NCD122263825_19870811_JFD Electronics - Channel Master_FRBCERCLA SPD_Hazardous Waste Manifest-OCR

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August 11, 1987
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:
This correspondence is an update of the cleanup activities
at our Oxford facility. Our contractor, under our
direction, continues ta press sludge and discharge the
filtrate to the Oxford sewer system. A copy of the latest
filtrate analysis is enclosed. Willms Trucking Company has
transported nine roll-off dumpsters to the GSX landfill in
Pinewood, SC. Copies of the manifests are enclosed.
Approval for the operation of the dryer and baghouse was
received on July 24, 1987 (permit number 6106). After test
running the dryer we determined that an adequate temperature
could not be maintained in the baghouse to prevent
condensation and plugging. Therefore we submitted on August
4, 1987, an amended air permit application ta the State Air
Quality Section replacing the baghouse with a wet scrubber.
A copy of the amended application is enclosed. We expect to
receive our amended permit this week and will begin sludge
drying activities upon approval.
If you have any
please contact me
Sincerely,
CHANNEL MASTER
questions or
at 934-9711.
Division of Avnet, Inc.
Roger L. Coats
Safety/Environmental Engineer
RLC/sc
Enclosures
cc: Charles Hansen
Buddy Mills
need additional information,
AN INDUSTRY LEADER SINCE 1949 • TELEPHONE (919) 934·9711 • FAX 919·934·0380
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\30IJTHEf':N TEtH I NCo ,:\ND f''.E,SEP,F:CH U"BOF:(HC1F: I E.S, I NC.
CCINSULTI~\1.3 /\NP,LYTICi>,L C'.HEM1'3T!.3
F'.D. B(]X. 13.q.c;, .--· 607 F·Ar-;:I< (},'..JE. -· ~1JlLt.)DN, N .. C._ 271::19::,
PHONE [phone]
WATER ANALYSIS REPORT
ANALYSIS NO.: 166A1 D/.HE rn=· R.EPCIR.T: ff7 ! 07 ! 16
RE.CE I 1/ED FROM
CH,'\NNEL M/\tHER
BO'f 1416
SMITHFIELD, N. C. 27577
ATTN: ROGER CCIATS
ACCOUNT NO.: 12600
MARKE:.D
A: OXFORD PLANT -EFFLUENT D:
I"· D :,
DATE RECEIVED : 87/07/10
A: 166Al B: c: D:
pH
TOT~\L F:E.SIDl~E (m1;i/L.) ;
TOTP,L \IOLATIL .. E RESIDUE. (mg/Ll
TOTAL. NONFILTEF,ABLE. RESIDUE: (mq/U: 12
TOTAL DISSOLVED f":E,,lDIJE (mg/Ll • 31.2
BOD (mg/Ll 14
'COD lmg/L) 75
/\MMON l /', r,s \··l ( mc:.i / L)
TOTA\_ t<JELDAHL. NIH':.OGEN (mg/1..l
NITHhTE (\S N (m,;:1/U
TOTAL PHOSHPATE. ASP [mg/Ll
CHLORIDE AS Cl Cmg/Ll
OIL & GREASE (mg/Ll
FECAL COLIFOF:M (/1.00 ml)
TOTAL COLIFORM (CFC/100 mll
TOTAL HARDNESS (mg/Ll
TOTAL AL\c'_(.,\_lNITY (mg/U
TOTAL CYi'\NIDE. (mq/U
ARSENIC (mg!U
SELENIUM (mCJ/Ll
CADMIUM ( mg /U
CHROMIUM ( mq / Ll
COPPER (mg/ U
LEAD ( mq /L.)
NlC<.E.L_ (mg/L..)
ZINC (mg/U
MERCURY [mg/Ll
HEXfe'-lP,LENT CHF:CJMILIM (mq/U
; SI L\/E.F! ( rnq / l..)
BARIUM (mq/U
B□F,.ON ( mg /L l
MAN.GP,NESE ( mq / L)
PHENCIL ( u.q I\__)
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.:1.0
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<.005
<.02
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South Carolina Department of Health
and Environmental Control ,::,"~
I Pilise PRIHT or TYPE (Form desl ned for use on ellte 12-Itch writer
Bureau of Solid & Hazardous WastB M9f.
2600 Bull Stree\ Columbia, SC 29201
Phone: (803) 73"-5200
Emergency & Holidays: [phone]
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UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. Manifest Oocument No. WASTE MANIFEST D
3. Generator's Name and Mailing Address
.:Channel Master
:P. 0. Box 1416, Smithfield, NC 27577
,: Generato(s Phone [phone]
5. Transporter l Company Name
Wilms 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
0 0 0 0 1
10. U.S. EPA ID Number
C D O 7 0 3 7 5
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.
15. Special·Handling Instructions and Additional Information
;; .. GSX Work Order No. : 70409 . ";\
Form A
2. Page 1
of
1 CM
roved. 0MB No. 2050-0039 Ex res 9-30-88
Information In the shaded a,eas is nol
required by Federal law, but is by State law.
)i-;'~ttt.~-''-1 F
2 O y I, Ft o, I
, O. GENERATOR'S CERTIFICATION: I hereby declare that !he contents ol this consignment are fully and accurately detcrlbed above by proper ahipplng n•m• and ar• claNtfted.
packed, marked, and laheled, and are In all respecls In proper condition for transpor1 by highway according to applicable International and naUonal govemmant regul■tlon. ■nd
the laws ol the Stale ol South Carolina.
tf I am a large quantity generator, I certify that I have a program In place to reduce tho volume and toxicity of waste generated to tho degree I ha Ye determined to be ~ooomk:aUy
, .. practicable and that I have selected the practicable method ol treatment, storage, or dlspoul currentty available tom• which mlnlml:tes the present and futur• thtMI to human
health and the environment OR, 111 am a small quantity generator, I have made a good faith effort to mlnlmtzo my waste generation and Hlect the boat waate m■nagem.nt method
that Is available to me and that I can a.Nord,
Prinled/Typed Name Signature
Signature
Prinled/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt of hazardous malerials covered by this manifest except as noled In Item 19.
Printed/Typed Name Signature
Month Day
Moolh Day Year
I lu..Ju..Jlu..illb& C lu..iu..i~llla
b I pt,s, d I libs.
Moolh Day Yw
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete IDHEC 1988 (Rev. 10/86)]
l
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE (on a 12-pilch (elitei typewriter] OR USE FIRM POINT PEN -PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
':.'.:~.GENERAL INFORMATION: Feder'al Regulations require generators and transporters ol hazardous waste and owners or operators_of hazardous waste treatmel
: • storage, or disposal licilities to use the U.S. EPA Form 8700-22 Rev. 9/86 [DHEC 1988 (REV 10/86)) and, ii necessary, the continuation sheet U.S. EPA Fo
! ·• 8700•22A Rev:9/86 (OHEC 1988A) loi both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States tr ,-i • __ ,another country are responsible lor completing the manifesl Federal and Slate regulations also require generator~ and transporters of hazardous waste and
;{· }:o~nens or operator~ ol hazafdous waste treatment, storage, or disposal facilities to complele the lollowing information. I ,,
'. ;. '. GENERATOR SECTION . . ,
;.~ '
1
1. Generator's U.S. EPA ID Number. Manifest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unique five digit
) , • : .. number assigned to this manifest by the generator beginning with 00001.11 your company does not have a U.S. EPA Identification Number. please contact S.C.
--~. \ • ::·· OHEC at [phone] about obtaining an identification number. • I \; .. ··_2;1; Page 1 of: . Enter the total number of pages used to complete this manifest, i.e., the riist page EPA Form 8700-22 Rey. 9/86 [DHEC 1988 (REV 10/86)) plus t
!. it ,.l,number of continuation sheets EPA Form 8700-22 Rev. 9/86A {DHEC 1988A) if any. · · · • • ·-I : • A:."' State Manifest Document Number. .. Leave blank: · : tf; a;:, State Generator ldenUficatlon Number:· Leave blank. · ·1 r.1::•3.· ; Generator's Name and Mailing· Address: .. Enter the name and mailing address or the generator who will manage the_ returned manifest forms. , . '
!:·., 4.' Generator's Phorie Number: Enter a tE!tephone number with area code where an authorized agent of the generator can be reached in the event ol an
~f~~ .. .,:iemergency including nights. weekends, and holidays. . _ .. ,1.rs:·: Transport 1 Company Name: Enter the company name of the first transporter who will transport the waste. "' · ·1
> ·' hfs.:--~U.S. EPA ID Number: Enter lhe·u.s. EPA twelve digit identHication number of the first transporter identified in ilem 5. ·. · · · ·-
~ ir:f,C. . .:.. State Transporter's ID Number:. Leave blank: . . ._ _ ~ ?i.' 0. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent olthe first transporter can be reached rn the event of
/·~f•··•. an emergency including nights, weekends, and holidays. · · 1 • ~ •f, r.: Tram porter 2 Company Name: If applicable. enter the company name of the second transporter who will transport the waste. If more than 2 transporters
,,:.: . be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) continuation sheet and list the transporters In the order they will be transporting the wa
, F:+,• i:::u.s. EPA ID Number:lf applicable, enter the U.S. EPA twelve digit 10 number of the second transporter identified in item 7.
·1.:,_.., .. . ·;-1\'i.: E. State Transporter's ID Number: Leave blank. I ; t~. F~-· . Transpor1er's Phone Number: Enter a telephone number including area code_ where an authorized agent of the second transporter can be reached in t · ·
f~•t~,--_! event ol an emergency including nights, weekends, and holidays. . · t-t;; 9:. 'Designated Facility Name and Sile Address: Enter the company name and site address ol the treatment, storage, or disposal facility designated to receive the
t f? 1 .t waste listed on this manifest The address must be the site address, which may differ from the mailing address. · I
1 i rn~ 10: U.S: EPA 10 Number: Enter the U.S. EPA twelve digit identification number of the designated treatment, storage, or disposal facility identified in item 9.
, . / t~ G:.;state Facillty's ID Number: Leave blank. · . i tf:Hi··, Facility's Phone Number: Enter a telephone number including area code where an authorized agent ol the facili.ty can be reached in the event of an
l' a_\:O,' ,. emergency Including nights, weekends, and holidays. · I ~ j~:}.11:··· U.S: DOT Oescripllons: Enter proper shipping name, hazard crass and ID Number (UN/ NA) lor each waste as identified in 4~ CFR 1 71-1 77.11 additional sp
~ ~~i,~ ... :is needed. use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) Continuation Sheet. · · •
~f.~jZ~Contalners (no. and type): Enter number of containers for each waste and the appropriate abbreviation from Table I (below) for the type or containers. !
!f!-~J}.f·, TABLE I · 1
1 J;?-i(:;'•DM = Metal drums, barrels, kegs TT= Cargo tanks (lank trucks) CM= Metal boxes. cartons. cases. roll oHs •1 f {:l:·t{zf,DW = Wooden drums. barrels, kegs TC= Tank cars CW= Wooden boxes. cartons. cases . _" ~ .. ;~)f!-': OF'= Fiberboard or plastic drums, barrels, kegs OT = Dump truck CF = Fiber or plastic boxes. cartons, cases . ::~f..!~-: :. TP = Tanks portable CY= Cylinders BA= Burlap, cloth, paper or plastic bags
• ---13 .. Total Quantity: Enter total quantity ol waste described on each line, relative to the units used in item 14. I
! i 14. Unit (weight/volume): Enter the appropriate abbreviations from Table II (below) lor the unit ol measure: t~ Tablell
t ! P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N;;: Cubic Meters Y = Cubic Yards G = Gallons (liquid only)
f ~ I.. Waste Number: Enter hazardous waste numbers as specified in South Carolina Hazardous Waste Management Regulation R.61-79.261 Subparts C and I
:.t. _ identify the hazardous waste on each line. '
1 , .. ~-·J:-:i Additional Descriptions lor Materials Listed Above: In the spaces pr'ovided, enter the authorization number (from the S.C. DHEC Authorization Request Fo tj rt~; for each waste stream listed In section 11 above. Note: Belo re any hazardous waste can be accepted lortreatment, slorage or disposal in South Carolina. the
~ l ::;> 'j. , , generator must obtain prior authorization from the treatment. storage or disposal fa.cility, ·i,
f :., , K.·,,. Handling Codes lor Wastes Listed Above: Leave blank. · · ~, f ·: :1s.::-Special Handling Instructions and Additlonal Information: Generators may use this space lo indicate special transportation, treatment storage or dispo I
(~ .· ........ information or Bill ol Lading Information. For international shipments. generators must enter in this space the point of departure (city and state) tor those
1~ t•o}... shipments destined lor treatment. storage, or disposal outside the jurisdiction ol the United States. • I
~ : ·. 16. Generator Certification: The generator must READ; SIGN (BY HANO IN INK}, and DATE the certification statement. If a mode other than highway is used,
·• ,· · ··word '"highway" should be lined out and the appropriate mode (rail, water, or air) inserted in the space below. U another mode in addition to the highway mod
\.,.:., • · used, enter the appropriate additional mode (e.g.,.and rail) in the space below.
; '.~ TRANSPORTER SECTION ' . . I
.. 11: Tran~porter 1 Acknowledgement: Enter ,the name ol the per~C?" _accepting the waste on beh,all of the fi_rst transporter. That person must acknow1e
· · acceptance ol the waste described on the manifest by signing (BY HAND IN INK) and entering the DATE of receipt. ·
;, .. 18 .. Transporter 2 Acknowledgement: Enter, ii applicable, the name of the person accepting the waste on behaU ol the second transporter. That person must
\ · acknowledge acceptance ol the waste described on the manifest by SIGNING (BY HAND IN INK} and entering lhe DATE of receipt · 1
FACILITY SECTION
• · · 19. Discrepancy Indication Space: The authorized representative of the designated facility's owner or operator must note in this space any discrepancy betw
, ,., lhe wu10 domibud on Iha manifo11 ond !ho woela oclliolly recoivod al lho loollily, Ownora and 0poro10ra ol locillll111 who cann01 rnolve 1ignificanI
~ i • ;;; · discrepancies within 15 days receiving the waste must submit to the'Oepartmenta letter with a copyol the manilestdescribing the discrepancy and attem,otl
} : , .. -',econcile il The treatment storage, or disposal facility must enter the actual weight ol waste fn pounds in the spaces provided ii the amount varies any from I
. ~ --· specified by the generator in item 13 or ii the generator uses a unit ol measure other than pounds. · : .!· .. 20. Facility Ownei-or Operator Certillcatlon: Print or type the name ol the person accepting the waste on behall ol the owner Or operator of the facility. That person·
• • must acknowledge acceptanc'e ol lhe waste described_ on the manifest by SIGNING (BY HAND IN. INK). and entering the DATE of receipt I
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST. CONTACT THE TREATMENT. STORAGE, OR DISPOSAL FACILITY DESIGNATED
'' REC!'i'·/E THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm.
i ,·
(,,~ South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardou, Waste Mgt.
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
I . Pl.EASE PRINT or TYPE (Form desi ned for use on elite 12· itch writer
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
Form A
2. Page 1
of
roved. 0MB No. 2050-0039 Ex 'res 9-30-88
Information in the shaded areas is not
required by Federal law, but i, by State raw.
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WASTE MANIFEST
3. Generator's Name and Mailing Address
. :Channel Master
·P. 0. Box 1416, Smithfield; NC 27577
4; Generato~sPhone 919 934-9711
5. Transporter 1 Company Name
Wilms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Oesignaled Facility Name and Site Address
Gsx· Services of SC, Inc.
10. U.S. EPA 10 Number
li:Tllil1•1~£1ieil.
:lltl~ti#l~;~tJtt~tilfitl?IIJI:
·'"'\Stiie:"·,.;;~:-.-;<,;<;:-,•,,,,, .. ,,,,io+t>:M¾:~J.ji>-:Y""t:i-,~--i. -: :¾t:.
'"' ' ·'" '.if '"'''f{( 80 3
Route 1, Box 255
Pinewood, sc· 29125 C D O 7 0 3 7 5 9 8
::l!;;:~~!t;;~il,rr,11:;,)lflt:41
llil~i-~1111ij!tf'l!J;rit1fwll
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 Additional Information
·"· GSX Work Order No. : 70410
12. Containers
No. Type
1 CM
lwr""'c\'F'"'"" ,
2 0 y U1 F1 01 91 61 · ·
8. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately da1crlbed above by proper ahipplng name and.,.. c1-....Jfkd.
packed. mark&d. and 111:beled, and are in ell respacb In proper condition tor transport by highway according to applicable International and natlonal government regulations and
the laws ol the State ol South Carolina.
It I am a large quantity generator, I certify that I have a program In place to reduce tho volume and toxicity of wa1te generated to the dog roe I have determined to be econo,njcafty
, •. practicable and that I have selected the practicable melhod of treatment, storage, or dlapos.al currently avallable to me which mlnimlzea the present and luture thrMt to human
health and the environment: OR. II I am a sma11 quantity generator, I have made a good faith effor1 lo minimize my waste generaUon and aelec1 the beat waate management me1hod
th.al Is available to me and thal I cen afford .
