NCD122263825_19881028_JFD Electronics - Channel Master_FRBCERCLA SPD_Hazardous Waste Manifest-OCR

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October 28, 1988
Mr. Jack Butler
NC Dept of Human Resources
Division of Health Services
Solid & Hazardous Waste
Management Branch
CERCLA Section
P. 0. Box 2091
Raleigh, NC 27602-2091
Dear Mr. Butler:
Enclosed for your file are copies
portation of contaminated subsoils
to the GSX landfill in Pinewood,
was the last load transported.
of manifests for trans-
from our Oxford facility
SC. Manifest Number 848
If you have any questions or need additional information,
please contact me at 934-9711.
Sincerely,
CHANNEL MASTER
Division of Avnet, Inc.
·~~~
Roger L. Coats
Safety/Environmental Engineer
RLC:sc
Enclosures
cc: Charles Hansen
AN INDUSTRY LEADER SINCE 1949 • TELEPHONE [phone] • FAX [phone]
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Wa.ste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)73-4-5""24
I PL.£ASE PRINT or TYPE (f-'orm desianed for use on elite r12-oitch1 tvnewrilerl Form A roved. 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS" 11. Generalor's U.S. EPA ID No. ManUoal 12, Page 1 lnlormal;on ;n tho shaded .,,., ;, not
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Document No, ol , F·' I WASTE MANIFEST N, C, D, 0, O, 7, 6, O, 4, 7, I, 4,0 ,O , 7 ,6 ,2 l requ,r~ by =eral aw.but;, byStalO law.
3. G;~:~~·~ ~a;~:;~ ~~ling Ad dross ~;,:,~,,:~:,~:.:t~,:: · 1 /t'-~,i}f)>)
P. 0. Box 1416, Smithfield, NC 27577
(. Generator's Phone( 919) 931,-9711
5. Transporter 1 Company Name
Willms Truckine 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 c/sill,it . 1 IO.,-:.·, ·.,.···· •. ',.;.,.,:'_;,,.
, s, c, o, o, 7, 3, 7, n. q, ?o C\ • li/.T •· •··--· if>hoM :.'iAn'\/n7:.:,-,_.,_.,_.,__
8. U,S. EPA ID Number .,.:;,,;;,;; .. •·ID: • ' · · · ·. · · · :,,,.:, · .. •• ·· • ·
I I I I I I I I I I I I f,'-T,anm,w'o Pf>or>o . . ·i~••·s.., •,
10. U.S. EPA ID Number "'"'""\~ff"~I~,;: . ·, · ... · ,:c '.',;;1):/.-
.._, .. . :,,.:•, >
rs, c, D, o, 7, o, 3, 7, '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity u. u,;t · l'.W&111 ,..,_/.
No. Type WJV~ \'.'.('\:{(/!f}.//{-jfj
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83024
1e. CEHERATOR'S CERTIFICATION: I horeby declare thal tho contonts ol lhls conalgnmen1 are lully and accurately described at>ova by proP4r a hipping nam• and ara clasa1fte<1,
pacl..ed. marl<"d· and l11h'1led, nncl nro In nil ro,riocls In p,or,or condition for trnnspo,t by higtiwny nccordlng lo nppllcable International and nallonal government r9Qulat1on1 and
tl'\e laws ol tho Slate ol South Carollnn.
111 am a l.111go quant,ty gonero1or, I ccrtiry lhlll I hnvo a progrnm In placo to reduce Iha volume and to,dcltyol wa1taganereled lo lhe dog re• I hive de11,mlned lo be" .c:onomle.a,lly
pr1c11Cable end that I have 11etected lhe practicable method ol treatment, storege, or dlspoaal currently avellable to me which minlmiie• Iha p1ewn1 and lutur1 U'\r-l \0 hu,...n
hea!lh end the environment; OR, U I am a smoll quantity genoralor, I hove made a good laith eltort to mlnlml.ta my waste gen a ration and selecl lt\1 boll .... ute management matt\Od
trial is available lo me and tt1nt I con nllord.
I Printed/Typed Name !Signature / / ~ {, Month Day Yoar
I +.,..,,..-~~:_,.!:.:~~.,.,....,.,-:-.,.,....-_j_---,,...,....!_o~./ --~•~...,.,..!Z:;;_:,_~--~-J, -->-~:,_ __ J.2..L:7J!..;i2_i£ ~ Roger L. Coats «-fA 1 , , , ,; ,
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~~ 17. JaQsporter 1 Ac1mowlcdger .enl ol Receipt ol Materials ' ) V }\ ~ f)
.... ~/Typed NJme 11 C::::....... 1 \ __ .1 ISigf(a ~-. ,
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R
E Printed/Ty ed Name !Signature v Month Day Yw
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19. Disc,~pancy Indication Space
...
•.--,--------------~ 20. Facility Owner or Operator; Certificalion of receipt ol hazardous materials covered by lhis manifesl except as noted In Item 19.
Prinled/Typed Name I Signature
EPA Form 8700•22 (Rev. 9/86) Previous Ed1hons are Obsolete !DHEC 1988 (Rev. 10/86))
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pbsdl111111'bs.
Monll> Doy Year
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I South Caronna Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste M9L
2600 Bull Stree~ Columbia, SC 29201
Phone: [BOO) 734-5200
Emergency & Holidays: (803)734-S42C
lr,E PRI.;;: TYPE (Form desioned lor use on elite 112-pitchl tvoewriter)
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A roved. OMS No. 2050-0039 Expires 9-30-88
Manlfe11t 12. Page 1 lnlormation in the shaded MHS is no1
required by Federal law, but is by Stale law. WASTE MANIFEST N, r,, n, O, 9, 7, 6, O, 1 .. 7, , pocumenl No. ol
1,lt"•0,7,6,3 l
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
'· Generator's Phone ( 91 9 I 9 34-9 7 11
5. Transporter 1 Company Name
Willms TruckinQ Co. Inc.
7. Transporter 2 Company Name
9. Oesignated 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
I S1 Cl Do Q, 71 31 71 fl, <Ji ?, Cj
8. U.S. EPA ID Number
I I I I I I I I I I f I
10. U.S. EPA ID Number
-Gi:~;:~:G:,f ::~1'ti:'.:=_::::·:;::;· · · ::-:::;tf~Q~J>·~:-'.· -.
c?siiie' · e ID'>>:. •.•· . :.-.·.:
D)T ·•····· 'a'PflOM\c.CRn,17~7::,,,,.
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11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Con!alners 13. Tolal Ouantily U. Unit L'W&SIII IM!d>or·
No. Type 'M/\ltJ \:•;://".';'::';'!'._k;)
a. ·. i F j □-,j,g-i':<
~1-.:.:.:.::.:.z_;::_r:.l ~:::_~::._u_s_w_a_s_t_e_,_s_o_l_i_d_, _n_o_s_o_RM_-_E ___________ _..j._lt_· J.t.'..l +D_Jt.:_T..j.....JtLtLJ..:t2:.L tO::...j._Y.:.._-lj~ /1::f=l::D::::I D:::::1 6~1 ~;:.Ji
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15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 83025
11!1. CENERATOR'S CERTI_FICATION: I hereby declare that the conten1s of this con1lonment •r• lu11yand accurately ducrlbod abova by proper 1hipplng nam• 1nd ar• cJa..,fl..:I,
packed, marked. and h1beled, and are in R11 respects in proper condition tor lrensport by highway according to applicable lnlernaUonal and national govarnm•nl ra,oulallon• al"\d
tl'I• law11 ol the State or South Carolina.
111 am• large quantity generator, I cer1ity tht1I I havo a program In ptaco to reduce the volume and to1dclty ot wa,tegeneratod lo the dogr-I have determined IO boa .conofflleally
prac1,cab1e and that I have selt1Cled lht! prac11cablt1 method of lrt1olmenl storogt1, or dlspo•al cuuenlly avalleb1e to me which minimize• the present and lutu1a u,,_1 to hu,...."
h•allh and tha environment; OR, ii I am a a mull quantity gon.,rator, I hove mad• a good faith etfort lo minimize my waste gt1nerallon and se!ac1 the bell w••ta manag•ffl•l'II rn.tl\Od
thal Is 11v11ilat,le to me and thnt I can ollo,d.
I Printed/Typed Name Month Day Yw
~b-=---..-'.;R:;;o~g.:e.:.r,..::L.:.·_::.Co~a:_'.:,t:.s--:---:---:--:-:--:---L---.L.~~~:..a_----':2'.~---'l..,2:l2::i~::....---.1'.:.t'0..1,:.7J'!.l..1,9:::.J{3~,8~
Signature ,,1;/~ -• -d. !.:~--r. ,
C1/ T 17. Transpor1er 1 AcKnowledgement of Receipt of Materials
I ~t--Pr-in_t_ed_/_T_yp_ed_;)f_m_e_-'----Q-'--------.------~~-------------------M-o-n-~--0-a_y_Y-:ear-➔
ij /-111.1-,J /4 /f',. ,. // i,::, ,7V Ii" IO.JY Signature 41_. _/4 ~ ~,11/
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(/ o 1 !. Transp0rter 2 Acknowledgement ol Receipt of Materials
l~A~~-P-,i-nl_ed_/_T_yp_ed_Na-m-,-~----~-----~-----------------------M-o-n-~--0-•y--Y-w~
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Signature
19. Discrepancy lndicalion Space
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} t,20,.,.-. -::F,-ac-:i-:lity-:O-w-n-,r-o-r-:0:-p-,-,.-to-,-, c=-,-rt-il""ic-a"'tio_n_of receipt ol hazardous materials covered by this manilesl except as noled in Item 19.
I y
Printed/Typed Name Signature
EPA Form 6700-22 {Rev. 9/86) Previous Ed1hons are Obsolete (DHEC 1988 (Rev. 10/86)]
a .._! ..__.__._._._.Pi>l c l._,._._......__._.!ll>l
b I P"'-d I jibs.
Month Day Year
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I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia. SC 29201
Phone: [phone]
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Emergency & Holidays: (803)734-542•
~E PRIITTor TYPE (Form desinned !or use on elite 112-oilchl tvn.wrilerl Form A roved. 0MB No. 2050-0039 Exoires 9-30-68
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo. 0 Manues~ 12. Page1 lnlormalion in the shaded a<oes is n01
WASTE MANIFEST N, c, D, O, Q, 7, 6, O, 4, 7, 1, 4lf ".r;"~•~6 ,Z-01 1 required by Federal law.buti, by State law.
3. Generator's Name and Mailing Address 'A(si$i.{M&ni188£0oc:umen1 ~ . ,.:-<·.-,:, ,-::,; ..... ' .,.. , .-,,-:,,: ..
Channel Master 'i{J:rnfH}( · ., .. :,: .. ,·}i,,.,:,.f'J".;->
P, 0. Box 1416, Smithfield, NC 27577
,. Generalor'sPhonel 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckin° Co Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number , s, C• o, o, 7, 3, 7, O. q, ?i q . O)f . 'af'hont 'Rn':1/7h7_:"l~"l"I
8. U.S. EPA ID Number ··,:o.·:·;.if'" . a·IO::, ..
I I t I I I I I I I I I Fh.T ,s Phonl C:::: .. :· ,;:... , .-,·. ·'' ;;;,~-,-.-:, .. ,:·-.
10. U.S. EPA ID Number ~ft~·1I,t.~,i:~NV·'· •. ,_.,,:t:•·1/•:}2,-•:-
, S, C, D, O, 7, O, 3, 7, ~ B '. ~~~;~;!,~Ji::'.i.i•H·J/;3/4;~11bcl'f;:
1,1. U.S. DOT Oescriptioh (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit ·l 'W&stl Nldbir··:/~-
No. Type 'MNr:l ·-:> >:{:(,·i~~
a. Hazardous Waste, Solid, nos ORM-E
N NA 9189 , ,1 D ,T , I ,2 ,0 y
b.
C.
d.
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··:,:! L -'-'-.1--·..l"i f_:,
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'. LI -'-'-.1--..ll ':};
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15. Special Handling Instructions and Additional Information
CSX Work Order No.: 83026
1e. C'ENf.RA TOR·s CE.RTIFICA TION; I hcHoby docln,n lhnl lho conlonls olthls con1lgnmont are lu1ly nnd 11ccur11tely d111crib&d above by prop-Gr a hipping name •"Clar• cl11.,ne-d.
packed. marked. and labeled.and are in 1111 rospoc1s In p,opor condilion for lransport by highway according to applicable International and nauonal governmaru re,;;Jutaaon1 an<J
t/"le laws ol Iha Slate ol South (;protlnn.
II tam a large quantity genero.tor, 1 cor1ify Iha! I ho.vo II program In placo to reduce Iha vo1uma and 1oxtclty of waa1e goner a led to the degree I have dotormlned IO b11 econo""leally
pr•cl1C::11ble and tha11 have 111lec1ed the practicable method ol lrealmenl alorage, or dlspoaa1 currently avellable 10 ma which mlnlml:r:111 Iha preaenl anCI lun...r• ltHMt to h1.1rnan
health and the envi1onmcnt OR, ii I am a smoU quantity gen orator, I have modo a good faith effort lo minimize my waste generation end select the be•! waste mane;•""•"' met1\oel
ttiat is available 10 me and thBt I can ollord.
I '• Printed/Typed Name Roger L. Coats
I Signature Month Day Yw
fJ,7;J.98f3
r , 7. Transporter 1 AtKnowledgemenl of Receipt of Maleri.'\ls V
I spl~~'_;.;;jP~rr;n~led2:./~T1yp~•~d~N~a~m~•~-....1,_~ ..... ::'.'.i~:::::::~..t.i~---l~Si~g~nnaa~tt~~uri.-J:,, "'d'!!:z..=~~-.. ~:::! ./=---~~~ /1::;;,;~~=-=--__:~/42...l!M~o1nmZILLDi•~Yl!;.,: .. a·~:...i' ,... I-7-7!-;..,.J. M (.,,"'--t _4<--(" ~ 1 ',1z_ #,, -#-.L .,,,r /-b_ --/ r ;z (.-, I Al 7l / ~ "
o 18. Tr.insporter 2 Acknowledgement of Receipt of Materials ..._
l
~r-P~,~in-,~~,T~y~ped=N~,-m-.~=~~~~~=~~~---rlS_i_gn-.-,u-re--------~---------~---M-o_n_m-~D-ay-~Y~w~
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1 S. OiJcrepancy Indication Space
I ~
L 11----------------
1
~ 20. Facility Owner or Ope,alo1: Certilicallon ol receipl ol hnzatdous malerlals coveted by !his manilas! except as noted In Item 19.
Printed/Typed Name I Signature
EPA Form 6700-22 (Rev. 9/86) Previous Ed1l1ons arc Obsolete [DHEC 1988 (Rev. 10/86)]
•I ... .l...l--"--'--'
b c..l .l...l--"--1..1
\lbl CI \Ital.
pbs. d I I'"'-
Month Day Yw
I , I ' I '
,·
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mg-t
2600 Bult Stre-el Columbia. SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12-itch ewriter
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 7 6 0
P. 0. Box 1416, Smithfield, NC 27577
,. Generalor'sPhone 919 934-9711
5. Transponer 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CSX 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 Numbor
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
Form A
2. Page 1
of
Emergency & Holidays: (803)734-5-424
roved. 0MB No. 2050-0039 E,pir .. 9-30-Ba
Information in the shaded a<eas is n0I
required by Federal law, but is by State la«.
12. Containers 13. Total Quantity U.Unit l'Watl~·:·~:
No. Type 'Mf'lo , >Pi
, F ; d'i r"jg-,;,:
E Hazardous Waste, Solid, nos ORM-E ,,
N l-.'.:N~A~9_:_1~89:_ _____________________ _j__l_tl4 D'...l.'.T+..L...LJ..'.:2J.04 _Y'.._W,.'::F::1::Q:=l;:::Q:;:l;:::6~1'z.:i# .,.;. ... ·., .. ~ ...... > ... t ·-~,
L-L-'--'---'' '.1,
1ft
b.
C. L--L--L-'L.....J:~i
:·; I -t.
d. -': LI ----1-L...l... ..
15. Special Handling Instructions and Additional lnlormation
CSX Work Order No.: 83027
1e. GENERA TOR'S CERTIFICATION: I harabydaclara lhal Iha con Ian ls olthls consignment are fully and accurately described abOYa by proper 1hipping nam• and are cL.....,flad.
packed. mark&d, and labeled, and are In nil respecls in propor condition lor transport by highway according to appllcabla lnlarnational and national govarnmaf'\I r~ulatlO<'\I and
!tie lawa 01 Iha State ol Sou!h Carolina.
111 am a large quantrty generator. I certify that 1 have a program In place lo re-duce the volume and toxicity of we.ate generated to Iha d~,-I have determined 10 ~ .conomlcally
practicable and thal I have aelec1ed the practicable method of trealmanl, alorage, or dh1poaal currently avallabla to ma which mlnlmlzaa the praaenl and lutura u,,_t to human
heanh and the environment.; OR, 111 am o small quantity generator. I hnve mado II good laith aNort to minimize my waste generation and select the ball wa11a management met1'10d
tnat Is available lo me end that I eon ratlord.
Printed/Typed Name Signature
Roger L. Coats
T 17. Transporter 1 At;1mowledgement ol Receipt ol Materials
rinted/Typed Na e --
19, Oi,cropancy lndica,ion Space
20. Facility Owner or Operator; Certification ol receipt of hazardous malerials coverod by this manilesl excepl as noled in Item 19.
Printed/Typed Name Signature
EPA Form 6700-22 (Rev. 9/86) Previous Editions arc Obsolc\e !DHEC 1988 {Rev. 10/86))
Month Day 't'aar
0 7 l 9 8 8
Monlll Day Year
I IL..W-JW-JL...Jpbl C L..I L..L..L..L..L...Jpbl.
bl pbo.dl pt,,.
Month Day Yw
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste M;L
2600 Bull S" .. l Columb;a, SC 29201
Phone: (B-OJJ 734-5200
Emergency & Hondays: (803)734-5-424
Form A roved. 0MB No. 2050-0039 E,plres 9-30-Ba
UNIFORM HAZARDOUS
WASTE MANIFEST N r, n 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 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
2. Page 1
ol lnlormation in the shaded iM'HS is not
required by Federal law, but is by State law.
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and JO Number) 12. Containers 13. Total Quantity 1(Unil l'W&1lekl.nber\~-
No. Type 'MN• : >:·:\)J,J:"G:/',
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
a.ir..Mj-J012171714I-J11l1012L:,]1";:&b!i 0·LLJ-J I I I I 1-1 I I I I%
b. LLJ-1 1-1 1!r1,i)l;::!!1!t~;W::J __ , , .•-"1.::1__ _,_Jf!j:
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83028
2 0 Y
i j F j o·, lj cj-1;\
<11F 1010I61~f
---.;...
'-'--'--'-.JI~'
'I l".'f
· ............... ·.· ''
, '. I ,.-,~
115. CE MERA TOR'S CERTIFICATION: I horobydoclore thnl lho conlonts olthl:, con1lgnmont are lutly rind accurately described above by proper •hipping n•m• and ara clasainll'd.
paci..od. ma,i..e-d, and labeled.and are in nll rospocls In propor condlllon for transport by highway according to applicable lnlornationol and notlonal go,,,ernm•nt r.-gulat10n1 •l'>d
uie taws ol the St.lto of Soulh Carolinn.
II I am a largo Quantity genera1or. I certily thaf I have a program In place to reduce the volume and 1oxlclty ol waste generated to the degree I have determine<! 10 be economically
l)rac11caC!e and that I have selocted tho practicable method of 1roolment, 11orego, or dl1poaal currently avaUable lo mo which mlnimlzu tho pros.en! and lutura trHMI to huma.n
heallh and the environment; OR, 111 am n smo!I quanlltygonoralor. r hnve mndo n good faith etfort 10 mlnlmlr:e my waste generaUon and set eel the beat wuto managem111nt rnetl"IOd
that is.availaClo to me and that 1 con ollord. ·
Printed/Typed Name Signature· Month Day Yeas
Ro er L. Coats 0 7 1 9 8 8
17. Transporter 1 At.11nowlcd~r.mcnt of nnccin1 of M:itori:\ls
~o
Month Day Yur
0
1_8. Transponer 2 Acknowledgement of Receipt of Materials
,, Priri'!ed_lTyped Name Montll Day ; Year
19. Oiscre~an~cy Indication Space
I I Jibs. C I I I Jibs.
bl Jibs. ,d I '} pm.
20. Facility Owner or Operator; Certification of receipt ol h;izardous materials covered by this manliest except as noted In Item 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions arc Obsolete [OHEC 1088 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hu.ardous Waste M9L
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-542•
(Form desi ned !or use on elite 12· itch ewri!er Form A roved. 0MB No. 2050-0039 E,pires 9-30-83
-UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. ManUeat Document No.
3. Generator's Name and Mailing Address
Channel Master
N C D 0
P. O. Box 1416, Smithfield, NC 27577
•-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
4 0 0 7 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
S C D O 7 0 3 7
2. Page 1
ol lnlormalion 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. Conlainers 13. Tola! Quantity 1,. Unil l Waa,._,_ ·
No. Type 'M/VrJ ,•;+\/0::L'J\;'/,
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83029
1 D T 2 0 Y
':,( < LI -'-'-.L....JI :;·
.. ~ ~/
1S. GENERATOR'S CEATI_FICATION: 1 hereby declare 1het the conl&nts ol this conalonmenl ere lullyend eccurelely described ebove by proper 1hippino neme end ere cla...,ne-d.
pecked. marked, and lebelcd, and aro in,.., rospects In proper condition for 1,anspo,1 byhlghwey according 10 appllcable International and nallonat oovornmenl re,gulatlon• al'>d
me laws 0111ie Stale or South CarolinA.
111 •ma 1erge quen11ty gone101or, I cortily ttmt I hnvo a progrnm ln pin co lo reduce the volumo end IO)(lcltyol waategenerated lo the dOlJree I hevo determined to b4 economic.tty
prect1cat11e and 1hal I havo selected the practlcablo molhod ol treotmenl. storage, or dlspoa.at curronny avoltable to me which minimizes the present •nd run.ire U"lrNI to hum.an
t,utth and u,o environment.: OR, II I am a smn!I quonlitygonoralor, I hnvo mado a good lei!h etfort 10 mlnlmlte mywuto generation end ulecl tho bet! wu\o man1gomen1 rn.~
lt\at is ·availat1l11 to me and lhal 1 con olford.
Prinled/Typed Name Signature ~ Month Day Year
Roger L. Coats 0 7 1 9 8 8
17. Transporter 1 A<;1rn gement ol Receipt ol Materials
Printed/Typed NJ Signature w T
18. TransPoner 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facilil)' Owner or Operalor: CertilicaJlon ol recelpl ol hazardous malerlals covered by lhis manilesi e,cep1 es noled In Item 19.
Prin!ed/Typed Name Signature
FPA Form 8700-22 {Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 {Rev. 10/86))
Month Year
{)
Monttl Day Year
•IL.. .w..~_._.l'b1 C ._I ............... _._.l'b1
b I l'b,. d I I'"'-
Monlh Dey Year
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streo\ Columbia. SC 2'3201
Phone: {BOJJ 734-5200
E PRINT or TYPE {Form desi ned for use on elite 12-itch ewriter
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Gene,alor'sPhone 919 934-9711
5. Transponer 1 Company Name
Willms Truckin Co Inc.
7. Transponer 2 Company Name
9. Designated Facility Name and Site Address
CSX 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 ID Number
S C D O 7 0 3
11. U.S. DOT Description (incfl.Jding Proper Shipping Name, Hazard Class, and ID Number)
a.
Hazardous Waste, Solid, nos ORM-E
Emergency & Holidays: (803)734-5-124
Form A roved. 0MB No. 2050-0039 E,pires 9-30-1,8
2. Page 1
ol Information in the shaded a<eas is no!
required by Federal law, but is by State taw. ·
A;''$tole M8nlf8ol Oocurtwll-
tk!J,r;:;//;{\('\;:'.
12. Containers 13. Total Quantity ttun;t L W&SIIINtiti>er'·i·
No. Type 'M/Vr/. \ >:;;.:.:-.'.;1::<.<J'J
N NA 9189 1 ll T 2 0 Y
b.
c.
d. • LI _._,._.1......JI ''
15. Special Handling Instructions and Addi!ional lnlormalion
CSX Work Order No.: 83030
1 8. GENERA TOR'S CEA fl FICA TION: I hnrflby declnre thnl tho conton1s ol thl, conalgnmenl ar& lully and accurately described above by proper ,hipping nam• and ara clas..ned,
packl!d, ma,l<od. and lt1\Joh:d, nnd nio h, nil ro:,pocts In prnpor condition !or lfanspo1\ by hlutiwny according to applicable lnlornationol and national go-,arnmanl r9"Qulat1on1 at'\d
uia laws ol lhe Stalo ol Soulh CnroUnn.
111 am a largo Quantity generator, I cor1ily that I hnvo a program In plnco lo reduce lhe votumo and 10,dcltyol waato ganernled to the d&gree 1 have determined lo be economic.Uy
pr1c11cable and that I have Hlocted \he praclicable method of treatment. atorage, or dlapowl currenlly avolleble lo mo which mlnlmlua the pruont and future tr'lful io h1,,1man
heaUh and !he environment; OR, 1r1 am a smoll quantity gonorator, I hove mado a good laith eHor1 to minimize my waslO generation and select the beat wute manegemenl m.thOd
that is available to me and that I eon ollord.
Printed/Typed Name Signature ~ Month Day Year
Roger L. Coats 0 7 I 9 8 8
ALKnowledgement ol Accei
Printed/Typed Name Signalure
, 9. Discrepancy Indication Space
I I Jib!. C I Jib!.
b I jibs. d I jibs.
cO. Facility Owner or Operator: Certilicalion ol receipt ol hazardous malerials covered by this manifest excepl as noled In 11am 19.
Ptinled/Typed Name Signalura Mon:ll Oey Yw
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
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. Manllest
Docum,mt No.
WASTE MANIFEST N c n o
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
<. Genmlor'sPhone 919 934-9711
5. Transponer 1 Company Name
Willms Truckin Co Inc.
7, Transporter 2 Company Name
400769
6. U.S. EPA ID Number
S C D O 7
Bureau or Solid & Hazardous Waste Mgt
2600 Bull Stre,e~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-542<
roved. 0MB No. 2050-0039 Expires 9-30-8.a
Information in the shaded areas is not
required by Federal law. bul is by State ta .....
OocumonlNumbor·
, 10·::
•,· ii Phont :,,'.::.·
• IO .
P!,oi,e;
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 ~i:~~4j%~-t~:I:;._,.
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Ouanti~ 14. Unit l"Wa:it:eN!nber=··:···
No. Type 'M/Vr;j \fi-,=i-:!'..\--.}:·,i_r{_,(tf"'.i
a.
Hazardous Waste, Solid, nos ORM--:E
NA 9189 1 D T
; i F i o··, Vi9-1):
2 0 Y ~•E1Q1D161i
15. Special Handling Instructions and Addiliona11nlormalion
GSX Work Order No.: 83031
115. GENERATOR'S CERTIFICATION: I hereby declare that the content, ol thl, consignment are lurty and accurately described above by proper •hipping riama and are cla ... fla<I,
pac-..ad. m;,r-..ed, and 1e,"belcd, and an, In 1tll rospf!Cls iri proper condition !or Iran sport by highway according to applicable lntflrnational and natlonal government r--.iulatjona and
uie la ... , of the St:11e ol South Carolinn.
111 am a large quantity gene,ator, I certify that I havo II program In placo lo reduce the volume and \01<lcltyol wastaganarated to Iha d&Qree 1 have determlri&d to be e.conomlc.ally
prachcable and that I have :,olocled tho practicabto method ol lroatmont, ,tore go, or dlspos.at currently available to me which minimizes tho pre,-anl arid lul\.lre thr-1 to hu~n
heallh and \he environmcnl: OR. If I am a smoll quantitygonorator, 1 hove made a good laith effort to minimize my wasl.a generation and select the best waste managamerit rr-etrtod
that is available to me and that I can aHord.
Printed IT yped Name Month Day Year
Roger 0 7 1 9 8 8
er 1 At:Know!ed __, Monlh Year
\'."
Printed/Typed Name Signature Montti Day Year
19. Oiscrepancy Indication Space
a I Jibs. C I Jibs.
b I Jib>. dJ I'"'-
20. Facility Owner or Operator; Certificalion of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Monlh Day Year
FPA Form 6700-22 !Rev. 9/861 Previous Edilions are Obsolelo [DHEC 1908 (Rev. 10/86)1
I
I~
L
I
T y
South Carolina Department of Health
and Environmental Control
E PRINT or TYPE {Form desl ned for use on elite 12-ilch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D 0
M11nlfc,11t
Document No. 400770
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste M!;l
2600 Bull S~ .. , Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.xpire:s 9-30-83
lnformelion in the shaded a<eas is not
required by Federal law. but is by Stale la•.
3. Generator's Name and Mailing Addross
Channel Master
A:'i$1$1o Miiiilfuol Documo<ll -i;h)>l,d{A=i)i\,.,~)/)'c?;' i•i1"h · :, , .. :
P. 0. Box 1416, Smithfield, NC 27577
Generator·, Phone [phone]
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 ID Number
S C D 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D 0 7 0
DOT Description (including Proper Shipping Name, Hazard Cfass, and fO Number) 12. Containers 13. Total Quantity 14. Unit l 'Wasta Nlnbw !:':·
No. TyJ>i3 'MNr:J \°f.;'\i/,.'->t~·-':'>\·\?i
b.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 l D T
~~~\~c\
1s1~ii1~~t:i\i~ijl!i:!Jci~l!1l~ii1Iilli1lct!il,J1i,li\:1!l~liiliiiili,lltlifll!lli
a. ~-IO I 2 I 7 I 7 I 4 1-I 1 ii I O I 2 LL)/!JHY C. LLJ-I I I I I 1-I I I I I}!
b. LL.]-! 1-1 1i':1::'li1li:\!\~:W:J 1-1 1
15. Special Handling Instructions and Additional tnlormallon
GSX Work Order No.: 83032
2 0 Y
:PF; 6,i,9"tjf
.\J1E1010161~f
10. GENERATOR'S CERTIFICATION: I horoby doclnro thnl lho contont, Ol lhl, conslgnmont are fully ond accurnt.ely de,crib&d above by proper 1hipplng nam• and ar• cluaih~.
packed. marl<od, and la-beled, and ore in nil ro,pocts In proper condition for transport by highway according to oppUcable lnh,rnationa1 and national gov•rnment re9ula!lon1 and
U'\e laws of the State of Souttl l;arollna.
II I am a large quantity generator. I cer1iry that I have a program In place to ntduca the votuma and toxicity ofwuteganeratod lo the d~roe I have determined lo be .c:onamlcally
pracllcable and lhal I have ,elected Iha practicable method ol lraalment. storage. or dl,poul currently avoUab1a to mo which minimizes the prn,ent and luture tnraal 10 hum.an
health and Iha environment: OR, 111 amp smnll quantity gonoralor. I hove modo o good loith eHor1 lo minimize my wa,te generaUon and salecl the be1l -,,.a1t• managem•nl rnetr>Od
that 1, available lo me and that I con ollord.
Printed/Typed Name Signature ~ Month Day Year
Roger L. ·coats 0 7 1 9 8 8
17. TranspQr1er 1 Aunow!cdgemcnl of Receipt of Materials
Printed/Typed Name Signature 2,tJ ~ Monttl /''q 'g .. k I m fJ1
18. Transporter 2 c nowledgement ol Receipt ol Malerials
Printed/Typed Name Signature Month Day Year
19. Oimopancy lndica1ion Space
I I )'bl. CI l'bl
b I l'bs. d I Jibs.
20. Fac,1,1y Owner 01 Opmlo1: CcrlilicMlon ol rccclpl ol hnwdous molerlals covered by this manliest excopt as noled In llom 19.
Printed/Typed Name Signature Month Doy 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 al Solid & Harardous Waste M;t
2600 Bull Stree~ Columbia, SC 29201
Phone: (BOO) 734-5200
Emergency & Holidays: (803)734-5-424 lrE PRINT or TYPE (Form desioned for use on elile 112-nilchl •··ewrilerl Form Ap roved. 0MB No. 2050-0039 E,pires 9.30.sa
UNIFORM HAZARDOUS ,1. Generalor'sU.S.EPAIDNo. 0 Manire,:., 12. Page1 lnlormalion in lhe shaded a<eas is not
WASTE MANIFEST N,C,D,Q,Q,7,6,O,4, 7, ], 4,o:0at77'1.°'1I 01 1 reouiredbyFederallaw,bulisbySlalelaw.
3. Generator's Name and Mailing Address ~,~.:.;_:~.t.,~ ... ',;~.: ... i_: ... '.·.·.':"·•.·.•.•.•,::.~_ .. Mat.'.:.·,.•·•'.~ •. -.·.·,:~ .. •··.'.:,·~-;;.,,:.·,.,.:~.-.•,::.·:.•.·:.:,:.::~ _Nutnbe(-." ·-/;/·'· ·,;:,, ",-;,.• ;· Channel Master ,a • '-•• -.:\:;,:., .. , .. ,:,,.,;.:•i}\hf:'f::'.
P. 0. Box 1416, Smithfield, NC 27577
•· Generalor's Phone I 9 1 9 I 9 34-9 711
5. Transporter 1 Company Name
Willms True kin~ Co. Inc.
7. Tran.sporter 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• 0. 9• ?. C\
8. U.S. EPA ID Number
I I I I I I I I I t t I
10. U.S. EPA ID Number
, s, c, D, o, 7, o, 3, 7, '.
B:· siaio Gontnlc<' e I).: . " , : ,:-,.,_. M· , •. · \~{khiJiH> )_;,·;•'.,:·:tiJ~+~-, , .. ':/•( ·:.:~., :~ -\\:t;-;:·::-.-.. >.-~ ·:·
11. U.S. DOT Descriplion (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
No. Type
13. Tola! Quantily ltUnil _l'W&SIII~/
Wi/VrJ . < . . :)
a. ' j F j O"1 l\ g·;-:c,
Hazardous Waste, _Solid, nos ORM-E ,. . ...
:i~b~.~N~A~~9!1~8~9 _________________________ +J•_·J•tlfD~L'Tf-L'L'i'2~~•0+~Y7i~·;7'::f7:D=:O~c:.:,~:~:~~:
~ I , , • • • • r·r, 1 , , , i;,,~
I
I
I
I
O~----------------------W-1.-J-..L.j_J-1.-L..L-l--+.;;.!::::!::::::::==...:..j
~ C.
:' .. '.,
I I I I I I ·:.;' I I I I ,~-<
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83033
1$. CEMERATOR'S CERTIFICATION: I hereby declare lhel lhe conlenls of this consignment are fully and accuralely described above by prop.er shipping l'lame al'ld are c.la...,n.-d.
packed. marked, and labeled, end ere in 1111 ro,pects In proper condlllon for tran,port by highway according to appllcablo International and nauonal gov■rnmant r90utauon111'\d
u,e laws ol trie State or Sou!h Carolina.
11 lam a large quantity generelor, I cortity th11t I have II progmm In ptoco to reduce tho volume and toxicity of waste generated 10 the d&gr-1 have determined 10 be economically
practicable and that I have ,elected the practicable method ol lrealmonl. ,1orege, or dlspo:5-al currently available lo mo which mlnlmltos tha present end lutvre thr-t IO human
t,ee!th and tho environment.: OR, ii ram a smo!I quantitygeneralor, I have made e good faith effort lo mlnlmlte my wa,te genera!lon and ,e!ecl Uie best waste management ~thod
mat i, avai1at,la 10 me end thel r con otford.
11 Prinled/Typed Name I Signalure /// ' _ ~. /"· 1 .. Monl/1 Day Yoar
1-::-i".':"'='""--""'."".;;R;:.o..:.::cger:;....;L:..:·-,::C:'-o;:.a':'ts~~~--...J..----.:...../L-t-<i.e~=·A"'---?::;....;;...•....;;~;;.:;..=;:::..-----'iJ.._.17'---',1;._.;9_.i;....BS--;
~~1:;_7.;.._T:;_,a:.n_:s:.po:.rt.c•::.r_:1.;.A_:c:;_,n:;_o:;_w:;_led:.:egc:•::.mc:•n::.t..:o::.l:;_R.;.ec::e:.:ip:clc:oc.l M=alc:•:cria:.l:.s ___ ,------,--,,, c..--------------------------~
I ~ Prinled/Typed Nome ISignalure ~ /) ~ J.--_ ___(;;-::./LlLL,AHu:'-A~).LR!::11.-, -.:lo!.·~ •-~ _ _j__ __ i.,e._~...:::..'...~~n..,..Q.....-==-------.J_LLLU..LJ!W~
o 18. Transporter 2 Acknowledgement ol Aeceipl or Materials v l,.:.:::.,:P.:.rin:.t:.:ed:.r::T.cyp::.ed.:.:.N:.:ac.m.:.e::c.:.:.ec:.:::=c::.c..::.=::.:====----,-,S-ig-n-al_u_r,--------------------------.,,---,,--l
19. Discrepancy Indication Space
i~ I I
11---------------T 20. Facility Owner or 0pera1or: Certificalion of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
l ~~_:.,:_____;:...:..:___~..:..:.;.___,..~=.::.:.:.:.:...;;______-i
PrinledlTyped Name I Signalure Monl/1 Day Yoar
I , I , I ,
Mont.'! Day Year
I , 11 I. 'iiS:-,?'
Month Day Yoar
I I I ' I '
a I I I I I I jibs. C I I I I I I l'bs.
bl I I I I I I'"'-d I I I I I I I',,.
EPA Form 6700-22 (Rev. 9/86) Previous Ed1l1ons arc Obsolelo IDHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Strei3i Columbia, SC 29201
Phone: [phone]
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
M11nllo•t Document No.
11,0077
P. 0. Box 1416, Smithfield, NC 27577
,. Generalor's Phone [phone]
5. Transpor1er 1 Company Name
Willms Truckin Co Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site 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 ID Number
S C D O 7 0 3 7
Emergency & Holidays: [phone]
F'ormA roved. 0MB No. 2050-0039 E.x ires 9-30-8,3
2. Page 1
ol lnformalion in the shaded a<eas is noI
required by Federal law. but is by State taw.
A.\sia!OMenifeol Clocutnot1I -t.J}fi?t/})?/':·' . ·, · ....... : .,:;:.;-.:;;·:,:,::.;;~;·\
iGen«ator'a 11)-;· · · ·
:Jt:'':/A'> /~ S
•,,,;>.;, J~;, ..... , A:·••
\ .. •: '/•''
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers 13. Total Quantity I( Uni! l Wata Nlli:Jbw
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
No. Type WVVr/. :;"->. ,,,;":
1 D T 2 0 Y
,I ('".':"
·; I
15. Special Handling Instructions and Addi!ional lnlormatfon
GSX Work Order No.: 83034
1e. GENERA TOR"S CERTIFICATION: I horobydaclara lhal tho conlonls olthb consignment are fully end accural81ydescribod above by proper 1hipping name and a,a clasain9d,
pacl..ed. marked. and labeled, and are In ftl1 rospecls In proper eondltion lor lransport by highway according to appllcabla lnlernational and national government r~ulanons af\d
u,e laws ol the State or South Carolina.
111 •ma large quantity genc,ntor, I cortity that I havo a progrom In ptaco to reduce the volume and toxicity ol wasle generated lo Iha dograe I have detarminad to M economically
prac11cable and that I have :,elected tho practicable method ol lroatmont, storage, or dl:,po:,al currently evailable lo ma which minimize, the pre:,ent &l"'ld lutura thr-l to hum.an
health and the environment; OR. If I am a small quanlitygonera!or, I hnve made a good faith atfort lo minimize mywasta gonoratlon and so!ec! the best waste management metr'lod
that is available to me and lhot I cnn ollord.
Prinled/Typed Name
Ro er L. Coats
Mon!tl Day Year
071988
17. Transporter 1 At;Knowledgement ol Acceipl of Materials
Printed/Typed Name
Printed/Typed Name Signature MonC"'I O~y Year
19. Discrepancy Indication Space
I I l'bl. C I llbl.
b I /11>1 d I /lbs.
20. Facility Owner or Operator; Certilication of receipt ol hnzardous materials covered by this manifest except as noted in llem 19.
Prinled/Typed Name Signature Monl/1 Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions ore Obsolotu IDIIEC 1000 {l1ev. 10/06)1
I
I
t
I
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]
1¥,sE PRINT-;;, TYPE (Form desioned for use on elile 112-oitchl ~"ewriler)
UNIFORM HAZARDOUS 11, Generalor'sU.S.EPAIDNo.
Form A roved. 0MB No. 2050-"C()J9 Expires 9-30-88
Manltoet • I 2, Page 1 Information in the shaded a<eas is not I, 4. (}~co:n7~17'01J of 1 requiredbyFederallaw,butisbyStateta111.
r
WASTE MANIFEST N, c, D· O· q, 7, 6, o, 1,. 1,
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
•· Generalor'sPhone( 919 I 934-9711
5. Transponer , 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
I SI (1 DI 01 71 31 71 n. g, ?J a,
8. U.S. EPA ID Number
I I I I I I I I I I I I
10. U.S. EPA ID Number
*' siaie~ Oocumw Numbe<' .M\liffH{IWHNJ}o\:+) :,=,·--, .. ,_.:_·;:.:..:-:.:.i_//,~;;).)\i:-:..·
-cr:State··: .... _ .. ,_.,<·,_, .... lo'._:: ... ,· .. ·.-,::. ·
.=>r~:t*~::~:'.·?· :. .:.<=-?;',"/ t:-,i : ,; .... =:.
D/T af'hono· ·••Rn,/71,7.:,~,'\
i=ro:.·:::·•-:::-.r ..... 11·10::,.
FAT ·=s··Phoof·:-Y
,,;;t~~FJ~I:ii,
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Conlainers 13. Tola! Quantity 1( Unil .l W.1.11111Mt!bor ·
No. Type 'M!Vo ·•··•·,>·/·.)i<i
a.
d.
Hazardous
NA 9189
Waste, Solid, nos ORM-E
,· 11 D 1T
I ' I
, , ,2 ,0 y
.. ' .
..... · ... , .. ·.---··'.--"· ..
