai1°·LLJ-I I I I I 1-1 I I I Li:
b. LLJ-1 1-1 1~(:~t1:11!1'!!tdw~1 1-1 ,,,,
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72521
lnlormalion in the shaded Meas is not
required by Federal law, but is by State law.
2 0 Y
:11~r,'0'1If9"1~l
~fa IF IQ IO I 6 1\f:'
1 6. GENERATOR'S CERTIFICATION: I hereby declare that tho contents of this consignment era fully and acct.irately described above bV proper •hipping name and are class1lied,
packed. marked, and la·beted,and are In all respects in proper condition tor transport by highway according to appllcable International and natlonal governmer'll re,gulaUon• and
the laws ol lhe State ol South Carolina.
111 am a large quantity generator, I certify that I have a program tn place to reducathevoluma and toxlcltyQlwaategeneraled to the degr-I have determined lo be economk.alty
practicable and thet I have selected the practicable method of treatment. storage, or dlsposa.t currently w'altable to "l3 which mlnJmizea the present and future lhr.,.t to human
health and the environment: OR. ll I am a small quantity generator, I have made a good faith effort to minimize my wasfll oeneratlon-shd select the beat waste management m«tthod
that is available to me and that I can afford. '
Signature~
ledgemenl of Receipt or Materials
Signature
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
Month Day
922
Monlh Day Year
I !._._.L..L.,_.__,! lbs. c 1._._ .............. 1 lbs.
b I ptis. d I llbs.
Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Ob_solete (OHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
· UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Generalo(s Phone 9 1 9 9 3 4-9 711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA 10 Number
S C D O 7
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Description· (including Proper Shipping Name, Hazard Class, and ID Number)
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72522
2. Page 1
of
12. Conlainers
No. Type
1 D T
Information in the shaded a<eas is not
required by Federal law, bul is by Slate law.
13. Tolal Quantity U. Unil jt\'N~-~j,+
ww~ f~L¾~f:tj/WtPft
2 0 Y
16. CENERATOR'S CERTIFIC.A TION: I horeby declare that tho contents of this consignment are fully and accuralely described above by proper shipping name and are clas.alfl.cl,
packed, marked, and 1a'beled,and are In all respects in proper condition for transport by highway according lo appllcable International and national government r.-gulatlona and
uie laws ol the Slate ol South Garollna.
If I am a large Quantity g0nerator, t certify that! have a program In place to reducethevotumeandto,dclty olwastegeneraled to the degr-1 have determined to be economlcally
practicable and th al I have selected the practicable method ol treatment. storage, or disposal currently available lo me which minimizes U,e present and luture lhr-t to human
heallh and Iha environment OR, ii I am a small Quantity generator. I have made a good faith effort lo minimize my wasta generation and select the best wuta manaoemenl method
th.al is available 10 me and that I can atford.
Signature Year
?7
T 17. Transporter 1 Ac:Knowledgement of Receipt of Materials
Print09./Typed Name
0 (P ,( <llL ./ /4 l(.<?,,.. Signature~~~-Monlh Day Year
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month -Day Year
19. Discrepancy Indication Space
' I._._ ........ ........ pbs. C I pt>s.
b ... I ................. ..... pbs d I pbs
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 Monlh Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolele IDHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
(Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N o 1
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbie, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved, 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a,eas is nol
required by Federal law, but is by State law.
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generato(s Phone [phone]
l1ili=:1~1~ttr:i!f~!{t:t~~l~t1
lii~i~%i~!l1'.~ititI~1i:~:;}Mit!!Wtt1!:)·
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name :
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
C D O 7 3 7
8~ U.S. EPA 10 Number
10. U.S. EPA 10 Number
S.C DO 7 0
11. U.S. DOT Description (including Proper ShiPJ!t.W,Name, Hazar~lass, nd ID Number)
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
~~~~~~:~~ -~~!l)J~ji
1
r,~l~~1i:1;~1u\~ii,~i1ir);l;j~:rrl[~!ll\~~~1~,~~
b. W:1 ···········•··•'=' · J!lli~1~!1iit~:W,:.L.• .. !,.-! .. ~.J=J .,!J.!I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72523
2 0 Y
i{t,·r~-~-,~--~,~lft1
;,:~ 1 · 1 ,ff
::{j"' .: .;,.,;.: .. ~•.w., .. •,•11,~
ih __ ,I
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents olthls conalgnmontaro fully and accurately described above by proper ■hipping name and are clau1fied.
pack&d. marked, and lahe1ed, and are in all respects in proper condilion for transport by highway according to applicable International and neUonal government re,gulationa and
tno laws ol the State ol South Carolina.
If I am a large Quantity generator, I certify that I have a program In place to reduce the volume and toxlcltyol wastageneratod to th a degree I have determined to be economically
practicable and that I have aelected the practicable method ol treatmant. storage, or disposal currently available to ma which minlmlr.ea the present and future threat to human
heelth and the environment OR. If t am a small quantity generator, I have made a good laith effort to mlnimlr.o my waste generation and 1etect the boat waato management method
that la available to mo and Iha! I can afford.
Signature Year
~7
T 17. Transporter 1 AtKnowledgement ol Receipt of Materials
Printed/Typed Name /Z O ....._ 11 0
f Signature
18. Transporter 2 Acknowledge
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification ol receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
EPA Form 8700•22 (Rev. 91B6) Previous Editions nre Obsoloto [DHEC 1988 (Rev. 10/86)1
Month Day Year
8 I ........ .._._...__.._.Pbs. c lu..J....J...J...L.Jl1bs.
b I jibs. d I jibs.
Month Dey Year
I · South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Manifest Document No. WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
1 0 0 2 7 3
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
c.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72524
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (8-03)734-5424
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnlormation in the shaded a<eas is no!
required by Federal law, bul is by State law.
:6'r-~ ·, :, ;,: :.;~_-·'•,:M'e;::~~::
,,,;
l 6. GENERATOR'S CEATI_FICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper •hipping name and ara cl&Hifled.
packed, marked, and labeled.and are in all respects in proper condition for transport by highway according to applicable International and national governmen1 r99utatlon• and
the 1aws ot the Slate ol South Carolina.
lfl am a large quantity generator, I certify that I have a program In place lo reduce the volume andtoxlclty or waste generated to the dO'j3ree I have determlned to be economically
prac1icable and that I have :,elected the practicable method of treatment, storage. or disposal currently available to me which minimizes the present and luture threat to human
health and the environmerit; OR, ii I am a small quantitygenera\or, 1 have made a good faith effort to minimize my wastogenerallon and select the be•I wa1ta management method
ttial is available to me and thal I can afford.
Signature
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.
Printod/Typod Name Signature
Month Day Year
C> '2~7
Month Day Year
a .. I J....J...J..J....L.Jpbs. c lu..J...J...J..J..J!lbs.
b I pbs. d I jibs.
Montl1 Day Yw
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bu_reau of Solid & Hazardous Waste Mgt.
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
£.A.SE PRINT or TYPE (Form desi writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-Ba
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA lD No.
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
S. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
6. U.S. EPA ID Number
S C D O 7 3
8. U.S. EPA ID Number
Manlreat Document No.
0 0 2 7 4
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
2. Page 1
of
!~~~!!~~~f~~'.~~j~~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72525
Information in the shaded a<eas is not
required by Federal law, but is by State la~.
. 16. C ENERATOR'S CERTIFICATION: I hereby declare that the cOntents of this consignment are lully and accuretoly described above by pro~r shipping nam• and are clasaili«I,
packed. marked. and labeled, and are in all respects in proper condition tor transport by highway eccording to appUcable International and nallonal govemment regulations and
the laws ol the Stale of South Carolina.
111 am a large quanlity generator, I certify that I have a program ln piece lo reduce the volume and toxicity of waste generated to the degree 1 have determined to be economlully
practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and lutura threat to human
health and the environment: OR, JI I am a small quantity generator, I have made a good faith effort to minimize my wute generation and select Iha beat wa1ta management method
that ia available to me and that I can afford.
Signature Month Day Year
2. R.-J
Month Day Year
ame Signature Month Day Year
19. Discrepancy Indication Spacr •
., ........ ,L..L ....... Jibs. C I I Jlba.
bl~~~ pbs. d I po,.
20. Facility Owner or Operator. Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Slgnalure Monlh Day Year
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree( Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (B03)734-5424
E PRINT or TYPE writer Form A roved. OMS.No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generalor's U.S. EPA ID No.
N C D O 7
·. P. 0. Box 1416, Smithfield, NC 27577
4. Generato~sPhone 919 934-9711
5. Transport~r 1 Company Name
Willms Truckin Co Inc,
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
Manifest Document No.
1 4 0 0 2
2. Page 1
of Information in the shaded areas is not
required by Federal law, but is by State law.
11: U.S. DOT Description (including Proper Shipping Name, Hazard Class. and 10 Number) 12. Conlalners 13. Tola! Quantity 14. UM tl\'.iiaiilii'Niiiilbiil
No. Type 'M/Vd :xt&{Hf:1{±01¾!\§'
15. Special Handling Instructions and Additional lnlormalion
,. ·c;sx,_Work Order No. : 72526 "t_i,,.,
16. GENERA TOR'S CERTIFICATION: I hereby declare th al the contents of this consignment are fully and accurately described above by proper ahlpplng name and are c1..-;t1ed.
p.aclutd. marked, and la'bated, and are In all respects In proper condition for transpor1 by highway according to applicable International and national government rogulatlona and
the laws ot the Stale of Soulh Carollna. · ·
111 am a largo quantity generator, I certify that I have a program In place to roduc8 the volume and l~xlclt)' of waate generated to tho dogr-I have d0termlnod to be oconomlcalty
.. practicable and that I have selected !ho pracllcabto method of treelment. storage, or dlspoul currently available to ma which minimizes tho proNnt and future thrNI to human
health and Iha environment: OR, ii I am a smart quantity generator, I have med a a good faith effort to minimize my was le ganeratlon and select Iha beat wa■te management method
that Is available to me and that I con ottord.
0 "Printed/Typed Name RO.GER L. COATS Signature
, ..
17. Transporter 1 At;Knowledgement of Receipt of Materials
. Printed/Typed Name .,, · . t)l./, 5 ::S-QIV'e5
Sign81ure
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature
!.9. Discrepancy Indication Space
20. Facility Owner or Operator. Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19 .
. PrlnledlTyped Name Signature
EPA Ferm 8700-22 (Rev. 9/86) Previous Edilicns are Obsolete (DHEC 1988 (Rev.10/86))
a I I 'I
bl I I
Month
0
Month
jibs. C I
libs. d I
Month
Year
Day Year
libs.
llbs.