Printed/Ty~ Name
h• L. Coe..~ Signature Month Day Year
07
17. Transporter 1 cKnowledgement ol Receipt ol Materials
Signature· Month
~ 6
18. Transporter 2 Acknciwledgement of Receipt ol Materials a
Printed/Typed Name Signature 'Month Day Yeai· ...
19. Discrepancy Indication Space
•lu...1..1...1..1. llbl. C I !!bl.
b._l ...................... l'bs. d I !Ibo.
20. Facility Owner or Operator, Certification of receipt of hazardous materials covered by this manHost except as noted Iii hem 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 (Rev. 10/86)]
l
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE (on a 12-pltch (elite) typewriter] OR USE FIRM POINT PEN· PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
~ • • GENERAL INFORMATION: Feder'al Regulations require generators and transporters of hazardous waste and owners or operators of hazardous waste treatmel
·-:;;·storage. or disposal ficililies to use the U.S. EPA Form 8700-22 Rev. 9/86 [DHEC 1988 (REV 10/86)] and, if necessary, the continuation sheet U.S. EPA Fo
: ·"'. 8700-22A Rev.-9/86 (DHEC 1988A) tof both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States Ir
· ,-•· another country are responsible for completing the manifest Federal and State regulations also require generators and transporters ol hazardous waste and
j) owners or operator~ of haza:"rdous waste treatment. storage, or disposal facilities to complete the following information. I
/\:~.GENERATOR SECTION .
1~-~ 1. Generator's U.S. EPA ID Number -Manifest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unique five digit
a.:.~ .... , ... number assigned to this manifest by the ge_nerator beginning with 00001. If your company does not have a U.S. EPA Identification Number, please contact S.C.
}~,~/}·:.OH.EC at [phone] about obtaining an Identification number. . I
. t_i-:_,,2;_:; Page 1 _of: . En~erthe total number of pages used to complete this manifest, i.e.,_the first page EPA For'm 8700-22 Re~. 9/86[DHEC 1_988 (R~V 10/86)~ plus
1 ;~i~~-.:..~number of continuation sheets EPA Form 8700-22 Rev. 9/86A (DHEC 1988A) 1f any.
' ~~ ·• '>. . . ,
f;J A:.:: State Manifest Document Number. .. Leave blank. ,. · . · !
11.t 1 B.: :, Stale Generator ldenltffcatlon·Number. ·Leave blank. I
(t_;•3.· ~· Generator's Name and Malling Addre59: Enter the name and malling address of the generator who wlll manage the returned manifest lorms. ,
{{':.: .. •·~-~Generator's Phorie Number: Enter a tE!lephone number with area code where an authorized agent ol the generator can be reached in the event of
.. ;:,;,:u.. ... :. emergency including nights, weekends. and holidays.
l; · ~ 5. ; Transport 1 Company Name: Enter the company name ol the first transporter who will transport the waste. I
p, t'.·e:=-·u.s. EPA 10 Number. Enter the'U.S. EPA twelve digit identification number ol lhe lirst transporter identified in item 5.
'f;,; C. • state Transporter's ID Number: Leave blank. .
· .. -~!,-0. ""Transporter's Phone Number: Enter a telephOne number including area code where an authorized agent of the lirst transporter can be reached in the event ol
'. '1;!.,;_, ,· an emergency including nights, weekends, and holidays. I
.· \11 r..· Transporter 2 Company Name: If ap~llcable, enter the company name of the second transporter who will transport the waste. II more than 2 transporters
J.~> .~ be used._ use a U.S. EPA Form 8700·22A Rev. 9/86 (DHEC 1988A) continuation sheet and list the transporters in the order they will be transporting the wa
: ;.~ e~\ U.S. EPA ID Number:11 applicable, enter the U.S. EPA twelve digit ID number of the second transporter identified in item 7.
t ri e:f Stale Transporter's ID Number: Leave blank.
i ff· F:. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the second transporter can be reached in I
f_ ~~~-~•. event of an emergency including nights, weekends, and holidays.
i'~.• 7:j 9:.~ Designated Facility Name and Sile Address: Enter the company name and site addres~ ol the treatment, storage, or disposal facility designated to rec~ive the
A/'.,.-.. ; waste listed on this manifest The address must be the site address. which may differ lrom the mailing address. I
. : ff(; 1o; .. ·• U.S: EPA 10 Number: Enter the U.S. EPA twelve digit identification number of the designated treatment, stor.ige, or disposal facility identified in item 9 ..
t ~G:.;_State Facility's ID Number. Leave blank. .
ift H;: _: Fa.clllty's Phone Number: Enter a telephone number Including area code where an authorized agent of the facility can be reached in the event of an
i .. :t~~".•; · •t emergency Including nights, weekends, and holidays. · '
. ~ i;:l 11_/ U.S: DOT Descriptions: Enter Rroper shipping name, hazard cl~ss and ID Number (UN/NA) lor each waste as identifie~ in 49 CFR 1 71 • 1 77.11 additional spl
i, f"f.-~ .. /is needed, use a U.S. EPA Form 8700·22A Rev. 9/86 (DHEC 1988A) Continuation Sheet
trr12."-: Containers (no. and type): Enter number of containers for each waste and the appropriate abbreviation from Table I (below) for the type ol containers.'
t~: ;t ·~ ~ TABLE I ,
( 1: !''1f.\: , OM = Metal drums, barrels, kegs TT = Cargo tanks (tank trucks) CM = Metal boxes. cartons, cases, roll otfs I
Y ~ •• :;=-~~OW = Wooden drums, barrels, kegs TC= Tank cars CW= Wooden boxes. cartons. cases
; i {:. :,:"}.~ . :; Tfi-:..:;;::·.,: QF= Fiberboard or plastic drums, barrels, kegs OT= Dump truck CF= Fiber or plastic boxes. cartons. cases
' fl ,•·\.~• •~•_,.· ~.,if~..r..::,TP = Tanks portable CY= Cylinders BA= Burlap, cloth, paper or plastic bags
:i-:· ... 13 •. Total Quantity: Enter total quantity ol waste described on each line, relative to the units used in item 14. '. :·1.
' ! [ 14. Unit (weight/volume): .Enter the appropriate abbreviations from Table II (below) for the unit of-measure:
f. ¼ Table II ii . P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G • Gallons (liquid only)
~: I.. Waste Number: Enter hazardous waste numbers as speciliedin South Garolina Hazardous Waste Management Regulation R.61 • 79.261 Subparts C and I
~~ 1 •. ~. Identity the hazardous waste on each line. ,
J i,-~·J.".:'-:-Additional Descriptions lor Materials Listed Above: In the spaces provided, enter the authorization number (from the S.C. DHEC Authorization Request Fa )
j i ~,.:"'•:u for each waste stream fisted In section 11 above. Note: Before any hazardous waste can be accepted lor treatment, storage or disposal in South Carolina. the
~ {;,~/·: .. ·~generator must obtain prior authorization lrom the treatment, storage or disposal facility. I
1 ; , , K.: •. Handling Codes lor Wastes Listed Above: Leave blank. · · · ·
. '· ·1S.:~ Special Handling Instructions and Additional Information: Generalors may use this space to indicate special transportation, treatment storage or disp I
: .. inf.~rmation or Bill of Lading lnlormation. For int~rnational shipments, generators must enter in this space the point of departure (city and state) !or those
S,.-~-, .. shipments destined !or treatment. storage. or disposal outside the jurisdiction of the United States. • I
, ·. 16 .. Gtnerator Certification: The gE!neralor must REA~, SIGN (BY HA Np IN INK), and DATE the certification statement. II a mode other th_~n highway is used,
• •
4 ··word .. highway" should be lined out and the appropriate mode (rail, water, or air) inserted in the space below. II another mode in addition to the highway mod
· used, enter the appropriate additional mode (e.g.,.and rail) in the space below. l :·•· TRANSPORTER SECTION . . . . . ~ ! 17: Transporter 1 Acknowledgement: Enter the name of the person accepting the waste on behall ol the lirst transporter. That person must acknowlef
~ : .. _. .. acceptance of the waste described on the manifest by signing (BY HAND IN INK) and entering the DATE of receipt.
, !··· 18 •. Transporter 2 Acknowledgement: Enter, ii applicable. the name al the person accepting the waste on behall ol the second transporter. That person must
: . • acknowledge accep1ance of lhe waste described on the manifest by SIGNING (BY HAND IN INK) and entering the DATE of receipt · I
1 ,. FACILITY SECTION
• .. , 19. Discrepancy lndlcalion Space: The authorized representative of the designated facility's owner or operator must note in !his space any discrepancy betw .
· • • lhe wai1e described on lhe ·manHesl and lhe wasle acllially received al lhe lac/lily, Owners and operators of lacillllas who cannol resolve 1ignilican1
~ ~ ~ , ;-·_discrepancies within 15 days receiving the·waste must submit to the.Department a letter wilh a copy of the manifest describing the discrepancy and anempl
} i , ... reconcile it The treatment, storage. or disposal facility must enter the actual weight ol waste in pounds in the spaces provided if the amount varies any from t
, •: ....• • specified by t~e generator in item 13 or ii the generator uses a unit ol measure other than pounds. · .
~ .; • 20. Facility Owner or Operalor Certilicatlon: Print or type the nameol the person accepting the wa·ste on behalf ol the owner Or operator of the facility. That person
· must acknowledge acceptanc'e ol lhe wasle described_ on the manifest by SIGNING (BY HANO IN INK}' and entering the DATE of receipt I
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATMENT, STORAGE, OR DISPOSAL FACILITY DESIGNATED
RECC''·/E THE WASTE OR THE S.C. OHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm.
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Ha.mdoU3 Wasle Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone] ..... ~
(Form des! ned for use on elite 12-itch I PLEASE PRll!T or TYPE
UNIFORM HAZARDOUS
WASTE MANIFEST
Form A roved. 0MB No. 2050-0039 Ex ·res 9-30-88
2. Page 1
of Information in the shaded areas is not
required by Federal law, but is by State law.
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3. Generator's Name and Mailing Address
· Channel Master
· P. 0. Box 1416, Smithfield;
4: Generatofs Phone [phone]
S. Transporter 1 Company Name
Wilms Truckin Co. Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood, SC 29125
NC 27517·
10. U.S. EPA 10 Number
CDO7O375
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a. ..
b. .
C.
d.
Hazardous Waste, Solid, NOS ORM-E
NA 9189
,~adit'aiiJiijrv
a. ~-10, 2 I 7 I 7, 41-11 I 1, O, l!
b. LLJ-1 I 1-1 I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 70412 .,,
I I 1-1
•;. f>'•;C,M, _,; .X,Y, X ' .. > "
ir=~=~~iit111t1.
1~1,~~i,~iii::~~:!:~~~!f;~~Jr111J~1:
:;~~i1~tf~iifi~!llif:~~E~iitilll11
~~1,a~b11~11t!:l~~~rw1B~-~~t11t&1
1 CM
:it,i,~<>'f···M''
2 0 y l,F,0,0,61:
1 e. GENERATOR'S CERTIFICATION: I hereby declare that tho contents ol this consignment are fully and accurately doacrlbod above by proper ■hipping name and ar. daUifled.
packed. marked. and le°boled, and are in all respects In proper condition for transport by highway according to applicable lntarnallonal and na~nal govemrnent r-oulatlon• and
the laws of tho State ol Soulh Carolina.
tr I am a large quantity generator, I certify that I havo a program In place to reduce !he volume and toxicity of waste generated to the di,gree I have determined to be econotnk:.ally
practicable and lhal I have selected lhe practicable method ol trealmont. storage, or dlspoaal currently avallable lo me which minimizes tho pre11t1nt and future thrMl to human
health and the environment: OR, If I am a small quantity generator, I have made a good lallh etfort to minimize my waste generation and &elect the beat waste management method
that Is available to me and that I can atford.
Signature Month Year
tJ7
Sign~ Month Day Year
eJ Ii)
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
•I jib& C I jibs.
bl jib& d I jibs.
20. Facility Owner or Operator. Certification of receipt of hazardous malerials covered by thJs manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day y..,
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev.10/86)]
J
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE [on a 12-pitch (elite) typewriter] OR USE FIRM POINT PEN· PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owners or operators al hazardous waste treatmel
storage. or disposal licilities 10 use the U.S. EPA Form 8700-22 Rev. 9/86 {DHEC 1988 (REV 10/86)) and, ii necessary, the continuation sheet U.S. EPA Fo
8700-22A Rev: 9/86 (DHEC 1988A) foi both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States tr
'i. another country are responsi6Ie !or completing the manifest Federal and State regulations also require generators and transporters ol hazardous waste and
i ; owners or operators of haza.rdous wasle trealmenl. storage, or disposal facilities to complete the following information.
'! .
GENERATOR SECTION :I
. 1. Generator's U.S. EPA ID Number. Manilest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unique five digit
• • number assigned to this manilest by the generator beginning with 00001. ·11 your company does not have a U.S. EPA ldentirication Number, please contact S.C.
· _ · OHEC at {803) 734-5200 about obtaining an identification number. I
,2:.,., Page 1 of: Enter the total number of pages used to complete this manifest, i.e., the lir,st page EPA Form 8700·22 Rey. 9/86 [DHEC 1988 {REV 10186)] plus
-;~ number of continuation sheets EPA Form 8700-22 Rev. 9/86A (OHEC ·1988A) ii any. ·
A:.· Stale Manifest Document Number': .. Leave blank.
~ .; a:· Stale Generator ldentlflcallon Number: Leave blank. I
: t:~· 3. Generator's Name and Malling Address: Enter the name and mailing address of the generator who wlll manage the returned manilest forms.
£·: 4. Generator's Phorie Number: Enter a tE!lephone number with area code where an authorized agent of the generator can be reached in the even! ol
. ;·.7 .... :• emergency including nights, weekends, and holidays.
: •: 5. Transport 1 Company Name: Enter the company name ol the lirst transporter who will transport the waste.
.. ;, /6.'· U.S. EPA ID Number. Enter the·u.s. EPA twelve digit identification number ol the first transporter identified in item 5. I ti C. Slate Transporter's ID Number: Leave blank. · ·
. ~: !,' 0. · Transporter's Phone Number: Enter a leleph0ne number including area code where an authorized agent of !he first transporter can be reached in the event of
.,.J ..•. an emergency including nights, weekends, and holidays. I
~ ~~ T...· Transporter 2 Company Name: If applicable, enter the company name of the second transponer who wm transpon the waste. If more than 2 transpot1ers
;~ • be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) continuation sheet and list the transpot1ers In the order they will be Iranspot1lng the wa
· fl 8.~ U.S. EPA ID Number:II a"pplicable. enter the U.S. EPA twelve digit ID number of the second transporter identified in item 7 .
. i·~·, E. State Transporter's ID Number: Leave blank.
·:~; F. Transporter's Phone Number: Enter a telephone number including area code where·an authorized agent of the second transporter can be reached in I
11• event ol an emergency including nights, weekends, and holidays. ·
. .; ; 9: Oesignaled Facility Name and Site Address: Enter the company name and site address of the treatment. storage. or disposal facility designated to receive the
~. ;i\ 10.: ~~:1~~~~~ ~nu~~e;an~f~te\ ~:: i1~r:;~ ~;:,~~ed~;~ ~!~n~i1i~:~~s~ ~~~:e~~~ t~i!':ef~~~~~e~::~\~e~~-d:1:~:~e. or disposal lacilify identified in ile~ 9 .•
k,..:.. G: Slate Facility's ID Number: Leave blank.
:. ffH;: .. Facility's Phone Number: Enter a telephone number including area code where an authorized agent of the facility can be reached in the event of ari
!~ ~-::, . emergency including nights, weekends, and holidays. · .
.if· 11·. U.S: DOT Descriptions: Enter proper shipping name, hazard class and ID Number (UN/NA) !or each waste as identifie~ in 49 CFR 171-177. If additional spl
'.. i ·:. ':. · ;is needed, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) Continuation Sheet.
· t '',"12..: Containers (no. and type): Enter number al containers for each waste and the appropriate abbreviation lrom Table I (below) for the type of containers. ,
/ H 1 , TABLE I .
•. ,( ._,_ y.. ~ • .
; -.,_,:,?_. •, ··•·OM.= Metal drums. barrels, kegs TT= Cargo tanks (tank trucks) CM= Metal boxes. cartons. cases. roll otts I
~ ~; ,:-·(.,.OW= Wooden drums, barrels, kegs TC = Tank cars CW= Wooden boxes. cartons. cases
~ tr(~~.:~; OF"= Fiberboard or plastic drums, barrels, kegs OT= Dump truck CF = Fiber or plastic boxes, cartons. cases ·
': ';:~:".\,.'· ·~ TP = Tanks pot1able CY= Cylinders BA= Burlap, ctoth. paper or plastic bags
~ , w 13 .. Total Quantity: Enter total quantity al waste described on each line, relative to the units used in item 14.
; 14. Unit (weight/volume): Enter the apPropriate abbreviations from Table II (below) for the unit of measure: I .,, Table II
f. i
: \
! ·. I ..