:=-'.\l ~ _.,_._.,__.J f:
~ -~
1 S. Special Handling Instructions and Additional Information
GSX Work Order No.: 83035
16. GENERA TOR·s CERTI_FICATION: I horoby docltHO th11t lho contents olthls consignment are lully and accurately described above by proper ahipplng name and are clasa,H..:I.
packed. marked, and labeled, and aro in nll respects in propor condition for transport by highway according to applicable lnlamational and national government ra,gulatton• al'ld
U'\e laws or the State or South Carolina.
111 am a large quantity generolor. I certify that r hevo a program In place to reduce the volume and loxicltyol waste generated to the d&gr&e I have detumin&d tot>. ocC:momic.tly
prac1,cable and \hat I have selected the practicable method ol lreatment, storage, or disposal currently avoilable lo me which minimize, the pr as.ant and lun..ra tl"lroat to hum&l"I
health and the environment.: OR, II I am a smell quantity genorator, I have mad a a good laith erlort 10 mlnimlta my waste generation and se1ecl U'\e boa I waate managemenl method
that is available lo me ond that I con attord.
Printed/Typed Name
Roger L. Coats 1
Signature Month Day Year
10,7,1.918,8
I T 17. Transpone, 1 Ac,nowledgemenl ol Receipl o( Malerials
Ss Prinled/Typed Name Signalure -Month Day Year
p 1-,-,:-------,'-/,'C'.)c"-""JJr7<....:..::l/____,,~'---'-"l)e:_;o/:,.,.l_·!..,,..,..____, __ _,_ __ a_.._,,___.___. __ ~ __ q._. _0_0.c.... _-______ ._,.o_,,..;.-,,..,___;11 ,.._'l'_..1.:..r'yl"'
V
~ 1-'..:8;... c.T..:ra..:n:.spoc.:::.n::e;..r :.2:.:A:.ck..:n..:o..:w..:le:.:d~g::;em..:e::;n..:l..:o;..I A..:•::c:.:•::iP..:l:.ol:..:M:.•::'::;"..:i•:::l•:...._ __ ~-----------------'--------'------------1 I r Printed/Typed Name Signature· Monet, Day Year
)\ I ' I I I •
, 9. Oi:screpancy Indication Space
I ~
L •1---------,-------
1
~ 20. Facili!y Owner or Operator; Cer1ilicalion ol receipt ol hazardous mriterlats covered by thls manifest except as noted In Item 19.
Printed/Typed Name Signature
_ FPA Form 8700-22 IAov. 9/86) Previous Editions arc Obsoloto IDHEC 1988 (nov. 10/86)1
aJ '-.L...L.-"-'--'-"Jlbs. c ... I .L...L.-"-'--'-"Jlbs.
b I i'b1. d I JlbS.
Month Day Year
I , I , I ,
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
. Generaio~sPhone( 919 934-9711
• Transponer 1 Company Name
Willms Truckin Co Inc.
7. Tran~porter 2 Company Name
. 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 I) 0 7 J 7
8. U.S. EPA 10 Numbor
10. U.S. EPA 10 Number
S C D O 7 0 3 7
Form A
2. Page 1
ol
Bureau of Solid & Hazardous Waste Mgl
2600 Bull Streo\ Columb;a. SC 29201
Phone: [phone]
Emergency & HoHdays: [phone]
roved. 0MB No. 2050-0039 Expires 9.30.ga
Information in the shaded Meas is no1
required by Federal law. bul is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and JO Number) ~2. Containers 13. Total Quantity U. Unil · L'Wa.it:e NIRbe,'·":''·
No. Type WVVd. ():,''.·;:.V\':;:f.,'~jfµ;'~
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
.L'~ Dmripfions tN Materia18 ·usted·~>t?I .. :;_J;rx:·>·'.:~t;~;:;l;i(~!llf!~l;;i~'.l!i!j;i;J!:11:IIJ:\W=/::('.\{!'.~Ift!:'.!!:t
pj~;~id(::ro'i:iS J 7 14'I~Yi ,:;;:~,;i·1r[l,i;,::::;,::::i:c:GJ:.:r ;dH:U•'•h ''\'.::( ·.·.·1:1:i,
b. L.t,.J:J ,-, ___ ,:!l!~:1i~1::it~~W.:J .. ) .. ,I.,,1..1.J-l .,L,L,LJ!:11
15. Special Handling Instructions and Addilional rnrormation
GSX Work Order No.: 83036
2 0 Y
1 e. GENERATOR·s CERTIFICATION: I horeby declore lhel lho contents ol lhls conslgnmenl are rutty and accuratelydoscrlb..:I above by proper •hipping n•m• and•'• cl•• .. h.-d.
packed. mark..:!, and labeled, and aro in all respects In proper condition tor transport by highway according to appUeablo International and nallonol go'o'ernm•nl ,.,_ulatlon• aflod
\he laws ol tho State ol South Carolina.
HI am a largo Quantity goncrolor, I cortily thnl t havo a program In placo to reduce !he volume and toxlclly ol waste generated lo tho degree I have dote rm I nod to be oconomtC&lly
practicable and that I ha"'o se!ected the practicable method ol lrealmont, storage, or disposal currently available lo mo which minimizes tho pre~nt and future tnrut to human
health and tho environment; OR. ii I am o small Quanlitygonorator. I hovo modo a good loi!h c,tfort lo minimize my wasll'I gonorallon and selecfthe be!l1I wute monagemenl rn.thod
1:1'1111 ls available lo mo and tho\ 1 con ottord.
Printed/Typed Name Signature Month Day Year
Ro er L. Coats 0 7 1 9 8 8
edNames Signature ~ / R Mon111 Year
;J £ 2 ~
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I Ill$
_b I jibs. d I jlbo.
20. Facility Owner or Operator; Cer1ilication ol receipt ol hazardous materials covered by this manilesl except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions arc Obsotolo (DHEC 1988 (Rev. 10/86)1
I
I
I
I
/§;,·•,, /~~::(~., \ . ~,-
~-
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste M;t
2600 Bull S"ee\ Columbia, SC 29201
Phone: [phone]
l=E PRUIT or TYPE (Form desioned for use on elite 112-oilchl tvnewrilerl
UNIFORM HAZARDOUS Jt Generalor'sU.S.EPAIDNo.
Emergency & Holidays· (803)734-542•
Form A roved. 0MB No. 2050-0039 Expires 9-30-88
Menireat I 2. Page 1 lnlormation in the shaded Meas is not
WASTE MANIFEST N, C, D, 0, 9, 7, 6, o, 6, 7, 1, 4, 0()c(t77' 7!0·~ ol 1 required by Federal law, but is by State law.
l Generator's Name and Mailing Address
Channel Master
~:"':-'~=-::'-:-=:'-';o'-;~'-·r.-=·:-'-~-'-~-=•~c..n;'-'; .. :-:-'!'-~6=-!m=-9.-'-ls_m_!"-"'~-'~'-:-'!'-;~i..,f'-·-N_c_2_7_5_7_7_6 ___ u_.s ___ E_P_A_I_D_N_u_m_be_r _______ ~i:.· -~·-•···;·._'·.~~-:.' X,':-c··••·::,.·1i::::••'··
Willms Trucki.n~ Co Inc. , s, c, n, O, 7, 31 7, n. 91 7, C\ 00'.T · · iJ>hont . cno/7r-.7_;_,,,,
7. Transporter 2 Company Name
9. Oesignate<l Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
S. U.S. EPA ID Number
I I I I I I I I I I I
10. U.S. EPA ID Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Ouantily 1( Uni! l 'W""' lu!lbef ., ·
No. Type WIF/rJ \ '· :. ·.•c:,,J .. ,:. \
a. : i F j ci'ii lei','?,
E Hazardous Waste, Solid, nos ORM-E ,-:,
N NA 9189 1 D T 2 0 Y /.•i'r,1Q1Q1611.\_l I b. I I I I I I I : ;, ;~f ~;-;~'.
61--------------------------------.J.--.ll_jlLI-L'-l---.l'-'LL'.l'-11---1-:::,.!
1::::1:::::=' =':::.1;;;?-1;-
~ t.
' ' ' I I I I
d.
I I I I I I I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83037
1 IS. GENERATOR'S CERT1_F1CATION: I hereby declare that the contonts ol lhls consignment are fully and aceurate1ydoscrlbed above by proper 1hipping nama and ara ctas..fied.
packed. marked. and labeled. end ere In all rospects in proper condillon !or transport by highway according 10 applicable International and nation al govarnmen1 r.-gulat1on1 al"<I
tne laws 01 the Stale ol South Carolina.
111 am a large ciuan!ity generator, I cer1ify \hot I have a program in place to reduce the volume and to,dcltyol waategenerated to Iha dctgrH I have determined to be economically
prac1,cable and that I have ,elected the pracllcable method ol treetment, ,tor age, or dlsposal currently avo11able to mo which minimizes the pro Mn! and future tr\r-1 to hu~n
health and tho environment; OR, II tam a small quantity generator, I hove mado a good lallh effort to minimize my wa,le generation and select the beat waste management rn.triod
t!'lal is available to me and that I con afford. I Printed/Typed Name !Signature /V /) / Month Oay Year
~h-~----!R!;;o~g!:e!.r..::L.:... ~Co~a!:.ts::..,,,..,.......,...,...,...,--L----'·:.:. f\-t::::;,A.'""~•::::,._.._.....,;--#--2;2::..,;_ .. ~lJud~~;;f:;t·:_ ____ _t:, 1,0.J,:_7.J1t,l.J,9;;.J{3~,8~
I ~ 17. Transporter 1 ,A,c,;11.nowledgement ol Receipt ol Maleria!s l/
i. Prinle-j/Typed Name !Signature Mont.'l Day Year
~1-----------------~--------------------~·~•~'•~·~•-1
o 18. Transporter 2 Acknowledgement ol Receipt ol Materials I ~f--P-r-in-Jed-'-/-Ty~p-ed_N_a_m_e_-"---'----'-'--------~IS-i-gn_a_lu_r_e __ ------------------------------1 Montn Day Year
I ' I ' I '
19. Oi,crepancy Indication Space
I ~ I I I I I I I !lbs. C I I I I I I pbs.
,. b\ I I I I I \lb> d\ I I I I I I'""
L •t-:----------,--------
1
~ 20. Facility Owner or Opcralor; Certilicalion of receipl ol hazardous materials covered by this manilesl except as noted in Item 19,
Printed/Typed Name I Signature Month Day Yw
I ' I I I '
~PA r=orm 8700-22 /Rev. 9/86) Pff.!'IIOUS Editions arc Obsololo jDIIEC moo {ncv. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mi;t
2600 Bull Stree~ Columbia, SC ~201
Phone: [phone]
.EASE PRINT or TYPE fform do,I nod !or use on ollle 12-itch owrllor
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0, Box 1416, Smithfield, NC 27577
,. Generator's Phone [phone]
5. Transponer 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 10 Number
S C D O 7 0
11. U.S. DOT Description (including Propor Shipping Name, Hazard Class, and ID Number)
a.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling lnslrucb'ons and Additional Information
GSX Work Order No.: 83038
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E.11 ires 9-30-88
2. Page 1
of Information in the shaded a<eas is n01
required by Federal law, but is by State law.
12. Containers 13. Total Quantity U.Uni! :L·wateNumblri:-'
No. Type WVVr:1. ·>,.·; ,,; :c,
1 D T 2 0 Y
.:;~• F :j·ci~;"tf'9!J~ ~
<)1E1Q1Q16uy
. .. ••'••··-····~---• . ~-~~~,'·::·
1 o. GENERATOR"S CERTIFICATION: I hereby declare that tho content, olthl1 consignment are fully and accurately doscrlb&d above by proper ,hipping name and ara clasaine>d,
pac1,,ad. marked. and 111.beted. nnd are In ,ill ro,pocts In proper condition for transport by highway nccordlng to appllcable lnlarnatlona1 and natlonal government re-;;iu1at1on1 al"ld
the laws of Iha St..11e of South Cnrolinn.
111 am a large quantity generator, I certify thst I have a program In place 10 reduce !he volume and loxlclty ol waste ganeralcd to the de-gree I have determined 10 be economic.ally
prect,cab!e and tr1at I have ,elecled the practicable method ol trootmenl storage, or dlsposal currenlly avallebte lo me which mlnimlza1 the pres-ant and future U'\rNI to nurnan
health and the environment: OR. II ram a smo!I quantitygonorator, I have mado a good lailh effort 10 minimize my wasle generation and select the best waste mal"lagament ,,.,.thod
mat i, available lo me and lhal I can etford.
Printed/Typed Name
Roger L. Coats
17. Transponer 1 Ar.:Knowle<lgement of Receipt of Materials
19. Discrepancy Indication Space
Signature
Signature
Signature
•I~~~
, b)~~~~
20. Facility Owner or Operator; Cer1ilicalion of rcceipl of hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signalure
!=PA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
Month Day Year
0 7 1 9 8 8
Mon7' /9 Jt
Montt, Day Year
/!bl CI /lbs.
pt,,. d I )lbL
Month Day Year
I
I
I
;t.;1~.;;
.•~:(l~ \
li,i~i/;~,
·---~
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull StJeeL Columbia. SC 29201
Phone: [phone]
Emergency & Hol;days: (803)734-542•
IE.ASE PRIN~ TYPE (Form do9ICJnod for use on olilo r12.pitchl tvnowrilcrl
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo.
Form Ar
ManUeal
1
12. Page 1
rovod. 0MB No. 2050-0039 Excires 9-30-83
lnlormation in the shaded iweas is not
required by Federal law, but is by State law. WASTE MANIFEST N, c, D, 0, q, 7, 6, o, 1,. 7,
Document No. ol !, 4, O, O, 7, 7, 7 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•-Genera!or"sPhone( 919 ) 934-9711
5. Transporter 1 Company Name
Willms TruckinQ 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
I SI Cl D1 01 71 3• 71 0, Q1 ?J Cj
8. U.S. EPA ID Number
I • r ! I I I I I I I I
10. U.S. EPA ID Number
, s, c, D, o, 7, o, 3, 7, '
0/T "iPhon<' Rn1/7~7~1111
. ·,, s,;b/i,ii,'~• I[); ., .. , .. ' ' ,,,,-, ••..
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and·/O Number) 12. Containers 13. Total Ouanti!y It Uni! l' Was!e Nlnber >:'
:, ... ,;'.,. ·.'/· '.,·.:t-:<':-:i No. Type
I ,1 D 1T r , ,2 ,O
I I I I I I I
' ' I ' I I '
d.
! I ! ! I ! I
W!No
y
········-"·-·•·· '( I I I 1·:
;"·
15. Special Handling Instructions and Addilional lnlormation
GSX Work Order No.: 83039
1e. GENERATOR'S CERTIFICATION: I horoby declare lhot the conton1s ol this consignment ore fully and accurately doscrlb&d above by proper ,hipping nam• •nd •r• clasaine<I,
paclo.ed. mark&d, and labeled, and are in nll rospocts In propor condition tor transport by highway according 10 appllcab1a International end neUonat govornmenl r~ulaUon1 and
tl'la laws or the State ol South Carolina.
I! I am a !arge quantity gencro1or, 1 certify that I hevo a program In ptaco to reduce the volume and toxicity ofwaategenerat&d lo !he degree I have da!ormlned to bo economlulty
prac11cab1e and that I have set acted the prac1!cable method of treatment, storage, or dlspoaal currently evollable to mo which minimizes the present and future U"ltNl to l'lurnan
l'lealtl'l and !he environment: OR. II I am a smol1 o.uantity gonorator, I have mode o good faith etfort to minimize my westa generation and so1ec1 !tie boll waste managomenl tT>etl'>Od
I
trlal is available to me and lhe.t I can atfo,d.
Printed/Typed Name
Ro£er L. Coats
I Signature •~~ Month Day Yw
1 o, 71 !, 91 8, 8
T 17. Transponer 1 At;Knowledgement of Receipt of Materials
l~~~/4P~,;'.V)L'~~'LJ~-~~N-,m~'t?=-<,C?o(JL~d,z..,_~~A~/~~~----,--Yl~~s;g~n•z::1£L~'/-4);_µ:;"L:::;~.£~'-+------'ft:::..'.:~·/~-~v~--_j_:L;L~~.r'
0
£Lay~..e~y~~
o 18. Transpcner 2 Acknowledgement of Aeceipl of Materials r /
I R:1-__ _;__:_;;__;_ __ :.;_,: __ ..:___;_'--'_;_------~-----------~------------------'-----i
Printed/Typed Name I Signature --
V
Montn Day Year
I ' I , I '
1s, Oimepancy lnc;ca1i0n Space
I ~ a I I I I I I Jibs. C I I I I I I pt,s.
' b I I I I I I pt,,. d I I I I I I !lbl
C •t---------------1 ~ 20. Facility Owner or Operator; Cer1ilicalion of receipt ol hazardous materials covered by this manifest e.:cepl as noted in Item 19.
Printed/Typed Name l Signature Month Day Yw
I , I r I ,
FPA Fnrm 8700-22 IRev. 9/861 Previous Editions arc Obsolete fDHEC 1908 {Rev. 10/06))
I South Carolina Department of Health
and Environmental Control
Bureau al Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia. SC 29201
Phone: [phone]
I
LEASE PRINT or TYPE {Form dos! ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generalor's U.S. EPA 10 No.
3. Generalor's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Gene,ato<', Pnone 919 9 34-9 711
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 Numbe,
S C D O 7 3 7
8. U.S. EPA lD Number
10. U.S. EPA 10 Numbe,
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, snd ID Number)
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83040
Emergency & Holidays: (803)73-4-5424
Form A roved. 0MB No. 2050.0039 E.x ires 9.30.ga
2. Page 1
of lnlormation in the shaded MHS is not
required by Federal law. but is by State law.
12. Containers 13. Total Quantity 14. Unit ··L'Wut:eNl.flbel' -.,.:,
No. Type 'MNr:l .·/f:,·,.:_'.,;,.:-.,,_HI):}:.:·/·~
1 F j O"jf~9"j';;'. ,.~~ '
1 D T 2 0 Y 1F1010161~f"
, e. CENERATOR'S CERTIFICATION: I hotebydeclare Iha! lhe con Ion ls ollhls conalgnmenl are fully and accuratelyde1crlbed above by proper 1hlpplng nam• and are claaailled,
packed. mar1,ed, and lii'be1od, and ore In an rospoct.s In propor condition tor lransport by highway according lo appllc.ble International and natlonal govarr1mant r~ulatlons •fld
ll'HI laws of the Stale ol South Carolina.
\11 am a large quantity generolor, I certify that I hevo a program In placo to reduce Iha volume and loxlcltyol waslegenereted lo Iha d&QrH1 I have datarminltd.lo be oc:onomiully
tirac11cable and that I have selected the practicable method of treatment, storage, or disposal currently available lo me which minimizes the pras.ent and lutur• tnrut lO t'luman
heallh and the environment: OR. ii I am a small quantity generator. I hove made a good laith etlor1 to minimize my wasle generation and select ttie bell wa11a managemanl met:r'\OCI
ttlat is available to me and thet I can etlord.
Signature Month Day y..,
0 7 1 9 8 8
Montn Day Yea,
v 7 Cf/
Montn Day Year
19. Discrepancy Indication Space ·~ I I 11b1. t I pbl.
bl pbl. d I jlbl
L
I
T 20. Facility Owner or Operator; Certilication of receipt ol hazardous materials covered by this manifest except as noted ln Item 19. "1---:-.,---,--------------------,.-----~-----------------------
Prin!ed/Typed Name Signature I Month Day y..,
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
Bureau or Solid & Haz.ardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form desi
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
ewriler
1. Generator's U.S. EPA ID No.
N C D O 7 6 0
Manifest
Document No.
1400779
P. 0, Box 1416, Smithfield, NC 27577
•· 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
CSX 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. Page 1
of
Emergency & Holidays: (803)734-5-424
roved. 0MB No. 2050-00.39 Expires 9-30-88
lnrormation in lhe shaded a,eas is no1
required by Federal law, bul is by State law.
F/T """°"' :.
ci/siito F aci!ity'a ID /@fh'H:! i,,<:: -
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit t · W&:ita t«l'aber :'.·
No. Type YrWo · ,,-,Jy,,
a.
Hazardous Waste, Solid, nos ORM-E
N l-.:'.N:;.A_;9:_:l:.;:8'.:_9 ____________________ .J.-LJ.:.l+D~T+..LLJC:2L'..O~Y~:.l!:::::::::::::=~
b.
... ........ ._.._.,_.,_..,, 4,
.' J ,;;,
OI-----------------------W--1..+.LJ..-1--1.....L.L-l----l-c:..!::====~
C. .:;, ····1y
::; '-' ....... _,._.._..,, -~
d.
,: ,.•· .....
· _; I . I ~'.':-
,. -.; {'·
<1
15. Special Handling Instructions and Addilional lnlormalion
CSX Work Order No.: 83041
1e. GENERATOR'S CERTIFICATION: I hereby declare !hat the content:, ot this consignment are lully and accurately described above by proper 1hlpping name al'ld a,a cla~fled.
packed. marked. and laheled. and are in a.II rospects in proper condition tor transpor1 by highway according to appliuble international and national go.,,emment r9"Qul1tion1 ar,d
v,e laws ol lhe Stale ol Soult\ Carolina.
If I am a large Quan\ity generator, I certify that I have a program In pleco lo reduce the volume end toxicity ol we,tegeneret&d lo the degree I h•ve determine<! to be eco"omk:alty
i:,rect,cat:11e and thal I have selected the practicable method of lreelmenl, storage, or dl,poaal currently evellable to me which mJnlmlz1u the preMnt and future thr-1 to l'luman
l'leat\r, and the environment:; OR, II I am a smo!I quantitygenorato,, I have mode a good laith etlort 10 minimize my waste generatJon and selecl the boeat waste management meltiod
tl'lat Is available to me and thel 1 con atlord.
Printed/Typed Name Signature Month Day Year
Ro er L. Goa ts 0 7 1 9 8
Monlh Year
6
e Signature Month Day Year
19. Oiicrepancy lndicalion Space
1 ... 1 ................. .... pbs. C I pbs.
•. b ... I ................ .... pt,,. d I pbs.
20. Facility Owner or Operator; Certilicalion of receipt ol hazardous materials covered by this manilas! except as noted in Item 19.
Prin!ed!Typed Name Signature Month D,, Year
EPA Form 6700-22 (Rev. 9/86) Previous Edilions are Obsolclo (DHEC 1988 (Rev. 10/86)1
I
~ rtp/J.,,$:
l.t!#;-1:. t \ \ \
*).~, ~
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC ;mo1
Phone: [phone]
Emergency & Holidays: [phone]
lu.se PRINT-or TYPE (Form dosloned for use on olile f12-oilchl tvnowriler)
f UNIFORM HAZARDOUS ,,. Genora\or"sU.S.EPAIDNo.
Form Ai roved. 0MB No. 2050-0039 E.1pires g.30.ga
WASTE MANIFEST N, c, Tl, o, q, 7, 6, 0, 1,, 7,
M111nlroa1
1
,2. Page 1 Information in the shaded a<eas is not
Document No. of . ed b Fed 11 b . S 1, 41 O, Q1 7, 31 O l requ1r y era aw. u\1sby ta.letaw.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Gene,ator"sPhone( 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckine 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
6. U.S. EPA 10 Numbor
1 St Ct Tlr 0t 7, 31 71 n. q, 21 ~
8. U.S. EPA ID Numbor
I t t I I I I I t I I I
10. U.S. EPA ID Numbor
, St C, D, o, 7, 0, 3, 7t '
'A;{~ Menlf8i,t Oocumonl -.·.
fJ:}Gtf.=:fi?H-}~?:i-\':\?i >:··'.;./_\~.; \i: / i/{: .:i
:at-.;,·~·•.f"••' ' ii'°JO ,,._•,,,.
F/T;,;:;;;;;;;,..-'• P!>oiio k: ,..-.. :
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity It Unit l'W&Sla-:·.
No. Type 'MNo .<·· .:,.c / .. '/i;<°'.•:
~ a. :,,F jO"i!i91':(
E Hazardous Waste, Solid, nos ORM-E ,< &;
N l-..!N:'.A:!.-9:'...'...18::..:.9 _________________________ -J-.1•_· .1t.:.1+0J•L'.T+_tLLt.Lt2:..1 ,o::..+--=-Y-1.:.:i:cl •~E=•~D==• D:::::' 6~• !;qf
I ~ b. '..: 1 ., ·; '-.,' ,0.
t e .J' ; I I.\
01-----------------------------f--_J'LJ'L.j~•c....j....J'....Jr....JI....Jlc....j_c....j...;:..!=::=::=:::::;,;.j
I rl c. . I ... ,.. . .. , .. ,.
1------------------,---------------+-.1'-tLi-L '+.JrLL'L 1.Jr_l--+-:_::::::: __ ::. :_:_::11t:.j'
I d. ~--~~~i:-x
I t r I t I t :;: I 1>~
CSX Work Order No.: 83042
18. C!.NERATOR'S CERTI_FICATION: I horobydeclare lhet Iha contents of this consignment are fully and accurately described abova by proper 1hipptng nama and a,a claHlflad,
pack ad. marked, and labeled.and are In 1111 rospecta In pro par condition for lransport by highway according 10 appllcabla International and nauonal govornmonl r9'9ulaUon1 al"ld
ll'le laws or tho State ol South Carolina.
111 am a large quantity generator, I car1ify Iha\ I have a program In p!aco to reduce the volume and loxiclty ol waste ganereled to tho d~rae 1 have determined 10 be oeonomically
practicable and tha11 have :,elocted Iha practlcablo method ol lroatment, s\orege, or dlspoaal currently available lo me which minimizes the preMnt and future ll'lrNI 10 P'luman
health end the envi,onment; OR, U tam a smoll quantity gonorator, I hove medo a good faith eHor1 to mini mite my waste generation and select ttle beat waste managemenl ,r,etTIQd
mat Is available 10 me and that I can allord.
Printed/Typed Name
RoQer L. Coats
Signature ~ ~ ~ Montlt Day Ysar
1 0, 71 1, 91 8, 8
V T 17. Transponer 1 Aunowledgemenl ol Receipt ol Materials
I ~s Printed/Typed Name
p ~ifl~O!-_.V-r';·,...,,.~-d:-l:J·T'~-,/~../',,.()~t'.j.1 P'4/',~;!:..~~:-:c;--~~~::::::_-.::j,~~...c.--------1~~~~
/
Sigo/j (Y/ Month Day Year
, ,-"ID' '1i. ,~ .
"IAL'f_.....~, -t , IF
o 18. Transponer 2 Acknowledgement of Receipt of Materials
I ~~f----'-------"-----'------~~---------'--------------'-----------~
Printed/Typed Name
'/ , /'
V Signature Month Day Year
I ' I ' I I
19. Discrepancy Indication Space
I I pb!. CI Jib!.
bJ jlb1 d I pbs. I ~
L tf--------------
l ~~t_0_._F_ac_,l_rfy_D_w_n_er_o_r_Q_p_c_ra_lo_r_;C_c_rt_il_ic_a_fiO_n_o_l_rc_C_C_ip_l_Ol_h_a_za_r_do_u_s_m_a~IC_r_ia_ls_c_o_v_er_oo_by'-lh_is_m_a_n_ii_o_sl_o_x_co~p_l_a,_n_o_loo_i_n_ll_om_\_9_. ______________ ~
Printed/Typed Name Signature Month Day Yw
i , I , I ,
!=PA FMm 8700-22 !Rev. 9/86) Previous Ed,l1ons are Obsolete !DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stfee~ Columbia. SC 29201
Phone: (SOJ) 734-5200
Emergency A Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E<oires 9-30-Ba
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No,
N C D 0
Manifest 2. Page 1
Docum,mt No. of
1 4 0 0 7 8 1
Information in the shaded a<eas is not
required by Federal law. but is by Stale la•.
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
•· Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sito 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..
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 83043
12. Containers 13. Total Quantity 1'-Unit L W&Slo Numbei"·:·
No. Type WVY,;J. . . . ,._, ' .. t \-,;:'~_.:
1 D T 2 0 Y
• •• •·••••><M~•-•• • (\
.q I" .</
HI. CEHERATOR'S CERTIFICATION: I horeby declare Iha! tho contonts of this conalgnment are luUyand accuretoly described abov• by proper 1hipping name and are cla....,.ILe<I,
packed. muked, and 11i'beled. and ore in all rospects lri proper condition !or transport by highway according to epptlcable International and natlonal government re,gulat10ns 11r<1
UUI laws ol lhe St.ale ol Soult\ Carollnn.
II I am a large Quantity generator, I certify thnl 1 havo a program In placo lo reduce the volume and loxlclty of waste generated to the di,gr&e I have determined to b<e economically
prachcfible and that I havo selocled the practlcablo method ol lrealmenl, slorage, or dlspo,.e,I currenl1y avollabla to me which mlnlmlu" Iha pres.en! and lulure trlr-1 lo human
l'\eatu, and the environmenl,; OR, U I am a small quanlllygonoralor, I have mado D good t11ilh erfort to minimize my waste genera!Jon and select U,a t>e,t wa,1e managamerH ~U'>Od
thal is availatlle 10 me end that I can aHord.
Prinle<:1/Typed Name
Ro er L. Coats
17, Transporter 1 Ac,nowledgement ol Receipt of Materials
Printed/Typed Name
< s
Printed/Typed Name
19. Di,crepancy Indication Space
Signature _/
Signature
Coak
•I~~~
b~I~~~
20. Facility Owner or Operator; Certilicalion ol receipt ol hazardous materials covered by !his manifesl except as noled in Item 19.
Printed/Typed Name Signature
Month Day Year
7 1 9 8 8
Monti\ Day Year
Montn Day Year
\lb!. CI Jibs.
jibs. d I jlbo.
Month Day Yrw
OP> Oo.m ~7M-?21Rov 9/861 Previous Editions arc Obsoloto IDHEC: 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau al Solid & Harardous Was:e Mi;t
2600 Bull Stre-el Columbia, SC 2'9201
Phone: (8/J3) 734-5200
Emergency & Holidays: [phone]
E PRIITT or TYPE (Form desi ned for use on elite 12-itch ewriler Form Ap roved. 0MB No. 2050-0039 E..xoires 9-30-a.a
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Mnnlfeat Document No. 2. Page 1 lnlormalion in !he shaded a<eas is not
WASTE MANIFEST N c n o 7 6 o 400782 or required by Federal law. but is by State ta .....
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
"· Generator's Phone 919
5. Transporter 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
NC 27577
6. U.S. EPA ID Numbor
SCD0737
8. U.S. EPA ID Numbor
10. U.S. EPA 10 Number
S C D 0 7 0 3 7
tl. U.S. DOT Description (including Proper Shipping Name, Hazard Cl8ss, and ID Number)
a.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
CSX Work Order No.: 831,27
12. Containers
No. Typo
1 D T
13. Total Quantity U. Ur,it _L W_dllunber ,·
WtNrJ
2 0 Y
iiF jo-!r;g·1>:
.. pF1Q1Q161\'
'i ,·:·
.. ~' ~-"'-.._-' ; I 1~/
'-'-'-'--·_J .
16. GENERA TOR"S CERTIFICATION: I horc,by dc,clore lhnl tho contonls ol this con:!ilgnmont ere fully ond eccuralely descrlbod above by proper 1hipping name arid•'• clase,r,..:a.
paci..ed, marked, and labeled, and are in nll ro!lpocts In proper condition !or t111n,por1 byhlghwoy according to epplleable lnlernetionnl end natlonal go .. ornmanl ra-gutauona •rod
t1u1 laws of the State of Soult! Caro!inn.
I! I am a large Quanllty generator, I cor1ify ttmt I hnvo o program in pleco lo reduce the volume and to)(iclty ol westeoeneratod lo the dog,ee I ha,,e determined to M oconomic.ny
pr•c11cable end that l have aelecled the praclicable method ol treatment. atoraga, or dlspoa.al currently avoilable to ma which minimize, the pres.ant and future thr-1 to hu~n
he a Itri and the envi,onmcnt: OR, ii lam o smoll quontitygonorolor, I hove mado a good lallh etfort 10 minimize my waste generation and select the b-81! wait• men•oam•nl ""8trlo<I
that Is available 10 mo 11nd tt"lnt I con nllord.
Printed/Typed Name Sign.ilure -;:/. Month Day Yea,
Roger L. Coats 0 7 2 0 8 8
17. Transporter 1 At:imowledgement ol Receipt of Materials
Printed/Typed N:ime Signature Mon!n Day Ye.,r
·--::::;;-I m ')C.5o s <J-..J 1 2 <.:, Ti
18. TransPOrter 2 Acknowledgement ol Receipt ol Malerials
Prinled/Typed Name Signature Monei Day Year
, 9, Discrepancy Indication Space
a I jibs. C I pbs.
b I p1>1 d I l'bS.
20. Facility Owner or Operalor: Certilicalion of receipt ol hazardous materials covered by this manifest except as noted in llem 19.
Printed/Typed Name Signature Mor,th Day Yw
EPA Form 6700-22 (Rev. 9/86) Previous Editions arc Obsolcto [DHEC 1988 (Rev. 10/86)]
I
l
I
I
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste M;t
2600 Bull Street, Columbia, SC 2'9201
Phone: (BOJ) 734•5200
Emergency & Holidays: (B03)7J.4-5-C24
1¥,SE PRINT or TYPE (Form desiqned for use on elite [12.pitchl lvoewriler)
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A □roved. 0MB No. 2050-0039 Exoires 9.30.ga
Monlfo111 ii 2. Page 1 Information in the shaded ;weas is no1
required by Federal law. but is by State la#. WASTE MANIFEST N, Cr D, 0, q, 7, 6, o, 4r 7r Document No. cl
lr 4, 0, Or 7r 8r 3 1
3. Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield,
•· Generator's Phone! 919 l 934-9711
5. Transporter 1 Company Name
Willms Trucking Co. Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Sito Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
NC 27577
•·~ ..• ·.·.···••: .•. ·.·.·•.•.· .. ·$1N··••·:.· .. ·.· .•. ··•·····~ Documool Nutnbor , :.:'-Y:};'.> .-, -.;:,;·.:,'_:. ;,,.:; .. ·-,❖;--.
6. U.S. EPA ID Number C/Sitli, .. ,... .. e ID . . · ·" ' ··•· • '
1S1 Ct D, 01 7, 31 71 0, g, 21 'l . o)l. . 'af'tioM . .iAn,l7fi7-1'<•1·
8, U.S. EPA ID Number f;io,~i,i'f;,.n=a IJ. ·• · · .... ,•.• · · ··
I I I I I I I I I I I I F/T oPl',ooe• •••" .,_, ... ,,, •·
10. U.S. EPA ID Numbor cCstiiioFacililf• 1D ·
, S, C, Dr Or 7, 01 3r 7, "
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U. Unit l'Wab!l tMt!ber :,:-
No. Type YI\NrJ •·CF,' •:•\''Xi-</<
a. •1jF ,□--,Tj9;/
Hazardous Waste, Solid, nos ORM-E ·,
N NA9189 I ,1 D,T r r ,2,0 y '}IE1Qr01611f
~~b_. _________________________________ ....)._.L. I_IL.\--JILj_.L.1_:ILLIJILj_ _ __f..· . .:.;..'.'.=~··=:=···=···-=:=•=:='=-:_;:r_:1;,".
~ c.
..
I I I I I~)
' ' ' I I I I < I I I I
d. '. , , , , , , , ·:-'., , , , ,!r
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83428
18. CEHERATOR'S CERTIFICATION: I hereby declare that tho contents ol this conslgnmentara fully and accurately described above by proper 1hipping name and are c:lasa.ille-d.
pac:lo.ed. marked. and l11b111cc1. and nro In nll ro:,pocts in propor condition for transport by highway according to applicable ln\11rn111ional and nallonal governmeril re-.iul•tlon, •rod
tt>e ta ... , ol the St.lie of Soulh Corotin11.
It I am a largo Quantity generator, I certify that I have a program In placo lo reduce the volume and 1011.!clty ol wasl11gen11ralod lo Iha degree I have determined to be oconomieally
prachc•ble and lhal I have selected the practicable method ol lreatmont, storage, or disposal currently available lo me which minimizes tha preMnl and lutut• lhr-1 \0 human
health and the environment, OR, if I am a smoll Quantitygenoralor, 1 have mado a good loilh effort to minimize my wasle generation and select the b<!,1! w111111 m•n•;iamenl ~thod
ltlat is available 10 me and tho! I con nllotd.
IJ-,.-P-r-in-ted-/T_y_p_ed_N_•_m_•_;,;.;.""--..:;.--..;;....;;.. _____ J_S_ig-na-tu_r_e __ f/,_V-,n+;-=oc--:;... ..,/_;:__.;:/=;..;.;;.:: _,='------_.M_o_n1,.t11..,1,..;.D.La-y_._Y_oat'-'-1 ,.. Roger L. Coats /'--en.,_.,.,._ -;;z_, ~ 1 Dr 71 2r 018, 8
T 17. Transponer 1 A<..:imowle<lgement ol Receipt of Materials v i----"----'-----,-----------1 ~ /Zi::~ed~";!,U/l~_n df;;y ISignalu~~ JI-// . ~:;,/~.~~
o 18. Transporter 2 Acknowledgement of Receipt ol Materials ty· Ri-----'----'------'-----'----'---~----------------------------------i
I T Printed/Typed Name I Signature Monttl Day Yw
~-+-_________________ ..__ ____________________ .._l.._,._l._.,l,.__,,--1
19, O,screpancy lndicaiion Space
I~ I I I I I I I jlbl CI I I I I I Jib!.
b I I I I I I pos. d I I I r I I pbs.
L + t-,2-0-. -,,F-,c-i-!i!y_O_w_n-er_o_r..,0,-p-,-,.-,o-,-: C,-,-rt-il-ic_a_tio_n_of receipt of hazardous malerials covered by this manifest except as noted in llem 19. I y Prinled/Typed Name I Signature Month Day Year
r r I r I r
EPA Form 6700·22 (Rev. 9/861 Previous Ed1l1ons arc Obsolclo {DHEC 1988 (Rev. 10/86)]
,·
I
I
I
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stre(tl Columbia. SC 2'3201
Phone: (803) 7~•5200
Emergency & Hol;days: (B03)734-542,
1¥,sE PAI,;;: TYPE !Form desioned lor use on elite 112-pitchl tvncwriter) Form A roved. 0MB No. 2050-0039 E,pires 9-30-83
UNIFORM HAZARDOUS I'· Generator's U.S. EPA ID No. 0 Mani!•;\, I 2-Page 1 lnlormalion in tho shaded a,eas ;s not
WASTE MAN I FEST N, C, I), O, '), 7, (,, O, /., 7, I, 11, n~n;";~ o.0i, I 01 J requ;red by Federal law. but is by Stale la•.
3. Generator's Name and Mailing Address ',\.\~'·Manifest· Ooo.smenl Nutnb«" .· · ···-:".::, ·>·;-·,·
Channel Master #i{( ·« ··••/t· •• ··•:•,··· ···.,C:,:, .. -./;:/
P. 0. Box 1416, Smithfield, NC 27577 "tlJStitiioiinoialot'alO/•.;-.,, . .-·· ·:•,c:,,,,.·,,,
,. Generator's Phone I 919 I 9 34-9 711 :,)\i:jjh{( di'" '•·• ,•.i,j .. ;/ ·••••• •/ii•'.'.•·
5. Transporter 1 Company Name
Willms TruckinQ 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?siaii,T' ···••• . e IO :,:.:•· . ·• ,·· . ·''
~, C• D, Q, 7, 3, 7, n. q, 71 Ci • oJr"·. ,. 'sl'hoot'•••,:ono·1.7~7;:,,~,.
8. U.S. EPA ID Number f:·=·0:t·~-.,:f'''·-· ai() -,.-,, · :·.,,t,,, ·
'1 I I I I I I I I I I F/."·fnin.;~.,.5~·' ··: ·, .:-·c'~,,:••c.~•-
10. U.S. EPA ID Number ~i..~~~f,•~l.i.f~ ;'.··.•••···•\'.·:ii .,:;:,.<: ,
, s, c, n, o, 1, a, 3, 1, '. ~ a , ~ljt\ft~ .. -::;/·J~:i/i;jz?tbcl'~::
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity It ur.;, L W&3111Ntrnl>of
No. Type WtNrl •' • ••• '< •·., .. ,,<'?
a.
f b .: I ~,I·
O ~-----------------------------+-.l'Jl_j_J•_j_J1L1LL1L1 .j.__-l,.;;;~I::::::=::=:=:·
f1 C. .. ,-· .... i
.
I J I
I J I
I I ' I f P I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83429
..... ,
I I I
,: I 1 I J
,._1 _..J--'1,.___~1 _,, ·. :·
/'.;
~l
1 e. GENERA TOR"S CERTI_FICATION: 1 horoby dec1oro tho! !ho con ton ts ol this consignment are fully end accuralely described above by pro~r ■hipping nam• ■nd are c:.•••••lled.
packed. marked. and labeled, and ore in n11 rospocls In propor condition for lrenspo,1 byhlghw11y according to oppllcable lnt11rnational and natlonal go,,ernm•nl r..;ivtauo"• •"'4
U"le laws or th!! State _or South Carolina. •
111 am II luge quantity ooncrn1or.1 cor1ify thnl I hnvo o proornm In placo to reduce the volume and 10)1:;lcltyol wa9teganerel&d to Iha de9ree l have determin&d lo be 8Conomieally
pr•chcabte end that 11111"0 sotoch1d tho prncUcolllo molhotl ol lrontrnont. slmoge, or dlspoaol currontly avollabto lo mo which minlmltes the pre:,.ont and ful\Jre ttlrNI ta hvman
l'lealth and the enviionmcnt; OR, ii I am a smol1 quantity gonorator, I hove modo a good lailh offort lo mlnlmlto mywasto generation and selocl U"lo belt wa11e managem•nt metl'\od
tl"lat Is availatile to me and th&t I con allord.
11-~-P-,;-nt_ed_/_T_yp_ed_N_am_,__:R:,:o~g~e:r::.__L::::,·....::C.:;:o,::a:.::t.:;:s__: ___ _j:._s_ig-na_iu_,_• __ !..,;.~:::2";;-~·~~....:~::'.::./..:·....:~~-:::::!:~~;_---....llM~OLo~L.~L~•~.1.•a!.!~~•;:J.~.!.8:.j
,_,.