Dey Yw
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haurdous Waste Mgl
2600 Bull Stree\ Columb;a, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5-424
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o 7 6 o
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 91 9
5. Transp0t1er 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7. Transporter 2 Company Name
NC 27577
6. U.S. EPA ID Number
S C D O 7 3
8. U.S. EPA ID Number
Manifest
Document No. 0 2 7 6
9. Designated Facility Name and Site Address 10. U.S. EPA ID Number
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125 SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Haz~rd Class, and ID Num~r)
Hazardous Waste, Solid, nos ORM-E
NA 9189
b.LL.J-1 ............... ,.,_,.,,
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72527
2. Page,
ol
l D T
Information in the shaded areas is not
required by Federal law, but is by State law.
2 0 Y
:~ll'F·,:t64'l't 9Y~;~;-
1H IE ,a ,a, 61{r 01·~~;:;~,:-~~~~~-:,;~·11
:~:1, · · I · I r\7'.
1 e. GENERA TOR'S CERTIFICATION: I hereby declare !hat 1he contents ol thls consignment are fully and accurately described above by proper shipping name and are cLaaallled,
packed, marked, and la.be led. and are in all respects In proper condition for transport by highway according lo applicable lnlernatlonal and natlonal government regulatlons a/'\d
the lows of the Stale ol Sou!h Caroline.
111 am o large quantity generator, I certify that I hove o program in place to reduce the volume and toxicity ol waste generated lo tha di,groe I have determined to be economically
procticable and Iha! I have selected lhe practicable method ol treatment, storage, or dispose! currently availoble to me which minimizes the present and future threat lO human
health and the environment; OR, 111 am a small quantity generator, I have made a good laith eNortto minimize my wa!lte generation and select the beat waste management method
tnet is available to me and that I can a.Hord.
Signature~ /7 Month Day Year
() 2 2. ;,-7
rials
Signature
.2 -+-. 7
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I jibs. CI jibs.
b I jibs. d I jibs.
20. Facility Owner or Operator, Certirication of receipt of hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 6700-22 {Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o 7 o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72528
Form A
2. Page 1 of ·
1 D T
Bureau ot Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded Meas is not
required by Federal law, but is by State law.
16. GEN ERATO R'S CERTI_FICATION: I hereby declare that the contents of this consignment are lully and accurately described above by proper shipping name and are clualllod.
packed, marked, and labeled.and are in all respects in propercondilion for transport by highway according lo app1Jcable lnternatlonal and natloneJ govemmantregulationa and
the laws ol the State of South Carolina.
It I am a large quantity generator, I certify that I have a program In place to roduca the votume and toxicity of waI1a generated to the deg roe 1 have determined to be ec:onomlcalty
practicable and that I have ■elected the practtcable method ol treatment. storage, or disposal currently avallable to ma which minlmlzaa the pres.ant and future thrNl to human
health and lhe environment: OR, 111 am a small quantitygeneralor, I have made a good lalth eflortto minimize my waste generaUon and select the bast waste managemantmethOd
that Is available to me and that I can afford.
Montti· Day Year
:2 2 ii'?
Montti Year
Month Day Year
19. Discrepancy Indication Space
a I pbs. C I libs.
b I pbs d I jibs
20. Facitify Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In ttem 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
South Carolina Department of Health
· and Environmental Control
Buraau ol Solid & Haz.ardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone] .
Emergancy & Holidays; (803)73'4-5424 ·.
Form A roved. 0MB No. 2050-0039 Ex Ires 9-30-88
: • .UNIFORM HAZARDOUS 1. Generator's U.S. EPAID No.
C WASTE MANIFEST N C D
2. Page 1
ol Information in the shaded areas Is not
required by Federal law, but is by State law.
1 GCh:~~~~a~;;~~~ing Address '.~1~:~::~'.~~tt:~~~ll!E:!
~•::.::.:G:::p•::.~:::•:.:~:::10::..(.::•.:.!.:;~.::0~:,::e::.,_
1
_
4
~!'-~"-9"'' _,_
8
_m_!"-"~"~'-=~!'-;'-
1
"1.!f_·_N_c __
2
_
7
_
5
_
7
_
7
_______________ pt~;;..?jiltia,tliil~f!!ltrt:rtt~llll1i·
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9., Designated Facility Name and Sfte Address ·csx Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) ~. .
a :r ... n~·· . •.-.Hazardous Waste, Solid, nos ORM-E
NA 9189
. I, 1 ••
!i~i:~R~iwv ... -.. --· -...... -.
a. lf..JHj-lO 12 17 17 . .
LL.J-1 1-1 I I 1-1 • •• <,, ,H,SW,•~•-~•••,••'"
15. Special Handling Instructions and Additional lnlormalion
Work Order No.: 72529
1 D T
. ........ , .. , . -~,..-~r-~--.. ,. ,• .
. . . Ji W-4B~J . .
1 e. GENERATOR'S CERTIFICATION: I hereby declare that !he conlants ol !his consignment are fully and accurately described above by proper shipping name and are.claulntd.
· packed, marked, and libeled, and are In all respecls In proper condlUon tor transport by highway according to appllc.abla lntarnatlonal and natlonal government rit0ulatton• and
ttie laws of the Stale ol South Carolina. . _. ,' · .
tf I am a large ciuanlity generator, I certify that I have a program In place lo reduce the volume and toxicity of waste generated lo the degree I have delarmlna,d to be economkalty
practicable and lhal I have selecled the practtcable method ol treatment. storage, or dlspoaal currently available to me which minimizes the pres.en! and future lhrNI to human
• •' health and the environment: OR, If I am a small ciuantily generator, I have made a good faith effort to mlnlml:r.a my waste genaraUon and select Iha be•t waste managamant method
V that is available lo me and that I can afford.
Printed/Typed Name ROGER L. COATS
T 17. Transporter 1 Ac.:,mowledgement of Receipt of Materials
Printed/T/ped Name cJ ( ' <l. ,.,._..,... -:S:-, \.~'SO,,....__
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
{/
Signature
Signature
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Signature '• ..
EPA Form 8700•22 (~ev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
Month Day Year
O 1 z.3 S',
Month • Day Year
.... , ........... ... llbl. C I pt,a.
b.._l ............ ... jlbL d I ilbs.
Month Day Year
E
South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt ·
2600 Bull Stree( Columbia, SC 29201 ·
Phone: [phone]
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
wriler
1. Generalor's U.S. EPA ID No.
N C D 0
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E.x ires 9-30-88
2. Page 1
of lnlormalion in the shaded areas is nol
required by Federal law, bul is by State law.
~4::,,..,:,,.'!!~e::,ra.,,_~,,,;,_,(s,_,!..:~:,:Ox,:ne'-l.,
1
_
4
..,!,.,~"9'-'S'-m-"-!-"~'-=~'-=~!'-;'-
1
"-/"-1_'_N_c_
2
_
7
_
5
_
7
_
7
______________ i;;f:;.;.;4;;1iitlrlt~m~0lw,'fti;;llfj
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
11. U.S. DOT Description (including Prop,, Shipping Name, Hazard Class, and ID Number)
a· nol .. ~. ,(
.-Hazardous Waste, Solid, nos ORM-E
NA 9189
d.
1S. Special Handling Instructions and Additional Information
12. Containers 13. Total Quantity 1,. Unit fUWafli'~~;
No. Type 'MN~ §{f}i}tf.('fUf~®g;f
1 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents 0l lhis conslgnmenl are lully and accurately d09cribod above by proper •hipping name and are cluaiflod,
packed, marked, and 1&beled,and are ln all respects in proper condition for transport by highway according 10 appllcabla International and national govammant regulation• and
the laws ol tha State of South Carolina. ·
111 am a large quantity generator, I certlty th al I have a program In place to reduce the volume and toxicity of wa■te generated lo the dogrN I have determined to be economically
practicable and thal I have selected the practlceble methOd of treetment, storage, or disposal currenl1y evallabla to me which minimizes the present end lutura throat lO human
health and the environment; OR, II I am a small quantity generator, I have made a good faith eHor1 to minimize my wasta generation end select the beat waste management mothod
that is available 10 me and Iha! I can afford.
Printed/Typed Name ROGER L. COATS
17. Transporter 1 Atacnowledgemenl of Receipt of Materials
18. Transporter 2 Acknowledgement al Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
t1 ·t .;
Signature
Signature
Signature
~
•lu.....L..L.J...L
b,_I ......,_,_L..L
20. Facility Owner or Operator; Certification of receipt al hazardous materials covered by this manifest except as noted in hem 19.
, . Printed/Typed Name Signature.
Month Year
t:J
Month Day Year
c-611i cl
Month Day Year
jibs CI fibs
!lbs d I !lbs
Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete {DHEC 1988 (Rev. 10/86))
1.-~ ..
•.-..:.
:,>.), .
, .... R.
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5"2◄
E PAINT or TYPE (Form desl ned for use on elite 12· ilch writer Form A roved. 0MB No, 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generalor's U.S. EPA ID No,
WASTE MANIFEST N c D o 7 6 o
l Generator's Name and Mailing Address
Channel Master
: P. 0. Box 1416, Smithfield, NC 27577
i. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
· GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA 10 Number
S C D O 7 0
11. __ y.s. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
™~~'.~~;~;l:M:lr'
2. Page 1
of
a. lI'...tl:LJ-Jo r 2 r 7 r 7 r 4 1-1 l r l r or 2 L, L...I.....J.....L.......__.-1 '
b. W.=1~ ~~~.~ .. ~~.~ .. 1::::L.L. r_ r__ .::::J __ ,_J ___ r _r)::-1 r __ r r I'
Work Order No. : 72607
Information in the shaded Meas is not
required by Federal law, bul is by State law.
16. GENERATOR'S CERTIFICATION: I hereby declare th al the contents ot !his conalgnmenl are tu Uy and accurately daacrlbed above by proper 1hlpplng name and are c!aaa.ifled.