P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (liquid only)
Wasle Number: Enter hazardous waste numbers as specified in South Carolina Hazardous Waste Management Regulation R.61-79.261 Subparts C and I .. Identify the hazardous waste on each line. '
; ,.,·J.:.. Additional Descriptions for Materials Listed Above: In the spaces provided, enter the authorization number (lrom the S.C. DHEC Authorization Request Fo )
, : _:: .... r. tor each waste stream HstP.d In section 11 above. Note: Before any hazardous waste can be accepted tor treatment. storage or disposal in South Ca retina, the
u ' . • 1 . . generator must obtain prior authorization from the treatment, storage or disposal facility. I
· i ., K.-, Handling Codes for Wastes Listed Above: Leave blank. ·
· t ' TS.: Special Handling lnslructlons and Additional Information: Generators may use this space to indicate special transportation, treatment. storage or disp I
: information or Bill of Lading Information. For international shipments, generators must enter in this space the point of departure (city and state) tor those
1 ~... shipments destined for treatment, storage. or disposal outside the.jurisdiction of the United States. I
16. Generator Certillcatlon: The generator must READ, SIGN (BY HANO IN INK), and DATE !he cet1ilicalion state'ment.11 a mode other than highway is used,
.. word "highway" should be lined out and the appropriate mode (rail, water, or air) inserted in the space below. II arlother mode in addition to the highway mo
used, enter the appropriate a_dditional mode (e.g .. ,and_ rail) in the space below .
. '·•·• _TRANSPORTER SECTION I
_11: Transpor1er 1 Acknowledgement: Enter·lh~ name ol the person accepting the waste on behall ol the first transporter. That person must acknowle
acceptance al the waste describ'ed on the manifest by signing (BY HAND IN.INK) and entering the DATE ol receipt.
, .. 18,. Transpor1er 2 Acknowledgement: Enter, ii applicable, the name of the person accepting the waste on behall of the second transporter. That person must
acknowledge acceptance ol thc waste described on the manifest by SIGNING (BY HAND IN INK) and entering the DATE of receipt. I
FACILITY SECTION
19. Discrepancy Indication Space: The authorized representative ol the designated facility's owner or operator must note in this space any discrepancy betw .
,.. lhe waste described on lhe ·manilesl end lhe wasle actually received al lhe facility. Owners and operalors ol lacilllies who cannot ruolve significant
discrepancies w1th1n 15 days receIvIng the waste must submit to the Department a letter with a copy of the manifest descnbmg the discrepancy and attem,ol
· reconcile 1t The treatment. storage, or disposal lac1l1ty must enter the actual weight al waste in pounds In the spaces provided 11 the amount vanes any trom t
spec1hed by the generator m llem 13 or 11 the generator uses a umt ol measure other than pounds.
20. Facility Owner or Operator Certification: Print or type the name of the person accepting the waste on behalf al the owner Or operator of the facility. Thal person
musl acknowledge acceptanc'e ol the waste described_ on the manifest by SIGNING (BY HANO IN INK)and entering the DATE of rece"ipl ·· I
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATMENT, STORAGE, OR DISPOSAL FACILITY DESIGNATED
AEC 1'"1E THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm.
•.... ~ . I~• '
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: (B03) 734-5200
Emergency & Holidays: (803)734-5'24
I .PLEASE PRIHT or TYPE (Form des! ned for use on elite 12· llch writer
UNIFORM HAZARDOUS 1. Generator's U.S. EPA to No. Manifest Document No.
Form A roved. 0MB No. 2050-0039 Ex rea 9--30-88
2. Page 1 Information in the shaded areas is not
of required by Federal law, but is by State law.
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WASTE MANIFEST n
3. Generator's Name and Mailing Address
.Channel Master
·P. 0. Box 1416, Smithfield;
4: Generator's Phone [phone]
5. Transpone, 1 Company Name
Wilms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood, SC 29125
NC 27577
0 0 0 0 4
10. U.S. EPA 10 Number
C D O 7 0 3 7 5
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.: 70413
'~iliillillil~!lllli!
~~liliil.®~4=1i~i~~il~iltillliil
. ....... ···•'•'••.;, . ....-:,,. ·a•i:f}X,:JitWU.{if.m{~fi{,i,M;f,tl
. --~,-=», =·\gt$f¾:%¥B!,f'S:i##S:4W§i'6.
Ill1liiliilt~lllt:~1ii~ifli~tllltl
, e. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol this consignment are fully and accurately described above by proper •hipping name and ara ctauHl9d.
packed, marked, and la·beled, and are In all respects In proper condlUon !or transpor1 by highway according to applicable International and natlonal govemment regulation.a and
the laws ol tha State ol South Carolina.
111 am a large Quantity generator, I cer1ify that I have a program In place to reduce the volume and toxicity ol wa■ta generated to the degree I ha Ye determined to be economk:atty
~ practicable and that I have selected the practicable method ol treatment. storage, or d\spoaal currently available lo ma which mlnlmlus tho present and tuture thrMt to human
• health and the environment: OR, ii I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the boa I waate rnanegomenl method
Iha! is available lo me and Iha! I can aHord,
, Printed/Ty Signature Month Year
()
T 17. Transporter 1 Ac.:Knowledgement ol Receipt of Materia!s Ri---'---------''-----'----~---~------------.,..a~-------------~ Printed!T),Ped Name .._..,.,.-Signature ~ I-''-..-"'. ~J,,_,_, ,_,/ I.:..· .::;C!...!::~=..:;_ __ ~=-;:;"'--"-"'c..l.r,,___,'\c.::"':....,:.~....:.._._ ___ '-..::,_,,..J_ __ .).,..:,.,_~:i=.-=-----.....Jl:a<.J!....t::..
2 1-1_8._T_ra_n.;.;spo'-rt-'e_r 2:..c.A.:.ck_n_o_w_led'-'-ge_m_e_n_t_o_f R_e_c_e.::ip.:.t o;:.f_M_acct•c.r..:ia-'ls ___ ~------------------------------
~ Printed/Typed Name Signature
Month Day Year ✓ ;I ? )?;7'
'Month Day Year
A
19. Discrepancy Indication Space
F •I jibs. C I ,~
b I jibs. d I jibs. I f
I
Month Day, Yeat
T 20, Facility Owner or Operator: Certlflca!lon of recelpl ol hazardous materlata covered by this manlfeat except aa noted In ttem 19. YF'-:-'=c-:==:,-;,...:..:==..:..:.......:......:.....:.:..::.;=====,'::,C===;:.!....===========-----------..::..-1 I Printed/Typed Name Signature
. ~~~__,,..,,.,....---,-----'=-------.L.....i....i....._.__.
EPA Form 8700-22 (Rev. 9186) Previous Editions are Obsolete (DHEC 1988 (Rev. 101861]
' STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE (on a 12-pilch (elite) typewriter] OR USE FIRM POINT PEN· PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owners or operators of hazardous waste treatmel
·storage, or disposal ficitities to use the U.S. EPA Form 8700-22 Rev. 9/86 {DHEC 1986 (REV 10/86)) and, ii necessary, the continuation sheet U.S. EPA Fo
(. 8700-22A Aev.-9/86 {DHEC 1988A) foi both inter-stale and intra-state transportation. Transporters who transport hazardous waste into the United States fr
!~-·another country are responsiDle !or completing the manifest Federal and State regulations also require generators and transporterS of hazardous waste and
:_.!·:. owners or operator~ ol haza.rdous waste treatment, storage, or disposal facilities to complete the loll owing information. I
' ·,
:: ;· GENERATOR SECTION . .
'. 1. Generator's U.S. EPA ID Number -Manllest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unlque five digit
1) • . , number assigned to this manilest by the generator beginning with 00001.11 your company does not have a U.S. EPA Identification Number, please contact S.C .
• ~ ··•. · OHEC at [phone] about obtaining an identification number. I
, ; r2:,:;.. Page 1 ol: . Enterthetolal number of pages used to complete this manifest, i.e., the liist page EPA Form 8700-22 Re~. 9/86 (OHEC 1988 (REV 10/86)1 plus
i --~•number of continuation sheets EPA Form 8700-22 Rev. 9/86A (DHEC 1988A) if any. ·
'. ,: A:: Stale Manifest Document Number: .. Leave blank. •
,· t • e.: State Generator ldenliflcatlon Number: Leave blank. I
~ { ,~ i · Generalor's Name and Malling Address: Enter the name and mailing address of the generator who wilt manage the returned manifest forms.
1',·, .. 4. -Generalor's Pholle Number: Enter a t81ephone number with area code where an authorized agent ol the generator can be reached in the event ol
/:: ... ~~~emergency including nights, weekends, and holidays.
-i '; 5 .. Transport 1 Company Name: Enter the company name of the first transporter who will transport the waste.
ii ; <as-u.s. EPA ID Number: Enter the·u.s. EPA twelve digit identHication number of the first transporter identiried in item 5. I ''i/ C.; Slate Transporter's ID Number:. Leave blank: . .
· t D. -Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the llrst transporter can be reached in the event of
, .• ~. an emergency including nights, weekends, and holidays. · I
· ~ ;_ T..: Tram porter 2 Company Name: 11 appllcable, enter the company name of the second transporter who wlll transport the waste. II more than 2 transporters
(+l • be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (OHEC 1988A) continuation sheet and list the transporters In the order they will be transporting the wa
, i ~:a:··· U.S. EPA 10 Number:11 applicab1e, enter the U.S. EPA twelve digit 10 number ol the second transporter identified in item 7.
t·'.·: E. · Slate Transporter's ID Number: Leave blank.
, ~-: F~. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the second transporter can be reached in I
· ~'· '· event of an emergency including nights, weekends, and holidays .
. ~, · 9;. Designated Facility Name and Site Address: Enter the company name and site address of the treatment, storage, or disposal lacility designated to receive the
' :1, • 1 waste listed on this manifest The address must be the site address. which may dilfer from the mailing address .
.'~.'r:_t.10_: U.S: EPA ID Number: Enter the U.S. EPA twelve digit identification number ol the designated treatment, storage, or disposal facility identified in item 9 .•
1 ,ii.•·. G: .... state Facility's ID Number: Leave blank. ; i\ Hi: Faclllty's Phone Number: Enter a telephone number including area code where an authorized agent ol the facility can be reached in the event of an
, ~-=--· · emergency including nights, weekends, and holidays. ·
• ~•:: 1 t U.s: DOT Descriptions: Enter proper shipping name, hazard class and ID Number (UN /NA) for each waste as identifie? in 49 CFR 171-1 77.11 additional spt
~ · · ;is needed, use a U.S. EPA Form 8700-22A Rev. 9/86 (OHEC 1988A) Continuation Sheet
, t,,;;_12.:·. Containers (no. and type): Enter number of containers for each waste and the appropriate abbreviation from Table I (below) for the type of containers.
! !;··. · ·· , TABLE I
. ; J.C/.,.. OM = Metal drums, barrels. kegs TT = Cargo tanks (tank trucks) CM = Metal boxes. cartons, cases, roll otts
i !. ~ -~;.;__OW= Wooden drums, barrels, kegs TC= Tank cars CW= Wooden boxes. cartons, cases
~ ,f;'i·H:/._•~: OF= Fiberboard or plastic drums. barrels, kegs OT = Dump truck CF = Fiber or plastic boxes. cartons. cases
': ·~ !;.•:~--!.,.-. TP = Tanks portable CY= Cylinders BA= Burlap, cloth, paper or plastic bags
I
.... 13 .. Total Quantity: Enter total quantity of waste described on each line, relative to the units used in item 14.
• : 14. Unit (weighl/volume): Enter the appropriate abbreviations from Table II (below) for the unit of measure:
1, ~ Table II I
: i P = Pounds. L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (1iQuid only)
, ; I.. Waste Number: Enter hazardous waste numbers as specified in South Carolina Hazardous Waste Management Regulation A.61-79.261 Subparts C ar.d I
; • identify the hazardous waste on each line .
• _;, •. ·J:·•-· Additional Descriptions !or Malerials Listed Above: In the spaces provided. enter the authorization number (from the S.C. DHEC Authorization Request Fo
· i :":: ·'·\• for each waste stream listed in section 11 above. Nole: Before any hazardous waste can be accepted for treatment storage or disposal in South Carolina. the
! { :· .. :·· generator must obtain prior authorization from the treatment storage or disposal facility. J
!'-1'• K.,. Handling Codes lor Wastes Listed Above: Leave blank. ·
• 1 • 15.:. Special Handling Instructions and Additional Information: Generators may use this space to indicate special transportation. treatment storage or disp I
" information or Bill of Lading Information. For international shipments, generators must enter in this space the point of departure (city and state) !or those
, -·~ shipments destined !or treatment, storage, or disposal outside the junsdict1on of the Unrted States, I
16. Generator Cerlilicalion: The generator must READ, S!GN (BY HAND IN INK), and DATE the cert1f1cat1on statement If a mode other than highway 1s used. •
• ' ~ word "highway" should be lined out and the appropnate mode (rail, water, or air) inserted in the space below. II another mode in addrt1on to the highway mod
1-.--. used, enter the appropriate a_dditional mode (e.g.,.and_ rail) in the space below.
; ! •• TRANSPORTER SECTION ~ _11: Transporter 1 Acknowledgeme~t: Enter the name of the person accepting the waste on behalf of the first transporter. Thaf person must acknowlel
acceptance of the waste described on the manifest by signing (BY HAND IN INK) and entering the DATE of receipt.
18. Transporter 2 Acknowledgement: Enter, if applicable, the name of the person accepting the waste on behall ol the second transporter. That person must
l !·• acknowledge acceptance 61 thc waste described on the manilcst by SIGNING (BY HAND IN INK) and entering the DATE or receipt · 1
. '
FACILITY SECTION
19. Discrepancy lndicalion Space: The authorized representative of the designated facility's owner or operator must note in this space any discrepancy betw
, •. lhe wasle described on lhe manilas! end lhe wasle achially received al lhe lacllily. Owners and operalors of facililies who canno1 resolve signilican1
discrepancies within 15 days receiving the waste must submit to the'Oepartment a letter with a copy of the manilestdescribing the discrepancy and anemptl
··· reconcile it The treatment storage, or disposal facility must enter the actual weight of waste in pounds in the spaces provided ii the amount varies any lrom t t .
specified by the generator in ilem 13 or ii the generator uses a unit ol measure other than pounds. ·
20. Facility Owner or Operator Cerlllicatlon: Print or type the name ol lhe person accepting the waste on behalf ol the owner Or operator of the facility. Thal persori
mu_ st ac:knowledge acceptanc"o of tho waste described on tho manifest by SIGNING (BY HAND IN INKf and entering the DATE of receipt I
i, A5fll5TANCE IS NEECED IN COMPLETION OP THIS MANIFEST, CONTACT THE TREATMENT, STORAGE, OR DISPOSAL PACILITY OESIONATED
REC-"••10 THE WASTE OR THE s.c. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM B:00 am TO 5:00 pm.
.
I ·',,\'% South Carolina Department of Health
. -~ and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone] I PLEASE PRINT or TYPE (Form desi ned for use on lit 12-· writer
UNIFORM HAZARDOUS · o.
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1
of Information in the shaded a<eas is not
required by Federal law, but is by State law.
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WASTE MANIFEST.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Wilms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood, SC 29125
NC 27577
10. U.S. EPA ID Number
CD070375
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and fD Number)
d.
~~~~~~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 70414
16. GENERA TOR'S CERTIFICATION: I hereby declare that the contents ot this consignment are fully and accurately dascrlbed above by proper 11hipplng name and are classified,
packed. marked, and labeled. and are in all respects in proper condition for transport by highway according to applicable international and national government regulatlona and
the laws ol the Slate ol South Carolina.
II tam a large Quantity generator, I certify that I have a program In place lo reduce !he volume and toxicity of waate generated to tha degree I have de!armlned to be economically
practicable and that I have selected the practicable method ol treatment. storage, or dlspoaal currently available to ma which minimizes the present and future threat to human
health and the environment; OR, if tam a smnll quantity generator, I have mnde a good laith effort to minimize my waste generation and select the beat waale management method
that is available to m8 and lhal I can al1'ord.
I ~b~-...J~~~~-=L.,::?.::-~.!:G~~''-~~-:---..l..S-ig-na_tu_r•_._..J..~~~~-..12.:::::.,_..:;:2;5.1'-'l:. ____ JM.!:o::&n,',th:L:IO::i.a:Jy~.i.t.j
~ ,1. Tran ementofReceiptofMal ·
I A
N Signature
~ ~;-:;::::-:-:::i1~t4-7'-£..¥f'~==:-'.:'~L_~~~~c5,<2:"'-2:l~J----...;;t:ili....f_,,1.:(,!U.~-=="7Ll~Z:~:!!:=!!C::.:==:.--.:_ __ J.f,.J.£...t::.t!:..J;LJIL~ o , 8. Tran er 2 cknowledgement of Receipt of Materials Al-'-0'--'-'===============---~---------~~-----------------~ I T Printed/Typed Name Signature Month Day Year ~~-+ ______________________ ..._ _________________________ .................. _ .... i
F I? L
I
19. Discrepancy Indication Space
T 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted in Item is.
l ...... y:::::::=:::::::::::::================ --ccc Printed/Typed Nama Signature Month Day Year
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete [OHEC 1988 (Rev. ,0/86)]
l
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE (on a 12-pitch (elite) typewriter) OR USE FIRM POINT PEN -PRESS DOWN HARO ALL COPIES MUST BE LEGIBLE!
• · • GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owners or operators ol hazardous waste treatml
:·• storage. or disposal licilities to use the U.S. EPA Form 8700-22 Rev. 9/86 [DHEC 1988 (REV 10/86)1 and, if necessary, the continuation sheet U.S. EPA Fa
8700-22A Rev: 9186 {OHEC 1988A) ior both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States tr
• · another country are responsible for completing the manifest Federal and State regulations also require generators and transporters of hazardous waste and
.!. : owners or operator~ of haza.rdous waste treatment, storage, or disposal facilities to complete the tallowing information. I GENERATOR SECTION
1. Generator's U.S. EPA ID Number -Manifest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unique live digit
, • • . number assigned to this manifest by the generator beginning with 00001. llyour company does not have a U.S. EPA Identification Number. please contact S.C.
· •. · · DHEC at [phone] about obtaining an Identification number. I
2;_...:. Page 1 of: . Enter the total number of pages used to complete this manifest. i.e .• the liist page EPA Form 8700·22 Rey. 9/86 [DHEC 1988 {REV 10/86)] plus
._-,:,number of continuation sheets EPA Form 8700•22 Rev. 9/86A (DHEC 1988A) ii any. ·
:-~ A.·· Stale Manifest Document Number. .. Leave blank.
:-~ :: B; ·· State Generator ldenliflcation Number: Leave blank. I
'.-:~r3. ,· Generator's Name and Mailing Address: Enter the name and mailing address of the generalor who will manage the returned manifesl forms.
';,.!•· .. Generator'• Phoiie Number: Enter a tE:lephone number with area code where an authorized agent ol the generator can be reached in the event of an
. t r~·., ... emergency including nights, weekends, and holidays.
~ 1 S •. ;: Transport 1 Company Name: Enter the company name of the first transporter who will lransport !he waste. I
i'r/6.'·~. U.S. EPA 10 Number: Enter the·u.S. EPA twelve digit identification number of the first transporter identified in item 5.
·t•f• C. ~ State Transporter's ID Number:. Leave blank: . . .
". ; 0. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the first transporter can be reached in the event ol
·.,~. • an emergency including nights, weekends, and holidays. I
~ , • T.. Transporter 2 Company Name: If applicable, enter the company name of the second transporter who will transport the waste. II more than 2 transporters
·, . be used, use a U.S. EPA Form 8700·22A Rev. 9/86 (DHEC 1988A) contin.uation sheet and list the transporters In the order they will be transporting the wa .
·; ·. 8.. U.S. EPA 10 Number:11 applicable. enter the U.S. EPA twelve digit ID number of the second transporter identified in item 7.
· :.~: E.' Slate Transporter's ID Number: Leave blank. f~ F:. Transpor1er's Phone Number: Enter a telephone number including area code where an authorized agent of the second transporter can be reached in I
event of an emergency including nights, weekends. and holidays.
; ~
4
•.: 9: Designated Facility Name and Site Address: Enter the company name and site address of the treatment. storage, or disposal facility designated to receive the
t 3 ~ · • waste listed on this manifest The address mi.rs! be the site address. which may differ from the mailing address. · 1.
, · :~, 10: U.S~ EPA ID Number: Enter the U.S. EPA twelve digit identification number al the designated treatment. storage, or disposal facility identified in item 9.
ttitG:_..State Facillty's 10 Number: Leave blank.
, 't.-.f H;.-'." Facility's Phone Number: Enter a telephone number including area code where an authorized agent of the facility can be reached in the event of an
., 11.::• .,. emergency including nights, weekends, and holidays. ·
-: ft 1_1:' U.S: OCT Descriptions: Enter proper shipping name, hazard class and 10 Number (UN/NA) for each waste as identifie~ in 49 CFR 171 ·177. If additional spf
n'•'.'... ~ is needed, use a U.S. EPA Form 8700·22A Rev. 9/86 (DHEC 1988A) Continuation Sheet.
:-i';,: 12.~ Containers (no. and type): Enter number ol containers for each waste and the appropriate abbreviation from Table I (below) for the type of containers.
rt•'-, TABLEI .
; f:\!·:'. OM.= Metal drums, barrels, kegs TT= Cargo tanks (lank trucks) CM= Metal boxes. cartons, cases, roll otts I
: !: ; ~~,OW= Wooden drums, barrels, kegs TC= Tank cars CW= Wooden boxes. cartons. cases
-~ :~:;:.i(! OF= Fiberboard or plastic drums. barrels, kegs OT= Dump truck CF= Fiber or plastic boxes, cartons, cases
, ';'..-., :_.~ ·~ TP = Tanks portable CY= Cylinders BA= Burlap, cloth, paper or plastic bags
. t
• 13.. Total Quantity: Enter total quantity al waste described on each line, relative to the units used in item 14.
t4. Unit (weight/volume): Enter the appropriate abbreviations from Table II (below) !or the unit ol measure:
Table II
I
" . ' ·,; ! P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (liQuid only)
. I. Waste Number: Enter hazardous waste numbers as spec1hed 1n South Carolina Hazardous Waste Management Regulation R 61. 79 261 Subparts C ar,d I
• • identify the hazardous waste on each line.
r-J.~~ Additional Descriptions lor Materials Listed Above: In the spaces provided, enter the authonzat1on number (from the S.C. DHEC Authorization Request Fo )
( :' ·•!:~for each waste stream listed in section 11 above. Note: Belo re any hazardous waste can be accepted for treatment storage or disposal in South Carolina. the
~ { ~,~'.--· generator must obtain prior authorization !ram the treatment. storage or disposal facility. I
1 i ., , K., :: Handling Codes lor Wastes listed Above: Leave blank. · ·
! ' ·TS.'. Special Handling Instructions and Addillonal Information: Generators may use this space to indicate special transportation, treatment storage or disp I
: , information or Bill of lading Information. For international shipments, generators must enter in this space the point ol departure (city and state) !or those
,._ _...... shipments destined tor treatmenl. storage. or disposal outside the jurisdiction of the United States. · I
16, Generator Certification: The generator must READ, SIGN (BY HAND IN INK), and DATE lhe certification statement II a mode other th~n h_ighway is used
·• • word "highway" should be lined Out and the appropriate mode (rail. water, or air) inserted in the space below. II another mode in addition io the highway mo s
· used, enter the appropriate a.dditional mode (e.g ... and. rail) in the space below. r
TRANSPORTER SECTION I
n: Transporter 1 Acknowledg1;menl: Ente~ the name of the person accepting the waste on behalf or 1he first transporter. That person must acknowle
acceptance of !he waste described on the manifest by 'signing (BY HANO IN INK) and entering the DATE ol receipt. '
~ !·. 18. Transporter 2 Acknowledgemenl: Enler, ii applicable, the name ol the person accepting the waste on behalf of the second transporter. That person must
acknowledge acceptance of the waste described on the manifest by SIGNING (BY HAND IN INK) and entering the DATE or receipt I
FACILITY SECTION
19. Discrepancy Indication Space: The authorized representative of the designated facility"s owner or operator must note in 1his space any discrepancy betw n
, •. lhe was1e described on lhe manlfesl and lhe wosle oclliolly received al lhe locllily. Owners and operelors cl lacilllies who cannol resolve 1ignilican1
, discrepancies within 15 days receiving the waste must submit to the'Oepartment a letter with a copy of the manifest describing the discrepancy and attempl
'··· reconcile it The treatment, storage, or disposal facility must enter the actual weight ol waste in pounds in the spaces provided if the amount varies any from 1
. 11pecilied by the generator In ltom 13 or II tho generator usoa a unit ol measure other lhan pounds.· ·
20. Facility Own el' or Operator Certllicatlon: Print or type the name of the person accepting the waste on behalf or the owner Or operator of the facility. Thal person
must acknowledge acceptance ol the waste described_ on the manifest by SIGNING (BY HANO IN INKfand enlering the DATE ol receipt. I
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATMENT, STORAGE. OR QISPOSAL FACILITY DESIGNATED
' REC[l'IE THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm.
I ~ 14i
·~ . ,_
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardouo Wasle Mgt
2000 Bull Stree\ Columbia. SC 29201
Phone: (803) 73'-5200
Emergency & Holidays: (803)73'-5424
PLEASE PRINT or TYPE (Form desi ned for use on elite 12· itch ewriter Form A roved. 0MB No. 2050-0039 Ex ·res 9-30-88
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UNIFORM HAZARDOUS
WASTE MANIFEST
1 Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
C D O 9 7 6 0 4 7 1 4
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
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
2. Page 1
ol l lnlormaUon in the shaded a,eas 11 not
required by Federal law, but is by State law.
:1111=;i~1~t~j!~tl!Mlf:
;~;t;:ti=1::~1;~:~{~ti1;i~~~t;,~rit1lmt
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125 S C D O 7 0 3 7 5 9 8 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
1-1
... ., ..... U{C••:
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 70598
, 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol this consignment are lully and accurately described above by proper shipping name and are c1.,..;fled.
packed, marked. and 1a'b11led, and are In all respects in proper condillon for transport by highway according to appUceble lntarnaUonal and national government r.,gulatlona and
the laws ol the State ol South Carolina. ·
111 am a large quantity generator, I certify that I have a program In place to reduce the volume and toxicity ol waste generated to the degree I have determined to b4 economlealty
practicable and thal I have selected lhe pract!cable melhod ol treatment, storage, or dlapoaal currently available to me which minimizes the prei,ent and future lhrMI to human
health and the environment OR, If I am a small quantity generator, t have made a good lalth artor1 to minimize my waste generation and select the best waste management~
that is available to me and that I can aHord. ·
Signature
Month Day y..,
19. Discrepancy Indication Space .~ •L.I 1..1..Ju...i
b LI .L.J....1....1..J.
libs. C I llbl
pbs. d I llhl
L
I l--:c,-:,-,,,-.,,----:;----::---,:,--,--
1 ~ 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by !his manifest except as noted In ftem 19.
Prinled/Typed Name Signature Moolh Day Year
EPA Forl)1 8700-22 (Rev. 9/86) Previous Edilions are Obsolele [OHEC 1988 (Rev. 10/86)]
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE [on a 12-pitch (elite) typewriter] OR USE FIRM POINT PEN· PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owners or operators ol hazardous waste treatml
storage. or disposal licilities to use the U.S. EPA Form 8700-22 Rev. 9/86 {DHEC 1988 (REV 10/86)] and, if necessary, the continuation sheet U.S. EPA Fo
. 8700-22A Rev.-9186 {OHEC 1988A) loi both inter-state and intra-state transportation. Transporters who transport hazardous waste into the United States tr
'. ·· another country are responsi61e lor completing the manilest Fcderai and StatEi regulations also require generators and transporters of hazardous waste and
•"' owners or operator~ of haza'rdous waste treatment, storage, or disposat" facilities to complete the !allowing information. I
GENERATOR SECTION
1. Generator's U.S. EPA 10 Number -Manilest Document Number: Enter the generator's U.S. EPA twelve digil identification number and the uniQue five digit
number assigned to this manliest by the generator beginning with 00001. lfyour company does not have a U.S. EPA Identification Number, please contact S.C.
OHEC at [phone] about obtaining an Identification number. I
2: Page 1 ol: . Enter the total number of pages used to complete lhis manifest, i.e., the fiist page EPA Form 8700-2~ Rev. 9/86 [DHEC 1988 (REV 10/86)] plus
number of continuation sheets EPA Form 8700-22 Rev. 9/86A (DHEC 1988A) if any.
A:. · Slate Manifest Document Number: .Leave blank.
B:
3. Generator's Name and Mailing Address: Enter the name and mailing address of the generator who will manage the returned manifes: forms.
Slate Generator Identification Number: Leave blank. I
4. Generator's Phorie Number: Enter a telephone number with area code where an authorized agent ol the ge_nerator can be reached in the event of
emergency includinQ nights, weekends, and holidays.
5. Transport 1 Company Name: Enter the company name of the first transporter who will transport the waste .
. ·5_ :· U.S. EPA ID Number. Enter the U.S. EPA twelve digit identification number of the first transporter identified in item 5 . I .f. C.] Slate Transporter's ID Number:. Leave blank: i . ,
· 0. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the first transporter can be reached in the event of
• . l an emergency including nights, weekends, and holidays. · I
T. .• Tran~porter 2 Company Name: If applicable, enter the company name al the second transporter who will transport the waste. II more than 2 transporters
_ be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) continuation sheet and list the transporters in the order they will be transporting the wa .
a.'. U.S. EPA ID Number:tl applicable, enter the U.S. EPA twelve digit ID number of the second transporter identified in item 7.
E. · State Transporter's ID Number: Leave blank. . I
F:. Tra~sporter's Phone Number: Enter a telephone number including area codf: where an authorized agent of the second transporter can be reached int
event ol an emergency including nights, weekends, and holidays. ·
9.. Designated Facility Name and Site Address: Enter the company name and site address of the treatment, storage, or disposal facility designated to receive the
waste listed on this manifest The address must be the site address. which may differ from the mailing address. _
10: U.S: EPA ID Number: Enter the U.S. EPA twelve di9it identification number ol the designated treatment, storage, or disposal facility identified in item 9 .•
G:. State Facility's ID Number: Leave blank.
H;. Facility's Phone Number: Enter a telephone number including area code where an authorized agent of the facility can be reached in the event al an
emergency including nights, weekends, and holidays.
11: U.s: DOT Descriplions: Enter Qropershipping name, hazard class and ID Number (UN/NA) !or each waste as identified in 49 CFR 171-177.11 additional spa.
is needed, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) Continuation Sheet.
12... Containers (no. and type): Enter number ol containers !or each waste and the appropriate abbreviation lrom Table I (below) for the type ol containers.
TABLE I
OM = Metal drums, barrels, kegs TT = Cargo tanks (tank trucks) CM = Metal boxes. cartons, cases. roll otts
OW= Wooden drums, barrels, kegs TC= Tank cars CW= Wooden boxes. cartons. cases I
OF"= Fiberboard or plastic drums, barrels, kegs OT = Dump truck CF = Fiber or plastic boxes. cartons. cases
TP = Tanks portable CY= Cylinders BA= Burlap. cloth, paper or plastic bags
Total Quantity: Eiiter total quantity ol waste described on each line. relative to the units used in item 14.
Unit (weight/volume): Enter the appropriate abbreviations from Table II (below) for the unit al measure:
13 ..
14. I
Table II
P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (liquid only)
1.. Waste Number: Enler hazardous waste numbers as specified in South Carolina Hazardous Waste Management RegUlation A.61-79.261 Subparts C ar.d]
identify the hazardous wasle on each line.
J. Additional Descriptions for Materials Listed Above: In the spaces provided, enter the authorization number (from the S.C. DHEC Authorization Request Form
for each waste stream listed in section 11 above. Note: Before any ha·zardous waste can be accepted lor treatment storage or disposal in South Carolina. the
generator must obtain prior authorization from the treatment. storage or disposal facility. I
K. Handling Codes for Wastes listed Above: Leave blank.
15.. Special Handling Instructions and Additional lnformalfon: Generators may use this space to Indicate special transportation, treatment storage or disposal
inlormation or Bill of lading lnlormation. For international shipments, generators must enter in this space the point al departure (city and s:ate) for those
shipments destined for treatment, slorage. or disposal outside the jurisdiction of the United States. I
is. Generalor Certification: The generator must READ, SIGN (BY HAND IN INK), and DATE the certification statement. II a mode other than highway is used,
' word "highway" should be lined out and the appropriate mode (rail, w~ter, or air) inserted in the space belo.;.,.11 another mode in addition to ·1he highway mode Is
used, enter the appropriate a_dditional mode (e.g.,_and_ rail) in the space below. ,
TRANSPORTER SECTION . I
11: Transporter 1 Acknowledgement: Enter the name ol lhe person accepting the waste on behalf of the first transporter. That person must acknow!ed
acceptance of the waste described on the·manifest by signing (BY HAND IN INK) and entering the DATE of receipt. -
18. Transporter 2 Acknowledgement: Enter. ii applicable. the name o/ the person accepting the waste on behall of the second transporter. That person must
acknowledge acceptance or the waste described on the manifest by SIGNING (BY HANO IN INK) and entering the DATE of receipt I
FACILITY SECTION
19. Discrepancy Indication Space: The authorized representative al the designated facility's owner or operator must note in this space any discrepancy betwe
lhe wasle described on lhe ·manilesl and lhe wasle aclually received al lhe lacilily, Owners and operalors ol lacililies who cannol resolve signilican1
discrepancies within 15 days receiving the waste must submit to the Oepartmenl a letter with a copy ol the manilestdescribing the discrepancy and artemptl
reeo~~ile it The treatment storage. or disposal facility must enter the actual weight of waste in poundS in the spaces provided ii the amount varies any lrom 1
specified by fhe generator in item 13 or ii the generator uses a unit ol measure other than pounds.
20. Facility Ownei-or Operator Certification: Print or type the name of the person accepting the waste on behall of the owner or operator ol the facility. That person
must acknowledge acceptanc·e of the waste described on the manifest by SIGNING {BY HAND !tJ :1rv~ ;1~d entering !he DATE al receipt. I
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATM 6A DISPOSAL FACILITY DESIGNATED
AECcl','E THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT (803) 73<-5200.WEEKDAYS, "5:00 pm.