19. Discrepancy lndicalion Space
I ~ I I I I I I I pos. C I I I I I I pb!.
b I I I I I I jibs. di I I I J I ,, ...
L ,,_ _____________ _
I ~ ri_o_. =-F_a_ci_lity--,O_w_n_e_r o_,_O_p_e_ra_10_,_: C_e_rt_il_ic_a_1io_n_o_l_r_ec_e_ip_1_o_l h_a_z_ar_d_ou_s_m...,.al_er_ia_i,_c_o_v_er_od_b'-y_lh_is_m_an_i_le_,1_e_x_ce_p_1_,_, _no_1_ed_in_ll_e_m_1_9_. __________ _
Prin!e-dflype-d Name Signature Monlh Day Year
I I I I I I
r-n. r:--.-C'l'r,n .,., mn11 0/A:hl Prr>Vlntl<:. J:rlitinM :tr~ nh~olete fOHEC 1988 mev. 10/86\1
I
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N
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0
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'
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R ~ s p
0 R T
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L
South Carolina Department of Health
c1nd Environmental Control
Bure.3u of Solid & Hazardous Waste Mi;t
2600 Bull Street, Columbia, SC 29201
Phone: [phone]
Emergency A Holidays: (803)734-S-424
-
E PRINT or TYPE (Form desioned !or use on elite f12-pitch) tvoewriler) Form A oroved. 0MB No. 2050-0039 E.rpires 9-30-aa
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAtDNo,
WASTE MANIFEST N, c, D, O, q, 7, 6, 0, 6, 7,
Mnnlfoet •,I 2. Page 1 Document No. of I, 4, 0, n, 7, 8, 1
Information in the shaded a<eas is not
required by Federal law. but is by State la •.
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Genmtor'sPhone( 919) 934-9711
6. U.S. EPA 1D Number
k~Miinif&st Clocumonl Nvmb«
<tr<·:~<)V<·:_ i\':)/:::/ ,:,.,:,//,: , ...... ,-<=.,-.... -·--... : .:,:.~--'~' _,;_ . ./: :<,·:-: .-.
Ji)c,siaJi~a I)/>.•.· -'.'C'• •."
=·~ \\dfW<,; i/;;:;i><:<: tt>---· -=-,,·,;:::, _.:.,.=
5. Transporter 1 Company Name
Willms Truckin~ Co Inc. 1S1 C, D, 01 7, 31 71 n, 9• ?, Cl
7. Transpor1er 2 Company Name e·. U.S. EPA ID Number
I I I I I I I I I I I I
9. Designated Facility Name .ind Sito Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
10. U.S. EPA 10 Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
Hazardous Waste, Solid, nos ORM-E
NA 9189
b.
C.
d.
GSX Work Order No.: 83430
cCsi.to Fii6i1i\y', ID
'.· ... ····.?L>··.: . .-: .. · .. :,.:
12. Containers
No. Type
I ,I D ,T
I I I
t t '
I I ,2 ,0
I I I I
t I I t
'iiF i0.ili9't:,
y ·,;, :t
\;1F 1Q 101611,i·
I I I I I I I ; I I I I !"!·
1e, GENERATOR'S CERTIFICATION: I hereby declare that lhe contents Ollhll conalgnmenl are fully and eccurelelydeacribed above by proper 1hipping name al'ld are claU1lied.
packed. marked, and 1aheled. end are in nil rospoc\s in proper condition for lransport by highway according to applicable lnhirnatlorial and l'latlonal governmenl r~ulatio•u •rod
ll'le law, ol the St.lie ol South Carolina.
ti I am a !arge quantity generotor.1 cer1ity !hat I hove a program In placo to reduce !he volume and 1oxlcltyol waste generated to the d&gr-I have determined to be economic.any
prachcatil,e end that I have ,elected !he praclleabla molhod ol treatment. 11\orage, or dlspoaa1 currently avai1eble to mo which minimize, the present and lurure tri.r-t to tiu~n
healtl'I end !he ,en,,,,ronmcnt; OR, ii I am n r;mnll f11Jnntity gonorator, I hovo mndo n good fnilh effort to minimize my wlll.Slo gentHlll.tlon and ,elect ttle beat wa1te management mell'lod
11,at Is ava;l.able to mo t1nd H1111 I cnn c,rtord.
Printed/Typed Name I Signature 14 ,. Roger L. Coats
Month Day Yaar
1 o, 7, 2, o, 8, 8
17. Transoorter 1 At.:~mow\edgement ol Receipt or Materials /I V
Printed/Typed~~/ I Signature/ /J-ra.k/ D 6n --rnulll(,4.U
Montti Day Ye.ar
A~ • • •~ • , 7, ~o 1.&',k l I
18. Transporter 2 Acknow!edgement of ReceMf1 of Materials . -
Prin!ed/Typed Name I Signalurc Montti Day Yeat
I I I I I I
19. Discrepancy lndicalion Space
a I I I I I I Jibs. C I I I I I I Jibs.
b I I I I I I !lbs. d I I I I I I pbs.
'1---------------1 ~ 20. Facility Owner or Operator: Cer1ilication ol receipl of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name I Signature Montti Day Year
I I I ' I I
EPA Form 6100-22 (Rev. 9/86) Previous Ed1t1ons arc Obsolete jDHEC 1988 (Rev. 10/86)1
I
I
I
~ -~~•~:;
, '•\ '
-~y
~ .. .-
' :<:t---:'
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste M;t
2600 Bull Stre,el Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)7'.l-4-5424
I.EASE PRINT or TYPE (Form designed !or use on e1ile r12-citchl tvoewriler\
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAtDNo.
Form Aporoved. m.m· No. 2050·00J9 E.xoires 9.30.sa
Manlfo11t '12. Page 1 Information in Iha shaded areas is no!
required by Federal law. but is by Stale ta,.,_ WASTE MANIFEST N, r., D, 0, q, 7, 6, O, 1., 7, 1, Oocumonl No. of 1,,0,0,7,8,6 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator', Phone ( 919 I 9 34-9 711
5. Transporter 1 Company Name
Willms TruckinQ Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Sito Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood, SC 29125
iJ~ Manifest Ooctimenl -p,,:F/,-,,:J r;:,: ,,-,-.-_ -=, ~-.,:-, ~,,,-.:.--,., ... • -,_ -=·== ---= · · · ··· -~ ,;. :,_:;;=~ (_!; r;'.~;~;:-<.
~):tj:!<;1;.'"' "t~:~ .>: ' ' <• <,: ' ..•• ' •' •.
6. U.S. EPA ID Number c?Sta~.t ...• II)'. : ' · · · . · • · ....
S, C, D• 0, 7• 3• 7•" Q, ?, Cl . D(T' .... · al'hooo, ·•An,/n7-'••••
8. U.S. EPA ID Numbor E_'.)'<ti·,;t.,,❖'fi-1.'n~a O · ·,~.
' ' ' ' ' ' ' ' I I r F,•,Tran;~•?t>ooo•· ... ' .. :,,, .. ,, ...
, S, C, D, 0, 7, 0, 3, 7, '.
11. U.S. DOT Description {including Proper Shipping Name, Hazard Class, and fO Number) 12. Containers 13. Total Quantity 1t Ur,it L W&Sllt-.. :··
No. Typo WtNo · ."•": :.,'.:·.• <.;,.':":
, a E, Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 11 DtT r r ,2tO y
~ b. ·;·j· ··-·t~·-•t-·,j~ .. j~;
~ f---------------------------------.1-L tJ•_lf--L'.j_J•_j•:_L'.l'-\--J.•~j.!:, ::::'::::::'::::::' ::::.'
1
.;:'f~·
a C. .,.! I
I 0 I I I I o
d.
1S. Special Handling lnslructions and Additional lnlormation
GSX Work Order No.: 83431
1 IS. CEHERATOR'S CERTIFICATION: I horeby declare Iha! tho contents of this conaignment oro lully ond occurotely do,crlbod above by proper ,hipping name and••• clasa,fla<S.
packed. marked, and labeled. and are in 1111 rospocts in propor condition lor transport by highway according 10 applicabla lntemahonal and natJona! govommont r09utat1on1 aod
ll'lf:I laws or tho $1.i'!.le o! Soulti Caroline..
111 am a largo Quantrty genera!or, I certily tho\ t havo e, program In placo 10 reduc11 the volume and loxJcltyol w1utegenerat8'd to !he de,gree I have dotormina-d to be economically
prac1,cabte and \hat I have selected !he practicable method of treatment, .!1\oroge, or disposal currently available to me which minimizes the pre,-enl and lutwo tr1,_1 to huma:"I
health and the environment; OR. ii I am a small quantity gen11rator, I hove mado e good laith effort lo minimize my waste generation and select l:tle b-est waste mana~omonl metJ'ood
tnat i.!I avai!at:Jle to me and that I con allotd.
I ~l--P-r-in-ted-/T-y-ped_N_a_m_,~R;:o;:;g~e::.:_r__:L:,:-~C:;:o;;;a~t,:::s _____ lj_si_g_n•-tu_r_•_..;£~·~ -c"';i::! -"~-~--'~e;!;;.:,• _ __:(;:;:":;:!;~!;L+"'-------l'Ml~!.l~'"'~!..l.r2£D.L'a:!~~•l;!.::-'i.!8~
T 17. Transooner 1 At:,mow!edgement ol Receipt ol Materials -q l~SR~------'------"-----'-------~---------------------------------~ frinted/hped ~;1'8 ,,/ A. ISignat~,e 1 ,.1 1-,_ ~ ! .Jt-J C, Mo~ Day Year 1; J J,..1· er o-e, /,A/ r~ .41AJ ~ .kk,,,,.,~;,.. di.-. o , ,., k,,P:r0: p µ.::i..:::....:.=_..J::::_~--=='--L-£2.:__.1,£::_ ___ _1_.,_<:::..1,a,:_-,L:::e!...£>L.C!e:C.!.t-=:.io-.-.:iz.::::......e;._::::... ___ _._,'-""'"-"'--"4~
o 18. Transponer 2 Acknowledgement of Receipt of Materials ---, /
IRT~r,~=-=~=======:.__-,-;;:--,-.--------t-r------'---;-:-=---;;---::-:-:-:-l Printed/Typed Name I Signature --Montn Day Yw
t ' I ' I '
19. Discrepancy Indication Space
I ~ a I I I I I I jibs. ' I I I I I I ptos.
b I I I I I I fibs. di I I I I I [Ito.
L
I )----,----,-----------T 20. Facility Owner or Operator; Certiricalion of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
I y
Printed/Typed Name I Signature Month Day Yw
I I l ' I '
EPA Form 6700-·n·(Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev.10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Har.ardous Waste Mi;t
2600 Bull Str~l Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)73-4-5-424
SE PRINT or rYPE (Form desi ned for use on elite 12-itch ewriler Form A roved. 0MB No. 2050-0039 E.xpires 9-30-aa
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. Manlfe11t
Document No.
3. Generator's Name and Mailing Address
Channel Master
N C D 0
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
4 0 0 7 8 7
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA JD Number
S C D O 7 0
2. Page 1
of lnlorma\ion in the shaded Meas is n01
required by Federal law, but is by State ra .....
11. U.S. DOT Description (including Proper Shipping Nam~. Hazard Class, and ID Number} 12. Containers 13. Total Quantity U. Unit l'WatllNlaubef···:·
No. Typo 'Ml'lo '':i''•{(:-<\·.:•.c.;,;))
a.
b.
c,
d.
.Hazardous Waste, Solid, nos ORM-E
NA 9189 l D T
J.°. Addrtionm De$Criptlom 1N Maierla1f Y'-,iit"-bow. .·.. ...... ,-··;:-:,-,,·.,. )_\/:ki;'.f~i , ,-~ ,:.: .. r.1.•.·.·.':.:i:: ... ;;i.•.::.:;::::1~.~~;J.•.:!:.\.).,!il.;.,.::.:[[~!,l~.'::j~i.::.t[.-i'..:\.:.~--i.[_l.•.::.• ~,,; 'i~'i = lo·: f:•5 ; ; : ~· i::(i :ii:'g ,''2l!~lll~!!\;:llil!~"~•~l~i11m&iidw,uw1 '= ' .. .·.. . ..... i ,fo
b. LLJ-1 1-1 11ij::1;i:!:!t~:w:1 I
15. Special Handllng Instructions and Additional Information
GSX Work Order No.: 83432
. 1 F j o·!f, 9"1/ : ',;'
2 0 Y l1f1Q1Q161:i
L.-L......JL......JL......J,;::
.; I 1?)_
16. CENERATOR'S CERTIFICATION: I horobydoclare lhet !he conIonts of this consignment are fully end accuralelydescrlbed abOve by proper ahipping namt and are clasailltod,
packed. marked. and !a.belcd. and are In an ro!lpccts in proper condition tor tran9por1 byhlghwny according to applicable International and national go-..ernment re,;v!at10n.1 and
tl"le laws ol tho Stale ol Sou!h Carolina.
II I am a 1ar9e quantity generator, r cortity that I have a program In placo lo reduce the -..olume and toxicity ol we11tegenerated lo the dog roe I have do!ormln&d to be economically
pract,cable and that I have 11alocted the prac1lcable method ol treatment, storage, or dlspo1Jal cvrronUy a-..o!lablo to me which minlmh:os the praMnl and lvtvr• ll'lr-l to human
l'leahn and tho envi,onmcnl; On.111 am n smnll (1uantity gannrntor. I hnvn mndo a good In Ith ollort to minimize my wa:,lo genoratlon and ,olec111'111 bo1t wa,1• man•o•m•nl ,....,r.od
11,at is a"ailaOle 10 mo and thnt I cnn nllord.
Printed/Typed Name Signature Month Day 'fear
Roger L. Coats 0 7 2 0 8 8
17. Transporter 1 Ac.:1rnowledgemenl ol Receipt of Materials
Signature
18. Transporter 2 Acknowledgement ol Aeceipl of Materials
P1mled!Typed UJmC Signature Month Day Year
19. Oimepancy indicaiion Spm
I I 11bs. e I l'bl.
bl pi,,, d I libs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
P1inted/Typcd Name Signaturo Month o,, Yoa,
EPA Form 6700-22 (Rev. 9/86) Previous Editions are O~~~lelo (DHEC 1988 {Rev. 10/86)]
I
I
I
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bull Stre-e~ Columbia, SC 29201
Phone: (BOO) 73'-5200
Emergency & Holidays: (803)73-4-5-424
E PRINT or TYPE (Form desianed !or use on elile r12-oitchl lvncwriler) Form Approved. 0MB No. 2050-0039 E.J:oire5 9-30·8.a
UNIFORM HAZARDOUS 11, Generator's U.S. EPA ID No.
WASTE MANIFEST N, C, D, 0, g, 7, 6, o, 4, 7,
Monlfeat J2. Page 1 lnlormation in the shaded a<eas is not
Oocumont No. of . ed F·• t b . S J, 4, O, O, 7, 8, 8 1 requ,r by =•ral aw, utl!by tatelaw.
3. Generator's Name and Mailing Address
Channel Master
P. 0, Box 1416, Smithfield, NC 27577
.a. Generator's Phone( 919) 934-9711
5. Transporter 1 Company Name
Willms Truckine Co Inc.
7. Transporter 2 Company Name
6. U.S. EPA ID Number
, S, C, Q, O, 7, 3• 7, n. 9• ?o Cl .
8. U.S. EPA ID Number ~•5,.' ""';::f;···.,:1··•:.!•t!Jrtl~··r,!!··~·~--:! . .:S:..!'o.!IO;,;,;,. ;;.;....;, ______ ----------'-I
, , , , , , , , , , , , F.moin,,,,;,..,•, pt.,.,.,,.·
9. Designated Facility Name and Sile Address
j GSX Services of SC, Inc.
Route, l Box 255
Pinewood, SC 29125
10. U.S. EPA 10 Number cf 6tolo Focilitf• ID ·. -··. ' <--,.·· ·<.
tt F aclllty't PMno -
1 s, c, o, o, 7, o, 3, 7, '. S\ 8 '. · < 803/452--5003 ·
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U. Unit l ·wa111 Nlinber ::·:
No. Type Wttlo .: "-
a ijFjOj!f9,>
E Hazardous Waste, Solid, nos ORM-E ,.
N 1-.:.N::A:.....:9~1:.'.8'..:9:,__ _______________________ 1-,;,L· _j•L'..1..J'.:'.o_J,l'..r+J'_j'__.l'::.2-1,.:'.o+-=Y--1~':::,:; ':::E:::1:::0=':::o=':::6=.'.::1,;~-
I b. j j ••• ~., -;:;
~ :.-! ,~~
01-----------------------------t-_JILJIL_JµIL_J_jl__JI__JI__Jf----1-----1_:;;_!=:===~
' c. ..... ................. _., ;,~;\:
T
0 I ' I I I r : '~-~-~~,\~
15. Special Ha·ndling Instructions and Additional lnlorma!ion
GSX Work Order No.: 83433
, 6. GENERA TOR'S CERTIFICATION: I hl!lrl!lby declare Iha! !he con1en1s ol this consignment are fully 111nd accur111t.ely described above by proper ahipping nam• and •r• cla..,.tie<I,
pac J,,ed. marked, and labeled. and are in n!I rospocts in proper condition !or transport by highway according to applicable International and national government ro-gu1at1ons al'\d
tl"le laws of the Stale or South Carolina.
I! Ism a large Quantity generator, I certity thet t havo a program in piece to reduce the volume and lo>tlclty of waste generated to the dogrl!le I have determinod to be oconomic:.atly
prachcabte and that I have seleC!ed the practicable method ol lreatmenl. slorege, or dl3posal currently avoilable to mo which minimize, tho pre:,.ent and lun.iro tl"ltoal IO human
health and !he environment; OR. ii I am a small quantity gonorator, I hove mado o good faith eNort to minimize my wa,t.e generation and ,elect ltle best waste managemonl rnotl"lod
trial i~ availat:Jlo to mo nnd thnl I con nllor(l.
11
i
Printed/Typed Name Signature
Roger L. Coats
17. Transporter 1 Au;nowlodgement of Receipt of Materials v
7
Month Day Y_w
10,7,2,018,8
Month Day Year
I Cl, 7t..?1 .• ~
p
o 18. Trafnporter 2 Acknowledgement of Receipt ol Materials .,-/ /
IR l-"-'--'---'.:.....:.....::_____;__=--'-=.;:.:...__;c_--'----'--.:...._~--------i;.,c...-------------l
Printed/Typed Name Signalure Mon!tl Day Year
I , I , I ,
19. Discrepancy Indication Space
I~
L lt-,----,-------------
1 ; 20. Facility Owner or Operator: Certilication ol receipt ol hazardous malerials covered by this manilest except as noted in Item 19.
Pnnted/Typeo Name Signature Month Day Year
I I I ' I I
<O• <o,m fi7M.?? /Rev 9/861 P1ev1ous Editions arc Obsolcto IDHEC 1988 (Rev. 10/86)1
I South C'1rolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mi;-t
2600 Bull Streo\ Columbia. SC 29201
Phone: (81).J) 734-5200
SE PRINT or TYPE (Form desi ned for use on elite 12-itch ewriter
UNIFORM HAZARDOUS 1. Genoralor'sU.S.EPAIDNo. . Manlle•t Oocumnnl No.
WASTE MANIFEST N c n o 7 6 O t ]!100 8
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
( 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 0 9
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E,,.:pire, 9-30-88
2. Page 1 lnlormation in !he shaded a<eas is not
ol required by Federal law, but is by State ta.,.,
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U. Uriit l'W._;.Nldber .. -:-·
No. Type 'MNrJ . ·,'..",·;.'"(
a.
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T 2 0 Y
b.
15. Special Handling Instructions and Additional lnlorma!ion
GSX Work Order No.: 83434
1 e. CENERATOR·s CERTIFICATION: I horoby doclore lhnt lho conlonls olthls conalgnmonl are lully end accurale1y descdbod above by proper 1hipping nam• •nd ar• clua,11.-d,
pack.ad. mark ad. and la.belcd, and are In RII rospocts In proper condition !or lrensport by highway according lo eppllcable International and naUonal government re-Qulabons •r>d
trH!I laws of tho Stale ol Soulh Carollnn.
111 am a large Quantity generalor, I certify th111I have a program In placo to reduce the volume and 1011lcltyol waslegoneralod to Iha d~rl!H) 1 have determined to b9 econOmiulty
practicable and that I hava selected the practicable malhod ol treatment. storage, or dlspoaal curranUy avo.llable to me which mlnlmliea tho prBMl'I! ar,d lurura tnrut \0 human
health and the environment: OR. ii I am a smo.11 quantity generator, I hove made a good lalth effort to minimize mywasl& generatlor, and select tho beat wa1ta management ,,.,.thod
that is availat:ile to me and Iha\ I can ot101d,
Printed/Typed Name Signature ed. Month Day y..,
Roger L. Coats 0 7 2 0 8 8
17. Transponer 1 Ac.Knowledgemenl ol Receipt of Materials
Prin!ed/Typed
/4 ~✓
Signature
owledgemenl of Receipt of Materials
Printed/Typed Name Signature Month Day Yeat
19. Oi5crepancy Indication Space
a I llt4. C j )lbL
b I \11>1. d \ \lbl
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest eicepl as noted in Item 19.
Printed/Typed Name Signature Month Day Yw
~PA Fnrm 6700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz..ardous Waste Mi;t
2600 Bui! Streol Columbia. SC 29201
Phone: (BOJ) 734•5200
Emergency & Holidays: [phone]
E PRIHT or TYPE ewriter Form A roved. 0MB No. 2050-0039 E.,;pires 9.30.aa
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
J. Generator's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Generalor"sPhone( 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transponer 2 Company Name
9. Oesigna1ed 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
t l. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a. Hazardous Waste, Solid, nos ORM-E
2. Pago 1
of
12. Containers
No. Tyl"'
lnlormation in the shaded a<eas is not
required by Fe<leral law, but is by State la .....
13. Total Quantity t( Unit
'MJVcj
l W.-lu!lbot:: . :;:,.,.,<\
N NA 9189 1 D T
.·. .:;..~.•~-·-~--= -·..,
b. . ~ I I ·::.
C. . ._, _.__, __ .._.,,, -~---.'~-~·-.
) I -
d.
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 83435
1 e. CENERATOR'S CERTI_FICAT10N: I horeby declore thol lho conton\:, Ol lhl:, conslgnmon1 au, lully ond accuratelydescrlb&d above by proper 1hipping n•m• •nd •r• cJaa .. lled.
P•Cli.ed. marked. and labeled.and are in RII ,o:,pects in propor condition for Iron sport by highway according to oppllcablo lntornationol end noUonol govarnm•nt re,gul•Uon, •nd
uie law, ol the St.a.te ol South ~erollna.
11 tam II ta,ge quant,ty ooncro1or, I co11ily tho I I hovo o proornm In ploco to reduce the volume ond IOKlclty ol w&slo genorolo-d to Iha dogroo I have dotormlno-d to be ec::or,omlcatly
pract,cable and that I tiavo seh.1cted tho pracUcablo method ol t,cotrnont, :11O,ogo, or dl:1posal currently 11vol1ablo lo mo which mlnlmlu" tho pres.on! •nd rurura ui,-1 lO human
nea!th and tho environment; QA, 111 am a smo11 quantity ganorator, I have mado a good laith eNort to mini mite my wasllt generatlon and select lfH1 be1t wa,ta m&nageme'11 metl'\OCI
that is available to mo and 1hat I can afford.
Printed/Typed Name Signature
Roger L. Coats ~ ~ Month Day Year
0 7 2 0 8 8
1 A1,;1<nowledgement or Aeceipl of Materials
Name-~
7,1,11, 1 /Sol\
18. TransDOrter 2 Acknowledgement or Receipl al Materials
Prinleo/Typeo Name Signalure
19. Discrepancy Indication Space
20. Facility Owner or Operator; Cer1ilication ol receipt ol hazardous ma!erials covered by this manilas! except as noted in 11am 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete jOHEC 1988 (Rev. 10/86)1
Mon!tl Day Year
rizo 0(\ o 'to
Monl!l Day Year
1 LI .L..1..-'-'--"-'pb!. cJ L J....J..-'-1.J...Jjlbs.
bl ptn.dl pti.
Month Day Y6clt
I South Carolina Department of Health
and Environmental Control
Bureau or Solid ! Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)73-4-5424 J 'ASE PRI~ TYPE (fo,m desioned to, use on elile 112-oitchl tvnew<ite,J Fo,m A ,oved. 0MB No. 2050-0039 E.<pi,e, 9-30-!la
UNIFORM HAZARDOUS ,1. Gonorator'sU.S.EPAIONo. 0 Mnnlfoe:..., 12. Page1 Information in the shaded MUS is not
WASTE MANIFEST N,C:1D,019,7,6101l11 71 l1 l110:co~77'9.0 t1 °1 1 requircdbyFede,allaw.butisbySta\ela .....
3. Generator's Name and Mailing Address '.({~··Menttest Oocumeru Nvtnb«, ,~ ··-.:>=, ;-;-.. ·
Channel Master f{}\:'.}fdfki::i/WYY :.,:,._.,<,:/._:-.-,.=.:=.:--~-: :·:<i;J,.>i)J\:>
P. 0. Box 1416, Smithfield, NC 27577 !i!is1,ii.~11D·/•,.· .-,., ... ",
,. Generalor's Phone ( 919 I 9 34-9 711 frT''.]/if+f:f:-'.:.:-:<<(\\<}/·>',··.:,.--;i.;/::·· · \~-).;;,~J;.;:_~_.c°.'.'· ;'.
5. Transp0r1er 1 Company Name
Willms Trucking Co. Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number C(siii,,f .,,. e JO''' . ·, ,., ·'' ···,·'
1 St C1 D1 01 71 31 71 0t 91 2J '\ -D.:lran•=aPhont· '. Ano 171,7_:1111
8. U.S. EPA ID Number
I I I I I I I I I I I I
10. U.S. EPA ID Number
, s, C, D, o, 7, o, 3, 7, '.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers 13. Total Quantity 1'. Ur.it l'Wl.1UI Pbnbef·······
No. Type W!Nr:A ,·\·. .~\
• a. Hazardous Waste, Solid, nos ORM-E ·,·;F·;·o·jT!'9-i?
~l-!N~A~9~1~8~9 _______________________ _jµ•-1•~l+DJ1~T+.1•_.1-•.1•~2.11~0+-~y-J.~{j.;1=f=':D=•:D=•=6~(Lf1
II f •· , ., -·-"~·,, -· -. ~ I I I I I.;,
..-; ~F
o ~--------------------------------1-L IJtL!-Ll.j_Jt_:ILL'.1'--i~-.j_,'.;':='::==' :::' ::::.1_:"-1
I
I
I
fl C.
. ..
.. ~J ~'~'~~•~I __ ' .. :
I I I I I I I -: ~' ~1~1~~· ~1 :~
d. .-::··i-~T-•.:, ... · j··· ,·:_:=:_
·:. I
15. Special Handling Instructions and Addi1ional ln!ormation
GSX Work Order No.: 83436
16. CENERATOR'S CERTIFICATION: I horoby doclore thnl lho contonts ollhls conslgnmenl are lully and accuralelydoscrlbod abova by proper 1hipping name and are c1eu,l1e,d.
pac,11d. ma,ked. and IBbclcd, end ore In nil rospocts in propor comli1lon for transport by hlghw11y nccordlng to 11pp1lcablo lntarnationol and natlonel governmonl 199ulat1on1 •n<J
tne laws o! the State of South Carolina.
111 am a lan~e ciuan11ty gencretor. I cor1ify \tlBt I hovo o program In pleco lo reduce the volume and lo,:lcltyol westegener11\od lo \he d~ree I have de!ermlnod lo be oconomiulty
practicable and that l have selected the practicable method ol treatment, storage, or d\sposal currently available lo me which minlmlu,s the present and lutura t.rHe,al to !'luman
health and !he environment; OR, if I am a small quan\itygenoralor, I have mado e good faith et1ort to mlnlmlze my waste generaUon and select ttie b<ltt w&1t11 manai;;iomenl m1JU'lod
thal is available to me and \hat I een atlord.
I k-.J....--Pr-in-tod-/T_y_p_od_N•_m_•_R~o~g,e:.!r:..JL~. _S:C20::;:ac!t~s!.-,..,. ___ _L ____ :C.⇒:;i:~-_;-d&:L--.\..(tG_"~-~ -f~.::.._ _____ J •".;~:!.''.J..'111!.7.J.1,~"1:~;!.J, •i.!;!!.~~8~
I
~ 17. Transporter 1 At:Knowledgement ol Receipt of Materials
I Signature -.. I
V'
~ Prin!ed/Typed Name
~ J4 >--I--,... c._ l /? ,:,; <",I·"'-ISig»_ 4
Month Day Year
,0 , ;:\.-<,c1J.:'..c
a 1§. Transporter 2 Acknowlcd9cment ol Rcccip! of Mntcrials Rf.-----'---'-----_;_ ____ _:. _______ ~----------------------------------1 I Signature I _i+_P_,_in-lod_/_Ty_p_od_N_•_m_• ______________ _,_ __________________________ :._o .. n ,111_,J.._D_.,•_Y.._ 1 v_:"'"-i
19. Discrepancy Indication Space
I ~
L •1-----------,----
1 ~ 20. Facility Owner or Operator; Certification ol receipt of hazardous materials covered by this manifest except as noled in Item 19.
Printed/Typed Name I Signature
cc Ac...,,,., i::.;nn.?? /Ar>v <VAm PrP.y1nus Editions arc Obsolete IDHEC 1988 me._., 10/86)1
1 I I I I I I
b I I I I I I
pb!. C I I I I I I l'b1
jlbs.dl111111'D1.
Month Day Yw
J , I , I ,
,-
I South Carolina Department of Health
and Environmental Control
SE PRINT or TYPE (Form desi ned for use on elite 12-ilch ewriter
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
~-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 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
ol
Bureau cl Solid & Hazardous Waste Mi;t
2600 Bull Stree~ Columbia, SC 29201
Phone: (BIJJ) 734-5200
Emergency & Holidays: [phone]
proved. 0MB No. 2050-0039 E.ipires 9-30-ea
lnlormation in the shaded a<eas is not
required by Federal law, but is by Stale ia ......
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity 14. Ur.it :t · w&.1te Number;-:·
No. Type 'lltf'lcl ",:
a.
Hazardous Waste, Solid, nos ORM-E
NA 9189
J. Additional Dmript!om 1o, Materials lisied Al><w1l';L ,
15. Special Handling Instructions and Additional lnlormation
. GSX Work Order No,: 831,37
1 D T 2 0 Y
16. GENERA TOR'S CERTl_f"ICA TION: I horeby doclnro thnl !ho con1onts of this conslgnmonl ere lully nnd accurately described abo..-111 by proper •hipping nama 1nd a,e clasa,11...:1.
packed. marked, and labeled, endue in all rospects in propor condition for lrensport by highway according to opp!lcebto lnlnrnationel and neuonel govemm111nt r~ulat1on1 and
U'le 1ews ol the Stale or South Carolina.
111 am a large quantity generelor, I cortily that I havo a program In placo to reduce tho volume and lo.1dclty of waslo goner a led to the dogree I have determined IO t>. e-conomlcally
prect1catite and that I have seloc\ed tho practicable method of lrealmonL slorage, or dlspoaal currently avoUabla lo me which minimize, the pres.en! end future u,,_, to human
health and the environment OR. ii ram a small quantity generator, t have medo a good faith eNort to mlnlmlza my waste genoratlon and select the best waste rr.anegemenl moU'\Od
mat is available 10 me and tho\ I con otlord.
Printe<1/Typed Name Signature
Roger L. Coats
17. Transporter 1 Af,;Knowledgemenl ol Receipt ol Materials
Signaturo
18. Transpor1er 2 Acknowledgement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
20. Facility Owner or Operator; Cer1ilication of receipt ol hazardous maleria1s covered by this manifest except as noted in llem 19.
Printeo/Typed Name Signature
Month Day Yw
0 7 2 0 8 8
Manni Day Y8M
a ... I .L.J....L....1-'-'llbs. c lw....L.J....L....1-'pbl
b I I'"'-d I I'"'-
Month Day Year
EPA Form 6i00-22 (Rev. 9/86) Previous Editions arc Obsoloto [DHEC 1988 (Rev. 10/86)1
I
~';i';?~~:.
.lt!f;, \ f, \ \ . I • 'i• •• ·~-h ,_,.-~
South Carolina Department of Health
and Environmental Control
Bureau of Solid i5. Hazardous Was:e Mgt
2600 Bull Suee\ Columb;a, SC :mot
Phone: (BOJJ 734-5100
I
Emergency A. Holidays: (803)73-4-5-424
I.EASE PRll'lT or rYPE (Form desioned for use on elite r12-oilchl tvnewriter)
UNIFORM HAZARDOUS I'-Genorator'sU.S.EPAI0No.
Form A roved. 0MB No. 2050-00J9 E..xpire3 9.30.ga
Mnnlfoat ,I 2. Page 1 Information in the shaded a-reas is noI Oocumonl No. of . F·• WASTE MANIFEST N, r,, Tl, 0, q, 7, 6, O, , .. 7, li L,■ O, Q1 71 91 3 1 required by ..... erallaw,butisbyStatela..-.
3. Generator's Name and Mailing Address
Channel Master
P. 0, Box 1416, Smithfield,
•-Generator's Phone I 919 \ 9 34-9 711
~-Transponer 1 Company Name
Willms Truckin~ Co. Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood. SC 29125
NC 27577
t;)~.~~-/i-\\;\;_,•.
,:it~:/)/····,. ·=:=·,:=i:C:l,<",'"' ---. '..) :"::: • •• .-,-·.,. ·-:: •• ::.=-;-:-::'::::'-:", ~ ;\ .. •_.
e) Sla!t ~. I) ; >
\)}JAhftt!i'.i{'.ihKfr~?//K\/\/
. ··'\··;>:''.>=\~·:•❖-:.
:::, .. :~ , ........ ,,,_..·:·
6. U.S. EPA ID Number 'c/siaiiJ.T
S• C• Tl, O, 71 31 7, 0. 91 ?, <> • D.f"
8. U.S.EPAIDNumbor ·;;;':,,..:.::::...::·r° .... sKJ .,.,,. ··, .· .· · .... ·,.-.. ,· .. ··: ·
' ' I I I I ' ' ' ' ' F/'T ,Pi,oo.::;:-,-· · .. ··"'-'0:·.,_., •. ·
10. U.S. EPA 10 Number <is't'iifacmiy',m< ·
, S, C, D1 O, 7, 01 3, 7, '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity t(Ur,il l'W&Stl'Nunbef•·--No. Type WINo :,,,. '·i, ·•; ••}":
a.
' Hazardous Waste, Solid, nos ORM-E
N NA 9189 y
i F j o·,r,g·t:,•,
:~11 ~ IQ IO I 6 I~~:
; I L....J...J._.J,_Ji-.,,.
I ~~t 01-----------------------W___L+_1_W___L_1__1_-1--...i.::.!:::::::::::::=:.::.i
~ C.
' ' ' ' ' ' ~ I
.·: I
' ' ' ' ' ' '
;i
d. ::1
I I I I I I I
-'--''-.,_.,1 : ... I:;~~-
15. Special Handling Instructions and Addilional lnlormalion
GSX Work Order No.: 83438
I .
16. CENERA TOR'S CERTI_FICATION: 1 horoby docl11re Iha! !ho con ton ts ol this consignment ere lullyand eccuraiely described above by proP4r ahippi,:,g nam• and ara clasa,ha-d.
p•c"-ed, marked. and labeled, and are In n!I rospocts In proper condition tor tron,por1 byhlghwoy according to applicable lnternalione! and national go ... ernment re,;ul•t1on1 &l"ld
uie laws ot the Stale ol Soulh Carolina.
II I am a 1ari;e Quan11ty gcne1otor, I cortily ttrnt I hnvo a progrnm In placo to reduce the votume end toidclty ot waste generated 10 the degree I have determined 10 be economieany
prac\lCillb!e and !hat I havo ,otoclcd the practicablo method ol lroolment. :!llor11ge, or disposal currently available lo me which minimize, \he pre:,.ent and tuture u·u-1 IO numan
heallh and the en.,.ironmcnl; OR, 111 am a small Quantity gonorator, I hove modo a good laith etfor1 lo minimize my wa:,tn genorellon and seh,cl U,e 01:11! wa1te mana;iement method
tnat is a ... ailable to me and that I can allord.
l~+---:p,-,;n_,_e<l_/_Ty_p_e<l_N_•m_,2R~o~g;:e::r~L~-~C~o~a!_!t:.;s!_ ____ JlLs_;
9
_n_a,_ur_• __ r:.::_v::;~·~-::::--:e~:::---164d.~!J-<¢--i:::._ ____ _]•LM~~~.l.
th
27~,~~-:~~~1~1;.1.ear·~8~
T 17. Transporter 1 At.:1mowledgement ol Receipl of Materials
lfpr~p'",;'"n,-e<l~/~T~yp-e<l~N,-m-,~~-~--~--~--~l~s~;g-na-,u-,-.-0~/0~-~-cn.,..JL----------------1-\o_n_th __ io-._y--~-u-~r~/
... ....,.,, H-U R1tw ~ "-, ,') p<..,,o ,~o
o 18. TransPClrter 2 Acknowledgement or Receipt ol Materials
I
jf-C"-Pr.::;n:..t.::e<l::./:..T.::yp.::e<l.::..:.N.::a.::m.::,:.::c.::.e.::.::.::..:...:.:.:..::.::c:c..::..:::.::.::.:::..=----~,s-;g-na-,-u,-,------------------------M-o_n_th __ O_a_y ___ Y_ear_~
., I , I . I ,
19. Discrepancy lndicalion Space
I~ L •1---------------
t
~ 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifesl excepl as noted in Item 19.
Printed/Typed Name I Signature
EPA Form 6700-22 (Rev. 9/86) Prev,ous Ed1hons arc Obsolete (DHEC 1988 (Rev. 10/86)1
a I.__L..1...L...L--'-'pbs. e .__I L..1...L...L--'-'pbs.
bj po,. d I pto<
Mor.th Day Yw
I , I , I ,
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia. SC 29201
Phone: (BOJ) 734-5200
Emergency & Holidays: (803)734-5-42~
SE PRINT or TYPE {Form desioned for use on elite f12-citchl tvnewrilerl Form A oroved. 0MB No. 2050-0039 Expires 9-30-sa
UNIFORM HAZARDOUS 11. Genoralor'sU.S.EPAIDNo.
WASTE MANIFEST N,C,D,0,9,7,6,o,, .. 7,
Manlloat 12. Page t
, Eocumenl No. of 1, 4• • ,0 ,7 ,9 ,4 1
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Genera1or'sPhonel 919 l 934-9711
5. Transporter 1 Company Name
Willms TruckinP 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
I s I C1 D1 o, 71 31 71 0, 91 2, ~
8. U.S. EPA ID Number
I I I I I I I I I I I I
10. U.S. EPA ID Number
Information in the shaded a<eas is not
required by Federal law, but is by State la#.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Un11 l 'W&Stll N\.wnbef /"·
No. Type W\/Vc/. .•, .• ,c,i.\
a. Hazardous Waste, Solid, nos ORM-E >jF jO",i·,·9 .. 1}. ..
~ NA 9189 , ,1 D ,T , , ,2 ,0 Y ·. 1F1010161:'i·
'
b. ; I j' -j'J
tii
o ~------------------------------1--L 1 .11-\__l1--\U1L 1LL1L1 -l---+·..!1::::::::=::=:::::..1
';;_.fi
'f
C.
..... ,,,·.
I I I I I ' I
d.
' I I ' I I '
GSX Work Order No.: 83439
,e. CENERATOR'S CERTIFICATION: I horoby declare that tho contonts ol this conalgnmenlere fully and accurately described above by proper 1hipping nam• and •r• claaa,11..:1,
packed, mar~ed. and tabeled, and ore In nll rospocts In proper condlllon !or transport by highway according 10 app11cabla lntarnaUonal and national govarnm1n1 re,g\.llat1on1 af\d
1.na laws or the Sl.lte o! South C:orollnn.
111 am a large Quantity generalor. t certily that I hovo a program In placo lo reduce lhe volume and IO)dclty ol waste generated lo !he d~ree I have de!ermined 10 be oconomiearty
prac11cabte and that I have selected the pracllcable method of treatment, storage, or dlsposaL currently avolteble to me which minimizes the pre:,.ent and lutl.Jre tnr-1 to l'lum.an
l'lealth and the envi,onmcnt.: OR, ii I am a small quantity gonoralor, 1 hove mode a good faith effort 10 minimize my wast& generation and se!ecl ttie best waste mana;,emant methOd
trial is ava;lable to me and that I con ollord. I Prinled/Typed Name
Roger L. Coats
I Signature Montn Day 'fear
10 17 t2, p {!, ,8
T l 7. Transooner l Ac.:1mowledgement ol Receipt ol Materials
llk1~PtrlinLti/(~/T~;PJ~~N~~~mLe_s~-~~~~~/~/L~~$~r~ ___ 1IS_ig_n_•'-u_;iur~•~~~~~/~~J~~~=~~-~~~~~~t~1/~-~---~·~~o~~?~r1~~~Ll·~J'ILi~~~s~
~,1_a_._T_ra_n_,_Po_n_e_r_2_A_c_>n_o_w_1e_d_,g_e_m_en_1_o_l_R_ec_e-'ip_l_o_lM_a1_e_ria_ls ___ ~----------------------------------,---t
"-+--P-ri-nl_ed_/_T_y_ped_N_•_m_• _______________ j_S_ig_n_a,_u_r• _______________________ ,.~_\o-'n-tn...,_D_•_y_.__Y,.ear-t
~ I , I, I ,
19, OilCIIPIMY
l~
L
I t} "2-0-. -F-,-,i-lity_D_w_n_e_r o_r_O_p_e_ra_lo_r_; C-•-n-il-ic_a_tio_n_of receipt ol hazardous malerials covered by this manifest except as noted in Item 19.
Printed/Typed Name I Signalure
c:011. c: .......... i:.7nn.?? /A.-,v Q/Rhl Prr>v1nt1s Fd11!ons nre Obsoloto IDHEC 1988 /flcv. 10/0611
a ._I ,_.__ ........ ._.!lb!. cJ '-,_.__....,_...,!lbs.
bJ jli>s.dJ jlbl
Montn Dey Yw
I , i , I ,
I South Carolina Department of Health
and Environmental Control
SE PRIITT ot TYPE ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Genoralor's U.S. EPA ID No.