· pac:k&d. mark&d, and ta"beled, and are in all respects In proper condilion tor transport by highway according to applicable International and natlonal government r9Qulatlona and
the lawa ol the Stat• ol South Carollna ·
HI am a large quantity generator, I certify that I have• program In place to reduce Iha volume and loll:lclty ol waato generated to tho degree I have determined to be economk:alty
- • practicable and that I have selected the practlcable method ol treatment. slorage, or dlspoaal currently avallabla to ma which mlnlmizoa tho present and future thr .. t to human
"} , health and lhe environment; OR, II I am a small quantity generalor, I have made a good tallh effort to minimize my waste generation and select the be·•t waate management method
. -th.at is available 10 me and that I can aNord.
•, Printed/Typed Name RO.GER L. COATS
17. TransPorter 1 Ac.:Knowledgement of Receipt of Materials
• Printed/Typed Name
'-:>ts,u-'<":::, ~=~ ' ..__
18. Transporter 2 Acknowledgemenl ol Receipl of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
Signature
~M-<2-
Signature
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
EPA Form 8700-22 (Rev. 9/86) Previous Edltlons are Obsolete [OHEC 1988 (Rev. 10/86)1
a I
bl
Month Year
0
Month . Day Year
0 '\ :, " 1
Month Day Year
jib!. CI llbl.
Jib!. d I 11bl.
Month Day Year
1---~~-'. . •~J· -~-~ ····:. . .
'
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Wa5te Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone] .
Emergency & Holidays: (803)734-542• ·
E PRINT or TYPE (Form desr ned for use on ellle 12-itch writer
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D O 7 6 o
Willms Truckin Co Inc.
7. Transporter 2 Company ~ame
Maniteet
Document No. 1400281
9. Designated Facility Name and Site Address
·GsX Services of SC, Inc.
Route,· 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
Form A
2. Page 1 ·
of
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is not
required by Federal law. but i, by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, snd ID Number}
¼""
12. Containers 13. Total Quantity 14. Unit \~\'.W~...,_ih
No. Type 'MN~ H'i111lf\)Jl¼fai%1~
8.fft't',11. I,
E •~Hazardous Waste, Solid, nos ORM-E
N 'NA 9189
C.
/"'~ ... T!!i ; ..
d. .
t.i.;::,: lc.1. .. •;~!.
15. Special Handling Instructions and Additional Information
(:' GSX Work' Order No. : . 72608
\,' t•'lf,,,, . I.._ ..
f:11~Y6nf91f~ ill ··,;
1 D T 2 0 Y /f;j1fJQJQJ6J.•. wq~'¾~~''...:.~ -.. -
%!! I I I I m 'itl. I
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 dual fled.
packed, marked, and laheled, and are In all respects in proper condition tor transport by highway according to app11cable International and natlonal government r9Qulatlona and
the law• ol lhe State of South Carollna. ·
111 am a large quantity generator, I certify that I have a program tn place to reduc"e the volume and 1011.tcity of waste generaled to the degree I have determined lo be oconomally
practicable and !hat I have ,erected the practicable method of treatment. storage, or disposal currently available to me which minimizes the present and future thr-t lO human
• health and the environment; OR, 111 am a smnl1 quanlitygeneralor, I have made a good faith effort to minimize my waste generation and select the beat waate management method
t:'," Iha! fs available 10 me and that I can afford.
, . Printed/Typed Name RQCEK L. COATS , Signature
17. Transporter 1 At:1mowledgement of Receipt of Materials
Printed/Typed Name
. · '0 v h 1-1 ,Se cP#/-J
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature
19. _Discrepancy Indication Space
20, Facility Owner or Operator: Cer1Jncallon of receipt of haurdoua materlala covered by this manifest except aa noted In hem 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9186) Previous Editions are Obsolete (DHEC 1988 (Rev. 10186)1
Month Day Year
a ._I ._._.._.,_.__.!lbs. c lu...L..L..LJ..J!lbl
b I !lbs. d I !lbs.
Month Day Year
I
. --~-"''1\_. '•_, ·~ . -~-
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Huardou, WtUte Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5-124
E PRINT or TYPE Form A roved. OMS No. 2050-0039 E,; ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
2. Page 1 ·
of Information in the shaded areas is not
required by Federal law, but is by State law.
~4::·c..G=P.::•~"•::ra.::~::;::.(.::•.:.!.:;~.::ox"ne::..,.
1
_
4
-"!-'~"9'--'-S-m_!=~'-Z'-:_!"-'-;-'i,.f"-•---'N-C __
2
_
7
_
5
_
7
_
7
________________ -f';I~~~i:~~~}~~~,0~~:~if~\i1~j~4A~;~~~f\;
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transponer 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA ID Number
11., U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
d.
15. Special Handling Instructions and Additional Information
: · GSX Work Order No, : n,. 72609
16. GENERATOR'S CERTIFICATION: I hereby declare th al the contents of this consignmenl are fully and accurately described above by proper shipping name and ara elasaifted.
packed. marked. and 1a·beled. and are in all respects in proper condllion for transport by highway according 10 appUcable International and national govammant regulation• and
the laws ol the State ol South Carolina.
If I am a large ciuanlity genara!Or, I certify that t have a program In place to reduce Iha volume and toxicity of waste generated to the degree I have determined to be oeonomtcally
practicable and that I have selected the pracllcabte method of treatment, storaga, or dlapoaal currently available to ma which mlnlmlzH Iha preMnt and future thrNI to human
health and the environment; OR, ii I am a small quantity generator, I have made a good faith effort to minimize my waste generallon and set act the beat waala management rnethOd
tf'lat ts available to me and !hat I can afford.
• Printed/Typed Name f,l'V.'.'.E'l L. COATS Signature
17. Transporter 1 A~Knowledgement of Receipl of Materials
18. Transp0ner 2 Acknowledgement ol Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
• ''j
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest excepl as noted In Item 19.
Printed/Typed Nama Signature
Month
Month
9
Monl!l Day Year
8 IL...L.L...L.J..l...lpbs. C ... , .L...L.J..J.-'-''lbs.
b I jibs. d I jibs.
Monl!l Day Yur
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolete (DHEC 1988 (Rev. 10/86)1
•.,
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer
,UNIFORM HAZARDOUS 1. Generetor'sU.S.EPAIONo. ManUeet Document No. WASTE MANIFEST N c D o 7 o 140028
l Generator's Name and Mailing Address
Channel Master
l p; 0. Box 1416, Smithfield, NC 27577
4. Ge~eralor's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
·Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Oescriplion (incfuding Proper Shippfng Name, Hazard Class, and 10, Number)
a. a:,,: :
Emergency & HoUdays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1 ' lnlormatlon In the shaded a,eas is not
of required by _Federal law, but is by State law.
-i11~1ilt~il;~:~ili[!IJi:
::l\ll~iiltllll~ti~l~~!~llt~i~
··Hazardous Waste, Solid, nos ORM-E E l T 2 0 Y N NA 9189
I
d ..
15. Special Handling lnstruC:tions and Additional lnlormalion
t°GSX Work Order No. : :i... ' 72610
, 6.-GENERATOR'S CERTIFICATION: I hereby declare that !he conlenls ol this consignment are fully and accurately described above by proper 1hlpplng name and are ciu.alned.
packed. marked, and la.beled, and are In a11 respects in proper condilion tor transport by highway according to appllcab1e International and national government re,gulations a.nd
the laws of lhe Slate ol Soulh Carolina, · ·
n I am e large quantity generator, I certify that I have a program In place to reduce the volume and toxicity of waste generated lo the degree I have determined to be economicalty
praC1icable and lhal I have setected the prectlcable method ol lrealmant. storage, or dlspoa.al currently avallab1a to ma which mlnimizaa tho present and lutura lhraat to human
1 health and !he environment;OR, lfl am a small quantity generator, I have made a good laith effort to minimize my waste generation and select the bail wa,1a management mo(hc)d 11 U\.al la available to me and lhnl I con nllo,d,
.~ Printed/Typed Name ROGER L. COATS
17. Transporter 1 Ac.amowledgement ol Receipt ol Materials
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
t' ...
Signature
Signature
Signature
Month
0
Year
Month Day Year
a lu......._.....,__.jlbs. c L-1 J...L.L..L..LJl·lbs.
b I !lbs. d I ilbs.
T 20. Facility Owner or Operator; Certiftcallon of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolele [DHEC 1988 (Rev. 10/86)1
I ',~
-=,.~·~-South· Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 6 o 1
Manifest Oocumenl No, 0 0 2 8 4
Emergency & Holidays: (803)734-5-124
Form A roved. 0MB No. 2050-0039 E, ires 9-30-88
2. Page 1 · lnlormalion in the shaded areas is nol
of required by Federal law, but is by State law.
1 G;~~~::~an;;;;dt~~ingAddress • lil:~11i=t~Jit{lr1{ffj{~;:
~4~~~~:p~~~·•~r~~~.~~~~·~!~~~:~n•~l-4~!~~~9~Ls_m_!~~~:~:_!~·~;~i~d~l_·_·•_N_c_2_7_5_7_7_~~~=~~~~-------+r±:;7:;F±:1i:;;;~.~3tie;;;t,~!t,Tulil1~fl
5. Transporter 1 Company Name 6. U.S. EPA ID Number
· Willms Truckin Co Inc. S C D O 7 3 7
7. _Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Ha;ard Class, and ID Number)
a.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
GSX Work Order No.: 72611
1 D T
1r1~f'fOfi~
2 0 Y ~1F1Q1Q161I
18. GENERATOR"S CERTIFICATION: I hereby declare that the contents ol this consignment are fully and accurately described above by proper shipping name and are cluaifled,
packed. marked. and lsh61ed, and are in all respects in proper condition for transport by highway according to applicable lnternallonat and national government r9Qulatlon• ar,d
Ina taws of the State ol South Carolina.
If I am a large Quantity generator, I certify that I have a program In place lo reduce tha volume and loxlclty of waala generated to the degr-1 have datermlnod to be economlcalty
practicable and that I have selected the practicable method ol treatment, storage, or dlspoaal currently available to me which minimize■ the present and future thrNI to human
haallh and the anvironmont OR, 111 am a small quantity gonorator, I have mado a good faith effort 10 minimize my waste generation and select the beat we.ala managemanl method
thal la available lo mo and that I can atford,
Printed/Typed Name ROGER L. COATS' Signature Month
c)
17. Transporter 1 Ac.:Knowledgement ol Receipt of Materials
Printed/Typed Name A _.A N'1 ES -Im.
Printed/Typed Name Month Day Year
19: Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by lhis manrfesl except as noted In Item 19.