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South Carolina Department of Health
and Environmental Control
LEASE PRINT or TYPE (Form desi ewriter Form A
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. 00:;,':,~~~~~o. 2. Paget
ol l CD097604714 00007
J. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Gen..alor'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co. Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
SCD0737
8. U.S. EPA ID Number
t0. U.S. EPA 10 Number
S C D 0 7 0 3 7 5 9 8 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and 10 Number) 12. Containers
No. Type
a
b.
C.
d.
Hazardous Waste, Solid, NOS ORM-E
NA 9189 1 C M
'.~?~~~
15. Special Handling Instructions and Additional lnlorm~tion
GSX Work Order No.: 70785
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-542,
roved. 0MB No. 2050-0039 Ex ires 9-30-8.!
Information in the shaded a<eas is nol
required by Federal law, but is by State taw.
[;:'i'i; b;"irW~\
2 0 y :q, F, 01 0, 6,-ey\
16. GENERATOR'S CERTI_FICATION: I hereby declare that the contents ol this conslgnmentarefully and accurately described above by proper ahlpplng name and are claaaif1..:I.
packed, marked, and lobe led, end ere In all respects in proper condition lor lranspor1 by highway according to applicable lnlarnotionol and naltonat government re,,gulallona and
u,e laws ol lhe Slota ol South Carolina.
111 om a large quantity generalor, I cer1itythat I have a program _in place to reduce the volume and toxlcltyol wastegenera1ed to the degree I have determined to be oconomlcally
practicable and that I have salec1ed the practicable method ol treatmenl, storage, or dlsposal curumlly available to ma which minimizes the present and lutura threat to human
health and the environment; OR, ii tam a small quantity generator, I have made a good laith ertortto minimize my waste generation and select ttle beat waate management methOd
that is available to me and that I can ortord.
Print~yped Name
'K-" i-L.
Signature Month Year
0
T 17. Transporter 1 Ac11:nowledgement ol Receipt of Materials RI----'-------'------'--------~------------------------------~ Printed/Typed Name ,__..,--Signature \ ~ (\ ~ I---"'~-"', L) L.1.!..(!,_· ,i._£:t---,='--~..::W~-U.!il~. r---......:::,._ _ __1 __ \~_L..-l_;,~,-,..,.::::.:::a......:\~];,,..,=-<:__./"=------...J.::~~
o 18. Transpor1er 2 Acknowledgement ol Receipt of Materials ~
Month Day Year
D <i D ~ 17
A~'-..:...'-"'c.,c;..,;;.;,.,;._;_;'-".;_.;__;__;-'-.;.;_-c..,:.._c ___ ~ ________ ...,;;; ____________________ _
11-i...,. __ P_rin_l_ed_/_T_y_ped_N_a_m_• ______________ ...1,_S•-·g-na_,_"'_• ______________________ _._I....._..I. Month Day Year
19. Discrepancy Indication Space
a! ......... ,_,__._._
b I ......... ,_,_ .......
Jibs. C I JibL
jibs d I jibs .~ L + 1-2-0-. -F-a-ci-lity--,O_w_n_e_r o-,-0,...p_e_ra_lo_r_; c""e_rt.,.il.,.ic_a.,.1io_n_of receipt of hazardous materials covered by !his manifest except as noted in Item 19. Yl----"-----'--C....----_:,.;,;_:_;. _____ ~---'-"'-'--'---C'-'__;,;;:;,,;_:.:,__;_:.:,_;,;_;;,:;,;,___;,; ________ _
Prinled/Typed Name Signature Month Oay Year
EPA Form 8700-22 (Rev. 9/86) Previous Edillons are Obsoiele IDHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
LEASE PRINT or TYPE ewriter
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416,
,. Generator's Phone 91 9
Smithfield,
934-9711
C D O 9 7 6 0 4 7 1 4
NC 27577
6. U.S. EPA ID Number 5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc. S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
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 5 9 8
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 lnlormation.
GSX Work Order No.: 70904
1 C M
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stroo~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State raw.
2 0 y
>767-"'3333·•·
::i'l''F;"'6t'tt9',~
;~~ I F, o, °' 6tl
16. GEHERATOFl"S CERTIFICATION: I hereby declare thal lhe contenla oflhia consignment are lully and accuratelyde1crlbed above by proP4r 1hlpplng Mame and are cla.aaifled.
packed. mark ltd, and le°beled,and are in aU respects in proper coiidition !or transport by highway according 10 appllcabla lnlemaUonal and nallonal go,,.ernment regulation, and
U'la laws ol lha Stale ol South Carolina.
If I am a large quantity generator. I certily that I have a program In place to rM&ucethevotuma and to,clclty ofwaslegeneraled tothed"'olr-I have determlnltd 10 be economicalty
practicable and that I ha"e selected the practicable meth_od of treatment. storage, or disposal currently available to me which minimizes the present and future throat to human
health and the environment; OR, ii I am a small quantity generator, I have made a good taith effort lo minimize mywasta generation and select the beat wute managemenl method
that is available to me and that I can afford.
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification ol receipl ol hazardous materials covered by !his manif8st except as noled In ttem 19.
Printed/Typed Name Signature
Month Day Year
CJ~/0 l?'
Month Day Year
a l ...................... ~Pbs. c ,_! .._._......__._.!lbs.
b I !lbs. d I !Ibo.
Month Day Year
EPA Form 8700-22 {Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE {On a 12-pitch (elite) typewriter] OR USE FIRM POINT PEN -PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE!
GENERAL INFORMATION: Federal Regulations require generators and transporters of hazardous waste and owners or operators of hazardous waste treatmenl
storage, or disposal ficilities to use the U.S. EPA Form 8700-22 Rev. 9/86 {OHEC 1988 (REV 10/86)] and, if necessary, the continuation sheet U.S. EPA For
8700-22A Rev:9/86 (DHEC 1988A) for' both inter-stale and intra-state transportation. Transporters who transport hazardous waste into the United States tro
another country are responsiOle !or completing the manifest Federal and State regulations also require generators and transporters ot hazardous waste anc
owners or operator~ of hazardous waste treatment, storage, oi disposal facilities to complete the lo!lowing information.
GENERATOR SECTION I
1. Generator's U.S. EPA ID Number• Manifest Document Number: Enter the generator's U.S. EPA twelve digit identification number and the unic;ue five digit
number assigned to this manifest by the generator beginning with 00001. llyourcompany does not have a U.S. EPA Identification Number. please contact S.C.
OHEC at [phone] about obtaining an ldenlilication number. I
Page 1 ol: Enter the total number ol pages used to complete this manilest, i.e., the liist page EPA Form 8700-22 Rev. 9/86 (OHEC 1988 {REV 10/86)1 plus tt',
number al continuation sheets EPA Form 8700-22 Rev. 9/86A (DHEC 1988A) ii any.
A. State Manifest Document Number: . Leave blank.
a: State Generator Identification Number: Leave blank. · J
3. Gent!rator'1 Name and Mailing Address: Enter the name and mailing addrE!ss ol the generator who will manage the re!urned manifes! lorms.
4. Generator's Phone Number: Enter a telephone number with area code where an authorized agent of the generator can be reached in the even! ol a
emergency including nights. weekends. and holidays.
5. Transport 1 Company Name: Enter the company nnrne al !he first trnnspor\er who will transport the wasltJ.
6. U.S. EPA 10 Number: Enter the U.S. EPA twelve digit identification number of the first transporter identified in item 5. I C. Slate Transporter's 10 Number: Leave blank.
D. Transporter's Phone Number: 0Enter a telephOne number including area code where an authorized agent of the first transporter can be reached in the event ol
an emergency including nights, weekends, and holidays. I
T.. Transporter 2 Company Name: II applicable, enter the company name ol the second transporter who will transport the waste. II more than 2 transporters wil
be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (OHEC 1988A) continuation sheet and list the transporters in the order they will be transpo~ing the wast
8.. U.S. EPA ID Numbed! applicable, enter the U.S. EPA twelve _digit ID number ol the second transporter identified in item 7.
E. Stale Transporter's ID Number: Leave blank. •
F .. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent ol the second transporter can be reached in th
event of an emergency including nights, weekends, and holidays. · · ·
9.. Designated Facility Name and Sile Address: Enter the company nome and site address ol the treatment, s_torage, or disposal facility designatec 10 receive the
waste listed on this manifest The address must be the site address, which may differ from the mailing address.
U.S: EPA ID Number: Enter the U.S. EPA twelve digit identilication number ot the designated treatment. storage, or disposal facility identilied in item 9. I
Slate Facility's 10 Number: Leave blank.
,o:
G:.
H;. Facility's Phone Number: Enter a telephone number including area code where an authorized agent of the facility can be reached in the event of an
emergency including nights, weekends, and holidays.
U.S: DOT Oescriplions: Enter proper shipping name, hazard class and ID Number (UN/NA) loreach waste as identified in 49 CFA 171 -1 Ti. It aCdi:ional spacl
is needed, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) Continuation Sheet.
, 1·.
12.. Containers (no. and type): Enter number of containers for each waste and the appropriate abbreviation rrom Table I {below) for the type or containers.
TABLE I
OM = Metal drums, barrels,. kegs TT = Cargo tanks (tank trucks) CM = Metal boxes, cartons. cases. roll otls
OW= Wooden drums. barrels. kegs TC= Tank cars CW= Wooden boxes. cartons. cases
OF.= Fiberboard or plastic drums. barrels. kegs OT = Dump truck CF = Fiber or plastic boxes. cartons. cases
TP = Tanks portable CY= Cylinders BA= Burlap, cloth, paper or plastic bags
13 .. Total Quantity: Enter total quantity ol waste described on each line, relative to the units used in item 14.
T4. Unil (weighl/volume): Enter lhe appropriate abbreviations from Table II (below) for the unit of measure:
Table II
I
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P = Pounds L = Liters K = Kilograms T = Tons M = Metric Tons N = Cubic Meters Y = Cubic Yards G = Gallons (liQuid only)
I.. Waste Number: Enter hazardous waste numbers as specified in South Carolina Hazardous Waste Manage!llent Regulation R.61 • 79.261 Sub pans C ar.d D tJ
identify the hazardous was!e on each line.
J. Additional Descriptions for Materials Listed Above: In the spaces provided. enter the authorization number (from the S.C. OHEC Authorization ReQuest Form
tor each waste stream listP.d in section 11 above. Note: Bel ore any hazardous waste can be accepted for treatment storage or disposal in South Carc-lina. the
generator must obtain prior authorization lrom the treatment. storage or disposal facility. I
K Handling Codes tor Wastes Listed Above: Leave blank.
15 .. Special Handling Instructions and Additional Information: Generators may use this space to indicate special transportation. treatment. storage or disposa
information or Bill of Lading Information. For international shipments. generators must enter in this space the point al departure (city and s:a:e) for :hose
shipments destined !or treatment. slorage. or disposal outside lhe jurisdiction or ltle United Slates. I
16. Generator Cer1ilication: The generator _must READ, SIGN (BY HAND IN INK), and DATE the certification statement.11 a mode other than highway is used, th
word '0hi9hway" should be lined out and the appropriate mode (rail, waler.or air) inserted in the space below. II an~ther mode in addition to the h_ignway mode i
used. enter the appropriate a_ddilional mode (e.g.,.and_ rail) in the space below. ·
TRANSPORTER SECTION .
11: Transporter 1 Acknowledgement: Enter the name ol the person accepting the waste on behalf ol the first transporter. That person mus! acknowledgl
acceptance ol the waste described on the manifest by sig'ning (BY HANO IN INK) and entering the DATE of receipt.
18:" Transpor1er 2 Acknowledgement: Enter. ii applicable, the name al the person accepting the waste on behalf al the second transponer. That person must
acknowledge acceptance al the waste described on the manifest by SIGNING (BY HANO IN INK) and entering the DATE cl receipt
FACILITY SECTION I
19. Discrepancy Indication Space: The authorized representative of the designated lacility's owner or operator must note in this space any discrepancy betwee
the wasle described on lhe manifest and lhe wasle actually received al the lacilily. Owners and operalors ol lacililies who canno1 resolve signilican1
discrepancies wilhin 15 days receiving lhe waste must submit to the Department a letter with a copy of the manifest describing the discrepar.cy and a~emo1s :,·
reconcile il The treatmenl storage, or disposal facility must enter the actual weight of waste in pounds in the spaces provided if the amount varies any tram tha
specified by the generator in item 13 or ii the generator uses a unit ol measure other than pounds. ·
· 20. Facility Owne'r or Operator Certification: Print or type !he name of !he person accepting the waste on behalf ol the owner or operator of the facility. That person
must ac:.:nowledge accept.anc'e or the waste described on the manifest by SIGNING (BY HAND IN INK) and entering the DATE ol receipt. t
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST. CONTACT THE TREATMENT, STORAGE, OR DISPOSAL FACILITY DESIGNATED T
AECEl\'E THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm. . '
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. Manlloat Document No. WASTE MANIFEST c D 0 9 7 6 0 4 7140000
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 91 9
Smithfield,
934-9711
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
Form A
Bureau of Solid & Ha.z.ardou, Waste Mgt
2600 Boll Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays; (803)734-542•
roved. 0MB No. 2050-0039 Ex ;res 9-30-88
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. Containers 13. Total Quantity U. Unit
No. Type 'M/Vo
Hazardous Waste, Solid, NOS ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
CSX Work Order No.: 70905
1 C M 2 0
16. GENERATOR'S CERTIFICATION: I hereby declare that thecon1en1s of this consignment are lully end accurately described above by proper ■hipping name and arecluaifitld,
pack.ad. marked. and la'befed, end are in all respects In proper condition !or transport by highway according to applicable international and national government r■,gulatlon, aJiod
U'le laws ol the State ol Soult\ Carolina.
111 am a large quantity generator, I certity that I have a program in place to reduce !he volume and loxicltyol waste generated lotha dogr&a I have dalarmlnod to be oconomlcally
pracllcable and that I have selected the practicable method ol trealmant, storage, or dlspoaal currently avellabla to me which minimize• the present and lutura thr-1 to human
haallh end the environment.: OA, II I am a small quanlityganoralor, I havo made a good laith effort to minimize my waste generation and select the be1t wa1ta management meU\od
ll'lal is av11ilatlla lo ma and thnl I cnn ollord.
Printed /~ed Name
7<..t>c er )_,. (;;,"-'f5
Signalure Monltl
l 7. Transporter 1 AcKnowledgement ol Receipt ol Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
20. Facility Owner or Operator: Certification ol receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 {Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
STATE OF SOUTH CAROLINA INSTRUCTIONS FOR UNIFORM HAZARDOUS WASTE MANIFEST I
IMPORTANT: TYPE [on a 12-pitch (elite) typewriter] OR USE FIRM POINT PEN -PRESS DOWN HARD ALL COPIES MUST BE LEGIBLE.
I GENERAL INFORMATION: Feder'al Regulations require generators and transporters of hazardous waste and owners or operators ol hazardous w. aste treatmen~
storage, or disposal licilities to use the U.S. EPA Form 8700-22 Rev. 9/86 (OHEC 1988 (REV 10/86)1 and, if necessary, the continuation sheet U.S. EPA For
8700-22A Rev: 9/86 (DHEC 1988A) for both inter-stale and intra-state transportation. Transporters who transport hazardous waste into the United States Ire
another country are responsible for completing the manifest _Federal and Siate regulations also require generators and transporters al hazardous waste and
owners or operators al hazardous waste treatment, storage, or disposal fac11tt1es to comple!e the follow1ng 1nlormat1on.
GENERATOR SECTION I
,. Generator's U.S. EPA ID Number -Manilesl Document Number: Enter the generators US. EPA twelve d1g1t 1dent1hcat1on number and the umc;ue five d1gi1
number assigned to this manifest by the generator beginning with 00001.11 your company does not have a U.S. EPA Identification Number. please contact S.C.
OHEC at [phone] about obtaining an Identification number. I
2;. Page 1 ol: Enter the total number of pages used to complete this manifest, i.e., the fiist page EPA Form 8700-22 Rev. 9/86 [DHEC 1988 (REV 10/86)] plus tr,
number ol continuation sheets EPA Form 8700-22 Rev. 9/86A (DHEC 1988A) if any.
A. State Manifest Document Number': .Leave blank.
a:
3.
4.
5.
Slate Generalor ldenlificalion Number:. leave blank. . J
Generator's Name and Mailing Address: Enter the name and mailing address of lhe generator who will manage the returned maniles: forms,
Generator's Phone Number: Enter a telephone number with area code where an authorized agent of the generator can be reached in the event of a
emergency including nights, weekends. and holidays. ·
T,ansport 1 Company Name: Enter the company name of the first transporter who will transport the waste. 1.
6. U.S. EPA ID Number: Enter the U.S. EPA twelve digit identification number of the first transporter identified in item 5.