N 1: DO 1 7 6 0 l
Manllosl
Oocumnnt No. \/100795
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
,_ Generator's Phone ( 9 1 9
Smithfield,
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
NC 27577
6. U.S. EPA ID Number
S C O O 7 J 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
fluroau or Solid A Hazardous Waste Mgt
2600 Bull Stre-el Columbia, SC 2'9201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.xpires 9.30.ga
Information in the shaded a<eu is nol
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 1 J. Total Quantity U. Unit l W&'Stll tMubw ··· ·
No. Type 'M!Vo :.,,., ... : ' ·,,·•,,.. · \
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T 2 0 Y
:,'.Si F \6ti'J'9J~~-
:.; 1fIQIQ161Y
0.
;. Li --1-L-.1--l
:'11 I~
.-... ·
: ·:IL --'--L--'--'' ·.'.,:·
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83440
1 e, GENERATOR'S CERTIFICATION: I horeby declare that tho c:ontonts of this consignment are fully ond accUralely described 11bova by proper 1hipping name ind are clua,lled,
pac"-ed. ma1ked, and 1a·beled, and are In 1\!I rospec:ts ln proper condition for transpor1 by highway according to applicable lntarnallonat and nallonal go-.,ernment r.;ulallo"• el'ld
uie laws of the Sta1o ol South Carolina.
111 am a largo quanltty generator, I cortily that I have a program In ptaco to reduce tho volume and toidclty ol was1o genera led lo Iha d&gr&e 1 ha-.,e determlne-d to be economic.ally
pract,cab!e and trial I havo solec\od the practicable method ol lreatmonl. storege, or disposal currently avoUable to ma which minimizes the pres.ant and lvture trH-1 to human
r.ea!tn and tho environment; OR, ll ram a small quonlitygenoralor, I have mad a a good taith effort to mlnlmlta my wast.a gonoratlon and sehtCI the bell waata manaQomet\l ,,...thod
mat ia available lo mo and ttie\ I con ollo,d.
Printed/Typed Name
Roger L. Coats
Month Day Yoar
072088
, 7. Transporter 1 At;Knowledgemenl ol Aeceipl of Materials
Printed/Typed Name
t1C S,.
Printed/Typed Name Mon!!1 Day Year
19, Discrepancy lndicalion Space
20. FaCi!iry Owner or Operator; Cer1ilication of receipt ol hazardous malerlals 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 arc Obsolete /DHEC 1908 (Hev. 10/86))
,"i'P7•'f_d' ... ~\'\\\ South Carolina Department of Health
~ and Environmental Control I Bure.au ol Solid & Haz.ardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: (BOJ) 734-5200
Emergency & Holidays: [phone]
I IL.£.lSE PRIITT or TYPE {Form deslaned for use on elite 02-oitchl tvnewriterl
1 UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A roved. 0MB No. 2050-0039 E.xoires 9-30-aa
Manliest ~ 12, Page 1 Information in the shaded a<eas is not
l • 4. ~~c~:n771 ~0~J of 1 required by Federal law, but is by State law. WASTE MANIFEST N, c, D, o, 9, 7, 6, O· 1 .. 7,
It 3. Generator's Name and Mailing Address
Channel Master
A:'f~.~~---
····'···', .-.--= <--:<i-./,.:-~,x:-:f::-:,
I
I
I
I
I
I
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone I 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckine 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• Q, 7• 3• 7, 0. q, ?, Cl
8. U.S. EPA ID Number
I I I I I I I I I f I
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, .
·c}Sblft''i'-., .... • '·-·-·tlD _,: ... ··.•.-·,:=.,_" .
D}T ... •··• •···•Phor>t':i...:A"' 1.7~' ', '',
i= ,Io.·~·~·.:rnt = .... -~-o:
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit l'W&StllNtl'nbef·•···
No. Type 'MN~ •,;::,{}>-}-t/i, :>
d. ;•·:,.
I I I I I I , j I ,•,•:,
GSX Work Order No,: 83441
1 8. CIENERA TOR'S CERTIFICATION: I l'H1rnby doclnrn lhnt lho contonu ol this con■lonm,u,t 11re lully nnd nccurntely deacrlbod above by proper •hipping n•m• and••• cl••••fl.-dl,
paci.e<.1, ma,i.nd, and 1 .. t:,.,lcd, ond nro In nll ,o:,poct:, In propor cond1tlon l011,11n:'lr1ort by hlghwny nccordlng 10 npplicablo ln1i..n11lion11I and naUonal go..-.rnm•nt •~ulaUon, •n<I
uie laws of lho Stato ol South t;arolina.
If I am a 1ar~o quantity generator, I certify the.I I he.vo a program In pie co to reduce tho volume and toxicity ot wastogonorat&d lo tho d&gr&e I have determlnctd to be economic.Uy
practicable and that I have selected tho practicable method ol tre&tmont. storage. or dlspo!lal currenl1y available to ma which minimizes the pre3-11nt and future tnr-1 to hvma.r'I
healtr'I and !he environment: OR, If I am a small quan!itygenoralor, I have made a good faith ottort lo minimize my waste gonora!lon and sotect tho best wa1te management m,etr,od
that is available to mo nnd thnt I cnn nllord,
I k-k-P-ri-nt_ed_'_T_yp_ed_N_•m_,_JR~o~g[e~r_lL.:.· ~C~o:_:;a~t;;;S:.._,_ __ _jll...s_ig_n•_'"_r_• __ r;.,'...,?::::'.~-~ --~·vi:,__~-d.::::,._,.!r..~z":1'-!.:~ -k.~~----..JlML.02.0''.l.'thz.7.!1 '~J.•·S!~~ .;~,:"'1:s4
T 17. Transporter 1 At:Knowledgement of Receipt of Materials v Rl----'--------''-----'-------~----------------------------------1 ~ Printed/Typed Name !Signature \'I Mon:n Day Year ~ 1--~..::::::!::.,,~'=-"'---.:-,~-,;;•, .. •~•iio-.h:.1 • _______ 1__-~.:1<-=·~.o:·=:::_~....:..:,~--s-----------~•oa!J,nc..Llar1..2=:•·!e:10~l'i:"~,'i4
o 18. Transporter 2 Acknowledgement of Receipt of Materials ) Rl---...:.._ __ _;_ __ _;__c_c_ _ _:._:_ ______ ~--------~"--------------~-----------1
·~i-+--P-•i_n_ted-lT_y_p_ed_N_,m_• ______________ ~l_s_ig_n_•_tu_r•-----------------------~•M-o~:~th-..__lD~~-Y-._IY~:"'--t
19. Discrepancy Indication Space .~ L •1-------------~-T 20. Facility Owner or Operator; Certilica1ion ol receipt of hazardous materials coverod by this manifest except a! noted in Item 19.
a,_! .L..L.J-l...J...J!lb1 c ,_I .w...J-l...J...Jpb1
b I pbs. d I pbs.
I v
Printed/Typed Name I Signature Mor.th Day Year
t....1---...,.,.--.,.,-.,,..--,--,-,-,----,.,---,.,..J.:-,------------------"-l,L-ll_J... ,IL...J'-1 EPA Form 6100-22 (Rev. 9/86) Prevoous Editions are Obsolete [DHEC 1908 (Rev. 10/8611
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: (il()J) 734-5200
'
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I
Emergency A Holidays: [phone]
~E PRIITT-:r TYPE (Fo1m desinned for use on elite {12-oi<chl "'0 ewrilerl Form Ap roved. 0MB No. 2050-0039 E.xoires 9.30.sa
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo. Manlleal
1
12. Page 1 Information in the shaded a<eas is not Document No. ol l . Fed I, l,, Q1 Q, 71 91 7 required by eral law. but is by Stale la-N. WASTE MANIFEST N, r., n, O, q, 7-6· O· 6, 7,
3. Generator's Name and Mailing Address
' Channel Master
P, 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone f 91 9 I 9 34 9 711
5. Transpor1er 1 Company Name
Willms TruckinD Co. Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, I llox 255
Pinewood, SC 29125
6. U.S. EPA ID Number 'C}Sttte··.f'· .. ·····,.. ., 9 I{)'~.,; . .,-, ·
•S• C• n, o, 7, 3r 7, 0. 9, 7i <>' o)T . ·,Pho<it',\•·ROOl7F,7.c.'"'
8. U.S. EPA ID Numbor ~•s,·w::o:~·,,!:·;,:··--._;:!!··,-j,-l!Jia!!:'i,.!!......vmr'·~·· ~·!!:· .!.•.!.IO!,_,;;,'::.:_:....:,;,;_;;c..:,_:....:,:;;;_.:..:,_;;-J
• , , , , , • , • , , , F/rnin~·:-:..: .. ~11-Pnoot:_._.,.--.·:::...,-·····.~-,
10. U.S. EPA ID Number @:mt,;~ttt~,:x ' .·. • ci•. f,i:;L .:
, S, C, D, 0, 7, 0, 3, 7, ' ~ a , ~j.5;;';1l;!,~:I :a63;4.s2::.Joch::
11. U.S. DOT Oescriplion (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13.TotalQuantity U.Unil ·L'Wuw-···
No. Type '1/JVo ;,,.,,.,,-;:•.:,,.-'.•<><':.':
' ' '
d.
' ' '
0 I I I
I
'·i···· . ······ .. ~·-.. ,= .'·
1 .• ;
;·,
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 83442
115. GENERA ToR·s CERT1_FICATION; I heroby doclnre th11t tho con ton ts ol this consignment are fully nnd 11ccur11tely described ■boY ■ by pro~r 1hipp1ng n•m• ind••• cl■1a,l1..::I.
P•Clo.ed. marked. and labeled. end are In llll rospocts In propor condition for transport byhighwtiy according to epptlcable lnlnrnetlonal and natlonal QOYOfl"lment ra-gulat1on1 af\d
lne 1a-, 01 the Stale of Soulh Caro1in11.
11 lam a large quantity generetor, I certily \hat 1 have a program In place 10 reduce the volume and lox I city of wasla genera led to tha dc-g,_ 1 have determined to b-e economicelty
prect,cable and that I have selecled the practicable mathod ol lrea!ment, storage, or disposal currently available lo me which minimizes the present and furure ttlroal to l"lvman
health and the environmcnl; OR, 111 am a small quantity generator, r have modo 11, good faith eHor1 to minimize my wa~ta generation and select the best wuta mana-iem•nt ,,,.thod
that is available to me and thnt I con nllord,
I l-
-+--Pr_1,_,ed_,r_y_p_ed_N,_m_,_.:.:.::.!:!.::..:......::.:....:...:..:~::.::..-----j-S_ig-na_1_u,_e __ ,.,,:.,f_ /_.;:::.. ·:::.:: . __ ·_ -' ___ i,;;1..:...., ·.::.. J,:_ ______ ...JM....::onLl/1.:.J...:D;ia_y:.i...:;Yoar~ Roger L. Coats /~Y"-'?--; ~ , 0, 7, 2, 0, 8, 8
,·
T ~7. Transooner 1 At.:rnowledgement of Receipt of Materials ~
IN~sr==~~~~=~======--~~==--~--------------==~-~~
p b-:P;-rin-led_,;:::;::::'~yy/'Jpc.;e~dc~NJJ~~-il.~ft',~,Jf-.,.--:-=----:-:-:-c:"".'-:-:---l ls_1g_n..::aar ~· k'.-fQ_s:..,_,:a. ~tJc.1~ ),,~A}.--------------j 1/>')~:;;•o)~jlh 1'...I' 'bl,,o!J~.!. IYJ...: )g;'::i .. .Ejl 1/
O 18. Transparter 2 AcknowledgJment ol Receipt of Materials // { J ' R)-CC-':....C:.;,:,.:::..:c:..:.::c:..:.:::::..:=====:.:.:.=::.::.:::.:.. __ ~ __ .c,_ ____ _,......,c_;; _________ ~ ________ --I
1-~R+-P,,r.,..in-ted_,_ry_p_ed_N_•_m_, _______________ ls_i_g_n,_,u_r_e ______________________ _:ML...oJ.nth...JL..DJ.a_y..1..Y_earL...-! I , I , I ,
19. Discrepancy Indication Space
I ~ L 11--:---,-----,---------T 20. Facility Owner or Operalor: Certilicatlon of receipt ol h:unrdous m11terlals covered by !his manifest e,:cept as noled ln Item 19.
l y~~~=~=====------1 Prinled/Typed Name I Signature Month Day Yw
I • I . I •
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
Bureau ol Solid & Hazardous Waste Mqt
2600 Bull Streel Columbia, SC 29201
Phone: (BOJ} 73-4-5200
Emergency & Holidays: (603)73-C-5"2C I 'LEASE PRI,;;;, TYPE (Form deslnned lor use on elite 112-pitchl ''"ewriterl Form A• roved. 0MB No.1050-0039 Expire, 9-JO-M
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo. 0 Menll••;, 12. Pagel lnlormation in lho shaded ..-,as is nol
WASTE MANIFEST N,C,D,O, Q, 7, 6, o, 4, 7, !, 4,o:0~779.°sl 01 1 requiredbyFederallaw,bulisbyStatelaw.
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3. Generator's Name and Mailing Address A{~-~--~Nurober>. :=;··;-;:,,_,_i\>=°:'·
• Channel Master •YX/if · ,•-::-?-i'.h ;.;;:>.:::
P. 0. Box 1416, Smithfield, NC 27577
•· Generator's Phone I 919 I 9 34 9 711
5. Transponer 1 Company Name
Willms Truckino Co. Inc.
7. Transpor1er 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• Dr Or 7r 31 71 Or CJ, ?r °' ·
B. U.S. EPA ID Number
' ' I I I r I I r ' '
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1,. Unit t·w&it.Nlauber'-:~-
No. Type 'MNrJ ···?/\':>'.{S°:i:'/\:~<'.:,:-.:
I~ a. Hazardous Waste, Solid, nos ORM-E ;fiFjO,'ffgf~
I A
i 1-b-. ..:N:'.A:__:9:_:1:.:8'..:9'..._ _______________________ W•L· ...l't.l_j:'.D.J't.T_j...Jl_jl_j•;:2J'.'.'.0...j.....:Y_j_:::>~; '::::::.~:::?:::':::0:::~_::,6_::_'..LJ3
.:;~ I I I I I"'~'.
T ~ I
Ol------------------------------~-.J-J1
_
1Lj__L1.j_JILL'L'J'-1--.J-'~'=:=::::::::=.1.:::'•~·-
I R~~ _______________________________ J_j•_:0L!..-L•..\.......11LL1L1 J1_J~-.L"~'===="=·:Jt~;
I
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I
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No,: 83443
1'5. Ci EN ERATO R'S CERTIFICATION: I harebydec1ara thal Iha conlenls ol this consignment are fully and accurately described above by proper ahipplng name and are cia...ne>d,
I packed, ma,~&d. and 1a·belcd. and are in an rospecls in proper condition tor transport by highway according to applicable International and national goyernmanl r~ulatlona ar,cl
the laws ol the State or South Carolina.
111 am a largo Quanltty generator, I certify that 1 hsvo a program In pin co lo reduce the volume end loxlclty ofwnalegenernled IO the degr-,.e 1 have dotnrmlned to be economic.Uy
I' pr■chcatile and \ha! I havn ,elected tho practicable method ol lroatment, ,tor age, or dl,poa.al currently available to me which minimize• the pre>enl ■nd future trlr-t to human
heo!th and tho environment; OR, ii I am a smell qunntitygonoralor, I have mado a good faith effort to mlnlmlte my we,ta generation and ,elect the beat waste management ""9tr'Od
trial i, availabl11 to mo and thnt I con nflord.
I r--+---Pr-in-ted-'T_y_p_ed_N,_m_,...,;R:;,0:;;>.11,;;ge.:r...:L;:,;·:,._C:;;o;;;;:a.,:t;:;s:,._ ____ .1.. ls_ig_n•_'_u,_•_,,:_~,;;,.;,.,,1:,[;:; 9•::;.::; A~~~;:;,..;;.·_.,;~;;;;,::..:;;.:;;.. ______ .. 11,1.,;i;.' ~1.lh;.7~ ,;.1~.:~.;'1.8;.~~ .. s~
T 17. Transporter 1 Ati<nowledgement ol Receipt of Materials r f/ ~ .,,,
IAR~f-'-::--:'c--'~'--':':-:'---"-'-=':_='-'="-'-'-'-'-'-"'=.;_~-,=---t+-----;r--,''---:,r,-----,.,-,--:----,:-i Prin)Od/T~N~. / ISignlt re_~/. / / ,/,/ / Monlh Day Year
P bV~r..,,:µV-~~;;;;-~ ,/'!A!,,',;JT::,/Z,H~-ff;?27~",,_,/;}:£,:~/h~v,/Z~e--~'~~-_l--,4,"a.~-;z..;-11-'~~ ,..A~::::~~~/~ £./:::;t;i._ ____ _Jt:Jl::::'...1.: ,)::'.)11_::'.'..:Z~,o::.iri~.r.:J~--
o 18. TranSporter 2 Acknowledgement of Receipt ol Mtllerials / 1 I / ./ .//
I ~A i-.:_:::..,:Pr:.,:in::1::ed::/::T::yp:::ed.:.:.N::a::m:::c:.::.:::::,::::::::::::c:::.:..:::.::::2::.:::..:::::::::::::.... ___ -rc IS"'ii!fi ~n!.n,-u-,c-...:...~------~.£-....t.~----------M-o_n_lh __ D_a_y_,..Y_oar-1
I , I , I .
•~ I
L •t-------~-------
1 ;:: 20. Facility Owner or Operalor; Certification ol receipl ol hazardous materials covered by lhi3 manifest except as noted in Item 19.
Ptin!ed/Typed Name I Signature
FPA Fnrl'1 6700-22 /Rcv. 9/861 Previous Edolrons arc Obsolete IDHEC 1988 (Rcv.10/86)1
a ._I ._._......_._,Pbl. c! '-L...L.JU-..l..Jl'b!.
bi jlb>.dj jibs.
Month Day Yw
I ' I ' I '
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: (803)73-t-5424
IPL.EASE PRINT or TYPE {Form desi ned for use on elite 12· itch writer
UNIFORM HAZARDOUS I. Geno,alo,'sU.S.EPAIDNo, Ml!lnlhnil
Document No.
Form A roved. 0MB No. 2050-0009 E..tpires 9-30-aa
2. Page 1
of lnlormation in lho shaded a1eas is nol
required by Federal law. bul is by Stale law.
I
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T
R
A
N s p
0
R T
E R
p
A
C I
l
I
T V
WASTE MANIFEST N c n o 7 6 o 400799
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Gene,alor's Phone [phone]
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 0 7 3 7
8. U.S. EPA ID 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
GSX Work Order No.: 83444
A/i!WMlinifasi Oocilri>onl -: i/'.fa\{£~);:tp·
12. Containers 13. Total Quantity U. Uni1 t· W&Stll Nll'Dblir :·-:·;·
No. Type 'M!VrJ < •·,><:<"i-ti;t,k'.i
18. OENERATOR'S CERTI_FICATION: I horobydoclaro that Iha contont1 olthl• con1lgnmontara lulty and accuratolyd111crlbod aboYO by proµ.r 1hlpp!ng n,ma 1nd •r• cl•1 .. ha4.
p•ckod. marhod. and labeled, end are In nl1 rospocls In propor condition for transport by highway according to applicable lntarnollonal and naUonal go ... arnmont r~u1at1or1, arid
ll'le laws ol tho S\J\hl or South Cnrollnn.
111 am ■ largo quantity generator, I certify !hat I ha Ye a program In place to reduce tho YOlume and 10.-.lclty olwaata generated to Iha degr-I ha Yo determined to b<I a,eonomlealty
prac11cable ar1d lhat I haYe selected the practicable method ol traalmant, :storage, or dl:spoael currently ayoilablo lo ma which mlnlml1111 the pra"9nt and lutur• thr-1 to human
heallh and tho enYironment: OR. ii I am a small quantityganarator. I ha Ya made a good faith aNort 10 mini mite my wa:sta generation and select the boa1t wa,ta management m9U'IOd
tl"lal is aYai!able lo me end thel I con afford.
Printed/Typed Name Signature Month Day Year
Ro er L. Coats 0 7 2 0 8 8
17. Transporter 1 Ac;Knowledgement of Receipt of Materials
Prinled/Typed Name Mon!h ~
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
I I Jib!. ' I Jlt\
b I pt,,, d I /lbs.
XI. Facility Owner or Operator; Certilication of receipt ol hilzardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signalure Month Day Year
~E~P•A-:F:-o-rm-=s-::10=-=0:-.:-:22:-(-:R:-e-v _-:g:-, B:-:6::-)-:P-,.-v:-io_u_s-:E:-di.,.,ti-on-,-,-,o-=o:-bs-o:-lo:-10""'.':ID~l~IE,:C:-1-:g:-o:-s "'(R'"o-v.-1-=o-, 8:-:6::-) l~---------------"l....l....1...J....J......L....I
I
\. . . .
South· t':arolina Department of Health Bureau ol Solid & Hazardous Wa.ste M;t
2600 Bull Streel Columbia. SC 29201
Phone: (BOJ) 73..4-5200 and Environmental Control
E PRltiT or TYPE (Form desi ned for use on elile 12-itch ewriter
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
NCDO 760
1 Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
•· Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Faci!ity 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
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 Propar Shipping Name, Hazard Class, and ID Number)
a.
is. Special Handling Instructions and-Additional lnlormation
GSX Work Order No.: 84439
Form A
2. Page 1
ol
Emergency & ~olidays: (803)734-5-424
roved. 0MB No. 2050-0039 E.xoires 9-30-aa
Information in the .shaded a<eas is nol
required by Federal law, but is by State la ...
F.>T opt,ooot·
ti.fsia\e' F 11cility'o ID itP,/Y:i.Nit/i>·,'\:/f.;·,:,
12. Containers 13. Total Quantity 14. Unit l W&.tf8 Nt.rnbel' ;-;:
No. Type Wt/VcJ .,,.,,.,/!,
1e. GENERATOR"S CERTIFICATION: I horoby declare that tho contents ollhls consignment are luUy end accurately described above by proper 1hlpplng n■m■ ■nd ar

■

clas.,fl■<I.
packed. marked. and libeled. and ore in 1111 rospocts in proper condition for transport by highway according to appllcable lntornational and national go-,ernmant r.-gulaUon, and
tne laws of the State o1 South Carolinn.
111 am a large o.uanlity generator. I certify \hot I hevo a program in placa to reduce the volume and loxlclty of wa,111 generated to the degrtH1 I ha"e determined to bet oconomically
pr11ct1cat1!e and that I ha-,a selocted tho practicable method ol lroatment storage, or dlsposal currently available lo mo which minimizes tho pras-anl and future lt'lraat to human
health and tha environmenl; OR, ii tam a small quantitygonora!or, I hove made a good faith oMort to minimize my waste genorallon and select trio t>c,st waste management melt'lod
mat Is a-,ai!able to mo and that I con aMord.
Printed/Typed Name
Charles R. Hansen
17. Transponer 1 Ao,nowledgemenl ol Receipt ol Materials
Printed/Typed Name
I
19. Discrepancy Indication Space
Signature ¾,J,
Signature
/ -
I I
,. b I
20. Facility Owner or Operator; Ccrtifica!ion of receipt ol hnzardous materials covered by this manifest except as noted in Item 19.
Prin!ed/Typed Name Signature
Month Day Year
0 8 0 3 8 8
Month Day Year
Monttl Day Yea,
Jibs. ~ I !tbs.
pt,,. d I pt,,.
Month Day Ye.a.r
EPA Form 8100-22 (Rev. 9/86) Previous Edilions nre Obsolclo [DIIEC 1908 (11cv. 10/06)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree( Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: {803)73-4-5-424
I '.Lc:;E PRINT or TYPE (Form desloned for use on elite [12-oitchl tvnewrilerl
UNIFORM HAZARDOUS I'· Gonornlor's U.S. EPAID No.
Form A roved. 0MB No. 2050-0039 Expires 9-30-sa
Mriinlrost ,2. Page 1 lnlormelion in the shaded .weas is no1
required by Federal law, but is by State ta .... WASTE MANIFEST N, c, n, o, <J, 7, 6, o, 1,. 7, Doc ()11r11nnl No]. ol I,/,.(), 1, 8, 0, I
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generalor'sPhonel 919 1 934-9711
5. Transpor1er 1 Company Name
Willms Trucki nP Co. Inc.
7. Transp0r1er 2 Company Name
9. Oesigna!ed-Faci!ity Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
·arsiaii~.11) :i:,c.. . ., ,,,Y.•;;;.·,,· .
Nfc'ifaXLlMtii)lhi/i)~\ (F\ 'f ·_-); :' / :,: ,./\i;;,:J ./,J>( :·~:.:.
8. U.S. EPA ID Number
I I I I I I I I I f I I
10. U.S. EPA ID Number
, S, c, D, o, 7, o, 3, 7, '
11. U.S. DOT Description (incfuding Proper Shipping Nc1me, H,uard Class, and 10 Number) 12. Containers 13.TotalOuantity 1tUnit l'W.,.tunber'/··
No. Type 'MNr-J · .... :•,>· · .. : .. ,-~~''<
a. Hazardous Waste, Solid, nos ORM-E XiFjO'il,'9r~'.
N i-_:N:_:A~9:_;l_:8:_:9:._ _______________________ µ,u,L:l+D_J1L:T+-1•_1i_1,_::2_1,_:::D+..:Y-J.:.)'!.:i i:::E::;:1;::0::;:1:::D:;:1:::fi:::•.:q0i
I J b. .'~. ~,,.-.<=;--··-1:·-,~ -,~:
t /ll I I I 1¥ o i.._ _____________________________ .j_J.l_jl_jL;IL;i.._1LL'L'L'.j_ _ _j_;..:::::;::::;:::::::=.;.:..j
t R C.
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d. : ... ' ., ....... , .............. , ::·.:L-. I 1:· .. \·:
··.~-I I I I 1·:"}
15. Special Handling Instructions and Additional Information
CSX Work Order No.: 84440
1e. GENERATOR"S CERTIFICATION: I hereby declare the I lhe conlents ofthl, conslgnmenl era fully end accurately ducribod abova by proper 1hipping nam• and are clas..lleod.
packed. markod, and la.beled, and ere in A11 respects In proper condition for transport by highway according 10 applicable International and natJonal go.,.ernment r99utation1 ar,(1
I . tria laws or the State ol South Carolina. ·
111 am a large Quantity generetor, I cer1ity that I have a program In place 10 reduce the volume and loxlcltyol wasle ganera1od to the dogree I have determina-d lo b4t economically
practicable and that I have selected lhe pracucable method ol treatment ,tor age, or dlspos.al currently available to me which minimizes the pre~nt and lurure tr1raat to tluman
health and the environment; OR, II I am Q smoll aiuontity generator, I hove made a good laith effort to minimize my waste generation and select the best wa,ta mana1,amenl method
thal Is available to me and th11,t I con 11,llord.
11 .•J-+_P_•_:in:.'.ted:.'.:.IT;_y:,p:ed.:'.N_•_:m:_:e~:'.::'.,::,:'.:~ _________ 1_si_g_n,_1u_,_•J'.'.:.: // .. '~ ,/~~~ /~....:,:'.$._...,..{:1~::;::;;!;:;::==:=----...l...:'.J~J..;:.i..;:~:.i.,::j ~ Charles R. Hansen f',?,_,._v<,.,
T 17. Transporter 1 A<.:Knowledgement ol Rccefpl ol Materials ,,/
,,l-'-'-;/;,~,in~:~~~j:_~•d~N~am~e'-=£T~ .. )../='-',/l:.:C.:.:.'/=-.p~6,~~.::......;__~,=s;g-na-tur-~----h7,//L,,,-.---A-.,,.---------:---::-.,,--i
;f' JL.. Month Day Year
,o,s,o,3,s,s
-
~/)
' to~ D)i,'p; ~
; ,
o 18. Transporter 2 Acknowledgement or Receipt or M.11eri;ils t1/ Rt---------~----~--------,---------------------------,-,----::---:-,---1
f-1--P-•i_n_ted-lT_y_p_ed_N_,m_• ______________ ..Jl'-S-ig_n_a_\u_,• _______________________ ..__.__._,_._..._-i
19. Discrepancy Indication Space
--
Month Day Yeat
I ' I , I ,
I ~ I I I I I I I Jib!. ' I I I I I I pbl.
•, b I I I I I I P"'-d I I I I I I pi,,.
I 1---------------
T 20. Facility Owner or Operator; Certifica!ion of reccipl or hazardous materials covered by lhi.s manifesl except as noted in Item 19.
1
~1------'-----'-----'--~---'-----'--------
Prinled/Typed Name 'Signature Month Day Year
I I I I I '
EPA Form 8700-22 (Rev. 9/86) Prev1ous Editions .:ire Obsolete [DHEC 1988 (Rev. 10/86)1
I
I
I
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Str .. \ Columbia, SC 29201
Phone: (80J) 734-5200
Emergency & Holidays: [phone]
1£.ISE PRINT or TYPE {Form desioned for use on eme (12-oilchl tvnewriler) Form A roved. OMS No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS ,,. Generalor'sU.S.EPAIDNo. Q, Mnnlloe~ 12. Pagel Information in the shaded a<eas is no1
'
N
' 0
WASTE MANIFEST N,C,D,O,q 7,6,0,4, 7, I, 4,u~co;"1i7'0,0 21 °1 l requiredbyFederallaw,butisbyStatolaw,
3. Generator's Name and Mailing Address i{~·;-~-~ Numb« -.: ;>;pi=:",\\:•,~·;,-.. •
Channel 'laster ;\\.--:.:.-;-.-/:f._ .,,./.).:.:.• .. t .. •.i.t.·:_::.,·.:,.· .• , .. : .===.· .. • ...... ·,··,,·· .. , · · -.--·· __ :;·, · ·· /.
1· <=:".::i=•:Ci,::)"c\:,;,.:, ' :-· .. H-;-:;:·:;: •,·'·'.('.'.•i•::: •. ::·.:r::-,i::'-;•(,i-Y · .,.
P. 0. Box 1416, ,Smithfield, NC 27577 i\Jsliii.'~slli·/••.i .. ,\:•ce,.,. :,•··P:•,g.•·'.";'
'-Generator's Phone { 919 ) 9 34-9 711 KHtfN{WfoHidJ/!iJ\ PHi\i.'}(/Jffri }i\):?)VJ<; ... tf
5. Transporter 1 Company Name
Willms Truckin~ Co_ Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
CSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
6. U.S. EPA 10 Number
IS I Ct Do 01 71 31 71 (), q, A (\
8. U.S. EPA ID Number
I I I I I I I I I I I I
10. U.S. EPA ID Number
·c/si.1i>' · ..... "' ·· ,o' · ··· •.·· ., ·• .· , .,, ..... , ..
or.r ,.,,f>OOM.· .. :,Rn,11,;7 .1111
.r?,-ai·~-hi.'.i' ...,_ · a O ., . .. . .. -,.;-.. ,., ·.:·
FXT ······ .... 9·•Phonf· . .< .. , .. :,.·, ,_~_.,,.'.·.,,:···.·
~::0itt!~'7\'~/i., · . · .. :ii+.:: ;.
I Sr c, o, o, 71 o, 3, 7, ~ a , ~i#:lL~~;~{iC:::::l6:iJ4;2I~6cl'f:i,'
11. U.S. DOT Description (including Propor Shipping Name, H,1uud Class, and ID Numbor} 12. Containers 13. Total Quantity 1 ◄.Unit t·wa:ste~,::-.
No. Typo 'MN~ , · ... ,. ·.·-\·· '..: :.1<?
a,
Hazardous Waste, Solid, nos ORM-E
NA 9189 I 11 D 1T I I 12 IQ
)'j F I O'!l i9c1'•:c\
;-'«'.:
y Xi1F1a,0161~r
b,
I r I I I I I
C, =·=' I I I I:
I I I I I I I ::JI I I J
d.
... · ............. ,..·:··· ...
:=·.:1 I I I j·):•
,.,. >.-.• ,,
I I I I I I I ·"i:t I I I i:h
CSX Work Order No.: 84441
'
,e, GENERATOR'S CERTIFICATION: I hereby declare lhel lho conlonls ollhls consignment are fully end accuralolydeacrlbed above by pro~r ahlpplng name and are clase1fted,
packed. marked. and 1a·beled. end ere in n11 ro,pecls in proper condition for lrenaport by highway accordino to appUcable International and national go'lernment t9\1ulatlon1 al'\d
V\e laws ol tho Slate or South Carolina.
\l I am a large ciuantity generator, I cer1iry that I havo a program In place to reduce the volume t1.nd loxlcltyol waste generated to the degr01t I have determlnod to t,e, ec:onomie.Jly
practicable and that 1 have selected lhe practicable method ol treotment. alorege, or disposal currently available lo ma which mlnlmlzu the presant and future thre.at to human
health end tho environment OR, 111 am a small quantity generator, I heve made a good faith a Mort to minimize my waste gonera1Jon and solt1ct tl1e belt waste manar;it1mon1 metnod
ttlal is availabl8 to me and 1hat I can afford.
11 Printed/Typed Name ISignalure /?/ ,,f• 1 / Month Day Yea1
~1---~C~h::;a:::r~l~e;;s~R~-:..,.!H~a~n~s:!e;.:n~ _____ .J. ____ ...J.:.:;½::e;;~;!!;:;-_J,:!::,:·:,_.!,/f_~· :.,_~)'.';:14..:i:,''-;:;;:;::::::=:=::.. ___ .L: 10!J.,,J8~, ,~O!J.,..;;3!Ji 1.,:8~, ,.,:8~
T 17. Transponer 1 Ae;,mowledgement of Receipt of Materials
lijl--P-rint-edl-Ty-ped_N_am~Cv.~•L,'l~:u/,1/~e-Lr~,~ll~.~/(_ilS_ign-alu_,.~W,~,;,d~·~;~n'..__~~.~b~~/2~~-ll~~#.~6~8d......~:~/,/~~~AaD•~~~~YJCl.ju~r
O 1 S. Transporter 2 Acknowledgement of Receipt of Materials
I 11--Pr-in-ted_l_T-yp_ed_N_a_m_e_--=----~--------,-,S-ig-na-l-ur-e-------------------,------,-M-o_n_th_-,D_a_y_Y"ear-'1
.., I I I I I I
19. Oi5crepancy Indication Space
I ~ L
I 1---------------
I I I I I I I
b I I I I I I
pbs.cj11111!lbl.
pbs.dj11111Jlbs.
T 20. Faci1i!y Owner or Operator; Cenilicalion ol receipt ol hazardous ma!eria1s covered by this manifest except as nolad in Item 19.
I Yl-----'------'--~---'----'-------
printed/Typed Name 'Signature Month Day Yea!
I , I , I ,
EPA Form 6700-22 (Rev. 9186) Previous Ed1t1ons are Obsolete IDHEC 1988 (Rev, 10/86)1
I
I
I
,QJ-~.~-
/~•,:/\ ;/ ~ ~ \
~ . .tc.J '.1 ~--~, ~
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Str~l Columbia. SC 29201
Phone: [phone]
•
!'.ASE PRINT or TYPE (Form desig~ed !or use on elite [12-pitchl tvoewriler)
UNIFORM HAZARDOUS I'· Gonoralo,sU.S.EPAIDNo.
Emergency & Holidays: (803)7l4-S424
Form A nroved. 0MB No. 2050-0039 £,:pires 9-30-88
Mnnllo91 , I 2. Page 1 lnlormetion in the shaded a.<ea, is nol
WASTE MANIFEST N, C, D, O, q, 7, 6, O, b, 7, 11 Lu 0(1c0,m&I (t·_i ol 1 required by Federal law, but is by State law.
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield,
(, Genera!or'sPhonel 919) 934-9711
5. Transporter 1 Company Name
Willms Truckl.ni, 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 ID Number
, S, c, llt o, 7, ), 7, o, 9, 7J C\ • 0, TrnniM<IM'a Phont
8. U.S. EPA ID Number ii/o,•;,;Tra•.;;;.,,;.,,a lO:•. ,, · .·, . · · ···
I I I I I I I I I o O I F(,rninti~e: Phooi, ,,)._ :c-,,-. · .-_ .... ·:·· .. ·: .... •·='>~,--,,.-'< ,., ·
10. U.S. EPA ID Number i1ii~i,1t~~•i'10 ..... ,. ·•· .·. • .. •·· : ,. ;, •• \t:1 •• :
, S, c, D, o, 7, o, 3, 7, '. ~ a , i!1¾=i!~lif:!::tl1tit:;?J; 2s:~,g§1i;r,).
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity U. Unit l 'W&"Sbl Nlnbef :·-/.
No. Type 'MNr:A /:-/~.~
' L Hazardous Waste, Solid, nos ORM-E
N NA 9189 I I ,2 IQ y
b. ';j· I ,-~ . .-·.:::....:.:v~ .. j'.;,
/,~~~~~~,
O 1-----------------------------------1--.L '-'L.j...J'LJ-.L '.J'LL'J'LJ-_-4-;_:-f_:'==::::::::::::.;17;;,{-'.
' C.
' ' ' / I I I
d.
' ' ' ' '
15. Special Handling lnstrucbons and Additional Information
GSX Work Order No.: 84442
,e. CEHERA.TOR"S CERTI_FICATION: 1 horebydoclare the! !he con Ion ts ollhis conslgnmenl are lully and eC:curately described above by prop-or shipping nam■ and ara clasa1fted.
p1c:k1d, marked, 1nd h1belcd, end are In 1111 ro!pec11 In proper c:ondlUon for lrensport by highway according 10 applicable International and nauonal governm1n1 r~ulallona af'\d
tfle laws 01 the State ol'South Carolina.
It I am a large quantity generator, I cer1lly th al I have a program In pie co to reduce the volume and toxicity ofwutegeneralod lo Iha d&Qr&e 1 have determined lo be economlcally
pract,cab!e and that I haYe ,elected tho pracl!cab1e method of lreatmont, :itorage, or dl:iposal currently available to mo which minimizes the pre$-&nt and future uir-1 to hurnAn
tieelth and the environment: OR. ii I am a small quantity gonorator, I have mado a good faith etfort to minimize mywa:,ta generation and :,elect ttie best waste manaQemenl rr,etr\Od
trial is t1Yailable to me end thet I can allord.
11 Printed/Typed Name I Signature /? _/.i,,. / .~ ~ .J / Month Day Ye.a,
. I Charles R. Hansen r,,fa_l, A 1 ~ , 0, 81 O, 31 8, 8 H---==~c...:.:.;_;=.::..:...;_ ____ _,_ __ .i....:;.;;..;;._.;__'""'--..'--=;..;..;---.;a...--'--'"'-"-'..;;.i...;.i..;...;,i
T l 7. Transporter 1 At.l(nowlcdgement of Receipt of Materials ·
t ~ Prinled/Typed Name I Signature d:; ~ 0.-.iQ .,,,.-::.7 Monl11 Day Year
~ l-,--"J:.cl)_;:,0Z!_)7_£t;/..:.lcY:::_t.:_r?.:_-;:_//;.::C1.!!_::_I _______ _L __ ..:,.l..../,,::..!:=------·==-~-=-----=·~=--------.J.'C)=-•.L 1.!?lu.,:0:.1•1.:::.S.L Ii.,_·~~
O 18. Transparter 2 Acknowledgement ol Acceipl of Materials
A f--,--'-,.,C:..::...;_.....:=_:......:___c.:.:..c..:___c..c__:_ __ _,,_---,--------------------,.,---::--:-:--1
J
T Printed/Typed Name !Signature· Month Day Year
~--,_ ______________ .,__ _________________ ..__.,,__.,_....,,,_~'
19. Discrepancy Indication Space
I~ L
I r---------------
1
-~ 20. Facility Owner or Operator: Certificallon of receipt ol hazardous malerials covered by this manifest except as noted In llem 19.
Printed/Typed Name I Signature
EPA Form 6700-22 (Rev. 9/86) Previous Ed1hons arc Obsolete [DHEC 1988 (Rev. 10/86)]
Month Day Yw
I , I , I ,
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardou5 Waste M9t
2600 Bull Streel Columbia, SC 29201
Phone: {803) 734-5200
SE PAINT or TYPE (form desi ned for use on elite 12-itch ewriler
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N r. n o 7 6 o 1
l Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416,
4. Generator's Phone ( 9 I 9
5. Transpor!er 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Oesigna!ed Facility Name aryd 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 10 Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and (D Number)
..
Hazardous Waste, Solid, nos ORM-E
Emergency & Hol;days: (803)734-5-424
Form A roved. 0MB No. 2050-0039 Expires 9-30-sa
2. Page 1
of lnlormation in the shaded a<eas is no1
required by Federal law, but i, by State law.
12. Containers 13. Total Quantity ltUrii! l'WISl9_~';/:
No. Type 'MNcJ. ·-\i.(\L·>·•':(~
N f-~NA'.:.....:9:..:1~8..:.9 ____________________ .j_LJ:._l .j.'.D:'...l.'.T-4-LLJ::..2.104 ....'.Y-4,:.:.:::::::::::=:::::::.:.,
,,:, .. ;·,._\,->..--~ .... ,.~
b.
) I :\~'
ol--------------------------1-..L.Lj_.W-1._L--'--.J__-+-_j_.=::::::::::::::::.;;;;:J
t.
d.
£'.~~'. ~~~S0,0ri~'.~,if 1~;~~i~;~!J::!l:\iij~:11i:iiji.;i~«~1~)l~~g:1\l::i1l~:i!:i~4,1.~ji1~rti:~ii.fflJI
a.lE..ilij-/012171714l-/11l10121,fVti c.LLJ-1 1-1 I:::
1-1
,,,, ,,,, ,,.,~.-,.,.~~-,•~· w,·,••.•,w--· b. l.l,J-:-1 I-! I
15. Special Handling lnstrucb'ons and Additional lnlormalion
GSX Work Order No.: 84443
115, O£N~RATOR'S CERTIFICATION: I hereby declare Iha! !he con1on1.s ol this con,lgnmenl •re fully ■nd eccuretoly do1crlbed ■bov ■ by proper ,hipping n■m• and••• cl••••had,
p•ck.od, m~uked. and le.beled, and are In 11!1 ro,pects In proper condition tor lranspor1 by highway according to applicable lntarnatlonal and neuonal go.,,ernm•nt r■-gulatlo,.., ■rod
I.he laws Ol the Stale ol Sou!h (;aroUna.