Printed/Typed Name Signature Month Cay YNI
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [OHEC 1988 (Rev. 10/861)
South Carolina Department of Health
and Environmental Control.
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
~r,r
E PRINT or TYPE (Form desi ·ned for use on elite 12-itch writer
,: . UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
, u WASTE MANIFEST N c o o 7 o
l Generator's Name and Mailing Address
Channel Master
-~ P. ·•o., Box 1416, Smithfield, NC 27577
,i"Generato(s Phone 919 · 934-9 711
5,1. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
6. U.S. EPA ID Number
ManUoat
Document No.
0 0 2 8
9. Oe3ignated Facility Name and Sile Address
GSX Services of BC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
11., U.S. DOT OesC:ription (including Proper Shipping Name, Hazard Class,. and ID Number)
a:·,1, ·
., Hazardous Waste, Solid, nos ORM-E
NA 9189
,•\
15. Special Handling lnstruCtio~s and Additional Information
·ocsx Work Order No.: CT ~!n, 72612
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1 · Information in the shaded a,eas is not
of required by Federal law, but is by State law.
i\fi1~;1;tlf ~iil1i~~;f:ji!;!~:\~#:il iiliiil~ll:
1;z:~ii1ilft~1l!~J~t:BfZ4;~~iW!tt,tf1
1 D T 2 0 Y
1e. GENERATOR"S CERTIFICATION: I hereby declare that !he contents ol this consignment are fully and accurately described above by proper shipping name and are cluaified.
packed. markod. and laheled. and are In a11 respects ln proper conditlon for transport by highway according to applicable lntarnallonal and natlonal government regulations and
· the laws ol lho Stale ol Soulh Carolina. ·
If I am a large quantity genoralor, I certify that I have a program In place lo roduc·e the volume and toxicity ol waste ganeratod to tha degree I ha.,,, de1armlnod to be oconomlcally
, practicable and that I have selected the practlcabla method ol treatmenl storage, or dlspoaal currently available to me whtch mlnlmizaa the pres.ent and luturo thrNt to human
• 1haalth and the environment OR, If I am a small qunnllty generator, I have made a good lailh a Hort to minimize my waste generation and select the bail wute management method
:'l'thal is available to ma and thnl I con nllord.
t : ;..P~inted/Typed Name ROGER L. COATS
Signature Month Day Year
(J '1 2, ?
17. Transporter 1 Ac.:Knowledgement ol Receipt of Materials
Printed/Typed Name ._ ...... Signature
.;.:7,
nowledgement ol Re
me Signature Month Day Year
19. Discrepancy Indication Space
•I Jibs. CJ Jibs.
b I I Jibs. d I Jibs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manrfesl except as noled In Item 19 .
. Printed/Typed Name Signature Month Day Year
EPA Form, 8700-22 {Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 {Rev. 10/86)]
'·.
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Wa,te Mgt
2600 Bull Street Columbia. SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer
. UNIFORM HAZARDOUS 1. Generator'sU.S.EPAI0No.
WASTE MANIFEST N c o
3. Generator's Name and Mailing Address
Channel Master
Ernergency & Holidays: (803)734-5-124
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1 Information in the shaded areas is not
of required by Federal law, but Is by State law.
~'::·..;G:::~::~.::•::·•:.~:::~:..r':.•:..!.::~:::0::.:.::..1.
1
_
4
_9,_
1
_,~~9'---'-S-m~!<..e;::zc.:_!<..!;-'i'-f"--·-N_c __
2
_
7
_
5
_
7
_
7
________________ -+:r;;);:,.,~;;.~~;0~;~;~~i0~;r~\1!~;~JJilif{~tit~;t11~1r
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
d.
15. Special Handling Instructions and Additional Information
.'.P Gsx· Work Order No.:
.;,il)'" 72613
12. Containers 13. Total Quantity 14, Untt :iiwuta'~li
· No. Type 'M.NrJ ft\f\i}}~ti~J#J.:d
t~-~-~~·'T'~~,,,
fir ,~)
1 e.. GENERATOR'S CERTIFICATION: I hereby declare !hat the contents of this consignment are fully and accurately described above by proper ahlpplng name and ar• cla.uifled.
pack&d, marked, and l&baled,and are In all respects In propercondillon !or lrenspott by highway according to appllcable lnlernallonat and national govemman1 re;ulatlona and
the laws of the State ol South Carolina.
lfl am a large Quantity generator, I certify lhal I have a program in place lo reduce Iha volume and toxlcltyofwaateganerated to the degree I have determined to ti. oconomlcalty
-•practicable and that I have selected the practtcable method ol treatment, storage, or dlspoaal currently avallable to me which minimize• the preaent and future throat to human
.: , health and the environment OR, If I am a small Quantity gener81or, I have made a good faith effort to minimize my waste generation and select the beat waste management method
. _: that Is availat>le 10 me and that I can afford.
i~: Printed/Typed Name Signature ,
Signature Month Day Year
19. Discrepancy Indication Space
a ... I .................. l'ba. e t..l .L.J...1..1.."-'l'ba.
b I jibs. d I libs.
20. Facility Owner or Operator; Certification of receipl ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Porm 8700·22 (Rav. 9/86) Previous Edltlo"a arc, Obaoloto [OHEC 1988 (Rev. 10/86))
t~
..... fl ... ;; •
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Boll Stree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holiday,: [phone]
E PAINT or TYPE {Form desf ned for use on elfte 12-itch writer Form A roved. 0MB No. 2050-0039 E, ires 9-30-88
.UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o 7 o
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA ID Number
S C D O 7 0
1 LU.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number/.
!1 .
a-~·;1:; ;~ ., ,
E ;!,·Hazardous Waste, Solid, nos ORM-E
N . NA 9189
......
15. Spec_ial Handling Instructions and Additional Information
r.o GSX Work Order No. : 72614 0 t;nt•-..' ·i
2. Page 1
of.
12. Containers
No. Type
1 D T
Information in the shaded areas is not
required by Federal law, but is by State law.
1 &. GENERATOR'S CERTIFICATION: I hereby declare that the contents of !his consignment are fully and accurately described above by proper •hipping name and are c!a.ulfled,
packed, marked, and labeled, and ore In all re:!lpects in proper condition tor lranspor1 by highway according to oppllcablo lntornallonal and natlonal govemment r11gulettona and
the laws of !he Stale of Soulh Caro1lna. ·
It I am a largo quantity generator, I certify th al I hove a program In place lo reduce the volume and toxicity of waste generated to tho degr-1 have dolormlned lo be economblty
precliceble and thal I have selected the practlc•ble melhod or treatment, storage, or dlspoaal currently avnllabla lo mo which minimizes the present and future d'UNI to human
heollh and the envi,onmont; Oil, II I om n 1im11II quontltygonorolor, 1 hnvo modo n good follh elfor1 to mini mite mywo51o genorallon and Hloct tho be1! wa1to management method
"lhel Is available to mo and thol I can allord.
P~nted/Typed Name
Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certificalion of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Prln1ed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 (Rev. 10/86)]
•I ..................
bl~~~~
Month Day Year
ti z_ J ?",J
Qn~
Month Day Year
l'bt. C I libs.
pt,,. d I pt,,. .
Mon~ Dey Ylll
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holiday~ [phone]
E PRINT or TYPE (Form desi ned for use on elile 12· itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9.30.eg
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Genera1ofs Phone [phone]
5. Tra·nsporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
Manifest Document No. 1400288
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
2. Page 1
ol
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
No. Type
a. Hazardous Waste, Solid, nos ORM-E
Information in the shaded a<eas is no!
required by Federal law, but is by State law.
13. Total Quantity 14. Unil •L'WaiaNlin,b,ii;G
wvvrJ wtt.4"N:+::x11m:t11ii
N NA 9189 1 D T 2 0 Y
b.
C.
d.
GSX Work Order No.: 72615
16. GENERATOR'S CERTIFICATION: I horebydoc1a.ro lhat1he conlenls ol this consignment are lully and accuralolydescrlbed above by proper ahlpplng name and are clasa1fied,
packed, marked, and laheled.and are in all respects in proper condition for transport by highway according to applicable lntarnaUonal and natlonal government regulatlona and
the laws ol lhe 514le ol Soulh Cerollna. ,
If I am a large quanlity generator, I certify that I have a program In place to reduc~ !he volume and to:lllclt)'or wastageneratodtothedegr-I have determined to be economically
practicable and Iha! I have selected the praclicable method of treatment, storage, or dlsposal currently available to me which minimizes the present and future threat 10 human
health and the environment; OR. Ill am a sma11 quantitygonerator. I have made a good laith ettortto minimize mywaslo generation and selec1 the beat waste management method
that is available 10 me and that I can afford.
Prinled/Typed Name RQGEr( L. COATS Signature
17. Transporter 1 A~Knowledgement ol Receipt ol Materials
Printed/Typed Name Month Day Year
19. Discrepancy Indication Space
a I !ibl. e I !ibl.
bJ !lbs d I !lbs
20. Facility Owner or Operator, Certlffcallon of receipt of hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Signalure Monlh Day Year
EPA Form 8700•22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE
UNIFORM HAZARDOUS
WASTE MANIFEST
l Generator's Name and Mailing Address
Channel Master
writer
1. Generalor's U.S. EPA ID No.
N C D O 7
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
. 6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
Form A
2. Page 1
ol
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30·88
Information in the shaded a<eas is not
required by Federal law. but is by State Jaw.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit Jt\Wat8Nianiberff
No. Type "MN/1, ·:Z;tY~h:\~hl'~)M(fi
C. :::::rj·----, ; -, · -i-!~::
:=h ._, ....L....J'-,.._~,_Ii,
1S. Special Handling Instructions and Additional Information
GSX Work Order No.: 72616
1e. GENERATOR'S CERTIFICATION: I hereby declare that the contents olthls consignment are fully and accurately described above by proper ahlpplng name and are c1asa1lled.
packed. marked, and la°beled, and are In all respects In proper condition for transport by highway according to applicable lnlemational and national government re,gulatlons and
the laws ol the Stale ol South Caronna.
111 am a large Quantity generator, I certify that I have a program In place loreduc~ the volume and toxici~ol waste generated to Iha di,gr-1 have determined lo be economically
practicable and that I have setecled the pracricablo method of treatment, storage, or dlsposal currently avo.ilab1a lo mo which minimizes the present and luture thrNt to human
health and the environment; OR, ii I am a small quantity generator, I have made a good lalth effort to minimize my waste generation and ■elect ttle beat wa■te managemantmettlod
trial i1 available to me and that I can afford.