C. Slate Tri!nsporter's ID Number: Leave blank.
D. Transporter's Phone Number: 0Enter a telephOne number including area code where an authorized agent ol the lirsl transporter can be reached in the event of
an emergency including nights, weekends, and holidays. · 1: Transporter 2 Company Name: II applicable, enter the company name of the second transporter who will transport the waste. 11 more than 2 transporters will
be used, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) continuation sheet and list the transporters in the order they will be transporting the waste
8.. U.S. EPA ID Number:lf applicable. enter the U.S. EPA twelve .digit 1D number of the second transporter identified in item 7.
E. Slate Transporter's ID Number: Leave blank.
F .. Transporter's Phone Number: Enter a telephone number including area code where an authorized agent of the second transporter can be reacned in !hi
event of an emergency including nights, weekend$, and holidays. ·
9.. Designaled Facility Name and Site Address: Enter the company name and site address of the treatment, s.torage. or disposal !acility designated m receive the
waste listed on this manifest The address must be the site address, which may di tier from the mailing address.
10:
G:
U.S: EPA ID Number: Enter the U.S. EPA twel\le digit identification number ol the designated treatment, storage. or disposal facility identified in item 9. I
Slale Facility's ID Number: leave blank.
H;. Facility's Phone Number: Enter a telephone number including area code where an authorized agent ol the facility can be .reached in t!"',e event of an
emergency including nights, weekends, and holidays.
11: U.S: DOT Descriptions: Enter proper shipping name, hazard class and ID Number (UN/NA) !or each waste as identified in 49 CFR 171-177.11 aCdition.at spacl
is needed, use a U.S. EPA Form 8700-22A Rev. 9/86 (DHEC 1988A) Continuation Sheet.
12.. Containers (no. and type): Enter number of containers lor each waste and the appropriate abbreviation from Table I (below) for the type of containers.
TABLE I
OM = Metal drums. barrels, kegs TT = Cargo tanks (tank trucks) CM = Metal boxes. car1ons. cases. roll otts I
OW= Wooden drums, barrels, kegs TC= Tank cars CW= Wooden boxes. cartons. cases
OF= Fiberboard or plastic drums. barrels. kegs OT= Dump truck CF= Fiber or plastic boxes. car1ons. cases
TP = Tanks portable CY= Cylinders BA= Burlap, cloth. paper or plastic bags
, 3 .. Tolal Ouanlity: Enter total quantity ol waste described on each line, relative 10 the units used in item 14. I
T4. Uni! (weight/volume): Enter the appropriate abbreviations from Table 11 (below) for the unit ol measure:
Table II
P = Pounds L = liters K = Kilograms T = Tons M:: Metric Tons N = Cubic Meters Y = Cubic Yards G = Gal loris (liquid only)
I.. Wasle Number: Enter hazardous waste numbers as specilied in South Carolina Hazardous Waste Management Regulation A.61 • 79.261 Subparts C ar.d D tJ
identify the hazardous waste on each line.
J. Additional Descriptions for Malerials listed Above: In the spaces provided, enter the authorization number (from the S.C. DHEC Authorization Request Form
for each waste stream listed in section 11 above. Note: Before any hazardous waste can be accepted lor treatment, storage or disposal in South Careolina. the
generator must obtain prior authorization rrom the treatment. storage or disposal lacility. I
K. Handling Codes for Wastes listed Above: Leave blank.
15. Special Handling lnslructions and Additional Information: Generators may use this space to indicate special transportation. treatment. storage or disposa
information or Bill ol Lading lnlormation, For international shipments, generators must enter in this space the point ol departure (city and s:a:e) for those
shipments destined lor trea!ment. storage. or disposal outside the jurisdiction ol the United States. • I
16. Generator Certification: The generator must READ, SIGN (BY HANO IN INK), and DATE the certification statement. ti a mode other than high_way is used. th
word "highway" should be lined out and the appropriate rTlode (rail, wate'r, or air) inserted in the space below. If another mode in addition to.the h·ignway mode i
used. enter the appropriate additional mode (e.g.,.and rail) in the space below.
TRANSPORTER SECTION . •
11: Transporter._1 Acknowledgement: Enter !he name ol th~ person accepting the waste Ofl behall al the first lransporte,r. That person must acknowledgl
acceptance al the waste described on the manifest by signing (BY HANO IN INK) and entering the DATE ol receipt. ·-~ \ -·• , '
18. Transpor1er 2 Acknowledgement: Enter. ii applicable, the name of the person accepting the waste on behatl ol the second transporter. That person must
acknowledge accep!ance ol the waste described on the manifest by SIGNING (BY HANO IN INK) and entering the DATE of receipt.
FACILITY SECTION . I
19. Discrepancy Indication Space: The authorized ~epresentative or the designated facility's owner or operator must note in this space any discrepancy betwee
the waste described on the manifesl and the waste actUally received al the facility, Owners.and operalors of facilities who cannot resolve significant
discrepancies within 15 days receiving the waste must submit to !he Department a letter with a copy ol lhe manilestdescribing the discrepar.cy and a~empts II
reconcile it The treatment, storage. or disposal lacility must enter the actual weight ol waste in pounds in the spaces provided ii the amoun! varies any from tha
specified by the generator in item 13 or ii the generator uses a unit of measure other than pounds. .
20. Facility Ownef or Operator Cerlilicalion: Print or type the name al the person accepting the waste on behalf ol the owner or operator ol the lacility. Thal person
musl acio::nowledge acceptance or lhe waste described on the manirest by SIGNING (BY HANO IN INK) and entering the DATE ol receipt. t
IF ASSISTANCE IS NEEDED IN COMPLETION OF THIS MANIFEST, CONTACT THE TREATMENT, STORAGE, OR DISPOSAL FACILITY DESIGNATED T
AECEl\"F. THE WASTE OR THE S.C. DHEC MANIFEST SECTION AT [phone] WEEKDAYS FROM 8:00 am TO 5:00 pm. . .
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North Cuolina Department of Natural Resources and Community Development
Environmental Minagement Commission
AIR PERMIT APPLICATION'
GENERAL INFORMATION
I · INSTRUCTIONS ON BACK
To construct and open.le Air Emission Sources and Control Devices In accordance with N. C. General Statutes Chapter 143, Article 21.
A page 1 of 1
PLEASE TYPE OR PRINT. ATTACH APPROPRIATE EMISSION SOURCE AND CONTROL DEVICE FORMS FOR EACH SOURCE
LISTED IN ITEM 6 BELOW.
1. Facility Name (Company, Establishment, Town, Etc.): Date FOR DEM USE ONLY
Channel Master Aug. 4, 1987 DATE RECEIVED: .2. Site Location (St./Rd./Hwy.): City Zip Code County
Industrial Drive Oxford 27565 Granville
Latitude Longitude SIC Code
3679
3. Mailing Address (P. 0. Box/St./Rd./Hwy.):
P. 0. Box 1416
14.
City State Zip Code Phone with Area Code
Smithfield, NC 27577 [phone]
Applicant Technical Contact: Title Phone with Area Code PERMIT NUMBER:
Ro<?er Coats Safetv/Env. En<?ineer [phone] DATE ISSUED:
Description of operation conducted at above facility:
The manufacturing operations at the facility have been shut down. The building is
I contaminated soils.
vacant an·d pending sale upon cleanup of an existing chrome sludge lagoon and VOC
1
6. List each EMISSION SOURCE and CONTROL DEVICE for which application is made. Assign an ID NUMBER to each emission source
and control device which uniquely identifies that source. Allach appropriate emission source and conirol device forms for each. '
EMISSION SOURCE I Rotary Drum Dryer
I
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USE SEPARATE SHEET(S) IF NEEDED
ID NO.
1
CONTROL DEVICE
Scrubber
ID NO.
2
I 1. Maximum facility operation: -~2'-4'-_ Hours/ Day 6 Days/Week 6 Months Total.weeks/Year
8. Name and address of engineering firm that prepared application or plans:
19. Signature -of responsible person or company official:
I -:-:--:-:----::==-=-=~==---------------------_:___Date ______ _
Signer's Name (TYPE OR PRINT) Title Phone with Area Code
Roger Coats Safety/Environmental Engineer [phone]
I FORMAQ,22
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APPLICATION INSTRUCTIONS
THIS APPLICATION IS NOT COMPLETE UNLESS ALL REQUIRED INFORMATION IS SUBMITTED
1. PRINT OR TYPE ONLY. FOR ASSISTANCE, Call the Air QualitySaction at (9191733-7015 or lhe eppropriate field office listed below:
Asheville [phone] Mooresville [phone] w .. hlngton (919) 94H481
159 Woodfin Street 919 North Main Street 1502 North Muket Street
Ashcvl\lc, NC 28802 Moorcsvlllc, NC 28115 W~hington, NC 27889
Wlnston-S,lem [phone] F,yettevllle (919) 486-1S41 R,lelgh [phone] Wilmington [phone]
100) Nor1h Point Blvd. Suite 714 Wachovia Building P, 0. Box 27687 7225 Wrighuvlllc Avenue:
Winston-Salem, NC 27106 Faycttcvlllc, NC 28301 Raleigh, NC 27611 Wilmington, NC 28403 I .2. Submit TWO (2) copies of the application, engineering dr'awings, speclficetions, 01her supporting dalB and documents to your local field offic1 or to:
N. C. DIVISION OF ENVIRONMENTAL MANAGEMENT
AIR QUALITY SECTION
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AIR PERMIT UNIT
P. 0, BOX 27687
RALEIGH, NORTH CAROLINA 27611
3. ALL APPLICANTS MUST COMPLETE FORMS "A" ANO "O", Submit ONLY those forms that epply.
IF APPLICATION IS MADE FOR: COMPLETE THE FOLLOWING FORMS:
"A" 11B" uc" "D" "E" "F"
General Process .... , ...... , .................... X X X X
Boiler ...................................... X X X X
Incinerator.· ...... · ......... · ....•.............. X X X X
Woodworking Operations ......................... X X X X
Piinting, Finishing, Spray Booths, or Printing Operations .... X X X X
Air Pollution Control Device ....................... X X X X
Concrete or Asphalt Batch Plant .••• , ••• , •••••••••••• X X X X
"A" GENERAL INFORMATION
"C" AIR POLLUTION CONTROL DEVICE
"E" HYOROCARBON EMISSION SOURCES
"B" GENERAL DATA FOR PROCESSES OR FUEL BURNING SOURCES
"O" AREA DIAGRAM
"F" INCINERATOR
4. The application MUST BE SIGNED on Form "A" item 9 by a RESPONSIBLE INDIVIDUAL of lhe Company.
5. Btcause the application is not ideally suited for every conceivable operation, applicenll are encouraged to submit additi9nal information when nu dad ta
complete the application and to provide adequate explanation of the operations. . ·
6. Addr,u compliance with applicable regulations under NEW SOURCE PERFORMANCE STANDARDS, NATIONAL EMISSION STANDARDS FOR
HAZARDOUS AIR POLLUTANTS, and PREVENTION OF SIGNIFICANT DETERIORATION in the comments s<ction on Form "A".
' .... CHECKLIST ....
ODES YOUR APPLICATION CONTAIN THE FOLLOWING?
A. Signature by a Company Olficial.
8. Pollutants end Emiuion Rates Beforund Alter Con1rol.
C. Process Flow Diagram(,).
0. Weight Rate ol Materials Entering "ch Proceu. .
E. Completion of Form ''E" if Solvents, Paints, Finishing Materials, or any Volatile Organic Compounds are Used.
F. Otseription of Emission Source(sl and Air Control Oevice(sl (Make, Model No., Efficiency, Design Criteria, etc.)
G. Completion of Forms "A" and "O",
•••TABLE OF EMISSION.ESTIMATION METHOD COOESu•
COOE
0 Not applicable. Emissions are known to be taro.
1 Emissions based on source testing.
2 Emis:sions baud on material balance using engineering expertise and knowledge of process.
3 Emissions calculated using emiuion factors from EPA publicalion No. AP-42 COMPILATION OF AIR POLLUTION EMISSION FACTORS.
4 Judgement
S Emiuions calculated using a special emiuion factor differing from that in AP-42. Specify reference In comments below.
6 Other. Specily in comments below.
COMMENTS:
(1) Emissions based on the highest total voe concentrations detected from sa1J anah-sis.
(2) Particulate emissions based on stack test data for Fenton screw type sludge dryer
October 1985
I
I GENERAL DATA FOR PROCESSES OR FUEL BURNING SOURCES. B
, page 1 of 3 I . NOTE: DO NOT USE THIS FORM FOR INCINERATORS, USE FORM "F''.
PLEASE TYPE OR PRINT. ATTACk TO THE GENERAL INFORMATION FORM "A". IF APPLICABLE, ATTACH AIR POLLUTION
CONTROL DEVICE FORM "C". USE SEPARATE FORM FOR EACH SOURCE .
• ,. Emission Source and ID NO. (FROM GENERAL INFORMATION FORM "A", ITEM 6):
Rotary Drum Dryer, No. I ------------------------------------
12. Description of Process or Fuel Buf. ning Source lncludiflg Air Control Device:
A rotarv drum dryer will be used in conjunction with a filter press to reduce the volume
of chrome sludge and will also be used to dri~e off VOC's from contaminated soils.
I 13. Permit Application is made for (C.HECK ONE ONLY):
IJ New Source ( ) Existing Source (x) Modification -Last Permit No. ~6~1~0~6~--I Commence Construction Date
4. Muimum Source Operation:
Part ah] e JTni t , 19 __
24 Hours/Day
S. Air Conuminants
Emitted:
Pirticub.tes .• l,pj.J._ .••
Sulfur Dioxide .. , .....
Nitrogen Dioxide .......
C.ubon Monoxide ......
I) Hi·drocarbons (VOC) ....
Lud ...............
2) Other (
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( Cbi::cme ) .
Other ( ) .
Maximum Actual Emissions
Before Control After Control
(lb/hr) (lb/hr)
10 ' O.I•,
___ Jl., .. 6.18 0.618
o. 771 u.u·us
Operation Date August 6,
6 Days/Week
Emission
Estimate Control
Method* Device••
4 Scrubber
6 None
6 Scrubber
•REFER TO BACK OF GENERAL INFORMATION FORM "A" FOR EMISSION ESTIMATION CODE
,19B-
Control
Efficiency%
99
QQ
I ••ATTACH AIR CONTROL DEVICE FORM "C" (1) See attached page for specific hydrocarbons
16. Type of Source: (2) See attached page for emission calculation
CHECK ONE
( ) A GENERAL PROCESS -Source not covered by Band C below. (Complete items 7, 8, 18 through 22)
C{.~ B I ( ) C
GENERAL PROCESS WITH IN-PROCESS FUEL -Source where products of combustion contact materials heated.
· (Complete items 7, 8, 9, 13, 14, 18 through 22)
FUEL BURNING SOURCE (boilers, etc.) -Source where products of combustion are for the primary purpose of pre>-
ducing heat or power by indirect heat transfer. (Complete items 9 through 22)
·I 7. Process Operotion: (xJ! Continuous ( ) Batch -Normal Batch Time ______ No. Batches per Day ____ _
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8. Process Name Sludgia: Drying & voe Removal
Miteriils Entering Process•: Input Rates (lb/hr)
(Include In-process Solid Fuels) Design Actual
A. Chrome Sludge ~ouu 4400
B. VOC contaminated Soils 20.000 12.000
C.
D.
E.
F.
G.
TOTAL WEIGHT ENTERING PROCESS 20.000 12.000
·oo NOT LIST ANY VOLATILE HYDROCARBONS, USE HYDROCARBON EMISSION SOURCES FORM "E"
Max. Requested
Permit Input
Rates (lb/hr)
8800
20 000
20.000
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1, 1 -Dichlorocthanc
1,1 -Dichloroethene
trans 1,2 -Dicl1loroetl1ene
Methylene Chloride
1,1,1 -Trichloroethane
Trichloroethene
Xylenes
0.0014
0.0134
0.0032
0.0058
0. 13
0.46
0.0042
1 b/hr
lb/hr
lb/hr
lb/hr
lb/hr
lb/hr
lb/hr
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CHROME PARTICULATE EMISSION ESTIMATE
Emission Rate= 0.0899 gr/dscf
(Ref: October 1985 Stack test data for Fenton screw type
sludge dryer)
Flow Rate= 2000 CFM
Chrome concentration in dried sludge= 50%
Chrome Emission Estimate: Before Control
0.0899 gr/dscf x 2000 CFM x 60 min. x 0.5 ~ 7000 gr/lb = 0. 771 lbs/hr
Cfo'orile"Emissi6'i1-Esfimate·: After Control
Control Efficiency: (Ref. AP-42, Table A-2)
Cyclone= 33%
Scrubber 98.5%
0.771 lbs/hr x (1 -.33) x (1 -.985) 0.008 lbs/hr
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12.
13.
14.
• ,s.
116.
117.
118.