111 am a large quantity generator, I cor1ify tho I I have a program In place to reduce the volume and 10,:lclty ol wa■te generated to the dogr-I have detormln&d to b-11 economic.ally
pr■chc■

b
l
e

and th1t I hav• ,eiecled the prectlceble method ol lrealment. slorege, or disposal currently avel1eble to mo which minimizes tho prewnt ■nd run.ir• thr-1 to human
heatth and the environment.; on, 11 tam n smnll quontity gonom1or, I hnvo modo o good loith ertort to minimize my wa:!11.e generation and ,elect the beat waSle managemen1 ~tr'lod
the.I is available to me end tho\ I con ollord.
Printed/Typed Name Signalure Month Day Year
Charles R. Hansen 0 8 0 3 8 8
17. Transponer 1 hKnowledgemenl ol Receipt of Materials
SignaIu1e
Signature Monttl Day Year
19. Discrepancy Indication Space
a I jlb1 C j jlb1
bj pt,,. d I po.
20. Facility Owner or Operalor; Certilica!ion of receipt ol hazardous materials covered by lhis manifesl except as noted in Item 19.
Printed/Typed Name Signature Mon!J'l Day Year
EPA Form 6700-22 (Rev. 9/86) Previous E~ilions are Obsolete [DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haiardous Waste Mi;t
2600 Bull Stre,e~ Columbia. SC 29201
Phone: [phone]
LEASE PRINT or TYPE (Form desi ned !or use on eme 12-itch ewriler
UNIFORM.HAZARDOUS 1. Genmato,sU.S.EPAIDNo.
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
•.Generator'sPhone 919 934-9711
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, I Box 255
Pinewood SC 29125
•
NC 27577
6. U.S. EPA ID Numoor
S C D O 7 3 7
8. U.S. EPA ID Numoor
10. U.S. EPA ID Numoor
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
Hazardous Waste, Solid, nos ORH-E
NA 9189
Form A
2. Page 1
ol
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Expires 9-30-M
lnformalion· in the shaded a<ea.s is no1
required by Federal law, bu! is by State law.
12. Containers 13. Total Quantity ltUnil l'Wab!Nc.rnber\:,
No. Type 'MN~ \(:;i/,.'.:,_\·!.;'.:{•\J!i
1 D T 2 0 Y
-, ts&.~.~::13·~~:~i~,:01~~1:~!~~li~j1i:1tiiii.i:~tl!ii1!!:!::j~,~1s1:1i~.!1!,1~i:ii:i1l,!•i~~1:1!~~1~
a. l.r__ilij-I0 I 2 I 7 I 7 1 4 1-11 I 1 I O I 2 ! : ·;)iii . c. LLJ-1 1-1 I h!
b.l_u-1 1-1 .... ,ti:;i,!Jjli:,:lL~W:J 1 1 ....... J=.[, 1
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84444
16. CiEHERATOR'S CERTIFICATION: I horeby declare Iha! the contents ol this conslgnmenl are lully and accurately described above by proper shipping name and are cla.,,..tleod.
pacl..ed. marked. and la°belcd. ond ore in All rospocts in proper condition !or transport by hlghwny according lo opplic..able International and nallonat government re,outallons al'\d
!/"la laws of Iha Stale ol South Carolina.
If I am a large quantity generator, I cartil'y \hat I have e program In placo to reduce !he volume and toidcltyol waalegenerelod to the d99r-1 have datarminltd to~ .conomic.ally
prachcable and that I have selocled the practicable method ol tre&lment. storage, or dlspoaal currently available lo ma which minimizes the pru,.ant and lul\Jra tf'\rut lO l'luman
health and 1h11 envuonmcnt: on, I! I am n i;mnll quonlily oonorntor, 1 hnvo mndo a oood lnilh ellor1 to minimize my was!.& genorntlon and select the bes! wa,111 managemanl '""'tho<I
t1'al is available 10 me and lhnl I con nl!ord.
Prinled/Typed Name
Charles R. Hansen
Signature Month Day Year
080388
17. Transporter 1 At:rnowle<l9ement of Receipt of Materials
Prinled/lyped ~fame
f,J
Montt, Day Yo.,
8 8 -:J
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
20. Facitiry Owner or Operator; Certilicallon of receipt of hazardous malerlals coverod by this manifesl except as notod In Item 19,
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions arc Obsolete {OHEC 1988 (Rev. 10/86))
I
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: (8-03) 7:14-5200
Emergency & Holidays· [phone]
~ ASE PRI,;;::, TYPE (fo,m do,lnnod lo, use on ollte r12-nltchl •·•owdic,} Fo,m A• ,ovod. 0MB No. 2050-0039 E,pl,es 9-JO-ea
UNIFORM· HAZARDOUS , 1. Generator's U.S. EPA ID No. 0 Ma~!;;~~. j 2. Page 1 lnlormalion in the shaded M8.!IS is not
WASTE MANIFEST N• C• D• 0, n 7, 6, O, 4, 7, !, 4, o~co~t·o:0•fl of 1 requiredbyFederallaw,bulisbyStatelaw.
5. Transporter 1 Company Name 6. U.S. EPA 10 Number 'C/Stafo·'f··· · a·fO= .-•: .::-;-,..:.: ·, ..
Willms Truckino Co Inc. ,s, C, n, O, 7• 3, 71 fl, Q, 7, a. · OJT' ... il'hoM·,:.,AnoJ,1;7..co,,,.
7. TranspMer 2'Company Name 8. U.S. EPA ID Number J::;::n.·:.·...;:·Trafl-__.;._.__,, IQ,.·.---": ,,,i~·,·., , ..
1 , 1 1 , 1 1 1 1 1 1 t 'FYf''•···.-. ''''•• 11Phooe·-(:.: ,; .. _ .. , .,.. ... _,.,;··•:<'•-,::<>~•-·::X<··•.:,~<
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
..
12. Containers 13. Tota! Quantity 14.Uni! t·wastaN!.wber··.··· ..
No. Typo 'M/Vo '.' , , './'>" .,',.(,/i
Ii F i O'flj9,::', Hazardous Waste, Solid, nos ORM-E ,.• ,:
e NA 9189 , 11 o ,T , , ,2 ,o Y <iiE1P1P16r;i
'1-b--______________ .:..._ ________________ -1-J.. lj'.:..._I--L'-1-.l'_j'LL'J.. '+--+
1
..:.: '':..'.:,=:=:='·=:'' =-:.:..:.~-1-
c.
0 I ' t I I I
d. <i'i'i'l'i'\
:,·.; ""
, , , , , , ·!.1 I I I (':
~, , i , , , \: ;•· -... : :'..::.;\,ui~:·,·
15. Special Handling Instructions and Addi!ional Information
CSX Work Order No.: 84445
16, GENERATOR'S CERTIFICATION: I horoby declare thal lho contont:1 ol lhl, con,lgnmont ere lully and accurately de,crlbod above by proper 1hipping name and ara c1asaif1~.
packed, marked. and labeled, end ere In 1111 rospect, in proper condition !or Transport by highway according lo applicable International and nallonat government r&9ulation1 and
tno laws ol the State ot Scurti Garollna.
111 am a large Quantity generetor, I certify the! I havo ~ program In placo to reduce the volume and 10,dcltyol wastagenon1lod to !he d&Qr-1 have determined to be economically
practicable and that t have ,t1h1cted the practicable melhod ol tree.tmen\, ,1ore.oo, or disposal currently e.voileblo to mo which minimizes tho pre,-ent and rutvre thr-t to l'lurnan
health and !he envi1onment OA, 111 am a small Quantily generator, I hove mado o good laith effort to minimize mywa,te generation and ,elect ttio boil wa,10 management rr,,sthod
ttlal is available to me end that I cen afford.
11 Printed/Typed Name
Charles R. Hansen
Signature Month Day Year
1 0, 81 O, 31 8, 8
T 17. Transporter 1 At:Knowledgement ol Receipt of Materials I ~ Prin~yped Name Signatur"() /) C Mon~ Da~ ],~ ,-:
;; 1,-....l..rh=.1.i 'L/,,<J~-1.P:i.....-1.A: ~-:l.<·':...::Q_=--------'--.µ.~~-:::><:...!p~,,.,&<c··:1,._ '-,le'.-, ();7'-· _____ __.,,_ot::.....L. '-"'.)::.if~-' o
O 18. Transporter 2 Acknowledgemenl of Receipt of Materials ,., I i Prinled/Typed Name Signature·
19. Oi~crepancy lndicalion Space
I i
L
I I I I I I I
-b I I I I I I
Month Day Year
t , I , I ,
Jib!. C I I I I I I Jlbl.
J'"'-dJJJIJJ['b<L ,.,_ ____________ _
l ~r2_0_.~F7ac_i_!ify~0_w_n_••~o_,_O~p_e_ra_1o_r~:C~•~rt_i1_1c_a_lio_n_o_f_re_c~•~ip~l~of_h_a_za_r_d_ou_s_m_aTt~er_ia_ls~c~o-v~••~oo-b~y~lh~i•~m-•~n_il~•~s1_e_x_c•~p~t~••=no~too~i-n_11_e_m~\~9~.--------------~
Printed/Typed Name Signature Month Day Year
I • I ' I '
.., EPA Form 8700-22 (Rev. 9/86) Prevrous Ed111ons are Obsolelo (DHEC 1988 (Rov. 10/86))
/;,?,_/Js,t\ South Carolina Department of Health Bu,eau o!Solid & Hawdous Wa,te M,t
~-~-J -~ d E • I C 2600 Bull Stree~ Columbia. SC 29201 ~:~-an nv1ronmenta ontrol Phone: [phone] ~ Emergency A. Holidays: {803)734-542-4
I
I l•SE PRINT o, TYPE (Fo,m desioned lo, use on ente (12-oilchl tvnew,ile,\ Fo,m A, rnved. 0MB No. 2050-0039 EJ<oi,es 9-30-M
UNIFORM HAZARDOUS 11. GonornlorsU.S.EPAIDNo. 0 M•n"•f~, 12, Pago1 lnlo,ma0on in lhe shaded a<eas is nol
WASTE MANIFEST N, C, D, O, Q, 7, 6, O• &, 7, J, 4, o~c~~"/i7 n,0 '71 of 1 ,equiredbyFedmllaw,bulisbyStalelaw.
3. Generator's Name and Mailing Address lfSttlie ... Manifest-Oociimtn! Nutnb«" Channel Master .'.tJ~}}::EfH?\:J:::J;-: .. ,-,::·.,.-,❖~=·,.,,.,-, , ...... ·
P. 0. Box 1416, Smithfield, NC 27577
•· Genmto,'sPhonel 919 I 934 9711
5. Transponer 1 Company Name
Willms Truckin~ Co
7. Transponer 2 Company Name
Inc.
9. Designated Facility Name and Site Address
;,-;':_'': .::: ?.~)=· ;,:··. ·:\•,:_,: \--~}/: __ ,
6. U.S. EPA ID Number
, S, C• D• O• 7• 3· 7.-" q, ?, ~
8. U.S. EPA 10 Numbor ~-:!'oo~...:.-·,T·ra·r, •. .: ... :.:_._..,a v:, .. ·
• • ' ' ' ' ' ' ' I I I FXT • , ... • ... P!loiie:
10. U.S. EPA ID Number .G.'6181of~cilily'll0
· GSX Services of SC, Inc. \/f(:;f:\
E
Route, I Box 255
Pinewood, SC 29125
H.{Fliall1y'• f'tione .:ti••· . · ' '· ;\·;,·,;::
, S, C, D, 0, 7, 0, 3, 7, ' 9i (\ ' •:·•••· ·. · ·: 803/452-5003>'
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
Hazardous
NA 9189
Waste, Solid, nos ORM-E
12. Containers 13. Total Quantity 1(Ur.i! l'W&1t8Nlnbef·:·:--
No. Type 'M/VrJ ;'<<•.: :,:•>::)';(, ::/;,i
I I ,2 ,0 y
·qr ,o.,ji\9';':t
)1F101Q161S
··.
~~b-·----------------------------------I--L1J1_\-11_.jl-L'1'-L'1'-l--+;~,:=:==l:::=·~:~i~i
C.
I I I I I I I ____ , . .,
d. ·"'.IC-'-'--'--''~,-;
GSX Work Order No.: 84446
1 e. GENERATOR'S CERTIFICATION: I horoby doclnro lhnl tho conlont:, ol thl:, con:,lgnmonl 11ro lully and accurnteJydo:,crlbed e.bovo by proper thipping nam• •nd ar• clas .. lla<I.
packed. marked. and labeled. and are in All rospoct:, in proper condition !or transport by highway according 10 applie&ble International and national government ra,oulations and
the la..,, ol lhe State ot Soultl Carolln11.
T
111 am a large quantity generator, I cor1iry that I h11ve II program In piece 10 reduce the volume and to1dcltyolwastogoneroted 101ho d09r&G I have dotermlned to t>e economicalty
practicable and that I have selected the pract!cable me!hod of treatment. storage, or dl:,posal currently avoileble to me which minlmltes the preMnl and luhH• tr1raat to hum&:'I
heellh and the envi,onmcnt: OR. II I am a small quantity genorator, I hovo made a good loilh effort to minimize my waste generation and select ttie t>est wasie manai;iemenl meU'lod
tt\et is avai1atlle to me and that I con ollord.
I Printed/Typed Name
Charles R. Hansen
I ~
T 17. T,an~porter 1 Ac,nowledgemenl ol Receipt of Materials
-'l.;a,r.,,/Typyl Name --r-:
p ' U/Ja /!es c/ fi/11/·~olf · f T8. Transpcrter 2 Acknowledgement ol Receipt ol Malerials I ~ P,inted/Tyoed Name
19. Oisc:repancy Indication.Space
I ~
L
I Signature
I Signature·
I I I
bl
Month Day Year
1 O, 81 O, 3• 8, 8
Mon:11 Day Yoa,
10 , ?'• r,, · t!i .":
Month Day Year
l , I , I ,
Jibs. C J Jibs.
jibs. d I P""
•1---------------
1 ~ ~2_0_.::F...,•_ci_li-'ty,:O:-w_n_e,,, ,,.o,_O_pc,.e_,._1_0,,;.: _C_ert_i_!ic_a_1i_on_o1_,_cc_c..:ipc..1_0_1 h_a_z_a_,d_o_u,_m,.al..,e7ria_l_s _co_v_e_,e_db-'y_lh_i,c.....m.:.a_ni-'leccs_l •c...•_c.:.•P:cl.c:a.:.•_n.:.01-'-ed'-in:.cl.::l•.:.mc...l.::9.:.. -----------:
Printed/Typed Name I Signature Month Day Yw
I , I , I ' EPA Form 6700-22 (Rev. 9/86) P,evious Ed1l1ons a,c Obsolclo (DIIEC 1988 (Rev. 10/86)(
I ~ ,t1}-"J·J.,,8 :.
!6;<\ ;-, \ ,,
~ • .tc..J '.\ #.W,~,
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hawdous Was:e Mgt
2600 Bull S~ .. l Columbia, SC 29201
Phone: [phone] ~ l:..se PRINT o, fYPE {Fo,m desloned lo, use on om, 112-pUchJ tvoewdle,) Fo,m A
UNIFORM HAZARDOUS 11. Gono1alo1'sU.S.EPAI0No, 0 Monlr••,•N,
8
12. Pagel
Emergency & Holidays: (803)734-5-424
roved. 0MB No. 2050-0039 C:..pires 9-30-Ba
lnlormation in lhe shadi,d .weas is no1
required by Federal law, bul is by State la•. ocumnn o. or
WASTE MANIFEST N, r,, n, o, 9, 7, 6, o, 4, 7, 1, ,,. 0, 0, 8, .o, I
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
<. Genmlo,'sPhone( 919 ) 9311-9711
S. Transporter 1 Company Name
\./ill ms Trucking Co. Inc.
7. Transporler 2 Company Name
9. Designated facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Numbor C/StatoTra••;;;,;;.;,• IO . ,·. '
1S1 Ctn, 01 7, 31 710,912, <:I • D.'TnwM<IM'af>hont · 801/7/,7~'<'<'<'<.
8. U.S. EPA ID Numoo, E. StabiTran..;.;.,.,,s ID·. , · ·
I I I I I I I I I I I I erninaoort...-. P!,or,f :: . . . .· .. ·,:;~,
10. U.S. EPA ID Numooi
1 s, c, D, o, 7, o, 3, 7, ' 9, & '.
11. U.S. DOT Description (including Propor Shipping Nome, 11,uard Class. and ID Numbor) 12. Containers 13. Total Quantity 14. Unit L w&stl~ ;~-
No. Type 'M.N(J \ · •·:·,·: '-~-,<.~:. ·. )-:, . .-•.; :\
: ._ Hazardous Waste, Solid, nos ORM-E ,iiF ,·o-jTj'9\;
N 1-..:N::A:....:9:.:1:.:8'..:9'.._ _______________________ l-'L . .J'tl+D:_i,_:T..j.._jl_jl_jl::_2_J,::.0..j....'.y--J.:::'::.:li:::E::•:::D::•::D::•::6::1.:.;X:_J.
I !~b_. _________________________________ -l,_1-,_•L.j._J•~j_1-•J•LL•J•~j...._..j.,..:,.::=····=··•,::·-=···=t=-=·j·=~-=-!.:r;;,~t"
I •~c-. -----------------------------L:.·..11_11_j'._J1L(-L'L'L.'L ,.t-_ _i:..
1
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CSX Work Order No.: 8444 7
1 &. GENERATOR'S CERTt_FICATION: 1 horebydeclara 1h01 lho conlonls ollhls conslgnmonl are fully and accurot.elydoscrlbed above by pro~r ahipping n•m• 11nd •r• clasai!L.c3,
pecked. maikod, and labeled, end nre In ntl rospocls In proper condiUon lor lransport by highway occordlng lo opp11cablo lnlernationol and notlonol government r~u1atlon1 •rod
tf\o laws of !he Sl.311! or South Carollnn.
II I om a 1aq~e Quantity gcnera1or, t cortily that t hevo a prooram In placo to roduca !he volume and to,dcltyol waste oeneral&d to tho d&Qree I have de!armlnod to be oconomiulty
prac11cable and that I have so!octed lho pract!cable molhod ol \r(m\mont, storage, or disposal currently availeble to me which m!nlmltes tho pre:,.enl and run.Ho ll"lraat to human
health and the environment OR. II 1 am a small quantity gonorator, 1 hnve mado a good faith ettort to minimize my wast.o generation and ,elect ll"le best wasto management mell"lod
mat Is available 10 me and that I con allord. I P1inled/Typed Name · !Signature (fl/ / -/J ,t,( Montti Day Yea,
k-l----JC~h2:a~rs.al~e~sLR~. _H!,!:!a~n~s.':e:!;nc.,_ _____ _j _____ J; (,~'.:::J4!::•~;:!4-A!!;!::~'--'--:...._!./4'.:S,,__,,;:::·:~· ~!::!::::!::::::::::=::=---J'-0~,.L..SB~,0.1...:::•3~18!J...;,8~
T 17. Transporter 1 Al.:1<.nowledgemen1 of Receipt of Materials __
IR~Sr~~~~-~---~----~~~-~~-----~~------~-~-~4
Printed/Typed Name \ /'} 11 !Signature -----~ _d 4 , l/ _/ Montti Day Year
r tt.<e:£YdJ <l /..-,-&<_ 7 A~ -r 10, f11, .. ~1!,&
cj f,1-8-. "T_,a_n-spo_rt_e-, .,-2-,-A-ck'"n_o_w_;le_d_g-em_;en:,t_o.:.I R::-e"-c-e.,-ip:.t_ol"M-,-a_;_t_er7ia71s ___ _._ ___ -c.f-=.::C=::..::__;:..._-<. ___________ ....Ju,<.u<_,..IA.,_,.a..=-i
I -RRTE-+----------------------._ _________________________ _.__._.._.._..,__._-1 Printed/Typed Name I Signature Mont11 Day Year
t ' I , I ,
19. Discrepancy lndicalion Space
Ii a I lib!. C I liti&
bl ptn. d I pt><
L 't:--:c-.,.-~---=--------
1~~2_0_._F_ac_il_ify_D_w_n_e,_o_,_D_P_e_,a_lo_r_;c_e_rt_,1_,c_a_tio_n_o_l_,._c_e~ip_l_ol_h_a_za_r_do_u_s_m_artc_r_ia_ls_c_o_v_e,_oo_by~lh_i,_m_a_n_il_e_sl_e_xc_e~p-l_as_n_o_loo_i_n_il_em_1_9. __________ _
Printed/Typed Name I Signature Month Day YW
I , I , I '
EPA Form 6700-22 (Rev. 9/86) Previous Editions arc Obso1cto [DHEC 1908 (Rev. 10/06)1
I Soulh Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Wa,te Mgt
2600 Bull Stree~ Columbia, SC 2'9201
Phone: [phone]
Emergency & Holidays: (S03J734-5424
Form A roved. 0MB No. 2050-0039 Expires 9.30.aa
UNIFORM HAZARDOUS I. Gonoralor'sU.S.EPAIDNo. Mnnifoat 2. Page 1
Oocumont No. ol lnlormation in the shaded a.eas is not
required by Federal law. but is by State la«. WASTE MANIFEST N c n o
3. Genera!or's Name and Mailing Address
Channel Master
P. 0. Box Jld6, 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, 1 Box 255
Pinewood, SC 29125
4 0 0 8 0 9
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA JD Number
10. U.S. EPA lD Number
S C D O 7 0 3 7
AS~~ Oocumo<ll Numb«, W~Y\tU@i rt\L\\:\\:J// , .-, --.. -.,,: ;,.:\:: .. ~·.r, ii))\·:.
!i),Stii.' o.iner'.10<'. I) :': .
L}):h}iI+ :<,; ;; .ht;;~,:::..~ :.~:·.::-:·. :
• ID . a··Pflont·=;:/_,_
j{JO .. ,.···
'l'l><N"''' ·,·• .. ·, ..
<f'S\ilioF,ici!ity'ilD:
;Wt)tfiF\\/E?i{t\: H/
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U.Unil l'W&StllNtttibef>:
No. Type 'MNr:J -'·>.~":··.\'//;t,ti
a.
C.
d.
~--•-~,0Ml.°7-~,'.~~;t1
_•:~
1~:A~!T_:"1':'.'':;!i', •••;;':1!::';!J~~i:;!f:,:'!:'.:1::r:_1!:::m•::n:;:!+:•••::t;;:.:)':;'·
;'fp -;u" 1::: jO'i':i ; 'i ; i ; 4 "j =1i'', i ','6 ,"ij''h),,,-w:, 'c'T~ ;M''F·r--;···~"' ~"",m~F 1 '-~ ., ,-.~---y+
b. Lu-1 1-1 . 1ii:l:l:'I'i!l11':'ldw_:J 111
1:'
15. Special Handling Instructions and Additional Information
GSX Work· Order No.: 84448
1 IS, GENERATOR'S CERTIFICATION: I hero by declare lhol lhe content, ol lhl:, consignment are lolly and accurately described above by prop,4,r 1hlpplng name arid••• cl■Mulle-d,
P•ci..ed. ma,i..ed. and labeled. and ore in 1111 rospocts in proper condition for transport by highway according 10 applicable lntarnational and natJone.l government r..;iulallon• •n.d
the 111..,5 ot the Stale of South Carolina. ·
111 am a !arge quantity generator. I cer1ify \hot I have a program In ph1co lo reduce !he volume and 10,dcltyol wastegenereled lo the dl!'Qr&e I have detarmlned to be economlutty
practicable and that I have selected lhe praclicablo method ol troatment, storage, or dlspou,I currently avolleble to me which minimizes the pres.ont and rutvre U°'r-1 to l',uman
1',taltl', and the environment; OR, ii I am o smoll quontity gonorator, 1 have mado o. good loith effor1 to minimize mywaslo genorotlon and select ttie best .,,..a1te management motl"IOd
that is available to me and !hat I con o.llord.
Prinled/Typed Name
Charles R. Hansen
Signature Month Day Yea,
0 8 0 3 8 8
T 17. Transporter 1 A(.;l<nowledgement of Receipt of Materials
Printed/Typed Na"}E!" (
(__, !'/{(;' "-'J .'-,\"//:; tv7'f/('
Signature Month Day Year
0,6
18. Transporter 2 Acknowledgement ol Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operalor: Certification of receipt ol hazardous materials covered by lhis manifest except as noted in Item 19.
PrinJed/Typed Name Signature
EPA Form 6700-22 (Rev. 9/86) Previous Edilions are Obsolele [OHEC 1988 (Rev. 10/86)]
a.._!'---'-'-'--'
b~I~~~
Montti Day Year
!lb!-C I !Jbl.
l'b1 dJ I'"'-
Monlli Day Yw
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Harardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: (8-0J) 734-5200
SE PRINT or TYPE (Form dcsl nod !or use on clilo 12-itch owrilcr
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box f416, Smithfield, NC 27577
Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
Designated Facility Name and Sito 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 1D Numbor
10. U.S. EPA ID Number
S C D O 7 0
DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
. Hazardous Waste, Solid, nos ORM-E
NA 9189
Emergency & Holidays: [phone]
Form A rovod. 0MB No. 2050-0039 E.toires 9.30.sa
Information in the shaded a<eas is not
require<fby Federal !aw, but is by State law.
12. Containers 13. Total Quantity lt Ur,it
No. Type '/1\NrJ
l' Wmi ~( .
Fi\t/--\'i;":\.)=\/:':/
1 D T
1FjO'jlj<J\C
2 0 Y ~(F!0!0!6Ji ---~.
T q( :w
□1-------------------------J-l_!_+.L_J-l_L_L.L_l----J...;...!::::===.:;;..i
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:·: I . ~~ ,,
d. ·-··• . ._..._ .... _.__,, '·'
• ❖ I~:?;··
1 S. Special Handling Instructions and Additional 1nlormation
GSX Work Order No.: 84449
1 5. GENERA TOR'S CERTIFICATION: I hare by declare that tho contonts of this conslgnmenl are lully and accurately described above by proper ,hipping n•m• •nd ••• cla~a,tle,d,
packed. marl<ed, and 1a·bc!cd. and are in /\II rospects in proper condition tor transport by highway according lo applicable international and national govarnmant r~u1au0n1 at'\d
ltle laws Of lhe Stale ol South Carolina. ·
111 am a 1arQe quantity generator, I cortily that I havo a pro"gram In placo to reduce the volume and toxicity ol waste generated lo the d~ree I have delormined to be economically
prac11cabte and thal I have selected the practicable rhelhod ol lreetmenl. slorage, or dlspo&al currently available to me which mlnimitu the present and luturo U'Haa\ \0 human
health and tho environment: OR, ii I am a smoll quantity generator, I have modo a good laith ettort lo minimize my wuta generation and select the boil wu:a managemonl method
ttiat is available to me end the\ I con etto,d.
Printed/Typed Name Month Day Year
Charles R. Hansen 0 8 0 3 8 8
T 17, Transporter 1 A<,;,o::nowledgement ol Receipt of Materials
Printed/Typed Name£. C-
Printed/Typed Name
19. Oi$Crepancy Indication Space
aJ ._ .,_.__._.__.
,.. b ... I"--'--'--'--'
20. Facility Owner or Operator; Certillcatlon of receipl ol hazardous malerlals coverod by !his manliest excepl as noled In llem 19.
Printed/Typed Name Signature
FPA Form 5700-22 (Rev. 9/861 Previous Edilions arc Ot,solclo IDIIEC 1988 (llcv. 10/86)1
Month Day Yw
Jibs. C I Jibs.
1101 d I ·1 Jibs.
MonU, Dey Yeai
I
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stre,(lt, Columbia. SC 29201
Phono: (BOJ) 7J..4-52DO
Emergency A Holidays: {603)73-4-5424
E PRINT or TYPE (Form desioned for use on elite I12-citchl tvnewriter) Form A, roved. 0MB No. 2050-~9 Expires 9-30-aa
UNIFORM HAZARDOUS 11, Generator'sU.S.EPAIDNo.
WASTE MANIFEST N, C, D, 0, g, 7, 6, O, 1 .. 7, !,
MenHeal 12. Page 1 lnlormation in the shaded Meas is not
4.Q:OuJ3"7l ~J.° of 1 required by Federal law, but is by State la#.
3. Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
(. Generator's Phone( 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckin~ Co
7. Transpor1er 2 Company Name
Inc.
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number 'c/si1af' ... ,,·• ... ,ID,,(·· ., ,.. •. • '··''' ·••··
OS I Co ])1 Q, 7, 3t 71 I), q, ?1 C\ -o>rran.,·~·:..s Phont =\ An1 / ?h 7~, ,, ,
8. U.S. EPA ID Number
I ' I I I I I I I I I I
10. U.S. EPA 10 Number
H.}FICiltty•a'P'hone ;·c;: .:: -.::::, .-:· . . : -= ;. ~:}.r,:~.;<·t~~:~ .~:
9, a ' :,;U:.; ;/.:: / • . . '. 803/ 452,-5003< .. ·
11. U.S. DOT Description (includin!} Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. TotalOuantir:-j l(Ur,iI L·w&.s::eNl.nbel'~":":.
No. Type WtN~ ·.,-.,,~\: .:-:>:\:~·:~·=,:.:,"/\
"_,,'
a. Hazardous Haste, Solid, nos ORM-E ·;·,F·,·o,·r;·r,/
~ ~,:::N~A:.....:.9.:.1::_89:.__ _____________________ _j_lt_.L 114 D::_ttT+.Jt:.....Jl--1'::.2.1104 _Y:..._J..:,:.:,! .::' F=1::0::t:::0::!1:::6::.J;::.J{;
I b. ,••,: :·,·•···"1 ·•·•,•-···.;' -j}
T :.',: f~
o µ _____________________________ .j.....1'.....11-J__j•µµrLrLL'Lr.j...._..j.;.;:i:c' '=1:::::::1 :::::1 :::..1';;..j\
C.
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15. Special Handling lnstrucb'ons and Additional Information
GSX Work Order No.: 84450
, 15. CENll!:RATOR'S CERTIFICATION: I hereby deelore lhnl lhe eonlon\s olthls eonslgnmenl are fully and aeeurat.e1ydeserlbed above by proper ■hipping name and a,a elaa .. nad,
packed. m;u~~d. :,nd 11\hfll<:rl. nn,11,ro In nll •o~pflCls In propor con,lillon for lrnn,porl hy high-fly nccordlng 10 nppllcnhle lntnrn•tionnl ftnd nl\tlonnl oo,,,.,,nmenl ra,ovlatlon ■ and
11\e ta ... , o! lhn Slatu ol South C11rotlnn, ·
111 •ma large quanuty generelor, I certify thnl I hn.ve a proorem In plaeo lo reduce the volume and loxlcltyol waslo generelod lo the dll-lJree I have dotormlne<I to 09 economic.arty
i,rect1cae>1e end Iha! I ha"" selected the practicable method ol treatment. storage. or disposal currently available to me which minimizes ltle present end luh.lte thr-11.0 human
health and the en,,,i,onmcnt.: OR, ii I am a smoll qu:,ntity generator, I hove medo a good lnith effort 10 mlnlmlxe my wast& generation and set eel U,e best -as1e mane;)emenl m.thod
trial is available 10 me and that I con allord.
11 Printed/Typed Name
Charles R. Hansen
Signature Month Day Year
10 ,8 {l ,3 {.l ,8
T 17. TransoMer 1 Ac.:i,;:nowle<1gement of Receipt of Materials
I E Pr~l;o/T yped Name ,/1
~ 7-/ r.,,.J, /.4 /~,I... I /7f,;£",1 ,-.,_ .
Montn Day Year
.10.A6.2i ~
o 1t.'TranspMer 2 Acknowledgement of Receipt of Materials ., 1
IRt,---"-------r--------,----c,--1
Printed/Typed Name Signature i
:; i
,
Montn Oay Year
I I I I I I
19. Oi~c;repancy Indication Space
I~ a I I I I I I pbs. C I I I I I I pm.
bl I I f I I Jibs. d I I f f I f pto.
L •1---------------
1f 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 Month Day Year
r I I , I I
EPA Form 6700-22 (Rev. 9/86) Previous Ed1t1ons arc Obsolete (OHEC 1988 (Rev. 1D/86)I
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Haz.ardous Was!e Mgt
2600 Bull $tree~ Columbia. SC 29201
Phone: [phone]
I
I
T
Emergency & Holidays· [phone]
E PRINT or TYPE (Form desinned !or use on elile [12-pitchl tvnewriler) Form A nroved. 0MB No. 2050-0009 Expires 9-30-88
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N, ,., n, fl, q, 7, r,, n, 1,. 7,
Menlleat •,12. Page 1 qoc~m!?.nt No. of 1 1, /1• 11, fl. Xt lo
Information in the shaded cW"eas is no!
required by F.e<leral law, but is by Stale la•.
3. Generator's Name and Mailing Address
Channel Master
,,,;1;_ S..... Mtinlf1lol Document Nvmb«. , . , .... :ff:>tU<~'-:,:,:·:': )kfr:J<:,:J-:.:::: ;,.:.;-.;:;, .,.,.,;, _;·: -.···-., ·:;';.\\: :·_ :· ::-~_,:.-. .--
r''-· -=:"'.~".'-''~::.:10"-.,·,=-!'-'~"0":.=-1'--1-4-'-!-'~-'-9-L 1s_m~!'-'~'-~'-=~!=-;'-1=--/=--i _' _N_c_2_1_s_1_1 _____________ ➔I'-.. _____ _ ,-_ ___ __ _ _ ____ .•.•.••.•. -~---~ UL''•.·:'.',? ;'({i;;it?'' ;":• ..
5. Transporter 1 Company Name 6. U.S. EPA ID Number c):.Staii,.r"'·· · · ·' · e K) :_,,; :· · · · -: · · · ·.: =-:= ,:: '"· '. · ·• ·.
Willms TruckinQ Co Inc. ,s, c, D, O, 7• 3• 7, n, q, 7, ~ • o)T •··•-•···','Pf>ont,'>0 n1/.7,;,~1.,1
7. Transporter 2 Company Name 8. U.S. EPA ID Number ~.TNi:-n.:.....:..;.:..,;.:a KJ ·.·:: .-· .. · , ·. · · .... ·. ,.,,-.,·,·, , ,·· ·
9. Designated Facility Name and Sile Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
' ' ' ' ' ' ' ' ' I I ' F:Tree;·.;;..;..,,.Ptiooo.. . .. :,.,.-
10. U.S. EPA ID Number (!.i6ta~~•cilit(1 ID/ .·. :;: .. '::• ·.
t6Flii:i!ity'i Ptionit ---.;,•; , ->: :: <:aa31i.;2~soci1\.: , S, C, D, 0, 7, 0, 3, 7, '. <:\ 1\ '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) ., 12. Containers 13. Total Quantity U. Unit
No. Type 'M/Vri
c.
I ' ' ' ' ' '
d.
. . .. , . . .................. -., ... ,"
I I ' '
b.LLJ I I I I I I I J I I l\1,;'.;::::.:\dJ~-LcJ._I I.I I _JJ_ I I,, I 1.J•:: >;;., , '''
15. Special Handling Instructions and Addilional lnlormation
CSX Work Order No.: il445 l
,e. GENERATOR'S CERTI_FICATION: I horeby declare th al lhe contents ollhls conalgnmonl are lully and accurat.e1ydoscrlbed above by proper 1hipping n•m• and ar• clasailied.
packed. marked, and labeled, and are In 1111 respect, In proper condi!lon for Iran sport by highway according to applicable International and natlonal government re,gulatlons •r.d
ttia laws ol the State or South Carolina.
1111m a largo Quantity gencralor, I certify lhal I havo a program In placo to reduce !he volume and loxlcltyol wule generelod to !he dog roe I have determlnlKI lo ti. oc:onomleally
practicable and that I have selected the practicable method ol lrealment, slorege, or dlspoaal currently avollab1a 10 me which minimize, the pre,anl and future thrNI to l'lurnan
health and the environment: OR, ii I am a small quantity gonorator, I have mad a a good faith eNort to minimize my wa,ltl generation and select the bell wuta management ,,,.tt,od
mat 11 available !o me ar'ld ttiet I can afford,
11 ~..........,.,.,----r=,----------,--l Printed/Typed Name I Signature • // /}' ./? . -' Month Day Year
Charles R. Hansen /? ~-.,,._.,(;',._ I( /./. , O, 8, 0, 31 8, 8
T 17. Transporter 1 A<.;1mowledgement ol Receipt of Materials I );.rinted/Typed Name _i;c... !Sig~'.:'.: _ _ , c.,/ _,.,-./ Month Day Year v
P i..:n.~cec'.,'7~'1~, fl,~12......'.,L::,,:....h{J,n~' U:t;<!'.,>'7.~"~P-!:......'.-,,....:....2--.... ~ ✓ ____ ...L::.-✓:...: ;ze.~-~--~ /'-fL::27'.........:~~===--------.l '~!:'.:.C ,,f~-,~O::.t,z.?~ LY..Yt.--l
o 18. Transparter 2 Acknowledgement ol Receipt ol Ma!eria/s /
I ef--P-r~in~led=/~T~yp-ed'--N~a~m~e---'"""'--=..:.:...c.:ccc..c...:.:..:...::..::=:.......---rls_i_g_n,-,u-r-,----------------------.C.... ... -o-nth--D-a_y.....,Y~ear---t
la I . I , I ,
~ ' L
19. Discrepancy Indication Space
,,_ _____________ _
I t 20. Facility Owner 01 Ope,ator: Certllicallon ol receipt ol hazardous materials covered by this menilest e,cept es noied In Item 19.
■ Printed/Typed Name I Signature
EPA Form 5700•22 (Rev. 9/86) Previous Ed1t1ons arc Obsolete [DHEC 1988 (Rev. 10/86)]
I I I 1 1 pb!. c 1 1 1 1 1 I JltlL
I I I I I pi,,. d I I I I I I pbo.
Montll Day Yw
J • J I I '
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. M11.nlleal Document No. WASTE MANIFEST N c n o 7 6 o 4 0 0 8 1 3
1 Generator's tfame 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 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. Page 1
ol
Bureau ol Solid & Hazardous Waste M;t
2600 Bull Sr.reel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-542.C
roved. 0MB No. 2050-0009 E.-.:pires 9-30-Ba
Information in the shaded a<eas is not
required by Federal law. but is by State la ...
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers 13. Total Quantity U. Unil :L'W&.1tl'Nldbef-t>
No. Type 'MNcl . .'.cs/;'<·;.?
a. Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T 2 0 Y
b.
C.
d. . LI -1....J-L...JI -
; I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84452
19. CENERATOR'S CERTIFICATION: 1 hereby declare Iha! the contents ol this eonalgnment are luUyend eccuretely deacrlb&d above by pro1>4r 1hipp!ng name and are cluaifled,
packed. mail<ed. and lt1.bc!cd. and are in t1!1 rospocts In prop or condition tor transport by highway according lo oppllcab1e International end naUonal government ra-Qulatlon1 and
U"le laws ol !he St.ala ol Sou!h CoroUnn.
111 am a large quantity generator, I certily the.I I havo a program In placo 10 reduce the volume end toxicity ol waste generated lo \ho de,Jree I h■vo delermlned to be ecor,omlc.ally pr■ctic~bte and thal I have selec1ed the practicable method ol treatment. storage, or d\spoa.al currently available to me which minimize, the pro:i.enl and lutvra uir-110 humar,
heal1h and tho environment; OR, 111 am a sma!I quantitygeneralor, I have made a good lailh effort to minimize mywesto generetfon and se!ecl tt,e b<oat wa1te managemanl ~tf'\OCI
that Is availat:lte to me and that I can afford.
Printed/Typed Name Signature
Charles R. Hansen
T 17. Transporter 1 At:Knowledgemenl ol Receipt ol Ma\erials
Typed Name
/ ~l /,'/4
nowledgement of Receipt of Materials
Printed/Typed Name Signature
Facility Owner or Operator; Certilication ol receipt ol hazardous malerials covered by this manifest except as noted in llom 19.
Printed/Typed Name Signature
EPA Form 6700-22 (Rev. 9/86) Previous Editions arc Obsolclo [OHEC 1988 (ncv. 10/86)1
I IU-.JLI..J-1
b ._I.,,_,__.__._,
Month Day Year
0 8 0 3 8 8
Day Yw
Monlt1 Day Year
Jib!. C J Jibs.
Ii"'-d I l'bo.
Month Day Yw
I South Carolina Department of Health
and Environmental Control
P SE PRINT o, TYPE (Form desi ned for use on elite 12· itch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Genera!or's Name and Mailing Address
Channel Master
1. Generator's
N r. D 0
P. 0. Box 1416, Smithfield, NC 27577
4, Gene,ato,'s Phone [phone]
5. Transp0r1er 1 Company Name
Willms Truckin Co Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site Address
CSX 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 ID Number
S C D O 7 0 3 7
Bureau of Solid & Ha1ardous Was:e Mgt
2600 Bull Strei;!t, Columbia, SC 29201
Phone: (8-03) 7:!4-5200
Emergency & Holidays: (803)7:!4-5424
roved. 0MB No. 2050.0039 E.xpires 9-30-ea
Information in lhe shaded a<eas is not
required by Federal law, but is by State law.
· .. _-·. . : ,_ :L}.:.,:::":".~'\i-=// :.
--BDJ/452-5003'··
11. U.S. DOT Descriplion (including Proper Shipping Name, Hazard .Class, and ID Number) 12. Containers 13. Total Quantity It Ur.ii L' W&ila tua , .. ,:.
No. Type 'M!VcJ ·: · ''!<'if)
a.