Printed/Typed Name
ROGER L. COATS
Signature Month Year
0
Month
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I !lbs. C I jibs.
b I pbs. d I pbs.
20. F acitity Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Yw
EPA Form 8700•22 (Rev. 9/86) Previous Editions are Obsoleto {OHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
E PRIHT or TYPE (Form desi ned for use on elite 12-itch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
NCDO 760
P. 0. Box 1416, Smithfield,
•· Generator's Phone [phone]
NC 27577
5. Transporter 1 Company Name
Willms Truckin Co Inc.
_7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
11. U.S. DOT Oescriplion (including Proper Shipping Naffle, Hazard ClsSs, and ID Number)
a
Form A
2. Page 1
ol
12. Containers
No. Type
Bureau or Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0009 Ex ires 9-30-88
Information in the shaded a<eas is not
required by Federal law, but is by State law.
Hazardous Waste, Solid, nos ORM-E. ~!!1r',ch'f'fg"(t~ ~ f-~N::A_9~18:'._:9::_ _____________________ 4 ....1..__i:l_j'.:'.DJT.:..j.-1.....L.J..'.2:..t:O+..'..Y-1,';j'.;j.tlf:;:=I P::::IP:::1::fi::;1:z¥;.Ji
~ 1-b.:.. ---------------------------------.!...L_l._j_L.I-.L...L....1-L.l--4::2iil1':'=~=~,,=,,:-~=··;,.=;~=·,.·=1•=:.;.·:=C!.i:r::;,f :J·
w·, . -.-.--'/ ·-.,_ -.. -.-i \.~~.
;:i «
t.
:1t! ...... '.,!. L.1~
d.
~~~:~\~1~•i1~1~J.ll1!!tl!i~~l1!·11,j1:il!~:~,·,·:
a U] -IO 1 2 1 7 1 7 1 4 1-I 1 1 1 1 0 1 2 hii,Lthkl C. LLJ-LI ...J.......J_.J...._L...JI~ f .. .
b. LLJ-I 1-I 1!!~:;!*:'l~!!t~ W:J , 1 • 1
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72617
16, OENERATOR"S CERTIFICATION: I hereby declare lhal the contents olthls consignment are fully and eccurately described above by proper 11hipplng name and era clasadle<S.
packed. marked, and la°beled, and are in all respects in proper condition for transport by highway according to appricable International and national governman1 re,,;ulationa al"ld
the laws of the State ol Soulh Carolina.
111 am a large quantity ganore1or, I certify that I have a program in place to reduce the volume and toxicity of waste generated to tho degree I have determined to M oconomlcalty
practicable and lhat I have selected lhe practicable method ol lreatment, storage, or dlspoul currently available to me which mlnlmlzea the preunt and lutur• thr-1 to human
health and the environment: OR. Ill am a smoll QUanlitygonerator, I have mado a good lailh elfortto mlnlmlza mywasle generation and select the bostwaate manegament method
mat is available to me and lhot I con ariord.
Printed/Typed Name ROGER L. COATS Signature
Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest excepl as noted In Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
'IL...L..L..L.~
bl ................ ~
Month Day Year
pbs. 'I pbs.
!lbs. d I l'bs.
Month Day Year
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streei Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE {Form desi ned for use on elite 12-itch ewriter Form A roved. 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D O 7 6 0
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Generator's Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72618
2. Page 1
of lnlormation in the shaded a<eas is n01
required by Federal law, but is by State law.
·:/~:r.L:r4·:~~:~,; •,~1\
,~?
1e. GENERATOR'S CERTI_FICATION: I hereby declare lhel !he con1entsolthls consignment are fully and accurately da,crlbod above by proper ,hipping name and ara c1a•••fled.
packed. marked. and labeled, and are in all re,pecls in proper condilion for tran,poA by highway according to applicable lnternatlonal and national governmonl ,..,_u1ation1 and
the laws ol tho State ol South Carolina.
111 am a large quantity generator, I certify that I have a program In place lo reduce the volume and toxicity of waste generated to the deg,_ I have delermlnod lo be economically
prac1ic.ible and that I have selecled lhe prac1icable method ol trealmenl storaOe, or disposal currently available to me which minimizes the present and luture throat to hum.en
health and the environment OR, ii I am o smu!I quantity gonorator, I hove mo.do a good laith effort lo minimize my was le genorutlon and select the beat waste management method
that is available to me and Iha! I can ottord.
Printed/Typed Name ROGER L. COATS Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
Month Day
a 1...I J.....L..1....1..J...JI lbs. c IL...L..J.....L.J....L.J!Jbs.
b I jibs. d I jibs.
Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete IDHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
SE PRINT or TYPE (Form desi ned for use on elite 12-itch · ewriler Form A roved. 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
NCDO 760
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 72619 .
Information in the shaded a<eas is not
required by Federal l_aw, but is by State law.
16. GENERATOR'S CERTIFICATION: I hereby declare that Iha contents oflhis conalgnmenl are lullyand accurately described above by proper shipping name and are clasaafled.
pack&d. marked, and labeled. and are jn all respects in propercondillon lorlransport by highway according lo applicable International and national government ragulatton• •.-.d
the laws of the State ol Soulh Carolina.
If I am a large quantity generator, I certity that1 have a program In piece to reducethavoluma and toxicity ol wa:iteganeraled to the dagroe 1 have determined to be aconomlcally
practicable and that I have selected Iha practicable method ol treetmenl, storage. or dlapoaal currenl1y available to ma which minimize, the present and luture lhr-t to human
health and the environment OR. ii I am o small quontitygonerator, I hove mado a good taith ettort to mlnimtza my waste generallon and select the be■t we11a management methOd
thal is available to me and that I can alford.
Printed/Typed Name ROGER L. COATS Signature Month Day Yea,
(}
T 17. Transporter 1 Ac;Knowledgement of Receipt of Materials
Printed/Typed Name Month Year
'"""
Printed/Typed Name Month Day Year
19. Discrepancy Indication Space
• I jibs. C I jibs.
b I jibs. d! jibs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Yw
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
4. Generato~sPhona 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
Manifest Document No. 1 4 0 0 2 9 3
6. U.S. EPA 1D Number
S C D O 7 3 7
a. U.S. EPA ID Number
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a
Hazardous Waste, Solid, nos ORM-E
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Expires 9-30-88
lnlormation in the shaded areas is not
required by Federal law, but is by State law.
t1~'V!~61Y'f~I~
N NA 9189 1 D T 2 0 Y ~1E1D10161~
b.
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72620
16. GENERATOR'S CERTIFICATION: I hereby declare !hat lhe contents olthis consignment are fully and accurately described above by proper shipping nam• and ara classified,
packed, marked.and la.beled, and are In all respects in proper condilion for transport by highway according to applicable lnternatlonal and nallonal government ragulallona ar,d
ll'la laws of the State 01 Soulh Carolina.
If I am a large quantity gener~tor, I certity that I havo a pr~ram In place to roduc8 thavotume and 1oxlclt)'o1 waategenerated lo the degree I have determined to be ec:onomically
practicable and thal I have selected the practicable method ol lrealment. storage, or disposal currently available to ma which minimizes Iha present and future thraat to human
health and the environment OR, If! am a small quantity generator, I have mado a good faith effort to minimize my waste generation and se1ectlhe beat waate management meltlod
that is availab!a to me and that I can afford.
Printed/Typed Name
RO.GERL. COATS
Month
0
Month Year
() 7
Signature Month Day Ye,r
19. Discrepancy Indication Space
• I pbs. C I pt>s.
b I pbs. d I pt>s.
20. Facility Owner or Operator, Certification ol receipt ol hazardous materials covered by !his manifest except as noted In Item 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [OHEC 1988 (Rev, 10/86))
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D O 7 6 O 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
a.
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree( Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x: ires 9-30-88
Information in the shaded &<eas is not
required by Federal law, but is by State law.
Hazardous Waste, Solid, nos ORM-E
N NA 9189 l D T 2 0 Y
T
R
F
b.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72621
16. GENERATOR"S CERTIFICATION: I horeby doclruo thottho contents ol this consignmonlarelully and accumtaly described above by proper shipping name and are classilia-d.
packed, marked. and labeled, and are in all rospects in proper condition lor transport by highway according to applicable International and natlonal govarnman1 r9<o1ulatlona •Ml
the laws ol the State ol Soulh Carolina.
111 am a large quantity generator, I certify that I have a program in place to reduce the volume and toklcltyor waste generated lo the di,gree I have determined 10 be economically
practicable and that I have selecled the praclicabla method cl treatment. slorage, or dlapoaal currenlly aval1ab1a to me which mini mites tha present and future lhrNt to human
health and the environment: OR, II I am a small quanlitygeneralor, I have made a good lailh eNortto mini mite my waste genara~on and select the beat waste management methOd
that is available to ma and thal I can afford.
Printed/Typed Name Signature Month Year
17. Transporter 1 Ae;Knowledgement of Receipt ol Materials
Printed/Typed Na~ /f?y2€,§ Signature Month Day Year
c5-d'? zv & ')
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I pi,,, 'I pi,,,
b I pbo. d I pi,,,
20. Facility Owner or Operator: Certification ol receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signalure Month Day Year
PA Form 8700•22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE writer
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D O 7 6 0 1 4
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 919
5. Transporter 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7. Transporter 2 Company Name
Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72622
1 D T
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x ires 9-30-88
Information in the shaded Meas is not
required by Federal law, but is by State raw.
2 0 Y
::~·;''"Y'"~""f•'·~-.:·.~•:_; __ l.·_;_:._.~_
\/1 ..
, 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are claaaifl.C,.
packed. marked, and labeled, and are in all respects In proper condition lor transport by highway according to appllcable International and national government r-.gulatlons and
the laws ol lhe State of South Carolina.
111 am a large quanllty generator, I certify that I have a program In place to reduc~ thevoluma and to:dclt)'ofwastegel'\eraled to the de<o1r-I have determined to be economically
practicable and that I have selected the practicable method ol treatm8nt. storage, or dlspoaal currently available to me which minimizes the preaent and future thr-110 human
health and the environment; OR, ii I am a small quantity generator, I have made a good faith ellort to minimize my waste generation and select the best waste managamanl method
that is available to me and lhal I can allord. ·
Printed/Typed Name ROGER L. COATS
17. Transporter 1 Ac;Know!edgement of Receipt of Materials
Printed/Typed Name
'-4<-,tJ...J ~,,_/._
18. Transporter 2 Acknowledgemenl of Receipl of Maleriafs
Prinled/Typed Name
19. Discrepancy Indication Space
Signature
Signature
• I
b I
Month
0
Monltl
Monltl
!lbs. C I
!Jbs. d I
Year
Day Year
!Jbs.