DATA FOR PROCESSES OR FUEL BURNING SOURCES -continued B
page2of3
Type of Fuel Burning Source:
( ) · Industrial Boiler ( ) Institutional/Residential Boiler ( ) Electric Utility Boiler (x}l Process Burncr(s)
( ) Other ____________________ Make and Model No. ___________ _
Type of Solid Fuel Burning Equipment Used:
( ) Hand Fired ( ) Overfeed Stoker
( ) Spreader Stoker ( ) Traveling Grate
( ) Underfeed Stoker ( ) Shaking Grate
( ) Pulverized
( ) Wet Bed
( ) Dry Bed
( ) Other.(spccifiy) _________________________________ _
Is collected flyash reinfected? ( ) NO YES Percent Reinjectcd ________ ,,,,
Combustion Air: Percent Excess Air-----~•·• ( ) Natural ( ) Induced
Specify method and schedule of tube cleaning:
( ) Lancing ( ) TubeBlowing ( ) Other _________ Schedule _________ _
Boiler Horsepower Rating_· _______ _ Boiler Steam Flow (lb/hr) ________________ _
Fuel Burning Source Heat Input: Maximum -~5_._8 ___ Million BTU/hr .Average ____ 3 ___ Million BTU/hr
Fuel Dau: Primary Fuel Type(s) (specify) ~N~a~t~u~r~a=l~G=a=s~--------------------
Standby Fuel Type(s) (specify) _P_r_o~a_n_e ______________________ _
FUEL TYPE FUEL USAGE Max.% Max.%
Max. Design Max. Actual Annual Sulfur Ash BTU Value
(gal/hr) (gal/hr) (gal/yrJ (BTU/cal)
#6 Fuel Oil
(gal/hr) (gal/hr) (gal/yr) (BTU/cal)
#5 Fuel Oil
(gal/hr) (gal/hr) (gal/yr) (BTU/1"1)
#4 Fuel Oil -(lb/hr) (lb/hr) (Ion/yr) (BTU/lbJ
Coal
(lb/hr dry) (lb/hr dry) (Ion/yr dry) (BTU/lb)
Wood SM/'J
Natural Gas 5524 CF/hr 1050 BTU/C
Other Propane 55 gal/hr 105,000 BT
If• combination of fuels is used, specify the maximum BTU/hr heat input for each:
Fuel Oil ________ Coal~-------Wood ________ Other _________ _
Toul maximum heat input in million BTU/hr of all indirect fired fuel burning sources within property boundaries excluding thl!
lndica.ted above:
Fuel Oil _______ _ Coal _______ _ Wood ________ Other __________ _
ToUI No. of indirect fired fuel burning sources within property boundaries:
Fuel Oil ________ Coal________ Wood ________ Other __________ _
Arc there any fugitive emissions (storage pile1.,.product handling, haul roads, etc.)? No (XJl Yes ( )
comments below, the type, size, estimated emissions and control measures.
If yes, please describe in
:7--:::----:,----::---:-:----:--:---------,--,----------------------
19. Describe ,ny liquid or solid wastes generated and method of diipoial: I Approved hazardous waste landfill
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DATA FOR PROCESSES OR FUEL BURNING SOURCES -continued B
Suck or f.mission Point Data:
Height Above Ground (ft.)
28.S
Volumetric Flow Rate
(ACFM)
2000
Inside Area (sq. ft.)
1. 77
Velocity (ft./sec.)
18,83
Gas Temperature (Deg. F)
250
Are sampling ports available?
( x) No ( ) Yes
page 3 of 3
Direction of Exit
(up, down or horizontal)
UP
Is rain cap or other obstruction over
stack? (X) No ( ) Yes, (specify)
Is scaffolding available for source testing? Stack ID No. __ 2c__ _____ -Sources with a common
• __ (_"l_N_o_(_) _v_es ____________ _i._s_ta_c_k_w_il_l h_a,...v_e_th_e_s_am_e_s_ta_c_k_n_u_m_b_er_. _________ _
21. Indicate monitoring and recording instruments installed on stack: N / A
I ( ) Opacity Monitor ( ) SO2 Monitor ( ) NOx Monitor ) Other _______________ _
2_2 ___ A_t_ta_c,_h _o_r -sk-e-tc_h_a_fl_o_w_d_ia-gr-am_o_f_t_he-pr-o-ce_s_s -or_f,...u-el,..,b_u_rn_i-ng-,o-u-rc_e __ -1-nc-lu_d_e_a-ir_c_o_n-tr,...o-l d-e-v-ic-e(,-s)-. -(S_E_E_I N_S_T_R_U_C_T-IO_N_S_O_N
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BACK OF THIS PAGE): : t :
I I
Baffle
(30")
*Wire
Mesh
S~ack (18'' Dia.·, 24' Height)
Folded Wire Mesh
Dia., 36'' Sides, 42'' Depth)
Water Level
ROTt.RY DRUM DRYER
5t-1PLE
:~LONE
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CHUTE
D ROLL-OFF
I CONTAINER
I ~23::-_--:C;:-o-m_m_e_n-:-ts-,-------------------------------------
Thc above unit will be portable/trailer mounted.
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* Installed to minimize air bubbling.
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I AIR POLLUTION CONTROL DEVICE C
page I of 3.
I PLEASE TYPE OR PRINT. ATTACH TO GENERAL INFORMATION FORM "A". SUPPLY DESIGN DATA, SPECIFICATIONS, AND
AVAILABLE ENGINEERING DRAWINGS.
Air Control Device and ID No. (FROM GENERAL INFORMATION FORM "A", ITEM 6)
Scrubber, ID No. 2
If there are several devices in series, list each unit in series starting at the emission source.
( ) Cyclone ( ) Scrubber ( ) 2
I 1 --'-------2 ________ 3 ________ TOTAL UNITS-~-----
-3-.--ln_d_i-ca_t_e_E_m_i_s,_io-n-So_u_r_c_e_a_nd-lD_N_o ___ t_h_at_C_o_n_t-ro_l_D_e_v-ic_e_(s_)_i_s-in_s_ta_ll_e_d_o_n_: ___________________ _
Rotary Drum Dryer, ID No. l I 4. Narrative Description of Control Device(s):
Cyclone and scrubber in~talled on a rotary drtim dryer to control dust emission associated
with drying of soil and sludge.
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Model Number
S. Estimated Cost of Control Device Period of Time Control Device is Estimated to be Adequate:
$ ________ _ 10 Years
6. Pormit Application is made for (CHECK ONE ONLY):
( ) New Source ( ) Existing Source ( X) Modification -Last Permit No. --<i6'-'J--'0"6'-'.---------
Commence Construction Date Portable Unit ,19 __ Operation Date August 6 1 , 19.Jl.L
7. Emission Parameters: PART. co
( )
voe
( )
LEAD OTHER OTHER
8.
9.
Pollut>nt(s) Controlled lxl
_lQ_
_.Q.L
---2.2...
( ) Chrome
Emission Rate Before Control (lb/hr) =
Emission Rate After Control (lb/hr) =
Remo,·al Efficiency Percent(%) =
Panicle Size Distribution of Particulates Entering Control Device(% Micron):
___ 0.1 ___ 1-10 ___ 10-25 ___ 25-50 ___ 50-100
Gas Conditions at Control Device:
Flow Rate (ACFM) =
Temperature (Deg. F) =
Velocity (ft./sec.) =
Pressure Drop (in. H20) =
Mo~ure(%) =
Oucribe Ultimate Disposal of Collected Materials:
Approved hazardous waste landfill
INLET
2000 250
80
INTERMEDIATE LOCATIONS
2000 250
42.46
_.J..ll_
.008
99
___ Over 100
OUTLET
2000 250
18.83
10. Suck or Emission Point Data:
Height Above Inside Arca
Ground (ft.) (sq. ft.)
28.5 1. 77
Is scaffolding available for sources testing?
(X) No ( ) Yes
Direction of Exit
(up, down, or horizontal)
Are there obstructions over the stack?
(x) No ( ) Yes, (specify)
UP
Are sampling ports available?
(X) No ( ) Yes
I 11. Comments:
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12
SUPPLEMENTAL DATA FOR AIR CONTROL DEVICES
••• "CYCLONE" (MECHANICAL SEPARATORS)•••
C
page 2 of 3
Efficiency (%) Volumetric Flow Pressure Drop (in. H20) Baffles or Louvers (specify) Position in Series
33 Rate (ACFM) # 1 of ·? Units
2000
Cyclone Dimensions (inches) Cyclone Body Diameter Cyclone Body Height (ft.) Cyclone Cone Height (ft.)
Inlet Outlet (inches)
6 12 54 33 2
Wet Spray No. of Nozzles Liquid Used (specify) Flow Rate (GPM) Makeup Rate (GPM) % Recirculated
(X) No ( ) Yes
A process flow diagram must be attached If cyclone is routed to another cyclone or other equipment, show sketch of entire system.
CYCLO"E OIIGPAM L T
CHECK APPROPRIHE OUTLET CCUFIGURATION 5ELCW SKETCH OTHER
COUFIGURA TION
ON DIAGRAM
Below .. -·
DUCT
INLET
DIMENSION +-----+
leOOY
I HEIGHT
ICONE
I HEIGHT
I 13 ••• "MUL TICYCLONE" •••
Efficiency (%) Volumetric Flow No. of Cones Pressure Drop (In. H20) Position in Series
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Rate (ACFM)
Louvers Inlet Dimension of Individual Outlet Dimension of Individual
( ) No ( ) Yes Cyclone (inches) Cyclone (inches)
14. ••• "FILTRATION" (BAGHOUSE) •••
Efficiency (%) Volumetric Flow Filter Surface Air-to-Filter Area Ratio
Rate (ACFM) Area (sq. ft.) (ft./min.)
TYPE OF FILTER FILTER MATERIAL
( ) Fabric Filter (BAGHOUSE) ( ) Fiberglass ( ) Nylon
( ) Packed Bed ( ) Mat Filter ( ) Nomex ( ) Teflon
( ) Panel Filter ( ) Wool ( ) Dacron
( ) Other ( ) Cotton ( ) Orlon
( ) Other
No. of Compartments Time Between Cleaning
(mins./hr.)
Inlet Temperature
(Deg. F)
# of Units.
Individual Cyclone Inlet Temperature
Diameter (inches) (Deg. F)
Pressure Drop (in. H20)
BAG CLEANING
( ) Mechanical ( ) Sonic
( ) Reverse Flow ( ) Air Pulse
( ) Simple Bag ( ) Ringed Bag
Collapse Collapse
( ) Other
Position in Series
# _____ of _____ Units
11S. ••• "AFTERBURNER" (FUME INCINERATOR)•••
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Type of Afterburner:
( ) Direct Fla.me
( ) Catalytic
( ) Other
Maximum Burner Rating
(Million BTU/hr)
Efficiency(%)
Combustion Chamber
Temp. (Deg. F)
Volumetric Flow Position in Series
Rate (CFM) #
' ,:
Retention Time Fuel Type
(sec.) Usage
1
Combustion Chamber Dimensions (ft.): _______ Length _______ Diameter
of Units
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SUPPLEMENTAL DATA FOR AIR CONTROL DEVICES -continued C
page 3 of 3
16 •••"SCRUBBER"•••
Type of Scrubber: Efficiency(%) Volumetric Flow Position in Series
( ) Venturi ( ) Orifice Type Rate (ACFM) # 2 of 2
(x) Impingement Plate ( ) Cyclonic 98.5 2000
( ) Packed Tower ( ) Condenser Pressure Drop Inlet Temperature Mist Eliminator Filter Area
( ) Gravity Tower ( ) Other
( ) Mist Eliminator (in. H20) (Deg. F) (sq·. ft.)
250
Gas Flow Liquid Scrubbing Medium 'Total Liquid Injection (GPM) Make Up Rate (GPM) ·
( ) Countercurrent and Additives (specify)
( ) Concurrent Water See Attachment
Venturi Inlet Area (sq. in.) Throat Area {sq. in.) Throat Velocity (ft,/sec.) ( ) Fixed Throat
Scrubber -( ) Variable Throat
Data:
Packed or Surface Area (sq. ft.) Packing Depth (ft.) Type of Packing: No. of Plates Type of Plates
Plate Tower ( ) Rings ( ) Saddles Folded
Dau: 10.8 ( ) Other 10 Wire Mesh
17. ••• "ELECTROSTATIC PRECIPITATOR" •••
Efficiency(%) 'Volumetric Flow Rate (CFM) Total Collection Plate Pressure Drop Inlet Temperature
(Deg. F) Area (sq. ft.) (in H20)
Resistivity of Gas Viscosity (poise) Charging Field Strength (volts) Collecting Field Strength (volts)
Pollutant (OHM-CM)
CLEANING METHOD
( ) Single Stage
( ) Two Stage
PRECIPITATOR TYPE
( ) Low Voltage
( ) High Voltage
( ) Hot Side
( ) Cold Side
( ) Plate Rapping ( ) Washing
( ) Plate Vibrating ( ) None
( ) 0th er ( ) Other
Corona Power Electrical Usage (kw./hr.) No. of Compartments No. of Cells/Comp. Position in Series
(Watts/1000 cfm) # of
18. •••"ADSORPTION"•••
Type of Adsorption: Efficiency(%) Volumetric Flow Rate (ACFM)
( ) One-Pass Regenerative ( ) Recirculating
( ) One-Pass Nonregenerative ( ) Other
Regenerative Method: Adsorption Material: Position in Series
Uniu
Units
( ) Discarded ( ) Thermal (dry heat) ( ) Activated Carbon # of Units
( ) Chemical ( ) Thermal (steam) ( ) Hydrous Silicated
( ) Other ( ) Other
Prtuure Drop Inlet Temperature No. of Compartments How are emissions controlled during
(in H20) (Deg. F) regeneration?
Size of Adsorbent Bed (ft,)
Length-------, Width--------, Height--------, Diameter ________ _
Regenerative Schedule: Maximum Time for Desorption ________________________ _
Length of Time to Maximum Saturation _____________________ _
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ATTACHMENT
The total water volume of the tank will be replaced twice per day. This may
vary depending on the amount of material collected. The total water volume will
be maintained at approximately 95 gallons. The water level will be maintained
above the bottom of the baffle at all times. Water will be added to the tank
through spray nozzles located above the folded wire mesh. The spray nozzles
will remove collected material from the wire mesh. Water and sludge removed from
the tank will be discharged to the lagoon for further processing.
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I AREA DIAGRAM D
pagelofl
I Show 111 surrounding building1 .1nd roads within 1500 feet of the equipment covered by this 1pplic.ation. AtUch J. 1itc diJrnm identify-
ins uch emiuion source loution(s), property boundaries v,d buildin1 (structure) dimensions (hciif,t, width, Mid len(th).
1500 feet
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,_.,, "' 500 feet
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INSTRUCTIONS
1. lndiut• location >nd type of building by the u,c of small
numben:d circlu with th• decrlption below.
2. Show roads u lin01 n:pn:><nting th• r~ edres. lndic:au
street nvnes 1nd highway numben.
3. Show wooded or deued ue• by 1pproxim1te bounduy
lines ind the words "woods'', "'deued'', 11c0<nficld", etc.
X
CODE
(1)
(2)
(3)
( 4)
(S)
(6)
(7)
(8)
(9)
(10)
DESCRIPTION
See attached drawing and
aerial photograph.
Ex,mple;
(1) Church
(2) Residence
--
·"'•-.t· .
,. ,r <--·.
, ..
r.-• • l • --,.~,-_-,._,_,,_, ~ ·•, • •, ...... ___ .
C--✓ I • ~~-.. , .. ......... ~.
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- ---
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TABLE 1
The Scrap Trailer Loading Area from Volatile Organic Analyses for Site
Number 1 ond 2, Channel Moster, Oxford, North Carolina.
Parameter
1,1-Dichloroethone
1,2-Dichloroethone
1,1-Dichloroethene
trans 1,2-Dichloroethene
Methylene Chloride
1,1, 1-Trichloroethone
Parameter
trans 1,2-Dichloroethene
Tetrochloroethene
Tr1chloroethene
Site Number
Units
ug/Kg
ug/Kg
ug/Kg
ug/Kg
ug/Kg
ug/Kg
ug/Kg
,. ug/Kg
Site Number
Units
ug/Kg
ug/Kg
ug/Kg
1
1 Ft. l..£b.
70 <50
<50 <50
670 <50
160 <50
290 <50
6500 <50
380 <50
210 <50
2
.l....ll.:. ~
78 38
20 24
<20 64
<50 • Means no quantifiable value or no peak detected.
~
<20
26
20
<20
32
330
<20
<20
~
<20
<20
<20
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Volatile Organic Analyses
Oxford, North Corol1no.
Por"ameters
trans 1,2-0ichloroethene
Methylene Chloride
Tr1chlor6oethene
1,1,1-Trichloroethone
Parameter-
trans 1,2-0ichloroethene
Tetrochloroethene
Tr1chloroethene
TABLE 2
for the Waste 011 Tonk Ar.ea,
Waste 011 Tonk Site
Units Units
ug/L <500 ug/Kg
ug/L <500 ug/Kg
ug/L 83,000 ug/Kg
ug/L 16,000 ug/Kg
Site Number 2
Sample Interval
Units .l...ll.:. 1..£.!.:.
ug/Kg 78 38
ug/Kg 20 24
ug/Kg <20 64
<5~ • Means no quantificible value or no peak detected.
•
Channel Moster,
C-4
150
160
23,000
<50
L.I.!..:..