Hazardous Waste, Solid, nos ORM-E
N ~::;NA'.!,_;9:_:l:_::8:_:9 _____________________ +-.L.l.'.l+DJ.:.T-\-LLJl.'.:2..l::'..0-\-Y'.-µ!::::::=::::::;:~:,I
''~•~•~•-•v..;. _h,..,
C.
d.
gr:~~t~I~/Iitiii;1i:1i1~ll1ill~,!~1il1!1
:ii~!~il~lllililtt!i!lf1\:il11ll~:;~l!~l!:,s:Ul\:itI}G!&ih;(J
a. U:.iHJ-10 I 2 I 7 I 7 I 4 I-I 1 d I O I 2 hirF:\W})i c,L _ _.i_J-1 1-1 1!4
b.LLJ-1 1 1 1 1 1-1 1 1 , 1t,;1!;~11liil'!dLLJ-I 1-1 J~f:
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 84453
I I I l~i ,~:
•••'• ••• .... •,d•»-•••
1,_.J.......I.......L_Ji:,;,.-
(;;
1 e. CENERA TOR'S CERTIFICATION: I hereby declare that the contont:, ollhl:, con:,lgnment are lully and accuraltllydescrlbod above by proper ■hipping name 1nd •r• claS&1lie<1,
packed. marked. and la-be!ed. and are in all raspocts In proper condition for transpor1 byhlghw11y according to 11pptlcable lnlern11tion11I and n11tlon11I government r99ulations and
u,e lews or the Suite ol Soult'! Carolina.
111 am a large quanhty generator, I cer'lity that I h11vo a program In placo 10 reduce the volume and toxicity of was le g1,ner11tod to tha d&gree I have determined lo b4t economically
practicable and that I have selected lhe pracUcable method ol tre.alment, storage, or dlspo~I cum1ntty 11v11Uab1e to me which minimizes, the pres.en! and !uture l/"lraa\ lO human
heallh end the environment OR. ii I am o smo11 quonlity gonorator, I h11vo modo o oood loith effort lo mlnlmlte my was to generation and se!ecl the bes! waste mana~emenl metr\Od
tf'lat Is available 10 me and that I con otlord.
Printed/Typed Name Signature
Charles R. Hansen
edgement ol Receipt ol Materials
Signature
Signature
19. Discrepancy lndicalion Space
20. Facility Owner or Operalor: Certification of receipl ol hazardous materials coverod by this manifesl exccpl as noled In Item 19.
Prinle<l/Type<l Name Signature
EPA Fo,m 6700-22 (Rev. 9/86) Previous Edilions arc Obsolete [DHEC 1900 (Rev. 10/06))
I !,_._......_-'-'
bl~~~~
Mon!/1 Day Year
080388
Monttl Day Year
libl. I I pbl.
pt,,, d I Ji"'-
Mon!/1 Day YW
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt
2600 Bull Streei Columbia, SC 29201
Phone: [phone]
r
E PRlh'T or TYPE (Form desi ned for use on elite 12-itch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
Nr.no07r,O1
Menire11t
Document No,
11,OORl~
P. 0. Box 1416, Smithfield, NC 27577
.Generator",Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Silo Address
CSX 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 Numbor
10. U.S. EPA 10 Number
S C D O 7 0 3 7
Form A
2. Page 1
ol
Emergency & Holidays: (803)73-4-5424
roved. 0MB No. 2050-0039 E.xoire3 9-30-Ba
lnlormation in the shaded a<eas is not
required by Federal law, but is by State la ....
,l,.\$1$1i, Miinifest Oocumool -.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and JD Number) 12. Containers 13. Total Quantily U.Unil l'W&1'1~·
No. Type 'MNrJ ':·•;/.:'.:.:/.,)<j
..
C. ._.._....I..._.__··.,·;~%
,w· ,,
d.
. ········~ .. -· .. -~ I · I : .~.
15. Special Handling lnstrucb·ons and Additional Information
CSX Work Order No.: 84454
16. CENERA TOR'S CERTIFICATION: 1 horebydeclure lhnt the con ton ts ol this conslgnmenl are fully end accurately described above by proper ,hipping name and are clasaifled.
packed. mMkod. 3nd lt1hoh:<l, t1r1<1 nro In t1II rospocts in propor concJitlon !or !1t1nsporl byhlghwt1y nccordlno to opptlcablo lnternationo1 and natlorial go,,.orrim1n1 r1-9ulauon1 ,r,o
ll'lo l11ws or lhn St.:ilo or South C11rollno,
111 am a large quantity generator, I certify thet I have a program In pie co to reduce Iha volume and toxicity ol wasla generalod to Iha de,greo I ha,,.e detormln&d to t>o c,coriomlc.Jly
proc11cabte and mat I have selected the practicable method of treatment. storege. or disposal currently available lo me which minimizes the pres.erit and luturo trlfNI lO human
l'leallh and the environment; OR. ii I am o small qui"lnlity gonorator, I hovo modo o good faith effort to mlnimlz.e my wost.e generation end select the t>o,t waste m•nagem1n1 IT'OCf'IOd
tnat is availablo to me end that I can atlord.
Printed/Typed Name Signature Month Day Year
Charles R. Hansen 0 8 0 3 8 8
At:imowledgement ol Receipt of Materials
Signal~ Montn Day Yoar
Signa!ure Month Day Year
19. Discrepancy Indication Space
a I pbs. C I pbs.
b I pi,,. d I l'bs.
20. Facility Owner or Operalor; Certilicalion 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 ore Obsolelo {DIIEC 1988 (Rev. 10/861)
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt.
2600 Bull Stree~ Columbia, SC 29201
Phone: {803) 734-5200
E PRIHT or TYPE (Form desl ned for use on eme 12· itch ewrlter
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
NCDO 7601 I 4
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 Sile Address
CSX Services of SC, Inc.
Route, l 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 10 Number
S C D O 7 0
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number}
L
Form A
2. Page 1
ol
Emergency & Holidays: (803)734-5-424
roved. 0MB No. 2050-00J9 Ex ·res 9-30-88
Information in !he shaded a<eas is no!
required by Federal law. but is by State law.
l;~~=t:=;100t:U{tt=~}~);:il~it!tl½=Zi
.;~;~;r~i:~;~~::;k~~:t~~t¥~~$~;::,~1:~:~:~'.{i~~¼~~i~~r~
12. Containers 13. Total Quantity 14. Unit t:wat11·NunJbei~,;,,
No. Type 'M!Vr:J. i/f\:{L)!-f:J\~ftJg1-
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T 2 0 Y
d.
15. Special Handling Instructions and Additional lnformalion
GSX Work Order No.: 84455
18. GENERATOR'S CERTIFICATION: I hereby declare that tho conlont, of this consignment are luUy and accurately de,crlbed above by proper ,hipping name 1nd •r• cl,...,fted,
packed. mark&d, and labeled, and are In Rll rospects In proper condition for lrenspor1 by highway according to applicable International and nallonat government revutatlon• al"ld
tl'le laws ol the s1..,111 ol South Cnrotlnn.
If I am a large quan,ily genera1or, I cor1ify lhet I have a program ln ptaco to re-duce the volume and loxlclty ofwuteganeratod lo the degr&e I h■va datarminod to b4I economicalty
practicable and that 1 have ,elected !he practicable method of lrealment, sloroge, or dlspoaal currently ev11.ilable lo m8 which minimizes the present and lutur• thraat to P'luman
healtP'I and !ha environment QR, 111 am o small quantity gonorator, I have mado o good railh effort lo mlnlmlte mywasta generation and se!ac1 the best wa,ta managam•nl n-..-tr,,od
that Is available 10 me and that I can afford.
Printed/Typed Name
Charles R. Hansen
Month Day Year
0 8 0 4 8 8
17. Transporter 1 Ac.:Knowle<lgemenl al Receipt of Materials
Mon!tl Day Year
Printed/Typed Name Mon!tl Day Year
19. Discrepancy lndica1ion Space
I I Jibs. C I JltlL
bl pt,,. d I ptis.
20. Facility Owner or Operator; Certificalion of receipt ol hazardous materials covered by this manifest except as noted in llem 19.
Printed/Typed Name Signature Month Day Year
L EPA. Form 8700-22 JRcv. 9/86) Previous Eclitions nrc Obsoloto (DHEC 1988 (ncv. 101861)
I
,;t,z,1$.,' I -:i. ~ .,_ ~ 6.--~" \♦\ ~
~
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bu11 Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)7'.>4-5424
LA.Se PRINT or TYPE (form deslQned for use on elile 112-pilchl tvoewriter)
tr" UNIFORM HAZARDOUS I'· Gono,ator'sU.S.EPAIDNo.
Form Ai roved. 0MB No. 2050-0039 E.xpires 9-30-38
WASTE MANIFEST N, c, D, 0, 9, 7, 6, 0, 1., 7,
Monlle11t ,2. Page 1 Oocumnnl No. of 1,4,0,0,8,1,7 1
lnlormalion in the shaded a<us is no1
required by Federal law, bul is by State law.
1 Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone ( 919 ) 9 34-9 711
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, I Box 255
Pinewood. SC 29125
6. U.S. EPA ID Number
I s I c, D1 o, 7, 3, 7, 0, CJ, ?i 'l
8. U.S. EPA ID Number
I I O O O o I I O I I I
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, '
b'iSii,i.-· .. IO•, ..... ,, .• ,:,•:,;;c,,
1R1 • · ·• l'hont .. ,: Rn.,_ ,.n 1:.: ·n, . .,,. .
11. U.S. DOT Description (including Propor Shipping Name, Hazard Class, and ID Number} 12. Containers 1J. Total Quantity 14. Unit ··L'Watil~·\".'
No. Type 'M/VrJ /i:\'/{:'i/•H:AV~ff;~
I ~ L Hazardous Waste, Solid, nos ORM-E :~'ljr';ci,f,if;'~
N ~..:N::A:....:9~1:,:8'._:9:_ ______________________ ~µ•L· _j•::l...j'.:D_j,::T...j_J'-1'-1'.:2J,:::,O...J_..'..Y_J;,:;?1~1=F=1~Q=1~Q=1~6=-1Ut'
I f b. '.C"·''"' ··""-'="·'-',
·:',: I I I I J ;{;
o ~----------------------------l-_j'c_l''-Jc_l•'-J-1'-1'-1'-1'-i--i.:;"':.:::::::::::::==-1;;:.;J!f
I
I
I
A C. .
d.
15. Special Handling lnslructions and Additional lnlormalion
GSX Work Order No.: 84456
O I ' . I O I I
I. 0 I ' ' ' '
-
1e. OEHERATOR'S CERTI_FICATION: I herebydeetara thal lhe conlon!a olthl:, conalgnment are tu11yand accurately described above by prol)Clr 1hlpplng name and ar• clu~ned,
packed. mark&<!, and labeled, and ere In n11 ro,pocla In proper condition lor lranspor1 by highway according lo appllcabla lntarnatlonal and nauonar governmenl r99ulatlona and
U'la laws 01 the State or South Ca,ollnn.
111 am a large Quantity gencralor, I certify thet 1 havo a program In ptaco to reduce the volume and toxicity ot wutagenerated to the d99r&e I have determln&d to be oconornUlty
practicable and that I have selected Iha practicable method of treetmenl, 1torage, or dlspoaal curren\1y available to me which mlnlmlus U'la prea,ent and lul\Jra U'ltNI 10 human
health and the environment.: OR, ii I am a small Qutanllty generator, I hove made a good lellh etfor110 minimize my waste generation and ,elect the beat waate managam11nt method
that 11 avai!at,111 to me and that I cen aMord.
I Printed/Typed Name !Signature /J Month Day Year
~1----C!d_ht!;as,rr_lJ_:e~s!LJR!S..:..,. _JH:!;a:!!n:!!Sl.,!e~n:!,_ _____ ...l. __ ...f.e!,:::;~1/.:!'!:"-"~/4!;/_,..!,A~·-,/~,C:.:e:::::::.:::==:::..-------~1-0!J.,,..!8~••.,!0!J.'•..!4!.J,l.,!B~,,..!8~
. I
~ 17. Transporter 1 Ac:Knowledgement ol Receipt of Materials
..... Printed/Typed Name I Signature a 2fl Month Day Year
/). , /,.,,. ,, ,,. " ~ . ~<'.?, ,,,,-·) -,,
"'' ,, /v ...,.;_,a,, I ~~"' L,_-/. 10 ,"I 10 •"'•~ ,,.
O
t--"-"'=<==--;,:_,;_..c,. __________ ,_ _______________________ ...,__.,_,._..__...,_...,-1
18. Transporter 2 Acknowledgement ol Receipt of Materials Ar--:,,,..--,.;---,.,,--~--------------r.,,,..-------------------------,---:--...,.,-'1
I -~A+_P_ri_n_led-lT~y-p_ed_N_am_e ______________ JI..S-ig_n_,_,u_r•-----------------------•M-ol..nl.."1-"-0-'al..y_.__Y_.ear-j I I I ' I '
19. Discrepancy Indication Space
I 1 .............. 1 .J..I ..... l1b1. C .... I .... 1 ... 1 .........,l 1t1
,,bJ II J'ln.dJ II Jibs.
I
T 20. Fac1hty Owner or Operator: Cer1il1cation ol receipt of hazardous materials covered by lhis manifest except as noted In Item 19. I v Pnnted/Typed Name I S,gnalure
~ EPA Form 8700-22 (Rev 9/86) Previous Edrt1ons arc Obsololo {DIIEC 1988 (ncv. 10/86)1
Monl/i Day Year
I , I , I ,
I •;
l \ ' ',1 -.~ .. ~
-i ',
Soutli Carolina Department of Health
and Environmental Control
E PRINT or TYPE {Form desf ned for use on ellle 12-itch ewriter Form A
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIONo. Manifest 2. Page 1 Oocumonl No. of WASTE MANIFEST N r, n o
1 Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Oesigna!ed Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
0 0 8 1 8
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
SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Number)
a Hazardous 1.faste, Solid, nos ORM-E
Bureau of Solid & Haurdous Waste Mgt
2600 Bull Streel Columbia. SC 29201
Phone: {803) 734-5200
Emergency & Holidays: {803)734-5424
roved. 0MB No. 2050-0039 E..x. ires 9-30-88
Information in the shaded a<eu is not
required by Federal law, but is by State law.
~::~YF ·(O!·I·l:~i
N NA 9189 1 D T 2 0 y <j1E1P1P16nj:
":j j''' ,· f"',"":i_ .. ·_:,:,_~_
·.:JI .
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84457
18, GENERATOR'S CERTIFICATION: 1 horeby declare Iha! the contents ot this consignment are lully and accurately described above by proper ahlpplng nam• and ar• c;lasaifl.ct,
packed, marked. and 111bolcd. nnd nre in n11 ro,poc!, in propor condition lor tr11n:,porl by hlghwny according to applicable International and n11Uon11I govarnmant r~u!atlona and
the laws ol the St.110 ol South Cnrollnn. ·
111 am a large quantity generalor, I cortily thn! 1 h.11.vo .11. progr.11.m In pie co lo reduce the volume and toxlcltyol waste genara1ed to the d~r&a I have determined lo be economically
pract1cable and that I have :,elected the practlcablo mathod ol treatment, :,tor age, or dlspos.al currently avoilabla to ma which minimizes the pres-en! and lutvra u,,_, to human
health and the environment.: OR, ii ram a small quan!ilygenora!or, I have made a good lailh atlor110 mtnlmlza my was le generation and sahtcl ll"le beat we.ate manegamenl method
than l:, available !o me and th.11.t I con atford.
Prinled/Typed Name Signature ? / ~ C:L,,_,J,
Month Day Year
080488
Printed/Typed Name Signalure · Month Day Year
19. Discrepancy lndicahon Space
20. Facility Owner or Opera!or; Certirication of receipt of hazardous ma!eria!s covered by this manifesl except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions arc Obsololo (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt.
?riOO Oull $t1N1t, Columbi11. SC ???01
Phone: {BOJ) 734-5200
Emergency & Holidays: (803)73-4-5424
E PRIHT or TYPE (Form dcslnned for use on ellle r12.pilchl tvoewriler) Form A nroved. 0MB No. 2050-(009 Expires 9-30-88
UNIFORM HAZARDOUS 11. Geno,ator'sU.S.EPAIDNo.
WASTE MANIFEST N, c, D, 0, q, 7, 6, O, 1•• 7, J,
Me.nlloet )I 2. Page 1 Information in lhe shaded a<eu is nol Oocumnnl No. of . b Fed I 4, O, O, 8, l, 9 1 required y eral aw. but;, by Stale law.
3. Generator's Name and Mailing Address
Channel Master·
P. 0. Box 1416, Smithfield, NC 27577
,. Generator',Phonet 919 I 934 9711
5. Transporter 1 Company Name
Willms Truckino·co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Silo Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood. SC 29125
6. U.S. EPA ID Number
I St Co D1 Q1 71 31 71 n, Q, ?, q
8, U.S. EPA ID Number
' • • • ' • ' ' I I t
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, '. 9, I\ '
ctsia;;.·
6P1
'C,'('','',:C.-
. : I()'.,/ . .".:" '·:··:. ·,:::,;_.+'7'.~-~-·i,
.. a PhoM°'i/.t An' l. 7 I'. 7 _:: ">. ">. 't ">.':,/
,;,_. •'·',. ·n:c/.,:,, .. ,:,.,,: ....... -,.:. ,· 0:i-r;;::::J.;:·,.,,(;,;i~<
l l. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Numbor) 12. Containers
No. Typo
13. Total Quantity 1 t Unit 1 · l' watl Nt.rnber"•i>.~:-
'M/V~ i/?+:.1:/:<1:t:/~lfrt}i
a.
Hazardous Waste, Solid, nos ORM-E
H ;F ; 61T1"9'f~ ::::: w:
N NA 9189 ,· 11 D ,T I I ,2 ,o y :1,F1Q1Q161'1f
b.
f:'/".':'.~.,:<..;.·,.s.: .. :.;.=,.-,:l,-;,;.:~
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01--.::...-----------,------------------+-jl__ltL!-L'.j.;.· J'-'LL'J'-.jf--+'.2?~,=====-'2W,;.::i·· ... .. :··:1 0:.
I I ' t I I I
d.
I I I I I I I
15. Special Handling Instructions and Additional lnlorma!ion
GSX Work Order No.: 84458
, e. GENERATOR'S CERTIFICATION: I hereby declare that lhe contont, ol lhl:, con:,lgnment are fully end accural.e1yde,crlb&d above by proper ehlpplng name end are clasiin.ct.
packed. marked. and 1tibeled,and are Jn 1111 ro,poct:, In proper condi!lon for transport by highway according to appllcabte International and natlonal government r~ulatlon, aM
uie la-, ol the Slate of Soultl Carolina.
111 am a large quantity genero1or, 1 cerliry !hat I hnvo o program In placo lo reduce the volume and loxlclty ol wa:,le genera led to the d~r-1 have determined to be economlealty
pracl1c1blt! and thal I hi'tvO :,olocti,d lhfJ prnc1lc11blo molhod ol lroll\rnont, ,1or11go, or dl:,poa11I currently avnilnble lo mo which minimize• the presonl end futvra U"lr-l lO human
l'l•alth end the 11nvi1onmcnt; on.11111m n smnll qunntlty gonor/llor, I hnvo mndo n good fnlth et!o,t to minimize my w11,to gonorallon and :,eh•cl 1h11 b-e11 w■11■ manag•ment ,.,.tr\od
ttlal 11 available 10 me and thnt I con allord.
I Printed/Typed Name
Charles R. Hansen
T 17. Transponer 1 Ac,nowledg,,ment ol Receipt ol Materials
Printed/Typed Name /..,
/II~'._.-,';:-.I~../
o 18. Tran'sp0rl:er 2 Ack.nowledgemenl onleceipt ol Materials i Printed/Typed Name
Ii, Oimepancy lndicalion Space
J
L
!Signature # /
D ,c.,_,_.,G
// I Signature·
•f----------------
[
T 20. Faciliry Owner or Operator; Certifica!ion or receipt ol hazardous materials covered by this manifesl except a, noled in Item 19.
Prinled/Typed Name I Signatu.re
EPA Form 8700-22 (Rev. 9/86! Previous Ed1t1ons are Obsolete JDHEC 1988 (Rev. 10/86)!
I I
b I
Month Day Year
1 0. I<. 0. 41 8, 8
r$1'J~i<c
Monttl Day Year
I , I I I '
Jilli. C I Jilli.
pr,,, d I pt>s.
Month Day Year
I ' I I I '
'/
, ~';i:;}1-;.~:-
I ~ -~.,, ,. '> >t!lfi';-•.<I\ >
l '.1
~-
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5-424 lrE PRl~r TYPE (Form de,inned !or use on elite (12•pitchl tvoewriter)
UNIFORM HAZARDOUS 11. Genoralor'sU.S.EPAIDNo.
Form A □roved, 0MB No. 2050-0039 E.:rpires 9·30-83
Manllosl , 2. Pago 1 Documnnt No. ol tnlorma!ion in the shaded a<eas is not
required by Federal law, but is by State law. WASTE MANIFEST N, C, D, 0, q, 7, 6, 0, 1·· 7, J, 4,0,0,8,2,0 1
1 Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
•-Generator's Phone I 919 I 9 Jlt 9 711
5. Transporter 1 Company Name
Willms Truckine Co. Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number ·c.\'Siaio'!f·'· .,, .... , iii · ·.•:• :+• :,y ,,.
I S1 C1 1)1 01 71 Jo 71 0, 9, ?1 (\ -o::rran•~·, Phofi. . . A,,, , 7 o..: 1111
8. U.S. EPA ID Number c:::"o.;;:.:.,::·_;;,-··· ··-.... . .. i,'.°IO
I I I I . I 1 I I I I I I FXf.. . :5, Phorif·:
10. U.S. EPA ID Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cf ass, and ID Number) 12. Containers 13. Total Quantity 1( Unit
No. Typo 'M/VrJ
I a. i\iF ;6,'Tt'9'f~ Hazardous Waste, Solid, nos ORM-E :J :C
N NA 9189 1 ,1 n ,T , , ,2 ,o Y ;•1iE 1PiP1&r(r
l~~b---------------------------------~j•~•L~L•~J'-'LL'J'~~-~1~:=···=,=··=-=;=·=~=··~:2i~·
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d.
I I I ' I O o I
I
I 15. Special Handling lnslructions and Additional lnlormation
GSX Work Order No.: 84459
I
I
l .
1e. CE.HE.RATOR·s CERTIFICATION: I hereby declare \he! !he conlents olthls conslonment are fully and accurnlely described above by proper ahlpp!ng name and are cluaifteod.
packed, marked, and la.beled, and ore In Rtl rospoc!s in proper condition for lranspor1 by highway according to oppllcabte International and national government r..gulatlon• and
U'le laws of the State ol Sou!h Carolina.
111 am a large Qu•nlily genera1or, I cer1ily th11I I he.ve o program In place lo reduce the volume and toxicity of waste generated lo !he d9<Jree I have de.termlned lo be economlcalty
prac1,cable and !hat I have selocled the practicable method ol 1re11lmont. sloroge, or dlspoaol currently evollable to me which minimizes the pres.en\ and future uirut to human
health and the environment; OR. 111 am o smol! qunntlty gonorator, r hove mo.do o. good railh erfor1 lo minimize my wesl8 generation and se!ecl tt,e best wa110 managem•nt metnod
tt'lal ls available lo me and tt,at 1 cnn otford.
I •, Prinled/Typed Name
Charles R. flansen
I Signature (~ ..L K /.:/,' Month Day Year
,0.8,0,4,8,8
I ~ 17i~~~=;Ye;~:':;:wledgementol::o:aterials !Sign~ ... .# I' ,1 _,,, _/ Month Day Year
Ji-,.:~~~2~~~~,--r{~~~!......'.~~·~,-+.:.~~"'--<7_:J_:_~_-,-,---_-1_L..!!.·/J.-~~~!!::::::::!..~~~--~,~::?:!:::!::::::_ ______ ~•O~•£._J,:Y1~o~,t~ll:~~:,9y'
o 18. T1anspor1er 2 Acknowledgement ol Receipt ol Malcrials ,?/'
1
~1---...,;_ _ _;_ _ _;:__;_ __ ...;_ ____ ~-----------------------~
,, Printed/Typed Name I Signature· Month Day Year
~ ' ' I ' I I
II ~ I L
19. Discrepancy lndica!ion Space
I l,_L...WL...WWjlbs. C ,_I ,._,_,._....,_.!lbl.
-. b I pb1. d I pbs.
•.---------------~ 20. Facility Owner or Operator; Cer1ilication of receipt ol hazardous malerials covered by this manifest except as noled In llem 19.
Printed/Typed Name I Signature Month Day Ye,ar
I · ,· , I ,
EPA Form 8700-22 (Rev. 9/86) Previous Ed1t1ons nrc Obsolo!o (DHEC 1_988 {Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste Mgt.
2600 Bull Streti~ Columbia, SC 29201
Phone: [phone]
I
.I
I
I
I
I
Emergency & Holidays: (803)73-1-~2•
FE PRINT 01 TYPE (Form desloned for use on ellle 112-oilchl lypewrilerl · Form A nroved, 0MB No. 2050-0039 Expires 9·30-88
UNIFORM HAZARDOUS 11. Generator's U.S. EPAID No.
WASTE MANIFEST N· C· D· O· q, 7, 6, o, 4, 7,
3. Generator's Name and Mailing Address
Channel Master
P. 0, Box 1416, Smithfield, NC 27577
•· Gene,alor'sPhonel 919 l 934-9711
M11nlfo11t 12. Page 1 Oocumnnt No. of
1 !, 4,0,0,8,2,1
Information in the shaded areu is not
required by Federal law, but is by State law.
5. Transporter 1 Company Name
Willms Truckin~ Co. Inc.
6. U.S. EPA 1D Number 'C?Stabt';f'·"" .. ,. , 10.::,,r .. ;: ·:·:-:,.::y/:;tti:t~-~:1,\;
,s, C, D• O, 7• 1, 7• 0. Q, 7, Cl· DXT ···,l't>OM·•):c,Ano1oq:.,;11.1·1· .. :,
7. Transpor1er 2 Company Name 8. U.S. EPA ID Numbor
I I I I o o O O I o O r
9. Oesignaled Facility Name and Sito Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
10. U.S. EPA 10 Numb-Or
, S, c, D, 0, 7, o, 3, 7, :
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and fD Number)
d.
15. Special Handling Instructions and Additional lnlormatlon
GSX Work Order No.: 84460
12. Containers
No. Type
, · ,I D ,T
' ' I
' ' '
' ' '
13. Total Quantity l(Uni!
W\NrJ
, , ,2 ,0 y
I I I I
' ' ' '
' ' ' '
I
I .
lS. CENERATOR'S CERTIFICATION: 1 hereby declare th&I Iha con1enls ol this consignment are lullyand accurately described above by proper 1hlpplng n•m• and •r• c1awnec1.
packed. mark&d, and labeled. and ora In t1.II ro,pect, In proper condition for lran:11por1 by highway occord!ng to opplfc.ab1a lnlornatlonal and nallonat governmenl re,ourallona el'\d
ll'lfl la-s of the Stale of South Carolina.
111 am a large quantity generator. r car1ity that I heve a program In piece lo reduce the volume and toidcltyol wastegenerelod to the d111Qr111111 have determined to be economk:alty
practicable and lt1al I havo ,elocted the practicable method ol treatment. ,torage, or dl,poaat currenlly avollable to me which mfnlmltes tho preMnl end lutura U'\rNI to human
l'leatni an·d tho environment; OR, Ir I am n small quontltygenorator, 1 hnve mado a good leith effort to minimize my wa,l.e generation and select the ~•t waata management~
tf'lal 11 av~ilab!e to me ,;ind tht1t I can olford.
J Printed/Typed Name !Signature ,f 1 Month Day Year
' H-----"'Ch..e' 0.._r._l...,ea.ss'-"R:..:..-'-'H-"a""n"-s e""n"--_____ ....,_ __ _;;da;;_;,.£:;;:{,...;~:;;.:t:;;.'<-.,;,'/,;._.,,,1...;~='::a...,..,=~==--------'1"'0"", ,_8_,,.:;o_. .... 4_.,,;,8"'-t ,8
~ 17. Transporter 1 Au;now!edgement of Receipt al Materials
I :, Prinled/Typed Name
~ -;:::t;/.-1-t..J Ro'-<)•~
I Signatur~,4 j} ~
,
Month Day Y~ _
I ,ft ,itff';'o
~ 18. Transporter 2 Acknowledgement of Receipt of Materials
I :~-1--P-n-·n-ted-lT_y_p_ed_N_•_m_• _______________ ls_ig_n_,_'"_r_•_· ----------------------.IM_o_nLttl-'....;OLay..1.-Y.lear-l t , I , I ,
19. Discrepancy Indication Space
I ~ 11---------------T 20. Facility Owner or Operalor: Certification of receipt ol hazardous materials covered by this manilas! except as noted in Item 19. I v Prinled/Typed Name I Signalure
EPA Form 87D0-22 (Rev. 9/86) Previous Edllions are Obsololo jOHEC 1988 (Rev. 10/86)1
I lc..wc..wc..wl1b1. ~ lc..wL...WL...W,~
bl pt>s.d/ pt,,.
Month Day Year
I I I I I '
I S~i~ Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt
2600 Bull SlreeL Columbia, SC 29201
Phone: {803) 734-5200
Emerge~cy & Holidays: (80J)73-4-S.C24
I LEASE PRINT or TYPE (Form do,loned lor use on elite 112-ollchl tvnewrllerl
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo.
Form A roved. 0MB No. 2050-0039 E,pires 9.30.ea
Menlfoe1 • I 2, Pag8 1 lnlormation in the shaded a<eas is not
11 41 ~~c~:"87' ~0 -?I of 1 required by Federal law, but is by State law.
I
I
I
I
I
I
I
I
I
I
n
I
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I
WASTE MANIFEST N,C,D,0,q,7,6,0,1•• 7,
1 Generator's Name and Mailing AddreSs
' Channel Master
G
E
N
E A
A
T
0
.A
T A A
N s p
0
A T E
A
~ A
C
I
L I
T y
P. 0. Box 1416, Smithfield, NC 27577
.t, Generator's Phone I 919 \ 934-9711
5. Transpor1er 1 Company Name
Willms Truckin° Co Inc. ~, c, D• O• 7• 1, 7• n. 9, ?, Cl • o:tr·· ·•··•·•••Phono·•i::Y0 n 1 ·1 .. 7~.7:io.1.1,,•,·••
7. Transporter 2 Company Name 8. U.S. EPA 10 Number Fl{Qt-;;:-.;,;:=·f···,q'·'"·. --·•·j{lo:::.c: · .. =·~f~ ... :-"t:.."'~;'.;".c,:f-.:
I I I I I I I I I I I FYt· "·-~·:): ·,'!:':'•,=<,:;.~·!»t~~-'.;:(:{J:;;~:::1~,:-,:
9. Designated Facility Name and Silo Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
10. U.S. EPA ID Number j~f~~~,,;fi:t\%!:ff.i_j!~r;:;.::\t·. c//d:~~~B11fJt
r Sr Cr D, 0, 7, 0, 3, 7, '. 9, !', ' '.1~£~;f:::{~i:J:~::;:iir::ti,o,~Yi:~-~'wg~lf!tA
11. U.S. DOT Oescrip!ion (including Proper Shipping Name, Hazard Class, and ID Number)
a.
t>.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84461
12. Containers
No. Type
, · ,1 D 1T
' ' '
' ' '
' ' '
13. Total Quantity
I I ,2 ,o
I o > >
' ' ' '
' ' ' '
14.Uni!
'MN•
y
1 F i 6,f,if,'~
1E1D1Q161$
.{{ 'i .. ,
'.it 1.
,a. GENERATOR·s CERTIP:1CATION: I hereby declare !hat the contenl:! ol this conslgnmenl ere lully and accu,atelyducrlbed above by pro~r ahipplng n•m• and are clau.ifle<I.
packed. marked. and la.baled. and are In 1111 rospoct:, in proper condition !or transport by highway according to applicable lnl11rn1.tion1.I and natlonal government re-gulallona an<S
U'le laws of the State of South Carolina.
If I am a larg~ quantity generntor, I cor1ily !hat I hnvo a program In placo to reduce the volume and loxlcllyol waste generaled to the de-gree I have determined to be economk:.alty
practicable and th11l I have :,elecled the prac\lcable method ol lree.tment, slorage, or dlsposal currenUy available to me which mlnlmlza1 tha pre:,.ent and future tl'\r-1 to l'luman
t,aat\r, and \ha environmenl; OR, If tam II small quontirygenoralor, 1 have made a good lei1h effort I0 minimize my wa:,te generation and select tl'\e beat waate managem•nt meotl'lod
rhat 11 available to me and !hat I c"an alford. ·
Printed/Typed Name
Charles R. Hansen I Signature 1/ /_'/4J..
Month Day Yoai
f!f,D/+fll'>
17. Transporter 1 Ac,nowledgemenl ol Receipt ol Materials /
Prin\ed/Typed Name -#/J )"G-( I Signature~,£ -Monlt1 Day Year
-./C-r ,_ r " · • " ,
18. Transporter 2 Acknowledgement of Receipt oi'Materials -
Printed/Typed Name I Signature Month Day Year
I , I , I ,
19, Discrepancy lndica!ion Space
I I Jib!. ; I 111&
b I pt,,, d I pbs.
20. Facility Owner or Operator: Certilicalion ol receipt of hazardous malcrials covered by this manifest excepl as noted in Item 19.
Printed/Typed Name I Signature Month Day Yaat
I . I , I '
EPA Form 8700-22 (Rev. 9/86) Previous Edilions arc Obsoloto [DHEC 190B (Rov. 10/06)1
- ------,
I f~\ -th Carolina Department of Health
·~:_ and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt.
2600 Bull Streol Columbia, SC 29201
Phone: (BOJJ 734-5200
Emergency & Holidays: [phone]
(Form deslnned !or use on ellte [12-pitch} tvoewriler) Form A1 oroved. 0MB No. 2050-0009 Expires 9-30-Ba I LUSE PRINT or TYPE
UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Generator's U.S. EPA ID No. Menlloal 12, Page 1 , ,.?ocumenlNo. f Information in the shaded a<ea.s is not
required by Federal law. but is by State law.
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N,C,D,0,0 ·7,6•0•'"7,J,4.i,0,8,2,3 ° 1
1 Generator's Name and Mailing Address
' Channel Master · ~ii~:l~:,:~l~--F:.~::~:::~::0'.\;!:~~f~?;:;::·
tilf ~~~~~f ~1.W~i;~~-:~;1\~'}i!1d:-:~:t~~;/!~~t¾!t:
•
T
P. 0. Box 1416, Smithfield,
(. Gene,ato<'s Phone I 919 I 934-9711
5. Transporter 1 Company Name
Willms Trucki111• Co. Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Silo Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood. SC 29125
NC 27577
8. U.S. EPA ID Nl!mber
I I I I I I I I ' I I I
10. U.S. EPA ID Numbor
, S, c, D, o, 7, 0, 'l. 7, ' 9, 8
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and fO Number) 12. Containers 13. Total Quantity 1( Unit ·L 'Wntll ~)f,
No. Type 'MNrJ :/>·,'•:i;{i::<~i:f}1¥f~1
L
Hazardous Waste, Solid, nos ORM-E
NA 9189 ,-11 D ,T I I ,2 ,0
b.
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C.
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d.
I I I I I I I
, S. Special Handling Instructions and Addi!iona1 lnlormalion
GSX Work Order No.: 84462
18. C[Ml!AATOA'S CERTIFICATION: I horeby declare that the conton1:, ol thls conslgnmenl are lully and accurale1ydascrlbed above by pro~r 1hlpplng nama and are cLal-aifl.ct.
packed, mark&d, and labeled, end are in n!I rospacts ln proper condition !or transport by highway according 10 appllcabla lnlarnatlonol and naUonal go11arnmant r~ulatlon1 ar,d
U'le laws ol the State ol South Carolina.
II I am a large Quantity generolor, I certify tha1 t havo o program In placo lo reduce !he volume and loxlcltyol waste gene,aled to 1he d&gree I have determined lo be economic.ally
practicable and that I have selected the practicable method of treatment. storage, or dlspoul curranUy available lo me which minimize, the pres.en! and luture tnreal to human
health and the environment: OR, II I am a small ciuantitygeneralor, t have mado a good lailh effort to minimize my waste generation and select the beat wutt1 management ~thod
that ls available !0 me and that I can afford.
Prinled/Typed Name
Charles R. Hansen
I Signature Monlh Day Yoat
10 ,8 ,o ,4 18 ,8
_. A I~
17. TransPorter 1 A1,;Knowledgement ol Receipt of Materials
I Signaiu,e ~ _£} .,./ _.: _ __, Monlh Day Year
p
Prinled/Typed Name F ~ <'..-62& J e. L-<:-~-I "· F1 "' A!'l,f, .f .
0
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18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name I Signature Month Day Ye.at
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19. Discrepancy Indication Space
1--~I I I Jlba. q Jlbl.
b ,_! U-J....1-1-'pbl. d ,_I ,._,__.......,_,pt,,.
L l~--------------T 20. Facilily Owne, 01 Opeialor; Certilicallon of ieceipt of hazardous malerlals covered by this manifest except as noled In liem 19.
Iv
Printed/Typed Name 1-Signature Month Day Year
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EPA Form 8700-22 (Rev. 9/86) Previous Ed1l1ons arc Obsoloto (DHEC 1988 (nev. 10/86)]
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South Carolina Department of Health
and Environmental Control
E PRIITT or TYPE (Form desl ned for use on elite 12· itch ewriter Form A
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. Menifoet 2. Page 1
Document No. ol
1 Generator's Name and Mailing Address
. Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Generafor'sPhone 919 934-9711
5. Transporter 1 Company Nam_e
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Silo Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood, SC 29125
14008 4
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
SCD07037
Bureau ol Solid & Hu.ardous Wuto Mgt.
2600 Bull Streel Columbia. SC 29201
Phone: (BOJ) 734-5200
Emergency & Holidays: (803)73-4-5424
roved. OMS No. 2050-0039 Expires 9-30-1!8
Information in the shaded areu is not
required by Federal law, but is by State law.
11. U.S. DOT Description (inc!Uding Proper Shipping Name, Hazard Class, and 10 Number} 12. Containers 13. Total Quantity U. Unit
No. Type WtMo
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84463
I F j o, l,'91~
1 D T 2 0 Y .. 1E1Q1Q161ij
18. CEHERATOR0S CERTIFICATION: I hor11by declare that the contents ol this consignment are fully and accurately described above by proper •hipping nam• •nd ar• cl....,fted.
p•ck&d. mark&d. and labeled. and are In 1111 res pacts In proper condition lor transport by highway according to appllcabla lntarnatlona1 and national govarnmant ra,gulatlon1 and
U'le laws ol tho State ol South Caronna.
II I am a larga ciuantity generator. I certify lh11! I h11v11 a progrnm In pie.co to roduce the volume and 10,dcHyol wa11e generalod to the d&,gr-I have detarmlned lo be OCC>f\Omlcalty
pracllcab1e and tha1 I have solocted the pracllcabte mothod ol lroetmenl storage, or dlspo1u1I currently avnllablo lo mo which mlnlml1.et tho pres.on! and fun.r• t.nr-t to hum.an
health and !ha environmenl; OR, if I am a small quantity generator, t havo made a good laith effort to minimize my waste generation and sol act Iha t>t,1\ wuta managem•nt m.tho<I
thal Is available to ma and \hat I ean allord.
Printed/Typed Name
Charles R. Hansen
Signature Month Year
0 8 8
17. Trans parter 1 Ac,nowledgement of Receipt of Materials
Printed/Typed Namth Signature Month Day Year
f;
16. Transporter 2 Acknowledgement ol Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy lndicai!on Space
I I l1b1. ~ I 1~
b I jib> d I l'b!.
20. Facility Owner or Opera!or; Certilication ol receipt ol hazardous malerials 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)]
;?7..,-.
I 'y·,\ \ South Carolina Department of Health BuraauofSolid&HaiardousWa,teMgt
.. -vc ... '"' .::..,-~ ::-..-~.,,,} and Environmental Control !:!'."11
1:~1~~;~:i•. sc
29201
i
I
Emergency & Holidays: (803)7:l4-5424
t. ~-'~E PRINT or TYPE (Form deslnned for use on eme 112-pitchl tvoewriler\ Form Ai orov&d. 6MB No. 20.SO-OOJ9 E.,;oire:, 9-30-88
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIONo. 0 Manllor~ 12, Page1 Information in !he shaded M'HS is nor WASTE MANIFEST N,C,D,0,9,7,'-·0·'" 7, I· 4-0~o"'.'Ii72,5 of 1 requiredbyFederallaw,bu<i,byStatolaw.
3. Generator's Name and Mailing Address
' Channel Has ter
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J---"W.:i.:l.:l"'m"-s_T"-'r'-'u"-'c"'k'-'i'-'-n"'Q'--"C"'o_,_ . ..,_In,.,_c"-'-. ______ ._,s.,._:,'-'c~·•__.D,,1o_,Q"-1o-'-7_._,."'3'-'-,7'-,"'"-n."'9,~2l"-"<.l"--''f-'~!',;}·l··•, ... , ............•.. :sl'hont. ·• •.. •.
10
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7. Transpcrter 2 Company Name 8. U.S. EPA ID Number ~ ··· .. ~;,.L./. ;:._··
I I I I I 1 1 I I f f I 'F-li:-r' '·· , .... , ...... 's"Phofw·J.:<::i,., '.··, .. :·•;::··e:·,',.,~~:if>,~~•;'.'.: . .:0::.\·:ii•i•,•,;·
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood. SC 29125
10. U.S. EPA 10 Number :i;::~;~:,~:~:i~\~;:~ii\{{:~:\{(/.-/::::: ··-.-.::_:_·/.'.,;·:~)lt\/.
, s, c. o, o, 7, o. ~ 7, , ~ ·a ~ .fj{t~~:~~~i;J;ill{\lfWJb'J·fi~•~¥~6~iV1t
11. U.S. DOT Oescrip!ion (incfuding Proper Shipping Name, Hazard Class, snd ID Nu,;.,ber) 12. Containers 13. Total Quantity U. Unit
No. Type WtNci
; L :.-;F;o,T,i:i'1% Hazardous Waste, Solid, nos ORM-E <;{ if<.·· s 1--.::N~A~9~1..:8'..:9~-------------------------1f--l'-· J•.:l--lD'.:.J,T.:--1.J'_.L '.1':.2.1•;'.0-J-Y.:__,i:;;;:j..:1 ::f::I ::P::1 :::P::1 ::6:.1 &r.:j'"'.
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.,s. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 84464
I .
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1 e. C!NERATOR'S CERTIF1CAT10N: I hereby declare thatlhe conlants ollhls conalgnment are fully and accurately ducrlbad above by prop.tr 1hlpplng name 1nd are cJaU,ft-,,
p1ck1Q, mark ad, and 1aheled,and are In nil rospecta In proper condition for lranaport by highway according to oppticab1e lntarnationol and naUonal govornment r99ul1tlona an<I
V'la laws ol lhe Stale of South Carollnn.