!Jbs. ,,__ ______________ _
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 Month Day Year
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control·
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12-itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
N C D O 7 6 0
P. 0. Box 1416, Smithfield, NC 27577
Generator's Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Oesigtiated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD073
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and JO Number)
C.
d.
2. Page 1 Information in the shaded MHS is no!
of required by Federal law, but is by State law.
~e~~,~~~lf~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72623
18. GENERATOR'S CERTIFICATION: I herebydeclorethat the contents olthls consignment are fully and accuralely deecrlbed above by proper shipping name and are clauill«t
packed, marked, and laheled, and are in atl respect, in proper condition for transpor1 by highway according to opptlcable lntarnational and natlonal govemmenl r.-gulations al'\d
tna laws ol tha Stale or South Carolina.
111 am a large quantity generator, I certify that I have a program In place lo reduce'thevolumeand to:dclt)'ol waste generated to tho de,groe I have determined lo be economically
prachcable and that I have selected the practicable melhod ol treatment. storage, or disposal currently available to me which minimizes the present and future lhr-t to humAn
health and the environment OR. ii I am a small quantity generator, I have made a good laith effor1 to minimize mywoste generation and select the be1I waste management method
that is available to me and Iha! I can attord.
Printed/T ped Name
19. Discrepancy Indication Space
20. Facilify Owner or Operator; Certification of receipt ol hazardous materials covered by this manrfesl except as noted In Item 19.
Printed/Typed Name Signature
•IL..J....1...1....1-L
b j._._.._.__.__.,
Month Day Yeat
Jibs. C I pbs.
pbs. d I pbs.
Month Day Yea,
EPA Form 8700-22 (Rev. 9/86) Previous Editions ore Obsolete [DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PAINT or TYPE (Form desi ned !or use on elite 12-itch Form A roved, 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
2. Paga 1
of
12. Containers
No. Type
Information in the shaded areas is not required by Federal law, but is by State law.
13. Total Ouentity 14. Unit ,l:Wala l•••ber\i;
WINrJ '·,.;i}+i/\'.)f/Flci}f{
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T 2 0 Y
d.
15. Special Handling Instructions and Additional rnrormation
GSX Work Order No.: 72624
16. GENERA.TOR'S CERTI_FICA.TION: I hereby declare that the contents olthis conslgnmentere fully and accurately described above by proper ahlpplng name and are cJ...,.,lled,
packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable lntarnallonal and nallonal government regulations and
the laws ol the State ol South Carolina.
111 am ii, large quantity generator. I certify that I have a program in piece to reducfl the volume and to:idclt'(ol waste generated to the degree I have determined lo be economlcally
practicable and lhat I have selected lho prncttcable method of treatment. storage, or dispose! currenlly available to me which mlnlml.toa tho preaont and luture lhr-t l.O hurnen
heelth end the environment:OR, itt am a small quantity generator, I have made a good laith etlort to mlnimi.te my waste generation and select the beat waste managemenl methOd
that is available to me and thal I can afford .
. Printed/Typed Name
ROGER L. COATS
17. Transporter 1 Ac;Knowledgement of Receipt of Materials
Printed/T~ed N"J"e ~ ,,/ /
f2:~lv(ll)tl, /ZP{,/hlif ,-,.._,
18. Transporter 2 Acknowledgement ol Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
~
Signature
20. Facility Owner or Operator, Certification of receipl al hazardous materials covered by this manifest except as noted in Item 19.
Prinled/Typed Name Signature
EPA Form 8700·22 (Rev. 9/86) Previous Editio~s are Obsolete [DHEC 1988 (Rev. 10/86))
Month Year
Monltl Day 'l/ 01 a-1. ?
Month Day Year
• I jibs. C I jibs.
b I jibs. d I jibs.
Month Day Year
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
4. Generator's Phone [phone]
5. TransPorter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-s.424
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded Meas is not
required by Federal law, but is by State 1aw.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit -,·:l\W~.N.l~V\
No. Type 'MN':A i/W'}fjf~#~l;}'.?}1.f
t a. Hazardous Waste, Solid, nos ORM-E i~;f,o,1,·g'f~~
N _l-..:N:::A~9:,:l:._:8:,:9:_ ______________________ _jl-J-1.:14D:::...1T~J-1-12:..104 _Y::__-1;';::4.::• E:::::1 P::::1 P::::1 6::::_;lf::.,i
I-b. _ a\'·"'·"""""'•·-'·•ii \,;I I I I 1%
;:j ~f' ~l--------------------------------~.L..L-J-..1.-J..-1...JLLL+--J-··•~•,,::'::::::::===:~1W~"~-
l c. At 1 ",-, ,tf
l!; ,_ L' .. 1~ I d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72625
, 8. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this con1ignmant are fully and accurately da1crlbed above by proper ahlpplng name and are cl AW fled.
packed, markod, and laheled,and are in aU respects in proper condition fortranspor1 by highway according toappllcable lntarnallonal and national govemmantrogulatlona and
the laws ol tha State ol South Carolina.
If I am a large quantity generator, I certify that I have a program ln place lo reducaihavolume and to,dclfy ofwastagonaralod to tho dog roe I have determined to be economicalty
practicable and that I have selected the prac1icable method ol treatment, storage, ordlapoul currently available lo me which minimize• the present end luture thr-1 to human
health and the environment; OR, 111 am a smell quantity generator, I have made a good faith el1or1 lo minimize my waste generation and aelact the be■t wa1te management method
that is available to me and that I can al1ord.
Printed/Typed Name
ROGER L. COATS
Signature f< Year
17. T ransponer 1 Ae;,cnowledgemenl ol Receipt of Materials
Printed/Typed Name Signature
T., ,_) ...7.
18. Transpo
Signature Month Day Year
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 Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)1
I
T
South Carolina Department of Health
and Environmental· Control
Bureau of ?')lid & Ha.z.ardous Waste Mgt
2600 Bull Street, Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
SE PAINT or TYPE (form desi ewriler Form A roved. 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. -··.• Manifest
C D O 9 7 6 0 4 7 1 4 ·000"2""/t'g
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4_· Generator's Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route I, Box 255
6. U.S. EPA ID Number
S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
Pinewood SC 29125 S C D O 7 0 3 7 5 9 8 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a
15. Special Handling Instructions and Additional Information
''~GSX Work Order No.: 72781
Information in the shaded a<eas is not
required by Federal law, but Is by State Jaw.
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are lullyand accurately described abo¥e by proper ahlpplng name and ar• el~ilied.
packed, marked, and 1aheled,and are in all respects in propercondi!ion for transport by highway according 10 appllcabla lnlarnational and national go¥ernmentre,gulatlona and
the laws ol the Stale ol South Carolina.
111 am a large quantity generator, I certify that! ha¥ea program ln place to reduce the volume and to)(lclty of waste generated to the degree I have detarmlned to be eeonomlcalty
practicable and that I ha¥e selected the practicable melhod ol treatment, storage, or dlsposal currently available to mo which minimize• the present and future trlrNI to hu~n
._;..,; health and the en..,ironment: QA, ii I am a small quantity generator, I have made a good faith effor1 to minimize mywai,tegenaratlon and select the beatw111te management method
••.•· that 11 available to ma and that I can afford.
n. Printed/Typed Name ROGER L. COATS Signature ~ Month Day Year
71.
17. Transporter 1 AcKnowledgement of Receipt of Malerials ~ed:rred ~m~ -~ .;:_ Signature
f c:,,-.._
, 8. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I jibs.
b I pbs. d I l'bs.
20. Facility Owner or Operator; Certification of receipt of hazardous malerials covered by this manifest except as noted In ltem.19 .
. Printed/Typed Name Signature Month O.y Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
-~:n-..
•,ir.. "d • ~ I South Carolina Dep,irtment of Health
and Environmental Control ·
Bureau of Solid & Haz.a.rdous Waste Mgt.
2600 Bull S~ee\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone] I P~E PRUIT or TYPE (Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
Form A
2. Page 1
of
roved. 01.48 No. 2050-0039 Ex ires 9-30-88
Information in the shaded aceas is not
required by Federal law, but is by State law.
I
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WASTE MANIFEST N c D o 7 6 o
1 G~:~~:~a;;::~ ~~ing Address lmlli:~J!J~i;:~~flltlli~& ..
,: !~er~~rs !~o~e 14 ! ~ 9 Sm!;~:! ;if ' NC 2 7 5 7 7 l~lti~t~f J:II{#~;{;~~h~;~~~'.,J111f i!ti: r==c.::..;_;="---"-"-"-'---"-"'-'---"--'--"-"----~-----------+~ 5. Transporter 1 Company Name 6. U.S. EPA ID Number · · "ID'\HAt:./rW/L·::::;:,b.t'i?i-V.)?#;:•
Willms Truckin Co Inc. SC DO 7
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255·
Pinewood SC 29125
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
15. Special Handling Instructions and Addilional Information
"csx Work Order No.: 72782
16. GENERATOR'S CERTIFICATION: I hereby~ec1are that lhe content:, of thl:,con:,ignmentaratully and accurately de:scrlbod above by proper shipping name and ar• clauifled.
packed. marked, and 18bclcd.and are in an re:,pect:, in proper condition tor tran:,portbyhighway according to applicable International and national government ra,;;ulationa and
tho law:, of the State ol Souttl Carolina.
If I am a largo quantity generator. I cof1ity that 1 have a program ln pince lo reduce thovolumo and 1oxicltyol waslogonara1ed to th• dograe I ha Yo datarmlnl>d to be .conomlcally
pr•cticabla and that I have selected tho practicable method ol trenlment, storage, or dl5poaal currently avol1ab1o lo mo which mlnlmizoa tho proaenl and lutur• ttlrNI to human
health and tho environment;OR, 1ft am a small quantity generator, I have i"nade a good faith effort to minimize my wa!lte ganaraUon and 1alact the boat w8a10 management meu,od
that Is 0Yailablo to me and that I can afford.
Printed/Typed Name Signature
·. GeR L. COATS
I
~ 17. Transporter 1 At;Knowledgement ol Receipt of Materials
A Printed/Typ~Name Signature ~ ~ l,,,J' v~ I \ p f---=--'--=.:==!.....L.!..L!.....,."-,,,-------'----'\....A...J=.::=:::....:·_..==..:::::..:::===;;__-'-..L----L:::L:...l.i2ll.
Month Year
~ ~1_8_. _T_ra_n_spo'-rt_e_r _2_A_ck_n_o_w_led'--"g_em_e_n_l_;_o_l R_e_c_e_;:ip_t .:..of_M_a_1e_r_ia_ls ___ ~------------------------------l 1-i-+--P-rin_•_ed_/_T_y_ped_N_a_m_• ______________ ..1,_si_g_n•-t-ur_e ______________________ ..1-L-.L...I..
Month Day
19. Discrepancy Indication Space
F I? L
8 LI J....L..L...L..J
b LI J....L..L...L..J
jibs. C I
jibs. d I
11---------------~ ~20_. ::-F.,.ac_il.:..ityc,O,..w_n_e_,,r ,,_or_O...;p_e ... ra_lo..;r...;Cc..e_rt_ifi.:..ca_li.:..on...;cof_re.:.c.:..•.cip_t o;_f_h_aza_rd_o.:.u•:..m_a,.le.:,r..ci•..cl•..:c.:..ov..:• ... •ed:.:..:b.:..Y ... lh ___ is:..m ... •;;.n.:..tt.:.es.:..I .:.••;.;c.:..ep:;.;I.:•.:.• .:..no.:..led:..::..l.:..n :..lle;;.m.:..1;.;9.:... _________ _
Prinled/Typed Name Signature Month Day
Year
jibs.
jibs.
Yw I ~-=-~=~~=--,---::-=---~-.-,,--,,,,J:~,,.,.,..,,,.......,.,,=-----------J....I....L...J...J~ EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (R~v. 10/86))
I South Carolina Depatbnent ·of Health
and Environmental Control
Bureau of Solid & Hazardous Wa,te Mgt ·
2600 Bult Street Colum~ia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
PLEASE PRINT or TYPE (Form desi ned for use on elite 12-itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA to No. , , ' Manifest
: Document No.
WASTE MANIFEST N c D O
1 Generator's Name and Mailing Address
Channel Master
P._ 0. Box 1416, Smithfield, NC 27577
,. Generator's Phone [phone]
5. Transporter 1 Co~pany Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
14 0301
6. U.S. EPA 10 Number
S C D 0 7 3
8. U.S. EPA to Number
10. U.S. EPA ID Number
S C D 0 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
2. Page 1
of Information in the shaded Meas is not
required by Federal law, but is by State law.
I~ .. Hazardous Waste, Solid, nos ORM-E .S\Ffo1if9"i'%
N NA 9189 1 D T 2 0 Y !~)ifrQrQr6r~
12. Contai~ers 13. Total Quantity 14. Unit ~ltWatii~$'t}
No. Type WtNrJ ~\b\)NWi'~\'.Pi':({,f:f'
I i l-b_ .. __ _:_ __________________________ .j_LL.j....L.-1--.L..L..L..L..+--4!2\i.!::•=·=•=···-=·=·•·=··=·=·:]i:.I]
I R c. \_;~_{ I ::.:-.. .<.--.w,.,-,'j\i.-
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b. Lu-I ', ,_1:1 ', ', I Jlil'l~:11:~til,l,t~:W:J..., 0•. J-J, , ',,J[i~
15. Special Handling Instructions and Additional rnrormation
GSX Work Order No.: 72783
1 ~ :~J, I I .. },.,._._~-~,
1a. GENERATOR'S CERTIFICATION: I hereby declare thatlhe contents olthls conslgnmentara fully and accurately deecrtbed above by proper shipping name and arec1uainec1.
packed. marked, and laheled, and are in all respects in proper condition for transport by highway according to applicable lnlarnational and natlonal government regulatlons and
the laws of the State of South Carolina.
111 am a large quantity generalor, I certify that I have a program in place to reduce the volume and 10:dcltyol waste generated lo the degree I have determined lo be economically
practicable and thal I have selected the practicable method ol lreelment, storage, or dlsposal currently available to me which minimizes the present and lut\Jre lhreal to human
health and the environment: QR, II tam a small quantitygoneralor, I hove made a good lalth ertortto minimize my waste generation and selacl the bait waale management method
that is available 10 me end that I cen afford.
Prinled/Typed Name Signature :✓. ~ Month Year
RO.GER L. COATS " 9
, 7. Transporter 1 Ac.:Knowledgement of Receipt ol Materials
Printed/Typ~ /11. Signal re Month _s.,...._ '7
18. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I !lbs. C I !lbs.
bl pbs. d I pbs.
20. Facility Owner or Operator: Certificalion of receipt of hazardous materials covered by this manifest except as noted in Item 19. y
Printed/Typed Name Signature Month Day Year
·~~~,.,.,.,,,.,,......,........,,.,.,,.----=:--,-,~~----,.,.,,.---------1...I...J...l-L.J-J EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/861]
I
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. <,.
m:~.A<Oc> •..-~. -:; ,.,..
·., South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
LEASE PRINT or TYPE (Form desi ned for use on elite 12· itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
T R
A
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0 R Ii .~ L I
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UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D O 7 6 o
l Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone 9 1 9 9 3 4-9 711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transp0rter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
t 1. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
2. Pago 1
of Information in the shaded a,reas is not
required by Federal law, but is by State law.
lt:;;i~:::~::~tlitff!il~!t~!lfi~i
:tlr:ti1~!~:µi:i~~lf ~~:1:i:~~1~~;:i~;i;it¼~1itl
1 D T 2 0 Y
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1
:,
11
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1
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1
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b. Lu-I .. '· 1-I 1~i,i:1lfiilil!i ~ W,:J
15. Speciat Handling lnstruc~ons and Additional Information
GSX Work Order No.: 72784'
18. CEHERATOR"S CERTIFICATION: I hereby declare that !he contents olthls consignment are lullyand accurately described above by proper ahlpplng nam• and are ct-.itl.c:I.
packed. marked, and labeled.and are in all ra:spects in proper condition for transport by highway according to applicable International and national government regulattonaand
the laws ol the State ol South Carolina.
111 am a large Quantity generalor, I certify that I have a program In place to reduce the volume and toxlcltyofwaalegeneraled to the degree I have determined to be economlcalty
practicable and thal I have selected the practicable method ol lreatment, slorage, or dlsposal currently available to me which minlmlu,. the present and lutura thr-1 to hum.an
health and Iha environment; OR, II I am a smol1 quanlitygeneralor, I have made a good lalth effort to minimize mywasl8 generation and select the beat waste management method
that is available to me end that I can olford.
Printed/Typed Name ROGER L. COATS Signature . Cad;;;_. Month Year .·, 0 'ii
17. TransPQrter 1 Ae;Knowled ement of Receipt of Materials
Printed/Typ Signature Month
/I f/4t,{..t-~ 0
18. Transporter Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I jibs.
b I jibs. d I jibs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by !his manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
I
I
I
I
I
I
South Carolina Depaftment of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bull $tree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5"424
Form A roved. 0MB No. 2050-0039 E.x ires 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o 7 6 o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Oesignaled Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 72785
2. Page 1
of Information in the shaded a<eas is not
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I hereby declare that the content., otthls consignment ara lully and accuratelydascribed abova by proper shipping name and are clauined.
packed, marked, and lahe1ed, and are in all respects in prOpercondilion tor transport by highway according to applicable International and national govemmantregulallons and
the laws ot the State ol South Carolina. ·
If I am a large Quantity ganarator, I certify that! have a program In place to raducathevoluma and toxlcltyol waste generated to the degr-I have de1armlned to be ec:onomlca.Hy
practicable and 11'\at 11'\ava aalaeted Iha practicable method or treatment. alorage, or dlapoa.e.l curranl1y avalleb1e to me which mlnlml.r.aa the preMnt and future th,_, to huffllln
health and the environment;OR. ll I am a small Quantity generator, I have made a good faith ellort to minimize my waste generation and select the beat waata management~
th.et is available to me and that I can allord.
I .Printed/Typed Name ROGER L C Signalure /1 / _
1---1,.::.··.;.,,.· ___ ....:.:..::.· .:.:...::·.=OA~T.:..S _ __J __ ~~.:i......~---~~~:!::------1.~~~
Month Year
1
~ 17. Trans rter 1 Ac,nowledgemenl of Aeceipl of Materials
p
Year
7
~~1_a._T_ra_n_,poc__rt_e_r_2_A_ck_n_o_w_led'-"g-•m_e_n_t_o_lA_e_c_e..cip_t.col_M_a_te_r_ia_ls ___ ~--------------------------------
l1-i-+--,P,,.rin_t_ed_/_T_y_ped_N_a_m_• ______________ ,_1,_s,_·g_na_1_ur_• ______________________ ..1_L...I....L...I.-
Month Day Year
19. Discrepancy Indication Space
F Ir 11---------------
a I......_..__._...__._
b IU-JU-J..J
Jibs. C I
jibs. d I
jibs.
jibs.
Month Doy Year
T 20. Facility Owner or Operator, Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Yt---:,-,..,.--:--:::--:-:-,-'--'------'-------,-::,--,---"'-'--....;.-....;.'-===-'-'--...C.....;.;. ______ -,-,--;---..,,--j
• ~:':-~P'.'.ri:'nt':ed,:-:::/T;:-y-:;ped:::-;;:;Na':m'.'.'e~=:-;:;::-~~;,::;~::-~~~:-:O:::""':~::eS::,ig:"'n:':al::u::re~;...,-,-::-:-::-::::------------------....l;...1....1....1....L....I'-'
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 (Rev. 10/86))
I ~~.--. ,,
South Carolina Department of Health Bureau of Solid & Hazardous Wa.ste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone] -~ ~ ..,.= and Environmental· Control
LE.lSE PRINT or TYPE {Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 6 o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Oescriplion (including Proper Shipping Name, Hazard Class. and 10 Number)
a. .
.. Hazardous Waste, Solid, nos ORM-E
NA 9189
b. L.i_J-
is. Special Handling Instructions and Additional Information
GSX Work Order No.: 72786
Form A
2. Page 1
of
Emergency & Holiday~ {B-03)734-5424
roved. 0MB No. 2050-0039 El< ires 9-30,B.!1
Information in the shaded &reas is not
required by Federal law. but is by State law.