If I am a large Quantity generator, t cor1iry the! I hove a program In placo to reduce the volume and 1oxlclty ol waale generated lo the d~rH I hava delermlna-d to b'CI economic.ally
pracbcable and thet I have ,elected the pracUceble method ol lreelment. slorege, or disposal currently available to ma which minimizes Iha pras.enl and lun.ira ltlrut lO human
health and the environment.: OR, irl am a smell Quantity generator, I have made a good faith aNor1 to mlnlmlte my waste oenera!lon and select the b&1\ we,10 management method
that Is a':'ailable to me and that I can ellord.
Printed/Typed Name
Charles R. Hansen I Signature L../ ("'~J,~
Month Day Year
10,8,0,418,8
T , 7. Transponer 1 Ar.;Knowledgement of Receipt of Materials
l ~~r~P,~in_t_ed~/~T~yp_ed_N~,-m-,-~------'--------=1s~ig-na-t-ur-e-----------------------~M~o-n-m-~D-a_y_Y~u-,~
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o , 8. Transponer 2 Acknowledgement ol Receipt ol Materials Af-----'------~------'-------~----------------------------------i
I ~~+--P_"_"_ted-/T_y_p_ed_N_,m_, ______________ J_s_ig_n_•_lu_" _______________________ _.M_o.Jn'-m..,._D ... •-y .... _Y_.oar-i l , I , 0 I ,
19, Discrepancy Indication Space
I ~ 11---------------'---T 20. Facilify Owner or Opera!or: CertHicalion of receipt ol hazardous malerials covered by this manifest except as noled In Item 19.
lv~~--'---=--------'----'--_.:..;_;__:_-----'--'--''-------i Printed/Typed Name I Signature Month Day Yw
I , I , I ,
EPA Form 8700-22 {Rev. 9/86) Previous Ed1hons ore Obsololo (DHEC Hl88 (Rev. 10/86)1
1.
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
l Generator's Name and Mailing Address
Channel Master
ewriter
1. Generator's U.S. EPA ID No.
N C D 0
Manlfoat Document No. 0 8 2 6
P. 0. Box 1416, Smithfield, NC 27577
4.Generalor'sPhone 19 934-9711
5. Transpor1er 1 Company N.ime
Willms Truckin Co
7. Transpor1er 2 Company Name
Inc.
9. Designated Facility Name and Site 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 10 Number
10. U.S. EPA 10 Numoor
S C D O 7 0 3 7
Form A
2. Page 1
ol
Bureau or Solid & Ha.z.ardous Waste Mgt
2600 Bull Str~l Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (603)734-5-42,,
roved. 0MB No. 2050-0039 E.rpires 9-30-88
lnlormation in the shaded a<eas is not
required by Federal law. but i, by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Ouantily U. Unit l"W&,11~,, ....
No. Type 'Mf'lrJ ;/i-.::,,.:<·'··-'.\;-);:~:/kj
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Speciat Handling Instructions and Additional Information
GSX Work Order No.: 84465
1 D T 2 0 Y
1· I ,--~
~~~~~,~
.. ... ,
:"-~ I
,e. CE.HERA TOR'S CERTIFICATION: I hereby declare lhetlhe conlenls ollhb conslgnmenl are fully and accurately described abov• by proper 1hipplng name and ara cta...,;ned.
packed, mark&d, and la"belert, end ere in n11 rospocts In proper condition ror transpot1 byhlghwey according lo applicable International and natlonal government regutatlon-1 at\d
!/'la laws of Iha St.-.111 or South Cnrollnn.
111 am a huge Quantrty genero1or, I cortily thel 1 hovo a progrom In piece lo reduce the volume and toidcltyol waslegenereted lo lhe d&gr-1 have datarmlnltd to tHI economlealty
pract,cab!e and that I have selected the practicable method ol lreotmenl, storage, or dl:!ipo!ltll currenlly available to me which minlml1es the pres.ent and lutura lhrwt 10 human
health and the environment: QR, II tam a smo!I quanlitygenora!or, I have mode a good lai!h eNort lo mlnlml1e my waste generation and selt1Cl ttle tHlal wa,111 managemanl m.ttiod
that Is available 10 me end lhol I can afford.
Printed/Typed Name
Charles R. Hansen
Signature Month Day Year
0 8 0 4 8 8
Month Year
Printed/Typed Name Signnlure Month Day Yea,
19. Discrepancy Indication Space
I I Pb!. ' I Jllll
b I ptn. d I ptn.
20. Facility Owner or Operator: Certiricalion of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Signature Month Day Year
A Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete IDHEC 1988 (Rev. 10/86))
; '
I South 'tarolina Department of Health
tnd Environmental Control ·
Bureau of Solid & Ha.z..ardous Waste Mgt
2600 Butt Street. Columbia, SC 29201
Phone: (6-0J) 734-5200
Emergency & Holidays: (803)734-S42C
I LEASE PRUIT or TYPE {Form desloned for use on elite r12-nitchl ...... ewriter) Form Ar
UNIFORM HAZARDOUS ,,. Gonoralor'sU.S,EPAIDNo. Monlloot 12. Pagel Oocumnnt No. ol
roved. 0MB No. 2050-0039 E.xpires 9-30-aa
Information in the shaded a<eas is not
required by Federal law, but is by State law.
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WASTE MANIFEST N,C,D,0,9, 7, 6, o, 4, 7, I, 411 ,0 ,8 ,2 ,7 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,. Generator's Phone( 919 \ 934-9711
5. Transporter 1 Company Name
Willms Truckinn 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
Is, c, n, o, 7, 3, 7• n. 0, ?, (\ • IJ/T ,,,. 'af>hoM' ''-''Ano/7h7.c,.,.,,.
8. U.S. EPA ID Number ~\o.·:;:-..;_,'}(·''· :· .. a'°CJ:\-:-.::·,,-·. =·:'~i~i: :Ji;-..::,r!·,
I I I I I I I I I I I I F:i'r:;c;.:··, ··_,;,Pi,o;;;e,;/.,> •·o•·.•i,,•'<c'i#,'''/4'-''.;,,.;
10. U.S. EPA ID Number
' .; d
, S, C, D, 0, 7, 0, 3, 7, ' ~ a , w:i[;0si.r:,~,n:.::';rsai1i;~2:::],g~rt;~
11. U.S. DOT Description (including PrOpcr $hipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1( Unil
No. Type 'lrWr:I
, · ,1 D 1T I , ,2 ,Q y
' ' I I I I I
' ' I I I I I
I I I 1 I I I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84466
,e. GENERATOR'S CERTIFICATION: I hereby declare lhat the contents ol thls conslgnmenl are lully and accuratelydescrlbod above by proper •hipping nama and are clauinao.
packed. marked, and la.be1ed. and are in all rospects In proper condition tor transport by highway according to opp1icable International and natlonal government rl!Milu1a110n.1 arod
the laws ol 1he Stale ol South Carolina.
111 am a large quantity generator, I cor1ily that I havo a program in p1aco to reduce the volume and to,:lcltyol wastegeneralod to the d&gr-I have determined 10 be economlcalty
practicable and that I have salecled the practicable method ol treatment storage, or dlspos.al currently available lo ma which mlnlmlzaa the pre Mn! and luture thrul to human
health and the environrnenl: OR. II I am a small quantity generator, I heve made a good laith arlor1 to minimize my waste generallon and select the boat watta management ~thod
that 1, available to me and 1h111 I c11n ol!ord.
I ~--P-rin-ted-/~T~;.!~!,:::!;:S;~~:;;•s~R~ • ...!;H,!!a~n;:s,;e:;;n~------ll_Si-gn_•_tu_,._...J./..;;;:¾!;.;!_,.:OJ.::!;;:,.· ...i/~·~--'-/L..::.::;~'./:;:;a;.:::;;::;;:;::::;;.. ____ l1M:;:Oo.l~,;::J,e;'O:.;o~i::[~!;•'8:_Y:"'.1;8~
~ 1-1..:7,;.. ,,.r..:r•..:n::,sp,..o:,rt::•.c' .:,1.;.Ac.'c:'nc:o..:w..:led:.:agc.em=enc:t..:o,;.! ..:R•.;.c::e::ip..:tc.oc:f M=•'c.''c:i•c:ls:_ __ --i-:::--:c---r---,-----------,------:-:--:---::---::---1 I j ~~liD.AL( (> I ft):K ISignatur~r/o.J)J r p~ ~o'.~~~<1({~
o 18. Transporter 2 Acknowledgement or Receipt or Malcrials Rf--'--.C...:=:.:....;:_::.:....;c_:=::..::..::..:"'-'..:.:..C.:..:'-..C:...::.=---,-----------------------,----=--:c--i
I -TRE-I--P-r-in-1ed_. _,r_y_p_ed_N_•_m_• _______________ ls_ig_n_•_1u_,_' ______________________ ,-1M-on,_t11_._□,.•y_._Y.,.ear"--i
19. Oi5erepancy Indication Space
I i
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1 , I , I ,
I IL...L.JL...L.JL...L.JJ!bs. C IL...,L...L.JL...L.J'-'!lbs.
b\ I \I"'-d\ .1 jibs.
T 20. Facility Owner or Operalor; Certificalion or receipt ol hazardous materials covered by this manilas! except as noted in Item 19.
I Vl------'-----'----'--~~--'-------t Printed/Typed Name I Signature Month Dey Year
I , I , I ,
EPA Form 8700-22 (Rev. 9/86) Previous Edtltons are Obsoloto [OHEC 1008 (Rev, 10/06)]
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haurdous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: (8-0JJ 734-5200
Emergency & Holidays: {B03)73.4-542t
I l~E PRINT or TYPE (Form desiqned for use on elite r12-pitchl tvnewriter)
I UNIFORM HAZARDOUS 11. Generator'sU.S.EPAI0No.
Form A "roved. 0MB No. 2050-0039 E.lpires 9-30-88
Manlleat 12, Page 1 Document No. of lnlormation in lhe shaded a<eas is not
required by Federal law. bul is by Sta.le law. WASTE MANIFEST N, C, D, O, q, 7, 6, O, '·· 7, !, 4,Q,Q-0 ,2,A 1
It 3. Generator's Name and Mailing Address
Channel Master
A\SiNMiinlfeiiiOocumon!Numbor, ,.;f-0::L:C::ii ; :(//:Jh;L'.{,: ... : .. ; ;<~<:.>,f),iX*~/'.-;
P, 0. Box 1416, Smithfield, NC 27577 !!J~~ti1f;/,.'.' .. ·,:,.:,.c,. , .... ";,,_;,,-;;,' • ·
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.. -·<·>, . '··, ' ,, .... . . . . . .. ",,' "' :··· . -· '·,_.-:_:.'_•.·._,,'.:_,_·.·.·,··,•,··,·:',_.·_:,,,.·,·.'.·.".·.-.·.:.·_,:·:.'·.'.~--;',····•. o&. Generalor's Phone I 9 1 9 ) 9 34-9 711 ::'frif:/:}J;\_C~~);::;;,i:°:),/./f<.;,f:./,,•,:_~:· ,
d.
' ' ' ' ' ' ' ~~~,f:~~!~~!~,i~~i:~I
15. Special Handling !nslructions and Additional lnlormation
GSX Work Order No.: 84467
18.. GE:NERATOR"S CERTIFICATION: I hereby declare thetlhe con ton ts olthls conslgnmenl are fully end accurately ducribed above by proper 1hipplng name and ara clasaiffed.
packed. marl<e<I, and reheled, end are in fl.II rospecls in proper condition !or transport by highway according to applicable lnternallonal and nauonal govarnmen1 reoutat1on1 and
u,e laws of the Stale ol South Ca.ro1in11.
If I am a large quantity generator, I certify that I havo a program In place lo reduce the volume and loldcltyol wastegenereled to the d~r-1 have deter min ltd 1o·b4o economlealty
prac1icabh1 and th11.t I tu1vc, sc,!ected lh6 pracUcablo melhod ol lrt111lm6nl, stort1ge, or disposal currently avollabte to me which mlnlml~es the presant and future~, .. , l0 humtin
heallh and 1hc, 11rwironmont: On. II I am n nmnl1 qunntlty gonorn1or, I hnvfJ mndo n oood lnlth ellort to mlnlmlte my was I.ft gt1ner11\lon nnd select the t,e11 wa1te managemenl ,,...thod
lt\al Is available to me 11.nd thlll 1 con nrlord.
I Printed/Typed Name !Signature , / Monll'l Day . Year
~1---....'.C:!h!.::a~rc;!l;:;e;.::s~R~ . ...!,;H;!;!a:;:n~s;;e:;:n ______ J. ___ _./':'-•.;·;;!~;:.--er::r:.J~::::-::.• _.a.,_/_t:,~::£&-!;,r:;:;:--:=;=,.__ _____ .i.:;,DJ.,.::8.J.1.::0J.'.:4.l'.::8J. . .::8~
T 17. Transponer 1 A(.;Know!edgement of Receipt of Materials
I A
A ~~ed/Typed Name V7 ~ 71-J.+1,Jf-J,,._ J /~1i/'-//L-.
Month Day Year
1 r-.-1. .,,,, ,..., r. <
~ :.;fl,:B-:__Tr:.:•::n•::oo:,:::n::,er:.:2:.A:.:c::k;:,n,:o:.:w:.:l•,:dg?:e::m:.:e::n::t::.ot:.:R:.:e:.:c.:eo.:·P:..to::t:.:M:::•::te::r::ia:.:ls:__ __ ~---------------------------------l
I -TAE-+--P-n_·n-ted-lT_y_p_ed_N_a_m_e _______________ ls_ig_n_•_tu_,_• ______________________ -1M.o_n1.tt,-1-01.ay...1,_Y_.ear----l
19. Oi5erepancy Indication Space
I ~ L •t-------------,-----,-----------
1
~ 20. Facility Owner or Operator; Cer1ilicalion ol receipl or hazardous materials covered by !hi3 manifesl e~cepl a, noted in Item 19.
Printed/Typed Name I Signature
EPA Form 6700-22 (Rev. 9186) Previous Editions arc Obsolete [DHEC 1988 (Rev. 10186)]
I , I , I ,
1 lw...J..-'-1-L..Jpb!. c 1 .................. L..Jll\ll.
bl P"'-dl jibs.
Monl/l Day Yw
I , I , I ,
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
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D O 7 6 0
M11nlfe11t
Oocumnnl No. 1400829
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 10 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 Shippfng Name, Hazard crass, and ID Number)
a. Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions arid Additional lnforrriation
GSX Work Order No.: 84468
Form A
2. Page 1
ol
l D T
Bureau of Solid & Haz.ardous Wa,te Mgt
2600 Bull Streo\ Columbia, SC 29201
Phone: (8-0J) 734-5200
Emergency & Holidays: (803)734-542,
roved. 0MB No. 2050-0039 Ex ires 9-30-8.!
lnlormation in the shaded a1eas is not
required by Federal law, but is by State law.
2 0 Y
115. OEHERATOR'S CERTIFICATION: 1 hereby declare Iha! the conlonts ol this com1lgnmont are lullyand accuretotydncrlbod above by proper ah Ip ping name and are cla.-ift..c:I,
paclo.od. marked. and ra·be1ed, and are In all respects In proper condition !or transport by highway eccordlng to applicable lntern1ulonal and nallonal goverl"lmon1 r~ulatlona arid
tno laws ol the State ol South Carolina,
II I am a large Quan1tTy gencrolor, I certify th11t 1 hnvo a program tn pin co lo reduce tho volume 11nd to11lcltyol wa1tegoneralod lo the d&QtH 1 have determlnod to~ economh:.alty
practicable and that I ha.,,e selocled the proctlcablo method ol lr(lotmont, storage, or dlspoaat currently avollablo to me which mlnlmlzet the pruent end lutur• thrMI to human
health and the environment; OR, II I am a smoll quanlitygenera!or, 1 hove mode a good la Ith effort to minimize l'Tly wasle generation and select the beat waat11 management ,,,..tr,od
that Is available 10 me end thal I con afford.
Printed/Typed Name
Charles R. Hansen
Signature t-d
Signature
Signature
19. Discrepancy Indication Space
20. Facility Owner or Opera1or: Cer1ilicalion of rcceipl ol hazardous materials covered by this manilas! except as noted in Item 19.
Printed/Typed Name Signature
Month Day
0 8 0 4
Month
Yeat
8 8
Month Day Year
Monlh Day Yea,
EPA Form 8700•22 (Rev. 9/86) Previous ~dilions are Obsolete (DHEC 1988 (Rev. 10/86)!
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D 0
Manlleet Document No. 1400830
Form A
2. Page 1
ol
Bureau ol Solid & Hatardous Waste Mgt
2600 Bull Streot. Columbia. SC 29201 .
Phone: {803) 73-4-5200
Emergency & Hondays: (603)734-542'
roved. 0MB No. 2050-0039 Expir"' 9-30-88
Information in the shaded a<eas is no!
required by Federal law, but i, by State law.
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
.C. Generalor'sPhone 919 934-9711
-~'.!;_;~::,~,,~;::: .. :~~-(~Ii;f'.!\~;i)
~~l~~;~~~,~~-{~:;;:t(;~:;;,:~'.,'.:~;_;;.:~~~;:~~~t~;~/;
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 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA 10 Number
S C D 0 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Numl>er)
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84469
12. Containers 13. Total Quantity 14. Unit
No. Type 'MNrJ
1 D T
::PF ; ci1f~~~
2 O Y ~1E1D1D161f
...... , .. , ,.,,. ..... ~ ··: ,._ ...... _,_.__, !i~
"'/.ll 1, __ I~
1e. CENERATOR'S CERTIFICATION: I herobydeclare thal lho contents ollhl, conslgnmenl are fully and accurat.elydescrlbed above by proper ahlpplng nama and are clasaifl.-d.
packed. marke-d. and labeled, 11nd are In nll respects In proper condition for transport by highway according to applicable International and natlonal government r~ulatlona at'ld
trie laws ol Iha Stale ol Soulh Caroline.
111 am a lar-.io quantity generator, I cortity that 1 have a program In placo to reduce the volume and toxicity of waa1a generated to Iha degree I have determined to be economle&lty
practicable end lhal I h11vG 11elocled thn pr11ctlc11blo m11thod ol lrctilment. :,lorngo, or dl:1poat1I curr&nlly avolloblo lo me which minimize• the present and lurur• ttirMt to human
h•atth and !Me environment. OR. II tam a smo!I quonlity gonorolor, r hove mado o good railh erlort to minimize my wa,t8 genoraUon and ,elecl the bell wlllte managemant ,.,,.thod
that 11 available to me and Iha! I can atford.
Printed/Typed Name Signature
Charles R. Hansen
17. Transporter 1 At:.i<nowledgement ol Receipt ol Materials
Printed/Typed Name Signature·
19. Discrepancy Indication Space
20. Facility Owner or Opcra!or; Certificalion of receipt ol hazardous materials coverod by thi, manifest except as noted in l!om 19.
Printed/Typed Name Slgnalure
Mont/1
0 8
Day
0 4
Year
8 8
Year
Mont/1 Day Year
I lw....Jw....JW....,I lbl. C lw....Jw....JU...,llbl.
bl /lbs.di pt,,.
Mont/1 Day Yw
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
I
, ~?~·-, ., ..,_
a l \ > •.1 . South .Carolina Department of Health
-. "'f artd Environmental Control · ·-.
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. Generalor'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Silo Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
MnnH011I
Oocumsnl No. 400831
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 0 7 0 3 7
Form A
2. Page 1
ol
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia. SC 29201
Phone: (BOJJ 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Expires 9-30-88
lnlormation in the shaded a<eu is no1
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. Unit
No. Ty!>" '1/JVd
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
~~ ~;;;~~~~t~:{tg~~!~!!l~t1:11t~;\~~:\l~~t~l~t1~~J~~!·:11~~:!~lf :1i~!:lf 1!:~1~~
b.L_u-J 1-J ..... 1.i;i!:! :1::dw~J 1-1
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84470
.. 1 F jQ,ffg'f;;;
.:;,: )l~
2 0 Y ~1f1010161i
1 e. CENERATOR'S CERT\_FICATION: I hereby declare that the contents ol this consignment are lullyand accurately described above by proper •hipping name and are claaa,fte,d,
packed. marked. and labeled. end are In t1II respects In proper condltlon tor transport by highway according lo applicable International and natJonal government ra,gulatlon• ar.d
11'le laws ol the Stale ol South Carollnt1.
111 am a h1HJO Qu11n11ty gnnflrntor, I corlily trrnt I hnvo" proornm In plnco lo reduce Iha volume 11.nd IOKlcltyol w11.ah1 g1mera1&d to Iha degree I hava determined lo ti. oconomleally
prect,cable and that I have selected tho pracUcable melhod ol treotment, sloroge, or disposed currently 11.vollabla lo ma which minimize, Iha present and lutura ll'lrNI to human
health and the environment OR. I! I am a smoll quonlity generator. I hove medo a good faith eHor1 to minimize my we,ui generation and ,e1ecl !he bell we1te managemenl moethod
tf'lal 11 available to me and !hal I can a Hord.
Printed/Typed Name Signature Month Day Year
Charles R. Hansen Ao.~• 0 8 0 4 8 8
17. Transporter 1 A<;Knowledgement al Receipt of Materials
Month Day Year
merso -s-tJ
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
11 L... L...LIW-J..J!ibl. I .... I ................ ..Jlltll.
b I I'"'-d I I'"'-
20. Facility Owner or Operator; Certilication al receipt cl hazardous ma!crials coverod by this manilesl excopl as noted in llem 19.
Printed/Typed Name Signature Month Doy Year
EPA Form 6700-22 (Rev. 9/86) Previous Editions are Obsolete [DIIEC 1988 (nev. 10/86)1
I
~~-~~;
!<!If}'\(,~ '
~
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Ha.z.ardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5-424
I ■L£ASE ,PRINT or TYPE {Form desioned for use on elite 02-oitchl tvnewrlterl
1 UNIFORM HAZARDOUS 11. Gonoralor'sU.S.EPAIDNo.
Form A roved. 0MB No. 2050-0039 E.loires 9-30-88
Mnnlreal ,2. Page 1 Oog_umnnl No, ol tnlormation in the shaded areu is not
required by Federal law, bul is by State law.
I
Q
E
N
I~
0
I A
I
I
I
I
I •
I
T
I R
" N s p
0
R
I T
E R
I ~
" C
' L I
T
I y
WASTE MANIFEST N, c, D, O, q, 7, ~-O, 4, 7, 1, 4.0,u,8,3 12 1
7. Transporter 2 Company Name 8. U.S. EPA lD Number 'i:\Qt;;,:•i,i;.''.Tw•···· ·· S'r:):::.,' · ·· · · ··
, , , , , , , , , , , 1 F/rmn;~. P11ooo .•.
, S, C, D, 0, 7, 0, 3, 7, '
9. Oesigna!ed Facility Name and Site Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U. Unit -l'._W&'Sti'N1.l'Dblf>+
· No. Type WVVcJ. ;'\('\::<•/~{=/{Jft/
a.
b.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Addil!onal lnlorma!ion
GSX Work Order No.: 84471
I '
I I
I I
, , ,2 ,0 Y
I I I I I
~ .. ,:...~ . .;;.,..:-.,-.,l .. ,:.r-. ·n ,..__.__,..__,__.,, i
'.°'.' I I:'.}:
' ' ' ' '
I I I I '
15. GENERATOR'S CERTIFICATION: I hiireby declare Iha! the contonts ol this conslgnmenl 111re lully and accurotely described 111bova by proper 1hipplng nam• and are cl•s.a.ined.
packed. ma1ked. and lo.beled. end are in RII rospocls ln proper condition !or tronspor1 by highway according lo applicable International and n111Uonat govarriment r9-Qulatlon1 •r>d
UHi laws of the Stale ol Soulh Carolina.
If I am a large Quantity geriera!or, I certify that 1 have a program tn pl111ce to reduce the volume and 1oxlclty ol wa1tagener111ted lo 1he dOQrH I have datarmlned to be oeonomleally
prachcable and lhal I ha Ya selocled tho practicable method of lrentmont. storage, or dlsposal currenlly avo.!labte lo me which mlrilmlzo, tha pres.an! arid lurura U'lr-1 lO l'luman
h•am, and the en.,,ironmonl; OR. II I rom II nmn!t ,iuonllty oonorolor, I trnvo mnc1o o oood lnl!h elfor1 to mlnlmlie my was lo gonorallon and select lh• befl wa,ta manag•manl m-eltiod
tl"lat 11 avai1at:,1e to mo ftnd thnt I cnn nllo,d.
Printed/Typed Name
Charles R. Hansen I Signature ../
/? ./ .,?' , • ½. , "' /4,
Month Day Year
1 0,s,o,4,s,s
17. Transporter 1 Ae;,mowledgement ol Receipt of Materials
Printed/Typed Name /l, / , /1 _ ~ \IFignaturo A I ~'L 0J'-• .. , J.J I l---,. . . J \ · ·
Mo~~' Day Ye.ar • D, ti, f,g', ~
18. Transporter 2 Acknowledgement of Receipt of Materials
Prinled/Typed Name I Signature Month Day Year
• ' I ' I I
19, Discrepancy Indication Space
I I Jibs. C I llllL
bl pt,,. d I jibs.
20. Facility Owner or Operator: Cer1ilicalion of receipt ol hazardous materials covered by !his manifest except as noted In Item 19.
Printed/Typed Name I Signature Monlh Day Year
I , I , I ' EPA. Form 8700-22 (Rev. 9/86) Previous Ed1hons are Obsolete [DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
1 Generator's Name and Mailing Address
Channel Master
l. Generator's U.S. EPA ID No.
N C D 0
M11nlfo11I Oocum11nl No.
400833
Form A
2. Page 1
ol
Bursau of Solid & Huardous Waste Mgt.
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Hol;days: (8-03)734-5424
roved. 0MB No. 2050-0039 Expires 9-30-88
lnformalion in the shaded a<eas is not
required by Federal law, but is by Sta.le law.
f-'':..· .:::.::;.n;c. •:::"::.:~O:::.r..:.'•.:.:.c~.::;O:;c.:..,_1 _4"-~-"~-'9:....Ls_m_!"-"-~-':-~-'!'-';'-'i,._f,....· _N_c_2_1_5_1_1 ______________ ... •~;,;";;;-ir,,.r,,.1t""' •. :~~~i,04EW:';;:),'::r: ;::c~~t0';;;;~~
6. U.S. EPA ID Number 5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. ~signaled Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
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)
a. Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling lnslructions and Addiliona11nlormation
GSX Work Order No.: 84472
12. Containers 13. Total Quantity 1( Unit
No. Typo WVVrJ
1 D T 2 0 Y
,SiF i 01if?,~
\i1E 1010161~·
1 8. CENERATOR'S CERTIFICATION: I hoteby declare thal \he contenls ol this consignment are fully and accuralely described above by proper •hipping ri•m• arid••• ctaW119d.
packod. markod, arid libeled. end are In nll rospoc\s lri proper condl!lon for lransport by highway t1Ccordlng to applicable lr,tarnalional and national governmenl te-Qutal:lon, ar,(11
u,e laws o! the Stale of South C:a,olin11.
111 am a large Quantity goncrolor, 1 certify thnl r hnvo a progmm In placo to reduce the volume and toxicity olwastegenaralod lo !he d~ree I have determined to b-e economic.arty
practicable and that I have seloctcd tho prncUcoble mothod ol lrot1tmonl. storoge, or dlspoaal currently avoUable to me which minimizes Iha pros.ant and rurvra thr-1 to tluman
health and the envi1onmcnt.: OR, 111 am a smoll Quantity gonorator, t hovo mo.do a good railh effort to minimize my w11st& generation and s11tect tha beat wa11e management metl'ood
that 11 available to m11 11nd th11.t I can nllord.
Printed/Typed Name Signature Montti Day Year
Charles R. Hansen 0 8 0 4 8 8
17. Transporter 1 Atrnowled ement ol Receipt of Materials
Signature Mo,rtt\ Day Yw
Signature Month Day Year
19. Discrepancy Indication Space
a .... I .L.L..L..J.-' pbs. C I p1,1,
b .... l .L.L.i-L....I P"'-di ['bs.
20. Facility Owner or Operator; Cer1ilica1ion ol rcccipl of hazardous malcrials covered by lhis manifesl except as noted in Item 19.
Printed/Typed Name Signature Monlh Dey 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
ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Genera!or's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,. Generator'sPhone 919 934-9711
5. TranspMer 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sito Address
CSX Servic_cs of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Numbor
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)
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
CSX Work Order No,: 84473
Form A
2. Page 1
ol
I Tl T
Bureau or Solid & Haz.ardous Waste Mgt.
2600 Butt SIieo~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)7l4-5"'24
roved. 0MB No. 2050-0039 E,pires 9-30-88
lnlormalion in the shaded a<eas is not
required by Federal law, but is by State law.
2 0 y
:.:i•~·-r·:i:·01:-.-1--'flfi~
:~:[t,r 161016 r~:
18. GENERATOR'S CERTIFICATION: I hereby dl!Clare that the contents ol thl, conslgnmenl arl! fully and accuratoly described l!boVe by proper ahipplng nam• and ar• cla1.a1fle-d.
packed. marl<ed, and la°betcd, and are In nll ro,pects in proper eondillon !or tran,port by highway according to epplicable International and natlonal go11ernm11nt rogulat1on1 al"\d
uie laws ol 1h11 State ol South Cnrollnn.
II I am a large Quantity gonera1or, I certify lhel r he.110 a program In placo to reduce the volume and toxicity ofwutegonoret~ lo Iha dogree I have dotarmln9d 10 be economlc.alty
prac11cablo end that I ha110 selected the pracllcab1e method of \reolmenl. slorege, or dlapoael curren\1y evellable lo me which mlnlml:r.01 the pre:,.ont and lutur• tnrMI to P'lu,,....n
f'le1!th and the environment OR, ii I am n smoll quantity gnnorotor, I h11,vo mado o good faith eNort lo mlnlml:r.e my waste generation and sole cl the bell wut• mar,agem•nl rnelhod
trial 11 available to me and that I con etlord.
Prinled/Typed Name Signature
Charles R. Hansen
Printed/Typed Name
19. Oi~crepancy Indication Space
20. Facility Owner or Opera1or: Certilicalion of receipt ol hazardous materials covered by this manifest excepl 83 noted In Item 19.
Printed/Typed Name Signature
✓
1\1..WJ-"-1
blLL.LL...L...L
Month Day Year
0 8 0 4 8 8
Monltl Day Year
Monltl Day Year
Jibs. I I \I\JI.
jibs. d I jibs.
Month D,y Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions ore Obsolete [DHEC 1988 (Rev. 10/861)
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
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
N r. D O 7
Manlleat
Document No. 400835
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transr,orter 2 Company Name
9. Designaled 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 Numbor
10. U.S. EPA ID Number
S C D O 7 0 3 7
Form A
2. Page 1
of
Bure.au ol Solid & Hazardous Waste Mgt.
2600 Bull Stree~ Columbia, SC 2920l
Phone: (BOJ) 734.5200
Emergency & Holidays: (803)734•5424
roved. 0MB No. 2050-0039 E,pires 9-30-88
lnformalion in lhe shaded a<eas is not
required by Federal law. but is by Stale law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Confainers 13. Tola! Quantity U. Unit
No. Type 'M/Vd
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9.189 1 D T
~~: :r:/1 !t~i:'.l:1tlt:~fli\'l:1\!!ii,i;\i1!~!1i,,i:ii:1ii1';11:!,i,/ilrli~i~Ii1ii~l!Ii~lt~j~1Itii:1~~11iiQ;;1lii
a. lE..Jlij-lo 1217,7141-11 d ,012l:1i)ii':!!.iiii!c.w-1 I I I I 1-1 I I 1 l:;Y
b. Lw-1 1-1° I ... 1['(\:;,li!!!*}tdl+d:::J. . ....... ' ... ti... J[i,li
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84474
liF jO,Jfgt~
2 o y a,f,a,a,611
16. G~Ml!:RATOR'S CERTlf'lCATIOM: I hereby declare that !he content, Ol lhl, con,lgnmentare lurty and accuraWlyde,crlbad above by proper ■hipping n•m• ind ara claa.a,ft..:t.
packed. marked, and Inhered, and are in All rospoc1, In proper condition !or transport by highway according to appUcable lnhunational and national oo,,,arnmenl r--oulatlon1 ar,d
ui• law a 01 lh" 51t1t<1 of South C11rnU11n.
!fl am a large quan1ity gencrotor, I certify !hot I have a program In ptaco lo reduce the volume and 10,dcltyol waala generated to the degree I have de\ermlned 10 t>. oconomlealty
practicable and ttiat I ti ave selected the pracllcable method ol treatment. alorage, or disposal currently avnl1abla lo me which mlnlmlzn tha pr a sent and lutur• trHMI \0 human
l'laaltf1 and the environment; OR, U I am a smol1 quantity gonorator, I have mado a good faith f!INort to mlnlmlu my wa,ta gf!lneraUon and se1f!ICI the btlll wutf!I managem•nl m.-thod
that is available to ma and lhat I can aNord.
Printed/Typed Name
Charles R. Hansen
Signature Month Day Year
0 8 0 4 8 8
17. Trans Porter 1 At;Knowledgement of Receipt of Materials
Month Year
"
Printed/Typed Name Signature· Month Day Year
l~. Discrepancy lndicalion Space
I I !'bl. C I !!bl.
bl ptn. d I ptn.
20. Facility Owner or Operator: Certilication ol receipt of hazardous malerla!s covered by this manifest except as noted in Item 19.
Prin!ed/Typed Name Signature Month Day Year
EPA Form 6700•22 (Rev. 9186) Previous Editions arc Obsolete jDHEC 1988 (Rev. 10186)1
I South Carolina Department of Health
and Environmental Control
I •LEASE PRINT or TYPE (Form dc9l~ned !or use on eme 112-oitchl "'"cwriler) Form A
UNIFORM HAZARDOUS ,,. Generalor'sU.S.EPAtDNo. Monllool 12. Page1 Ooc:umonl No. of · WASTE MANIFEST N,C,D,0,9,7,6,0,4,7,J,4,0,0,8•'·6 1
It 3. Generator's Name and Mailing Address
Channel Master
NC 27577
.
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bull Stre<il Columbia, SC 2'9201
Phone: (BOJJ 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-00J9 E.xoires 9.30.ga
lnlormation in lhe shaded areas is not
required by Federal law, but is by State law.
: ;:•, "P. 0. Box 1416, Smithfield, ·.,1. ,;, Generator'sPhonet 919 I 934-9711
t. Transporter 1 Company Name
·Willms Truckin° Co Inc.
6. U.S. EPA lD Number
s, c, o, o, 7, 3, 71 0, q, ?, "
'C} Stitt{ .... ,,. ... . . •' 't{IO ':.,:-/-/ , : '· · 1 ~:·c"/:.•::};A~J.:;11,~y··'!f;
DftT "·"'·' --'S'PhoM \'·>RnT/.-7~ 1:a-~-~-~~''"'-· l 7. _Transporter 2 Company Name 8, U.S. EPA 10 Number
I I 1 1 1 I 1 , , , 1 ,
10. U.S. EPA ID Number I 9. Designaled Facility Name and Site Address
I GSX Services of SC, Inc.
. Route, I Box 255
Pinewood. SC 29125 , S, C, D, 0, 7, 0, 3, 7, '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and fD Number) 12. Containers
No. Type
·.,1 ~
~
a.
·Hazardous Waste, Solid, nos ORM-E
, ,1, D ,T I , 12 10 y NA 9189
b.
•.• 0 ' ' ' ' ' ' ' J~ t.
' ' I o O I I
·1
I
I
I
I ,
d.
> I I I I I I
15. Special Handling Instructions and Additional lnlormation
GSX'Work Order No.: 84572
•
r,e. GENERATOR'S CERTIFICATION: I horebydeclore lhnl the contents olthls conalgnment ere fully nnd accurately described •bove by proper 1hlpplno n•me •nd •re c••-ned.
pecked. marked, a.nd la.be led, and are In n11 rospoc!s in proper condition !or lronspor1 by hlghwey according to appllcable International and naUonal government r99ulatlon1 •n<I
tr1e laws or the State or South Carolina.
111 am a large quentity genera!or. I certify thal 1 have a program In place to reduce the volume and to deity ot wa,tegenereled 10 Iha d~r-I have determined to be economic.arty
practic11ble and that I have ,elected tho practlcebla method ol treatmenl. storage, or dlsposat currenlly avnllable to me which mlnlmire, the pre~nt and future ttH-110 h1,1man
healU"I end the environment: OR, II I .im n smn!t 11uan!itygonor:itor, t hnvo mndo n good le.it/, ellort lo minimize my we.slo generation and select l/"le ~,t waste management ,,.,.tf"lod
trial is available to mo e.nd that t cnn nllord.
I Printed/Typed Name
. Charles R. Hansen
Monl!i Day Year
10,810,518,8
~ 1-, __ 1.",T_r;;:.an--•::.P--Ort--•--r __ ,--A--"' __ n..:o_w..:ted::.ge.:e..:m..:e--nt..:o::.t..:A--ec..:e..:ip--to--'--M--•--te--ri--al.:.s ___ ,..,., ______________________________ 4 · 1 ~~ Printed/Typed Name , / • . ISignaluro ~ ,r/ -/, _ ,,,,.---:;. /7 Monl!i Day Year L'.'./011<?'/4--" <7-Oa-,:J (.2..--"'~ w, .l!.,../....j:/ "',i?lc::,,51~,li" : o 1-,-a-. -T-,,-n-soo_rt_e_r 2-A-ck-n"'o"'w::.ted.::.;ge:..m--e.::nc.lc.o_t A_c_c.:.e_ip-t s,ot::.M:::ar.1:..er.1.ia--ts ___ J. ___ :.,:::.._:::::.~:::;,~:.._ _ _..::==..:::,::c __________ __.""-.W...l!a"'-"--';w"'--l
Rf--'--:-c'-"-=.:C...:c:..:.::.C..:_::==.::...:.c:..:.::=:.:..:.:=:=:c:.. __ _,,.,,-----------------------:c----,,--,-,-i
.I ::;+_P_n_·n-1e<1_1_Ty_p_ed_N_•_m_e _______________ ls_i_gn_•_tu_r_e _______ _, ______________ _.M .... on~1t1--'-D~•Y_._Y~ear'---i I , I , I ,
19. Discrepancy lndica!ion Space
P I luu...i.J-1...JJlbl. Cl u LI..J.J-1...Jjllll.
I ~~ b I '--LJ....LL...L..Jjlbs. d I jibs.
I
T 20. Facility Owner or Operator; Certification or receipt ol hazardous malerials covered by this manifest except as noled in llem 19. I Y Printed/Typed Name I Signature Monlh Day YIW
I I I I I '
EPA Form 8700-22 (Rev. 9/86) Previous Editions arc Obsolclo IDHEC 1988 (Rev. 10186)]
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt.
2600 Bull SUeel Columb;a, SC 29101
Phone: (llOJJ 734-5200
Emergency & Holidays: (803)734-5,,424
E PRINT or TYPE .(Form dcsl ned for use on eme 12-itch ewriler Form A roved. 0MB No. 2050-0039 Ex res 9:30.aa
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D 0
Manifest
Documenl No. 1400837
2. Page 1
ol
lnlorma!ion in the shadod MHS 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
•· Gene,ator's Phone [phone]
·;;;;~t;;;t~\g~;~~~:.'~{;:t:i~~:t;;)!iji;!•::~
;~~~;~~;~y;::W=r,:;~l>'.='.';'·_:'.t.i:.;\{~1~~tt~\t:·t:{~·:
5. Transporter 1 Company Name
Willms Trucki n Co
7. TranspMer 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
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
Hazardous Waste, Solid, nos ORM-E
NA 9189
12. Containers 13. Total Quantity l(Unil
No. Type 'MNrJ.
;JjF·',b1Tf9,~
1 D T 2 0 Y 1•E1P1P161t
a. lr..MJ-10 12I7I7,41-1 l I l IO I 2 hki::,;;;;, c.[_1_J-I 1-1 IV:
b, l.J_J-! 1-1 1!!!!i11,i';'i!/::!!t~:W,:J
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 8/1 5 7 3
1 e. GENERATOR'S CERTIFICATION: I herebydectare the! the contents ol lhls consign men! are lully and accurately described above by proper thll)plng name and are claHlne>d,
l)ackad. mark&d, and 1aheled, and are in all rospocls In proper condition tor transport byhlghway according to applicable lnternallonal and natJonal government ro,gu1atlon, al"d
tne 111 .... s or 1he Slate or South Carolina.
111 am a large Qu11ntity generator, I certify that 1 have a program In place lo reduce the volume and loxlcltyol waste generated to the degree I have d&termln&d lo~ economleany
practicable and Iha! I have ,elected the practicable method cl treatment. :storage, or disposal currently avnllable to me which minimizes the pre~nt and lutura inr-1 to human
health end !Me environment: OR, If I am a small quontitygenorator, t hove mode a good loith effort to minimize my wa:st.e generation and :selecl the be al wa,te management "'"'thod
tnal is available to me and Iha! I cnn nl!ord.
Printed/Typed Name Signal(.1~ ;f7 /2£_ Monttl Day Year
Charles R. Hansen . ,,,J!. 0 8 0 5 8 8
17. Transporter 1 A{;)<now!edgemenl of Receipt ol Materials
/tnled/Typed N;:ime Signa~~ Monttl Year
/J rrl~ ?-, f:;, f/1 /JC,p ·~ 1r
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature· Monttl Day Year
19, Discrepancy Indication Space
I I I I I I Illa ; I I I 1~
b I I I I I l'bs. d I I I pti.
20. Facility Owner or Operator: Certilication of receipt of hazardous materials covered by lhis manifesl except as noted ln Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions .ire Obsolete [DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
E PRIITT or TYPE (Form do9I ned for use on eme 12-itch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D 0
Manlfoel Oocum,,nt No.
1400838
Form A
2. Pago I
ol
Buroeu ol Solid & Hazardous Wa.ste Mgt
2600 Bull $tree~ Columbia, SC 29201
Phone: (BOJ) 734-5200
Emergency & Holidays: (803)734-542,
roved. 0MB No. 2050-0039 Expire, 9.30.5a
Information in !he shaded a<eas is-not
required by Federal law, bu\ is by Stale law.