12. Containers 13. Total Quantity 14. Unil
No. Type W/d
1 D T 2 0 Y
16. GENERATOR'S CERTIFICATION: · I hereby declare thetthe con1ents olthisconslgnmenlere fully and accurately described above by proper ahlpping name and are clas.ifled,
packed. marked, and labeled.and era In all respects in proper condition for transport by highway according to applicable lnlernational and national government regulatlon1 and
the laws ol the State of South Carolina.
111 am a large quantity generalor, I certify that I have a program In place to reduce the volume and tox!cltyol waste generated to the dagr-I have determined to b4 economlcally
practicable and Iha.I I have selected the practicable method ol treatment. storage, or disposal currently available to me which minimizes the pres-ant and future thr-1 to human
heatlh and the environment: QR, II I am a small quantity generator, I have made a good le/th effort to minimize my waste generation and select the beal waate managemenl methOd
that is available to me and thal I can allord.
• Prinled/Typed Name ROGER L. COATS Signature
17. Transporter 1 AcKnowledgement of Receipt of Materials
Printed/Typed Name
a-Ph 1'1 o89€i,/l-l---r-
18. Transporter 2 Acknowledgement of Receipt of Ma\erials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
c:?
Month Day Yeai
a lL...L..L..J..-"..L-'pbs. c ._I .._._.,.........,!lbs.
bl pbs d I pbs.
Monlh Day Year
I South Carolina Depattment of Health
and EnvironmentalControl
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
PLEASE PRINT or TYPE {Form desi ned for use on elite 12-itch write'r Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
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UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Manifest : Document No. WASTE MANIFEST N c D o 7 o 1 0 0 3 0 5
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
SCD07370
8. U.S. EPA 10 Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72787.
2. Page 1
of Information in the shaded a,eas is not
required by Federal law, but is by State law.
1 6. GENERATOR'S CERTIFICATION: I hereby declare that tho contents ol this conslgnmentare fully end accurately described above by pro~r shipping name and are cla.saified,
packed. marked, and la.beted,and are in all respects in pro par condition !or lranspor1 by highway according to applicable lnlernatlonal and national government r99ulattona al"ld
the laws of the Stale ol South Carolina.
If I am a large Quantity generator, I certify that I have a program In place to reduce the volume and toxlcltyol waste generated to th a degree I have determined lo be economleally
practicable and thal I have selected the practicable method of treatment, storage, or disposal currently avaUabla to me which minlmlzu the pr'!lsent and future ttHNI to human
health and the environment; OR, 111 am a small ciuantitygeneralor, I have made a good lalth etfortto mlniml1.e my waste generation and select ttle be•I wa•te management method
that Is available lo me and that I can afford.
Year
.~ L
8 '-' L...L.Jw...L...Jjlbs. C '-' L...L.JL...L.J'-ll'bs. bl jibs.di jibs.
lr----------------T 20, Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted In Hem 19.
I L..y:::::::::==::=:=:::::::::=================== = Printed/Typed Name Signature Month Day Yw
EPA Form 8700•22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
I
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South Carolina Oepatbnent of Health
and Environmental·Control
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter l Company Name
Willms Truckin Co ·Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of.SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number)
a. Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional lnfor~alion
GSX Work Order No.: 72788
Form A
2. Page 1
of
l D T
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
P_hone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State l~w.
2 0 Y
t~¾"F .. rOfitifii
;;i1E 10 JO 1_61t?;
16. GENERA TOR'S CERTI F1cATJON: I hereby declare that the contents ol this consignment are lully and accurately described above by proper ahlpplng nama end ere clasedl.cl,
packed. marked, and 111heled.and are in alt respects in proper condition fortranspor1 by highway according to applicable International and natlonal govemment r9gulatlona and
. the lews of the Stale ol sciuth Carolina. ·
II I am a large Quantity generator, I certify that I have a program In place to reduce thavoluma and toxicltyolwastaganaratod to the dog roe I have detormlnod to be economlcalty
procticab!e and that I have selected the practicable method ol treatmenl storage, or disposal currently .11.vailobla to me which minimizes the present and lutvra throat to human
health and the environment; OR. ii ram a small Qunntitygenorator, I have mado a good laith etlor11o minimize my waste generetlon and aelect the bait wa1te management method
that is available to mfl and that I con aMord. ·
19. Discrepancy Indication Space ·~ a L-1 J...L..L.J....J...Jpba. c ._I ......._.._.__.__.Pba.
bl !Jbs.d! !Jbs.
11,---------------T 20. Facility Owner or Opera!or; Certilicatlon ol receipt ol hazardous malerlals covered by this manifest except as noted In Item 19.
I YF-;:-'-':~~=====~======.:;;__----,-,-,---::~ Printed/Typed Name Signature Monttl Day Year
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
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South Carolina Depaftment of Health
and EnvironmentalControl
Bureau of Solid & Hazardous Waste Mgt
2600 Bull $tree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
PLEASE PRINT or TYPE (Form desi ned for use on elite 12· itch writer . Form A roved, 0MB No. 2050-0039 Ex ires 9-30-88
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UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number)
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No, : 72789
2. Page 1
of Information in the shaded areas is not
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents olthls consignment are fully and accurately de1crlbed abova by proper •hipping name and ere cl•-1fie-d.
packed, marked, and labeled.and aro in all respects in proper condition for transport by highway according to appllcable lnlernaUonal end natl.onal government r99ulatlon• and
the laws of !he Slate ol South Carolina.
If I am a lerge quantity generator, I certify lhat I have a program in place to reduce thevolumeand toxlcltyolwaategenerated tothedogroe I have determined lob-. 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 hum11n
health and the environment: OR. Ir I am a smalt quantity generator, I have made a good laith effort to minimize mywasle generation and select the beat waata management mothod
that is available to me and that I can afford.
Printed/Typed Name Signalure ~ Giak Month Year
" 17. Transporter 1 Ac.Knowledgement of Receipt of Materials
Prin'1/..";YP1 NamEi
/JC, a pff,,'J;t V\.
Signature
18. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I l'bs. C I !fbs.
b I Jibs. d I Jibs.
20. Facility Owner or Operator, Certification ol receipt ol hazardous materials covered by this manifest except as noted In llem 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
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South Carolina Depa~bnent of Health
and Environmental Control
Form A
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. . ,. Manlleal 2. Page 1
•Document No. of WASTE MANIFEST N c D o 7 6 o 1400308
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generato,sPhone 919 934-9711
5. Transpor1er 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
6. U.S. EPA 10 Number
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and 10 Number)
d.
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 72790
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streei Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex 'res 9:30.sa
Information in the shaded Meas is not
required by Federal law, but is by State law.
is. GENERATOR'S CERTIFICATION: I hereby declare lhal the contents Ol!his conslgnmenl are fully and accuratelydeacribed above by proper shipping nam• and are claa~lied,
packed. markll'd. and labeled, and are in all rospecl.s in proper condlUon lorlransport by highway according to applicable International and national government r-.gulationa at\d
the laws of tha State ol South Caroline. ·
111 am a large quantity generalor, I cortify that I have a program In place to reduce the volume end toxicity ofwaslegeneraled lothedagr-1 have determined to be oconomlcally
practicable ond Iha! I have selecled the praclicable method ot treatmenl. storage. or dlspoaal currently available to me which minimizes the present and future threat to human
health and the environment; OR. ii I am o smo.11 quanlityganeralor, I have made o good faith effort lo minimize mywastegenaratlon and select the beat waale management method
that is available to me and thal l can afford.
Printed/Typed Name ~©C.ER L. COATS
Signature Month Year
t)
17. Transporter , Ac;..:nowledgement of Receipt of Materials
Printed/Typed Name../. Month Year
$,1
18. Transporter Acknowledgement ol Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I Pbs. C I p1>s.
bl !lb< d I pti1.
20. Facility Owner or Operator; Certification of receipt of hazardous malerials covered by this manifest except as noted in Item 19. y
Printed/Typed Name Signature Month Day .Year
·~~~~...,.....-;:-,,,,..--~~~---,.,,,....------L..L-L..I....J-,L..I EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 (Rev. 10/86)1
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,.,
South Carolina Department of Health
and Environmental ·control
Bur88u Of Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (B03)734-5424
(Form desi ned for use on elite 12-itch ewriter Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generalor's U.S. EPA ID No. , ' Manifest
~· Document No. 2. Page 1
of
3. Generator's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4.Generator'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
_Route, 1 Box 255
Pinewood, SC 29125
7 6 0 4 0 3 0 9
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA 10 Nurriber
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and 10 Number) 12. Containers
. No. Type
a.
Hazar.dous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72791
1 D T
lnlormation in the shaded a<eas is not
required by Federal law, but is by State law.
13. Total Quantity 14. Uni! f~\~~•~11113b~if(.ji
VMrJ \flYWW\;[e-mail]
2 0 Y
16. GENERATOR0S CERTIFICATION: I hereby declare that the contents ol thlsconslgnmenterelullyand accurately deacrlbed above by proper 1hlpplng name and ere clasaifl«s.
packed, marked.and lahaled, and era in aU respects in proper condition for transport by highway according to applicable lnlernallonal and national government regutatlona and
uie laws ot the State ol South Carol!na.
II I am a large quantity generator, I cer1ify th11t I have a program In pl11ce to reduce the volume and toxicltyol wastegenoratod totha d&gr-1 have determined lo be oconomlcaJty
practicable and that I have selected the practicable method or treatment, storage, or disposal currenlly available to me which minimizes the prasont and future thr-t to human
health and the environment; OR, Ill am a small Quantity generator.1 have made a good laith eNortto minimize my waste generation and select the t>aat waate management method
th.at Is available to me and !hat I can atlord.
Printed/Typed Name R§©I\R L. COATS Signature ~ Year
ff j'c}
Montll Day Year
19. Discrepancy Indication Space
a I !fbs. C I libs.
b I pbs. d I jibs.
<1---------------20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted In Item 19. 1~
':E::P-':A-:F:-o-r-m-:8~7~00-:-_-:2-::2-:(:::R-ev-.-::9-::18"'6:-)-::P:-re-v""io_u_s-:E:,d-:-,it:-io_n_s_a_re'""'o""b-so-:l-:et-:e-::[D"'HJ,,,.EC""'1"9':'55"°"(R:-e-v-.1"'0'"1"'a""a1""1 ________________ ...1...i....1-11.-L...1-1
Printed/Typed Name Signature Month Day Year