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,. Generator'sPhone 919 934-9711
~!~:;;~~;j~;:=_-};_~:l~~~!liiNJi•:~-
li;l.t;r~!J0i,1)~f t:;?i1t;1;_~~l;:.{lt}]t{f ~t
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
10. U.S. EPA ID Number
S C D 0 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Container, 13. Total Quantity 14.Unil t·was11Numbef:·c'·
No. Type 'MNrJ. \·i-:,~.-~::>!:f-th:))\1
b.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
~/f'~~i~l~)~~~
b. Lu-I 1-1 .... ii1l!!li!i:!,!i1it~:W:J.... ,, ' ,,,J:L .......... ,.J!~i
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84574
2 0 Y
: \\F·'j•o1f1·91~
:,:~11E 1010161'~1°
115. CENERATOR·s CERT1FICATIOU: I ht1rt1by dt1c11nt1 Iha! the conlenls ol this consignment art! lullyand accurately descrlbod 11bov11 by proper ,h_ipplng n•m• and are cla....,ned.
packed. markod. and le.°beled. ancl are In 1111 rospocts In proper condition !or transport by highway according to appllc.able International and naUonat government r90ulatlon, al'\d
u,e lews of the State ol Soult\ C11ro!inn.
111 am a large quantity gencrotor. I corlily that I hnvo o program In ploco to reduce !he volume and toxlcltyol wastegenerelod to the d&9ree t havo deuumlnod 10 be economic.ally
practicable and that l have selected tho practlcable method ol treatment, storage. or dlsposal currently available lo me which minimizes the pres.en! and luture tl'H-1 to human
health and the environment.: OR, 1:1 am a smoll quantity gonor310r. I hove modo o good lelth effort to mlnimlzt1 my waste goneratlon 11nd select !he beat waste managemenl metnod
that is available lo me and tho\ I ,;on ollo,d.
Printed/Typed Name Signature
Charles R. Hansen
~
Printed/Typed Name Signature
19. Discrepancy lndica!ion Space
20. Facility Owner or Operator; Cer1ilica1ion ol receipl of hazardous materials covered by this manifesl except as noted in Item 19.
Printed/Typed Name Signature
Month Day Year
080588
Month Day Year
11 L-L-L..JL...L..J_.J!lbl. ' L-1 L-L..JL...L..J_.Jpba.
b I pi,,. d I P"'-
Month Day Yw
EPA Form 8700-22 (Rev. 9/86) Previous Edilions arc Obsolclc IDHEC 1988 (Rev. 10/86)]
I
1;
L I • ~
•
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generalor's U.S. EPA ID No.
N C Tl O 0
P. O. Box 1416, Smithfield, NC 27577
4. Generator·,Phone [phone]
5. Transporler 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
Form A
2. Page 1
of
Bureau of S.Olid & Huardous Waste Mgl
2600 Bull Sl!Nil Columbia. SC 29201
Phone: [phone]
Emergency &. Holidays: {803)734-5424
roved. 0MB No. 2050-00J9 E.x ires 9-30-88
Information in !he shaded Meas is no1
required by Federal law. but is by State la•.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, a~d ID Number} 12. Containers 13. Total Quantity U. Unit ·l'W&itat••®tlf\~~
No. Type 'M/Vcl ;)/tY.t/f}/:'.f(<{f:{~i ..
c.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional lnforma!ion
GSX Work Order No.: 84575
I D T 2 0 Y
115. GENERATOR'S CERTIFICATION: I horeby declere lhnt tho con ton ts ol this consignment are lully end eccuretely descrlbod abo,..11 by proper ahlpplng n•m• and ar• clu~nll<i.
packed. marked, and labeled, end ere in nll rospec!s in proper condition !or transpor1 by highway according to applicable International and naUonal government r99ulatlona af'ld
the laws o! the St11te o! South (.;nrollnn.
111 am a large Quantity generalor, I certily thal I hevo a program ln piece lo reduce the volume end toxlcltyol waslegenenlled to the degr&fl I have determlnod to be oconomlcalty
practicable and that 1 have selected the practicable method or treotment. storage, or d!sposat currently avolleble to me which minimizes the present and future tT\raat to humen
health end the environment: OR. II I am a smell quantity generator, I have made a good lailh effort to minimize my wasl.e generation and select the best waste menegem•nt m1tltlod
tnal is available to me and that I con ollord.
Printed/Typed Name Signature e4.J. f ~ Month Day Year
Charles R. Hansen 0 8 0 5 8 8
17. Transporter 1 Ac.:1mowledgemenl ol Receipt ol Materials
Printed/Typed Name
'f>EJJ70
Signature
. <JO HrJ
18. Transporter 2 Acknowledgement of Receipt of Materials
Prin\e<l/Typed Name Signature· Month Day Year
19. Discrepancy Indication Space
I I I I I I I Jita ' I I l 1~
b I I I I I I pt,,, d I I I Jibs.
20. Facility Owner or Operalor: Certifica!ion of receipt ol hazardous malerials covered by this manifest except as noted in Item 19 .
Prinle-d/Typed Name Signature Monlh Day Year
EPA Form 6700-22 (Rev. 9/86) Previous Editions arc Obsololo {OHEC 1988 (Rev. 10/86)]
I . ~/:{\ South Carolina Department of Health BureauolSolld&Hazardou,Wa,teMgt
&;,-"Cd-~-, d E • t I C t I 2600 Bull SOe<>\ Columb;•. SC 29201 -•• \"#5. an nv1ronmen a on ro Phone: (803)7:J.<-5200 ~ Emergency & Holidays: [phone] FE PAI,;;:, TYPE (Form de,;nned lor use on eme 112-0;1chl
0
'""ewr;1er) Form A, roved. o_MB No. 2050-0039 E.tpires 9-30-sa
UNIFORM HAZARDOUS 11. GenoralorsU.S.EPAIDNo. 0 Monllo,~ 12. Page1 lnlormal1on ,n lhe ,haded a<eas ;, not
WASTE MANIFEST N, C, D, O, q, 7, 6, 0, 4, 7, 1, 4, o~co~s~'4,0ol 01 1 required by Federal law,bulis by Stale law.
I a 3· G;~:~~:t~:::~~·;;ng Address ~f~ilitHstt'.~l,~\,;}£:i,A\iJ:
I
I
I
I
I
I
I
I
I
P. 0. Box 1416, Smithfield, NC 27577
,. Generalor">Phonel 919 l 934-9711
5. Transporter 1 Company Name
Willms Truckino Co -Inc.
7. Transporter 2 Company Name
9. Designated Facili!y Name and Site Address
CSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number C·¥:Sta;;. =" -• ID· . .,:. · ". :,-.. ,:: ,\._i. ~~_.,.· •:.
I s I c, D, o, 7, 31 7• fl, 9• ?, Cl 0}1' '" ' ·. "a'Pfioot {'/ Af'I > '/-7 (,.1 :CCO..>-> >. ·
8. U.S. EPA ID Number
I I I I I I I I I I I I F>t : . . e·-Phoot·-,J,,,r.,-,,-.,·,;·"'" .:.?··,·,:/-,:,~,i'¥>f\·<:·:--:,=·.··
10. U.S. EPA ID Number ;~;:~;~;~~~'.~~,,~ i ) ;;;,....... · .• :•.)•·••· <>_;1•i': .• ,·
I S1 C1 o, o, 7, 0, 3, 7, : " B : :~isti~:~;i~ ril1Isilt3'/i~ ~rtt~~,~I\
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Tota! Quantity 1•. Unit ·l'Wl3tliNunibw\{:
No. Type 'M.JV,j \J:=·•:+:};;'.1°:{'.·(:{·!?j~
d.
15. Special Handling Instructions and Additional Information
CSX Work Order No.: 84576
1 e. GENERATOR'S CERT1F1CATION: I horeby declare tha! lho contents olthls conslgnmenl ore lully and accurololy described above by proper 1hipplng ,iam• and••• claSalned.
packed. marked. and labeled, and are in 1111 rospecls in proper condi!lon for transport by highway according to applicable lnternahona! and n11Uo,iat gover,ime,it re,gulatlons ar.d
the lews or the State o! South (;arollnn.
111 am• large qvanhty generator. I certify thnt I hnvo a program ln ploco to rodvce the volume and toxicity ol wnstegenerolod lo !he d~r-1 have de!ormlnod to be economlcatty
practicable and that I hnvo soloc\ed !hn prnctlc:oblo mo!hod ol lrcm!mrinL stornge. or dlsposnl currenlly avoHnbte to mo which minimizes the pres.en! and lut\Jra trlr-1 lo t'luman
h•allh and the envitonml:!nl; on, II t 11m n ~mnn qunnlllygnno,nlor, I hnvn mndo n good lnllh ellor1 lo minimize my wasln gennrotlon 11nd ,elect the b-oll wait■ m•n•g ■ment ,,,..u-,,od
ltlal Is available to mo and thn! I con nrtord.
I Printed/Typed Name 'Signature /? / l Y'7 1 ./ Month Day Year
f...J~---..J"'.Jl.i'-l.l' ~U-111 °a.:• 0wR:1..-.....t"li' "lI.-1."a. -i-1:I --1.... _____ ,L_ ___ ~( ;,,;;:'·l[::;::"'"'.:!'/4:::,;;:;:·,;_:_/.:,_<:-'./-:/4~:.,;:-<:.;:~~~-~==----J..l 10a1,ir..J8a.1>1,.:0a1,J1_.S.i,.:18.i11..Ja.l8
T 17. Transpor1er 1 Aurnowlcdgemenl ol Receipt ol Ma!erials Rf-...,...,-'-'--'-----=-'--'---'-'-'---'-'-----r-----+,-------------------------! I A Prinled/Typed Name ,-'I ISignalure -~ p ,0, Monlh Day-we, ~ ';::Tti/4} K di, 1-...A.; ,, ,...:..~ I 1 ~ ,..!>1 ~ d'
o 18. TransDOner 2 Acknefwlcd9cment ol ncccipl of Mnterials ,., Rl----'--------"------'-------~---------------------------------
1 !::~+-P-n-·n-led_,_ry_p_ed_N_•_m_e _______________ ls_ig_n_•_lu_r_, ______________________ _."'_o_n .. ltl_._D .. •y ..... _Y ... ear--i
19. Discrepancy Indication Space
I ~ L ,,_ _____________ _
I
::;: 20. Facility Owner or Opera!or; Ccrtilication or receipt of hazardous mn!eria1s coverod by thi9 manilesl excopl a:! noled in Item 19.
Printed/Typed Name I Signature
EPA Form 6700-22 (Rev. 9/86) Previous Ed1l1ons are Obsolele IDHEC 1988 (Rev. 10186)1
1 , I , I ,
IJ ._ u....,u....,_,jllll. ; j_....,......,......,j~
bJ pb3.dl pbo.
Month Day Yw
I I I ' I I
,jp:;-~., ..
I "' ~ ,fl ''>-
,' ,!#', '..J( \ .\ ' -I '1 . ~
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Str .. \ Columbia, SC 29201
Phone; [phone]
Emergency & Holidays: {803)73-4-5424
Form A roved. 0MB No. 2050-0039 E.l:pire, 9-30-M FE PRltiT o, rtPE (Form de,lnned for use on ellle l12-ollch1 tvnewrllerl
UNIFORM HAZARDOUS I'· Generator'sU.S.EPAIDNo,
WASTEMANIFEST N,C,D,0,9,7·6·0·'" 7, 1,
Manlleal 12. Page 1 lnlormation in the :ihaded a<eas is not Document No. ol . 41 Q1 O, 8,41 1 1 requ,redbyFederallaw,butisbyStatelaw.
1 Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
•· Generato,·,phonef 919 l 934'-9711
5. Transporter 1 Company Name
Willms TruckinP Co. Inc.
7. Transp0r1er 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• Dt Ot 71 31 71 n, 9• ?.·Cl
8. U.S. EPA ID Number
' • ' I I I I I I I I
10. U.S. EPA ID Number
, S, C, D1 01 7, 01 3, 7, ' CJ, B
;,(\!State~~-~ livtttb«":. :('.7-_.'_-:_,_ti,;;fr> ..
H¼t~JJJ(i/b:/i'i'./h\1/,::(,/://;_\ ,_,, :::-, );:,+>i:;-d)iJ: t\/-:~
bYr ·•·· · "i'Pfloot·\\ ,fln, "f., i:.., ::·.~ ,·., ,•: .. •
-,-;:.;.<.:.'.:;;'·.1 .. •ito::=..: .. , ..... -• ·
11. U.S. DOT Description (includinf! Propor Shipping Name, Hazard Class. and ID Number) 12. Containers 13. Total Quantity 14.Uni! L W--,,. ~ i, w: ,.<-j;" //r\;, };!, No. Typo 'Mf/r,
I ~ ..
N l-~~:c::~z::_;~~:'.~~~~u-s_w_a_s_t_e_,_s_o_1_1_· d_, _n_o_s_o_RM_-_E ___________ _)_1_1~~t.:...l-LL ' ,1 D ,T ,2 ,o y I I
I f'lrE b. 1-
o l-----------------------W_L__j__l_)._LJ ' ' ' I I I I
A C. I ' ' ' I I I I
d.
I ' ' ' I I I I
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 84577
I
~t
1 e, CtNERATOR'S CERTIFICATION: I horoby doelare tho I lho conlon!s olthls eonslgnmont are fully and accurntety descrlb&d above by proper 1hlpplng r,1mt and trt c1u~fllld,
i,acked, marked, and I11belcd, and ore In nil rospocts In proper condition for !ranspor1 by highway according lo oppllcab1o lnternaUona! and nauon11t oov11rnm11nt r119utet1on1 end
lt\11 t11ws or the St.,te o! South Cnrollnn.
II tam a t11rge Quantity gcnerolor, I cor1ify that I hova a prooram In ptecq to reduce the volume and toxicity ol wuta generatod lo the d119ro1!1 I have de!ormln&d to b-e oeonomlc.atty
practicable end 1hat 1 have ,elected lho pract!cablo mothod of treatment. 3lorooe, or dispose! currently avollab!e lo me which minimizes the present and lutvre ll'lre.at to human
health and the environment: OR, 11 lam a small quantity generator, I have mado a good faith eNor1 to minimize my wa,te generation arid selecl tho beat waa!e management mi!ltTlod
tnat Is available to me and !hnt I can orlord. •
l~+-P-ri_"_'ed_,r_y_p~~:lh!_:Na~•;!::.:!:~~ec':s:...;R!S.,,:.-....!:H!_:a,2n;2.s::!e1n~ ______ JILS-ig_n_,_,u_,•-i~/,t:?.,£~· ~:;_.,:;, ✓::.-ia:=:/:.,,,,.-'K~· :.___.,:.A;L:Z!!•,(r:·:::::.=:;;;;::=:=:.....----l'MJ~:.'~L.
th
~8:c,i!J'~L.~~•1•·~;~.':'J8;_J
T l 7. Trans_porter 1 A(;Knowledgement of Receipt of Materials ._. Rf--'-:..C..C;:;__;,=:::_,~=====:..:.:.:=====--~-~~---,1,------------~---------~ I j /)~~sm• ~1j6}1 1~/ AAnr~AYl ~ Month Day Year
1A,{l'16.1,"'\1 ;,
o 18. Transpcrter 2 Acknowledgement ol Receipt of Materials ~ ...
R f-'-C================--~1------,#,:_--------------------~ I _i.,.._P_r_in-led_/T_y_p_ed_N_•_m_, ______________ ..J.s_ig_n_•_tu_r_,_· ______________________ .,1 IM_o_:1,.lh_.1.. ,D ... ~L.y-.L.,y.1:"'-1
19. Discrepancy lndica1ion Space
I ~
L 11--,-------,-------
1 ~ 20. Facility Owner or Operator; Certilicalion ol receipt of hazardous materials covered by lhis manifest except as noted in Item 19.
Printed/Typed Name I Signature
EPA Form 8700-22 (Rev. 9/86) Prcv1ous Ed1t1ons arc Obsoloto [OHEC 1988 (ncv. 10/86)]
I .... I L..J..J..J-1..J)lbl. ,1 L.. ..,.........,...,lltll.
b I pbs. d I ptis.
Month Day Year
I , I , I ,
I South-Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia. SC 29201
Phono: [phone]
Emorgoncy & Holidays: (803)73-4-5-424
E PRINT or TYPE (Form desl ned for use on elite 12-itch ewriter Form A roved. 0MB No. 2050-0039 E.tpires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. Manuoat 2. Page 1
Oocumnnl No. ol
3. Generator's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NG 27577
(. Generalor'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
400842
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
Information in lhe shaded Meas is not
required by Federal law, but is by Stale law.
11. U.S. DOT Description (including Propor Shipping Namo, ll.1z.1rd Class, and ID Numbor) 12. Container, 13. Total Quantity 1'. Unit L W,_ IM1lbof _·,
No. Type 'MNr:J ;)/F:iH.<+t>\i/f1
Hazardous Waste, Solid, nos ORM-E
NA 9189
J.' Ai!diticini,i omript!oii;, ior ,.iaieiia1; U,f;;,r,-g.;.;i't!\f --"\, ,,, ·-' ---,
f1~\w'-1-10';2;'7 ;7 ,4'/~'1T;Y; 6 tJ·(>'.:~' ;-,, C. tJ::)li!iij'i•ii:;,;l]:,'!:li;'!t~/:fr:
<' ~ <
b. LL.J-1 1-1 ,t;(:_}!,;t',J~,LLJ-:1 I 1-1
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 84578
1 D T 2 0 Y
1e. CEHERATOR"S CERTIFICATION: I hereby declare that the conton1, ol thl, conslgnmenl are fully and accurately de,crlbod above by proper ,hipping name and are cla•a1fled.
packed. marked. and le.beled. end ore In 1111 ro11poct, in proper condillon for tran,port by highway according lo appllcable International and natlonat governmanl re,gutatlona and
trio law, ol !he St.ate or Soulh Car0Hn11.
111 am a hu-.ie Qunntity Q~ne..-1tor, I cnr1ily \llnt I hnvn n progrnm In p1nco lo reduce the volumn 11nd loxlclty or wnale gener11tod lo lhe degree I have determined to be economic.atty
pr1chcab!c and Iha\ I /1t1ve ,oloc!cd tho prnctlcnblo molhod ol tronlrnont. 111mnge, or dl11poan1 currnntly ,wnllnblo to mo which mlnlmho, the p,o:,.ent and futu•• u,,_1 to human
hea!1r, and the environment; OR. II I am a 11moll quontlty g6norator, 1 havo mado o good faith 6llor1 to mtnlmlzo my wa,to genera!lon and 1101ocl \t1e bell waile managemanl m.thOd
trial is available !o me and thal I can otlord.
Printed/Typed Name
Charles
19. Discrepancy lndicalion Space
Signatur
20. Facility Owner or Operator; Certification ol reccipl ol hazardous materials coverod by this manil0sl except as nolod in llem 19.
Printed/Typed Name Signature
Month Day Year
Month Day Year
Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions arc Obsololo [DIIEC 1988 (Rov. 10/86)1
I .,-,;!/:;::;. South Carolina Department of Health Bureauo!Solid&HazardousWasteMgl
~ '-?'-J d E • I C I 26CO Bull StreeL Columbia. SC 29201 ~\~ an nv1ronmenta ontro Phone [phone]
I
I
~ Emergency & Holidays: {603)734-5424 1¥•E PRINT or TYPE (Form deslnned !or use on eme (12-pilchl tvoewrilerl · Form A, roved, 0MB No. 2050-0039 Exolres 9-30-1\a
UNIFORM HAZARDOUS ,,. Generator's U.S. EPA ID No. Manlh,~t I 2. Page 1 Information in !he shaded an,as is nol
WASTE MANI FEST N, (:, ll, 0, <), 7, 6, 0, !,. 7, 1, t,. 'if0o'."§7 4-0 '.3/ 01 1 roqulred by Fedmllaw. bul Is bys .. ,. l1w.
1 Generator's Name and Mailing Address
Channel Master
P, 0. Box lld6, Smithfield, NC 27577
4. Generator's Phone I 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckino Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
I S1 Cr D1 01 7, ]t 7• n, q, ?, 'I
8. U.S. EPA 1D Number
• ' ' ' • I r I \ I '
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, '
'CJ:Stato'tra'.·t.-.:.~s 10=:,<-/-: =-"-" ?~ ,, :-iJ·J·;,;,:~-.<:\:-·-:·,_;
O?Triim;;_.;.,;, PhoM ' .. ;-;. ono .,_, ~ ,~ 11-, 1.:,
. FNT~"•'··;;;;_,;, i>i,of,. ,i,:,,,, .,. , ·'· ,.,·" /,.,f,,i,i--,,,, ..
I r;~-~-t~·· r ~ 10 ·:,:-· ::: ·;
11. U.S. DOT Descriplion (including Proper Shipping Name. Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1( Unit :.·l'__~~-N1.111~>•jf=/·
No. Type 'MNrJ. I \)i:,.,.'.//,<\</h{,:.(~~-.. Hazardous Waste, Solid, nos ORM-E
N NA 9189 1· 11 D ,T t t ,2 ,0 y
• I
b.
I I ' I I I I
d.
I I I I I I I
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 84579
1 &. GENERATOR'S CERTIF1CAT10N: I horoby doclnro lhol tho con Ion ts ol !his consignment are lullyond accurotGly doscrlbod above by proper ,hipping name and ar ■ ctas..,n..,,
packed. ma,kod. and labeled, and ore In 1111 rospoct, In proper condition lor transpor1 by highway according to oppllcable lntornational and natlonal government r~ulatJon.1 ar>d
U'UI laws of tho State o! Scutt, (.;orollna.
If I am a !a roe Quantity gener11lor, 1 Ct:H11ty that I hovo a program ln pince to reduce the volume end to11lcltyol w~sle genere,!ed to the, d&gree 1 have d11it11irmlned lo be economic.Uy
practicable and that I have selected tho practicable method ol treotmonl, storage, or disposal currently avolle,ble to me which minimize, the pre~nl and future threat to human
health and !he environment: OR, II I am n smnl1 quantity gonorator. I hnvo mndo n good l11.ith ettort to minimize my wa:,to genoro.tlon and :,elect the t>e,t waste manar;iement rM!'thod
that is available 10 mo nnd u,nt I con oflo1d .
Prin!ed/Typed Name
Charles R. Hansen
I Signature Month Day Year
1 0, 8, o, 51 8, 8
T 17. Transporter 1 At:1mowle<lgement or Rcccip! ot Materials Sf--,--------'-----'-------~------------------------------i " Pri~Typed N.'.lme !Signal~ ( _ LJ Month Day Year 'J6'~7Jz:_,0~l~~~u~~=-~l:_LA~u~f~·~~(~8-·c.--1~°'~-~r~/.=L,,_...,..~~0..,a.~~4~-✓-~-~' ___ _1!1~~~~,~~-<~•✓~,~~
O 18. Transporter 2 Acknowledgement of Receipt of Malerials r ' -
IRf----'---~~_:___---------1
Printed/Typed Name !Signature· Month Day Year
t ' I I ' I
19. Discrepancy Indication Space
1,:
I '?
L 't---------------
1 ~ 20. Facility Owner or Operator; Certificalion of receipt ol hazardous malerials covered by this manifesl except a:i noted ln Item 19.
Printed/Typed Name I Signature
EPA Form 6700·22 (Rev. 9/86) Previous Ed1llons are Obsolote !DHEC 1988 (Rev. 10/86)]
a ,_! .__.__.~__.Pbs. cJ '-L..J..JU-1-'!lbs.
b I pbs. d I libs.
Monlh Day Yrw
I , 1 ' I I
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia. SC 29201
Phono: [phone]
I
I
Emergency & Holid<'lys: (B03)7J..t-5,,424
Form A oroved. 0MB No. 2050-0039 ExDire, 9-30-M
Manlleat 12. Page 1 8ocum~nt No I I• 4• ,0.~,4,4 ° 1
Information in lhe shaded areas is not
required by Federal law, but is by State law.
3. Generator's Name and Mailing Address ·AJ~·:·~-~ Numbe(·· _::;.y:;,i/};<>·-··
'J.~:~:.::~o:~,~1H9 ,sm;~~~;;~f' NC 27577 It)/ .. ' ;/i· ·••,<ir•:.:.:,::~::
1:t:;:
f'5::. . ..:Te:,",n","p::;o::.n:.c,'-, '-, "c"'o"m'-pLa_n_y'-N"',-'m'-e.L.~'-'<::...-"-~'-'---------6-. -U-.S-._E_P_A_I_D_N_u_m_be_,--------Fc?Sb~'T"·· ··" · ... , ·· 0 ·' '. :-»~:-::·,:~'fi/,;..·~,,
Willms Truckino Co Inc. , S• C• D• O• 7• 3• 7• n. 91 21 (} D:'rnini=c.,;Pf>o<i.i·•0 ~,1.,~7_;_,,.,,,.
7. Transporter 2 Company Name 8. U.S. EPA ID Number
• • ' ' ' ' ' ' ' · I I I
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
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14.Unil ·V.WUtii~_';:::\
No. Type 'MNrj ·;.,~ 'j\f:T5h/-')D~ I , ._ .,\ r i 6--;Tyefj',,,:
E Hazardous Waste, Solid, nos ORM-E H 1,
N ~~N~A...!_9.:_18~9:_ _____________________ -t_.11·_.t 11:._f:D'....t.'.iT+..JI.JI.JI 2:..L 104 __:Y~i:;i;~j !::f:::1:::0::l:::D:::I :::6:.hlq}
I r b. =!f(~-~-~--~~,~---j~;
r'\ "-1:·
6 ~------------~---------------------I--L'J'-~L'-I--L1L '-'LL1+--I..::··;_; =1 ::::'.:==:::::=1
::.?:,;j/
R~ ~1~·~··_-Jj_··~··-I~-,½
I
I
I "
I I ' ' ' ' '
d. ''1 LI -'-~-'--..J) }:: '": ~-=~
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.:;:,
1S. Special Handling Instructions and Addi1ional Information
GSX Work Order No. 811580
, 15. CE:NE:RATOR'S CERTIFICATION: t horeby declnre lhnl the conlont, ol thl, con,lonment ere lully and 11ccur11tely do,crlb&d above by proper ,hipping name and are ctaaa1ne<:1.
packed. marked, and 1t1heled, end nre in ntl 10:,poct, In propor condition lor t,an:,port by hlghwny occordlng to applicable International and netlonal governmenl r.-gul•tlon• •nd
U'le ta-, or the State or South Cerollnn.
II I 1m a large quenhty genera\or, I cet1ity lhllt 1 have a program In piece I0 reduce the volume and loxlcltyol waste generati,d to the d09r&e 1 have datermlnod IO M economic.ally
practicable and that I have selected the practicable method ol lreatment, storage, or dl:,posat currently available lo me which minimize:, the presant and future tnr .. , to human
heallh and the environment: OR, 111 am a smnl! quentity generator, I have mode a good loith ettort to minimize my wa,t.e genera!Jon and :,elect the be:,t waste management rnett'\Od
mat is available to me and that I con nllo,d.
I Printed/Typed Name !Signature /) ,,/ // £' // Month Day Year
l--l-----'C;..h;.:a;.:r;.:l;.:e:.:s:....R:....._H=a;..nc:.s_e_n;__ _____ ..1.. ___ .i..../_.,=·'.4.~L-;:;.-':.;·;;.....--_C_.,_..::/;__((";..· _ _./:..:;Z;:dd=~-;....;;-----=::..=a...---'''"0;;.'..,;;.'8~10~,5...;;18J1..;8~
T 17. Transporter 1 Ae;i<nowledgement of Receipt of Materials
I ~l-~P~,-in-le<J'-'--,/T_y_p_e<J_f..;fa_m_e_/1_::_
1
-'----/--'--------=1si~gn~,-tu-,-,---IY~--,f-----------------,.,..--,----:c--:c--1
p k---..JL=1.j,Ld."L{!.i/1''.l_f £_-'--'r 'S?L1i/,,'./2/,,,b!;:l/.-"J£.·"J ___ .::,(~ _'_,/L~-~/'1._.L~, f&,/J;ii. ~J.~,·~~·--22:.11-1{.LLll.LQl.~il.j
Montli Day Year
-:g.."'f) 117, z, r11t''.i319
o 18. Transporter 2 Acknowledgement ol Receipt ol Ma!erials
IR:~~~~~=~~~====~~---~~--------------------~~-~~~~ Printed/Type<! Name . I Signature· Month Day Year
t ' I ' I '
I ~ I
L
19. Dimepancy Indication Space
11---------------1 ~ 20. Facility Owner or Operator; Certilication ol receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name I Signature
EPA Form 8700·22 (Rev. 9/86) Prev1ous Ed1hons arc Obsolete [DHEC 1008 (Rev, 10/86))
I lw...Jw...JC..J
b ~I_,_,_,_~
\lb!. a I \!bl.
pin. d I pt,,.
Month Day Year
I , I , I '
I
I
I
I ' ,'~~:r-\ South Carolina Department of Health Bureau or Solid & Hazardous Waste Mgt
,,,. --.,.J d E • I C I 2600 Bull S~eo\ Columbia, SC 29201 ~-an nv,ronmenta ontro Phone: [phone]
I ...,am.,, · Emergency & Holidays: (803)734-5-124
·..&.~E PRUIT or TYPE {Form desloned for use on elite r12-oitchl tvnewriter) Form A :,roved, 0MB No. 2050-0009 Expires 9.30.ga
UNIFORM HAZARDOUS 11. Gonorolor'sU.S.EPAIDNo. Mn.nllosl J2. Pago1 tnlormation in lhe shaded a<ou is not
W E F ST Documftnt No. ol I d Fed AST MANIE N,C,IJ,0,0,7,6,0,l.,7, J,L,,0,0,8,4,5 1 roqu,c by erallaw,butlsbyS"'l•l•w.
3. ~~:~~;~a;;:;~~~ling Address ;~i;1;r;rnst~ ~·;:;t .. :!~'.~:lt'.;\t
P. 0, Box 1416, Smithfield, NC 27577 1" ;o,''•· '· ·(:''."./ .. ·., ·•·
•· Generator's Phone ( 919 l 934-9711 ~, .... =::,~_:':.: .. ·_"""' , ... _.,.,_-: _ _"~'·:C-.:, --;.,=::, ·· =·, .. __ ::/;;·_, ... _,
5. Transpor1er 1 Company Name 6. U.S. EPA ID Number c;.-·Stlh,. •·o ··>'.=-•;,~=;
Willms Truckino Co. Inc, 1 St Ct Dt Ot 71 31 71 0t 91 7J C, • D;'Triw;;;;.,.,ipfiont:,,'-'An1/7f>7..:.,,:n•.
7. Transpor1er 2 Company N;imc 8. U.S. EPA ID Numbor f::'StJitfl.lrannt1'Vtftr'a IO·. · :.',~··:i ;•·
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
, , , , , , , , , , , , F.\Tm.,;;;;;,,.,-,F'tloiit:::·••·· •··:•·: • .. ,.,,,,,,:::.,,,,.
10. U.S. EPA ID Number uf~~fii Fecility'i ro r ·· ._ .. · • .. ":>t;,;Ui<
:tMMA'.H?t\}/:<W-.ti'!//< .... , · ... · :'::.::.' v., .. ·,·:·.,·,.-,.;•~::.::·,.·,,
IS, C, D, 01 7, 01 3, 71 -~ 8 ' ~;~t:;:;~;i, '{';:'.'§bi/43~~~~i5j)'.::
11. U.S. DOT Description (,ncfuding Proper Shipping Name, Hazard Cfass, and fD Number)
a.
I 0 ' I I I I
d.
I I I I I I I
15. Special Handling Instructions and Addilional lnlormalion
CSX Work Order No.: 84581
115. GEHEAATOA'S CERTIFICATION: I haroby doclaro thnt lho contont, ol thl3 con,lgnmont are rully ond accurately do,crlb&d above by proper 1hipping nam• ■l"ld are cladifieod,
packed, marked. and Ia·belcd, and are In All rospocts In propor condlllon for lransport by highway according to oppl!cable lnternat/onmt and natlonat govornmonl r~ulatlon1 af'd
ttio laws 0l lhe St.11o cl South Carollnn.
111 am a large c:iuantiTy generator, I certify that I have II program In p1aco to reduce tho volume and loxlc1ty ofwaatogeneral&d lo tho d~r" I have dotormlned to be economlealty
practicable and Iha! I have selec!ed tho praclicablo method ol lrontmont, slotogo, or dl3posa1 currently avollablo to mo which minimizes tho pre~nt and future thra.at l0 human
t,ealth and 11,e environment; OR, If tam o small quantity gonorator, I hovo modo D good loith etlort lo minimize my was to generation and selocl the bt'ls! waste management method I : ;,:::~;;;;:•~::: ,nd lhal I can nlfo,d Signalure <,7 / / ,//
1
/
Charles R. Hansen / /,..-~. ,R" /'.-4,...._..,.__
Month Day Year
1 0, 8, 0, 5, 8, 8
1~r'~~~-P.:~~'.•~n7~~~;~=;~~~~~~~:i~~,~~;~w=l~~g~•m=•n~t~o~l~R£c~c~e~ip~l;T~~l,:=at~•r~i•~ls~---ISIS'.~~g~~~1;_~_~//,_?~~~,/--~/,.:~-~~----,--/?'/~~------Mt"'>M-0o~n,~~~C~O~a,;y~-l-,~YY<u~,-~;,i
I :
~ 1 f.' ransporter 2 Acknowledgement or ~eceipt or Materials ~ / /
Printed/Typed Name Signnturc "' Month Day Year
-+-....,,,-----------------.I....--------------------.L-•1....•1....''L-J'c....1•-i
19. Discrepancy Indication Space
I ~ I L
I i r2-0-. -F-,c-i-liry_O_w_n_er_o_r""O_p_e_ra_lo_r_: c-.-~-11-ic_a_tio_n_ol receipt of hazardous materials coverod by this manilas! except as noted in llem 19.
Printed/Typed Name Signature
'··-•t. ~Mm .r.7M.?? IRr>v A/Afil Previou.<. Ed1t1ons arc Obsolete rDHEC 1988 /Rcv. W/8611
11 L.. "-'-JU-J..Jl1b1. 1 1 L.. .................. libl.
bl jibs. d I libs.
Month Doy Year
I , I , I ,
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (form des! ned for use on elite 12-ilch cwrller
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generalor's U.S. EPA ID No. M,u,llnal
Document No.
3. Generator's Name and Mailing Address
Channel Master
N r, D 0
P, O. Box 1416, Smithfield, NC 27577
(. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin · Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sito Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
7 0 400846
6. U.S. EPA ID Number
S C D O 7 3 7
a. u.s: EPA 10 Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
Form A
2. Page 1
ol
Burnau ol Solid & Hazardous Wa.ste Mgt
2600 Bull Street, Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803}7l4-5424
roved. 0MB No. 2050-0039 E.x ires 9-30-S,8
Information 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 lt Uni! ·L:wast:a·~··~/·
No. Type 'MNrJ \)<=·;:C:/:.i>,i_\,;tt~J0<'.~i
a '.1\r·';•·oc,·f'f'if,;;;
E Hazardous Waste, Solid, nos ORM-E :il ,';
N i__.::N'..:A:.....:9~1:::B'..:9'.___ _______________________ wu:.'..l~D..i:T...1-..1-..1-J..'.:.2J.':'.o...l-..:Y-1:."j~1:::f:::'=Q::!1=Q::!1=6=-'U*
,,; ~ I :y.<" ~ ..... ~-.-.! --:,;E.·.-.~.f.
·:q .
d.
al1..ili.J-I0,2,7,7,4l-ll,I,0,2lii}'.';%J:\:cLLJ-I I I I I 1-1 I I I HH
b. LLJ-1 1-1 il!i::l:!ii;ii!l~:W:J. I-I ... Jlli
15. Special Handling tns!ructions and Additional lnlorma!ion
GSX Work Order No.:
16. CENl!:RATOR'S CERTIFICATION: l horaby dacl1ue thnt lhe contonts ol thl, conalgnment are fully nnd nccurntoly daacrlbod above by pro~r 1hlpplng nam• •nd •r• clea111na<1.
packed, m1,i.ed, and 1a·belcd. ond ora In nil rospocta In p,opor condl!lon for lron,porl byhlghwoy 11ccordlng 10 appllcabla lntnrnaUonat and nauonat governrnant re,oulaUon■ •"4
tne laws or the State ol South Carolina.
111 am a largo ciuantity generator, t certify that I h&vo a program In place to reduce Iha volume and toxicity ofwasteganeratod lo the degrl!li!I I have datormlned to be economlcalty
practicable and Iha! I have ,elected the prac!lcable method ol trealment, ,toroge, or dlspo:J.a.1 currently avo!tabla to ma which minimizes the presant end luh.Jr• uiro.al IO humaM
health ar,d the environment OR. if I am a smoll quantity gonerator, I hove modo o good loith effort 10 minimize mywa,to generation and ,elect tl"la beat was10 mar,agam•nt ,.,.,.,thod
ll"lal Is av,<1it;ib!i, to mo tmd lhnt I cnn nl!ord.
Printed/Typed Name
• Charles R. Hansen
Signature e~ , Month Day Year
0 8 0 5 8 8
T 17. Transpor1er 1 At;,mowledgemenl ol Receipt of Materials
Prin!ed!Typed Name Signature Mon!tl Day Year
Signature Month Day Year
I I lib!. C I pbl
b I libs. d I libs.
20. Facility Owner or Operator; Cer1ilicalion ol receipt of hazardous materials covered by !his manifest except as noted in 11cm 19.
Printed/Typed Name Signature Month Day Year
EPA Form 6700·22 (Rev. 9/86) Previous Editions arc Obsolete {OHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12-ilch
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
N C. D 0
P. O. Box 1416, Smithfield, NC 27577
•· Generator's Phone [phone]
5. Transpor1er 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designaled 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 Numbor
10. U.S. EPA ID Numbor
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name. Hazard Class, and ID Number)
L
Form A
2. Page 1 ol
Burnau or Solid & Haiardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-542•
roved. 0MB No. 2050-0039 E.t ·,es 9-30-Ba
Information in lhe shaded ;weas is no!
required by Federal law, bul is by Stale law.
Hazardous Waste, Solid, nos ORM-E
N NA 9189 1 D T 2 0 Y
b.
C. .
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 84583
18. GENERATOR'S CERTIFICATION: I horeby declare lhnt tho contonts ol this cons!gnmont ar11 fully and accuratolyd11scrlbed above by proper ahlpplng name and are clasained,
packed, mar\o.&d, and laheled, end ere In 1111 ro9pec!s In propor ~ondlllon !or lran9pot1 by highway according lo app!lca.bte ln!i!trnatlono.l and nallonal government r~utatlona and
11'\e lews of the Stale o! South Carolina. ·
111 am a large quantity gl!!nera1or, I cer11ty tha! I havo a program ln placo lo reduce !he volume and loxlcltyol wa1t11 generated to the d&grH I have datermln&d lo~ eeonomlcalty
prectIcable and that I have selected tho practicable method ol tre11.tmenl, 9\orage, or dlspoul currently available lo me which mlnlmlza1 the pres.,nt and luture ltlreat to human
health and the environment: OR, II ram a small quantity gonorator, I hove mado a good l11.lth eNor1 to minimize my waste genern.Uon and selecl 11'\e ~91 wa,te management n,,ethQd
that is available to me 11.nd that I con alford.
Prinled/Typed Name Signature Day Year
Charles R. Hansen
Printed IT yped Name Month Day Year
l 9. Discrepancy Indication Space
20. Facility Owner or Operalor: Certilicallon of receipt of hazardous malerlals covered by this manifest ex capt a, noted In Item 19.
Printed/Typed Name Signature Month Day Ysar
EPA Form 8700-22 {Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Aev. 10/86)]
I
r;
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. MenHoal
Oocumenl No.
WASTE MANIFEST N c D o 7 6 o 400848
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Generator's Phone [phone]
5. Transpor1er 1 Company Name
Willms Truckin Co Inc.
7. Transpor1er 2 Company Name
9. Designated Facility Name and Sito 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
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street, Columbia, SC 29201
Phone: (SOJ) 7,4-5200
Emergency & Holidays: (803)734-5-124
roved. 0MB No. 2050-0039 Expires 9-30-88
Information in lhe shaded a<eas is not
required by Federal law. but is by State law.
DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity It Ur,it
No. Type 'Mf/rJ
~,1 /
Hazardous Was tc, Solid, nos ORM-"!\,'
NA 9189 1 D T
::i~':r.:·;,·01-:·rf?i~~
2 0 Y ~j1E1D1D161t
:{· ~i"_' .,___,__.__,•i'"~t
,:;.i, t\t . .•.
b, LLJ-! 1-1 ....... ,.,
15. Special Handling Instructions and Addi1ional tnlorma!ion
GSX Work Order No.: 84584
1fl. OEHERA TOR'S CERTIFICATION: I horeby declare !hat tho conlont, ol lhl, conalgnmenl •re fully and accurately described sbov• by proper shipping n•m• and •r• cl••.,ne,d.
packed. marked. and h1beled, and ere in all rospects In proper condition !or transport by highway according 10 applicable lntnrn11tlon111 and nallonal go ... arnmant r911ut•t10na af\d
U'le laws of the State or Soulh Carolina.
II I am a large Quantity generotor, I cortlly that I havn n progrnm In p1nca to roduce lhe volume and loxlclty of woala generated lo the dograe I have determined 10 b<o economlealty
practicable and thal I have selecled tho practicable method ol trentmont, storege, or disposal currently avollab111 to me which mlnlmlu,, the present and lutvra u,,_t to human
health and the environment.: OR, 111 am a small ciuantitygonorator, I hove mode o good lolth oHort lo minimize my waste gonora\!on and u1ecl ttie boll w11ta management rrtoetnod
trial 11 available to me and lhtU I con olford.
Printed/Typed Name
Charles R. Hansen
Signature Month Day Year
0 8 0 5 8 8
17. Transponer 1 A{;1mowlcdgement ol Receipt of Materials
Signature Montti Day Year '· .r
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
I I pbl. cJ I llbl
bl pbs. d I 'I I'""
20. Facility Owner or Operator: Certification or receipt ol hilzardous malerials covered by this manilesl excepl as noted in Item 19.
P,in1ed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/861)