<20
<20
<20
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TABLE 3
Volatile Organic Analyses for the Drainage Ditch Downgrodient from 8"
Discharge Pipe, Channel Moster, Oxford, North Carolina,
Parameter
trans, 1,2-0ichloroethene
Tetrochloroethene
Trichloroethene
Parameters
Volatile Organics
Parameters
Volatile Organics
Parameters
Vinyl Chloride
Units
ug/Kg
ug/Kg
ug/Kg
Site Number 6
Units
ug/Kg
Site Number 7
Un 1 ts
ug/Kg
Site Number 8
Units
ug/Kg
C-3
<5
<5
<5
C-2
18
34
<5
C-5
110
5400
670
Below Detection Limit of 20
Below Detection limit of 20
210
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TABLE 4
Volatile Organic Analyses for the Chemical Pod Area, Site Numbers 9, 10
end 12, Channel Moster, Oxford, North Carolina.
Parameters
trans, 1,2-Dichloroethene
Trichloroethane
Parameters
Trichloroethane
Acetone
Parameters
Tetrachloroethene
Site Number 9
Units
ug/Kg
ug/Kg
Semple
.l..£h
170
420
Sample
~ ug/Kg
.l..£h
ug/Kg
Site Number 12
Units
ug/Kg
<20
<20
Semple
1 Ft.
<20
Interval
.Lil,.
TR
30
Interval
.Lil,.
<20
<20
Interval
.Lil,.
<20
<50 • Means no quantifiable value or peak detected.
JR• Means peak detected but under quantifiable limit.
2...£S.
<20
20
7 Ft.
20
290
7 Ft. ---TR
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Was:e Mgt
2600 Bull Stre-et. Columbia, SC 29201
Phone: (B/J.J) 734-5200
Emergency & Holidays: (803)73-4-5424 I '.I.SE PRI~ TYPE (Form desioned for use on elite 112-citchl tvnewriterl
UNIFORM HAZARDOUS 11. Genorator'sU.S.EPAIDNo.
Form Approved. 0MB No. 2050-0039 Exoires 9-30·88
Monlfoat ,2. Page 1 IJnlormation in the shaded Meas is not Oocumnnl No. f . • WASTE MANIFEST N, c, n, 0, 9, 7, 6, o, 1,, 7, 11 410 1 O 1 7 1 l , 3 ° 1 required by Federal law, but is by State law.
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Genera\or'sPhoner 919 I 934-9711
5. Transporter. 1 Company Name
Willms Truckino 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 C) StileTr'aii•~• ff), · ·. ·--~/ ,..--: ..• :._: .•
•S• C• Dr Or 7r 3r 7, 0, 9r ?i a.' D!!T ·,Phorit .. ,on,1-7~7_:,~~,·
6. U.S. CPA 10 Numbor
' ' ' 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 Quantity I( Ucit l'WISlllunbef:·•c'· No. Type W✓,j. ::;-. .:-,:: .. ,.:-:<:..;"-_~:·;r,';>)'j
Ea. Hazardous Waste, Solid, nos ORM-E JiFjo·;r,Cf;~
N ~..:.N:.!A!.....;9:,:l:..'.8:.:9'._ _______________________ i__L•·-•L'.l..)'.'.D'...,L'.T+...l'U'U'l:2...l'i.'.:O'....l-..:Y--i~'.~j !::'::::i:::D:::l:::D:::1:::6:::J:.1(':.:J ..
I ~ b. ~: j'",'."," -;i
ol-_________________________________ _J_.1_•_L•j_J0L.I-.L'-'LL1J1Lj_ _ _J·;_:·;t~1=='::::1=1::::~Li~-J
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\1·1~::
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I I 1 1 I I I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79091
1 e. GENERA TOR'S CERTIFICATION: I horoby doclare lhnl tho conlflril:s Ollhb conslgnmonl au, fully and accuretely described above by proper ahippirig name _,,dare cl&.M.lfte<I,
packed. matkN:1. and labeled. and ore in nll ,o:spocts in propor condition for transport by highway according lo applicable lnt11rna1ional and national Q0"11rnment re,gulatlons an<I
tr111 laws o! !ha Stale ol Soulh Carolina.
111 am a large quan11ty generator, t cortily ttlat 1 havo a progrnm In ptaco to reduce tha volume and toxlcltyol weslaganaratod 10 the d&graa I have datarmlnod tot>. oconomiealty
practicable and ma! I have selected the practicable mothod of troolmant. ,torago, or dl.1posal currently a"o.itab!a 10 mo which minimize, tho present and lutura U'lrMI to human
healtn and the environment; OR. ii I am a smull quantitygonora1or, t hnvo modo o good faith a Mort to minimize my was to ganaraUon and salacl tna best wa,:a l"T'.anagemenl metnod
tha! is available to me and !hot I con nl!ord.
I l-
-+~P-r-in-teo_t_T-yp-ed~N:..am;..:e~..,;;:.:.,_:;.::;.;,:.::.:;,__ _______ J._S_ig_n_at_u,_• __ ✓_ /,C/_u.;_.:;e.d"--.,,....; .;__;a:,_.../..;_ __ /:....''_. _,_,_ . .L....:,. _____ .J.,M;;.oc~,l.'l,;:..i.;;.DJ.a~yJ.,;;Y;Jear~ Roger L. Cants I -~ Zf-. Lc-c. l..J.. 10,3,3,118,8
T , 7. Transooner 1 At:i,;nowle,-jgement of Receipt of Materials ·, -.
R I A Printe,-j/Typed n:imc / L,I. 1• 4c.ci< I Signature f::J ,~✓ ;1,I I/ N LA'P/f?/.' /. s ('\ . ,
p
,
' 0 18. Transpor1et 2 Acil'fiowtcdgemenl of Receipt of Materials / , --,
" I T Printed IT yped l1ame I Signature. E R
Mon::, Day Year
1t?.3.3,/ 1Q,li'.
Montti Day Ye.a,
t , I • I •
19. Discrepancy Indication Space
I ~ • I I I I I I l'bo. C I I I I I I pt:s.
b I I I I I I pi,,, d I I I I I I pbo.
•1---------------T 20. Facilit1 Owner or Operalor: Ccrti!ic;i!ion of receipt or hazardous materials covcrod by this maniresl except as noted in /lem 19.
I y I Sign~ture
E"2!"~nr:::,:::,p::: .. ,~:1,:::~;,:i?.-,<:r.f!"_ ,::r1::._.:::.,'". 91l"1l"lstl·5tl)"l'f~"'::",::,:::n:'."l~D;-_._:::c:::"::"':::.:::.,-:-,-:,.7,o,-;:0::1>-:,-u"1071u'""11>"'1..,,r""'c:::-:,:::9-:-n:::D:::(l""10-v-."',"'0"'1"°no"'J7J _________________ _)L.....l.....L...L-1-I-J
Printed IT Month Day Yoar
f ' I . I '
I /1f./~:,;,, s"'outh Carolina Department of Health Bureauo!Solid&HazardousWasteMgt
"~ . .-: \..J::-and Environmental Control !::U11
1:~1~
0
;~:ia.sc
29201
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~ Emergency & Holidays: (803)734•5424
I :.1.~E PRIITT or TYPE (Form desioned for use on elite r12-oitchl tvnewriterl Form A roved, 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS 11, Generator'sU.S.EPAIDNo. 0 Monll••~ 12, Page1 Information in the shaded a,,as is not
WASTE MANIFEST N,C,D,0· Q, 7. 6· O· 4, 7, ], 4,o:'/t":i7'i ,0i, 01 1 requiredbyFederallaw,butisbyStatelaw.
~ 1 Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smiti1field,
4. Generator's Phone I 919 1 9 34-9 711
5. Transporter 1 Company Name
Willms TruckinP Co Inc.
7. TranspOl1er 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, n, o, 7, 3, 7• n. o, ?, <1
8. U.S. EPA ID Number
• ' ' ' ' ' ' ' ' ' ' I
ID. U.S. EPA ID Number
-~ii:~;~;;~,-~_~;:-~s;;~)tt~t
~V4¥!iii~0ti~:r:~:::k1J:;~~:\:;;~-:}.,:::.kS~{f~~{~t;1?~
c/'Sbii,"tfln~~& 10·.,.... ·· ·: :.,:. :i?.•-+·t<7:_::· :'.,
Oil... . .. i Phont,:' ·An-, i-7~ 7_:o, -,-,-,· • ..
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity l(Unil ~'Wat8~':t :.,. ,-.:,·~~ ~ :>;,~·-tI:y~~tJ No. Type W\NrJ
a. ,;·'F: (i'"'f'Tifi'i;( ~ Hazardous Waste, Solid, nos ORM-E :.;; 1 I J I ':ti
N ~.::N'.'.:A~9.:,l::_8?_9 ______________________ ..j.......L.J.:...j'.'....1.:..I-JLJ.-l.:..J.4_.:,_-i::•::1.'.J~1 E:::::i D::i::D~1=6::'1.'IY t b. ::1·t~';-~--~7-~ ' ,1 D ,T . ' ,2 ,0 y
~ ~-------------------------------..l-.l..-1._\.--1_,j_JLLL.J..._j_ _ _i:.ci)~•=::1 =:' ::::1::::::1.!;.!f ' ' ' ' I I '
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' ' ' ' I I '
d.
I I ' ' I I '
15. Special Handling Instructions and Addilional lnlormalion
·csx Work Order No.: 79092
l&. GENERATOR'S CERTIFICATION: I horeby declare that the content, of thl, eon!lignmonlara lullyand accurately described above by prop.er 1hipping name lllr'ld are cla ... ne>d.
i,acked. marked, and laheted,11.nd are In All rosp11cts In proper condi1ion lor transport by highway according to applicable International and naUonal gova,nmenl ,a,guleUon, er,d
U'le laws or the SI.ate of South Carolina.
II I am a large Quant1ty gencrntor, I cor1ily that I hnvo e program In placo lo reduce the volume and toxlcltyol waslegenarelod 10 the d&fJrN I have data,mlnod 10 be economlealty
pracl1cable and Iha! I have ,elocted tho prnclicablo method ol lrontmont, slorogo, or dlspoS&1 currenUy available lo ma which minimizes lhe pres,ant and lurura lhrut lC human
health and the environment OR. ii I am a small Quantity oonorator, I hnvo mado o good laith ertor1 lo minimize my wa,1.e generation and ,elect ttlo beat wasta managamant l'floetl"od
that Is available to me and that I can oflord,
. Printed/Typed Name
Roger L. Coats
Signature Monttl Day Year
,0,3,3,1,8.8
~ 17. Tr~nsporter 1 Ae;Knowledgement of Receipt of Materials
_., / I o/o~'j'1 IT yp8_Wa'!)r,,,,.,
fV/(J,.f:: }--/ 1///,//t.K,.,, J,,//4/f'f:" V -.
Monttl Day Year
.,.,,?13,1 .~.Ji'
• fl. Transporter 2 Acknowledgement ol Receipt of Materials I I I
Mon!fl Day Year
I
;;, Pnnted/Typed Name
19. Discrepancy Indication Space ·
F a I pt.. c 11....L....._._..._._,!lbs. i rl-:-:,--=-..,,,.-=----:-----::---b ,w.. ...... w.....L.J"bs. d , ,,bl.
~ 20. Facility Owner or Operator; Cer1ilication ol receipt ol hazardous materials covered by this manilesl except as noted In Item 19.
, ·-~~~'.~-~T~-ped Name I Signature
Signature
I , I . I ,
Month 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 :?9201
Phone: (BOJ) 734-5200
Emergency & Holidays: (80~)734-542,
E PR/HT or TYPE (Form desioned for use on elile r12-oitchl tvoewriter) Form A nroved. 0MB No. 2050-0039 E.,pires 9-30-68
UNIFORM HAZARDOUS 11. Generator's U.S.EPAIDNo.
WASTE MANIFEST N,C,D,0,9, 7, 6, O, 1,, 7, !,
Manlloet 12. Page 1
4 ODocQum7ont)No5. of 1 .. ' ' ' '
Information in the shaded .weas is no1
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
•· Generator's Phone I 919 l 934-9711
5. Transporter 1 Company Name
Willms Truckino Co
7. Transporter 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
Is, c, D, o, 7, 3, 71 0, q, ?, Q .
c/siaia .. r .. ~. 10 :.·, ,<. 'j•,
0/T" •· af>hoM:.•:.:Rn,l.•n7~«·«•·.,
8. U.S. EPA ID Number j:·:;;.;.:.·~·.:::=·f··, S'o :;. . '. :·'4-~-"'-?:;., ,,, :,•..::-~;:..:
,t ,;;:o,,.~~A:< '.,:-,:,··,< , , , , , , , , , , , , F>rran';;,_,..,.. Pt,ooo :· ·
10. U.S. EPA ID Number
K .. •.·•.·.:F .. ";..'11)''1·.·.=. ··---.. ..·. . . . · .. ,.,,.,,.,_,.,,
Is, c, D, o, 7, o, 3, 7, ~ 9, a ' \;r:32·:/ '.'.'.07::.,!\}:f:sb3/4~~±~00:i:;•&•
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14.Unil L·wasfli•tMubl,~
No. Type wwr;;. ;:=/.·-:=<:t:~-:';';};i~·\}iti
a.--.~ 'I. <'"'.·~t ~~; '\',. · ·-·--· !•;,;.•·• • ... ,'''_'":· ... ~_i.l:,."•'.....:..'r ..
Hazardous Waste, Solid, nos ORM-E
N NA 9189
\j F i d,Tfcf,;i;
,,1 D,T , , ,2,0 Y ''!1E1P10161¥
•
b.
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. . • . ' ' .
d.
I 0 I I I I '
15. Special Handling Instructions and Additional Information
CSX Work Order No.: 79093
16.. GENERATOR"$ CERTI_FICATION: I horebydeclare thal the con1onts ol Chis conslgnmenl are lullyend eccuratelydncrlbed abova by proper •hipping name •nd ar• ci--,nad.
packed. marke-d, and labeled, and are in all rospecl.s in propor condlllon lor transport by highway according to applicable lntornalionat and national government ra,gulatlOl'I• and
u,a laws ol 11"1'11 Suite ol South Cnrolina.
11 I am a huge Qu11nhty genc,ralor, I cttrlily Um11 havr, a p,ogmm In rlnco lo roduca lhavolumo nnd lo11lclty ol we1tagoneraled lo lhe dograe 1 h•v• determined lo M .conomk;.alty
prachcat,le and lhal I ha Yo solocled tht1 p1nc11cablo mothod 011,oralrnont. ,1orngo. or disposal cutrenlly avoilablo lo mo which mlnlmliea Iha pres.en! and lutur• tl'\r-1 IO human
health and Uie environment; OR, if lam n 15mnlt quanlitygonoralor. I hnvo, modo n good lailh eNort I0 mlnlmlzo, my westa genareUon end select the bo■I wa ■ te man•o•manl m-eU'IOd
that Is aVailabte to me and Iha! I can olford. ·
I Printed/Typed Name !Signature .? ,cA ..1 ~ ·. p• /1 _j_. Monttl Day Yw Roger L. Coats /~~,__ --;;;:z:.., (.___<fra.4z, 10 13 13 ,1 18 ,8 -+---___,:;;__ __ _,_____;,.___;;,.__;;;;____=.;:.~-----'-"--'-"~
~ 17. Transporter 1 Ac.:i,;now!edgement of Receipt ol Materials
Prinled/~J;:R/ z=AAf/' I Sign'ature
> 18. Transporter 2 ..<cknowledgement of Receipt ol Materials v' Rl---...;._------"-----'-------~-------'----------------------------i t Prinled/Typed Name I Signature Mon!h Day Ye.ar
19. Discrepancy Indication Space
"1---------------~ 20. Facility Owner or Operalor; Certiricalion of receipl ol hazardous materials covered by lhis manifesl except as notod in /lem 19. L Printed/Typed Name I Signalu,e
A Form. 8~0~,23 (Hl?Y: OtllO) P,uvlou.a ~dltfons n,u Obsoloto 1rnn:c H)OB (flcv. 10/06)1
t , I , I ,
• Li .1...1....1....L.J..JJibs. ' l~~_._.~libs.
bJ l'"'-dl jibs.
Montn 01, Yw
I , I , I ,
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bull Str~L Columbia. SC 29201 Phone: [phone]
3. Generator's Name and Mailing Address
Channel Master
P. 0, Box lld6, Smithfield,
•-Generato,'sPhonel 919 l 934-9711
5. Transporter 1 Company Name
Willms Truckin~ Co. Inc.
7. Transporter 2 Company Name
9. Oesignaled Facility Name and Site Address
CSX Services of SC, Inc,
Route, I Box 255
Pinewood, SC 29125
NC 27577
Emergency & Holidays: (803)734-542•
Form Ap roved. 0MB No. 2050-0039 Exofres 9-30-68
Manlleal 12. Page 1 tnformalion in the shaded a<eas is not
1, 4, 8~(f~7\~06 °1 1 required by Federal law, but is by State law.
6. U.S. EPA 10 Number
I SI C, D• Q, 7• J, 7• Q, Q, ?, C>
8. U.S. EPA 10 Number
I I I I O I O I I I I '
10. U.S. EPA 10 Number
, s, c, D, o, 7, o, 3, 7, _
C)siiio"f" ,. .. "'" ... e IO·._' ,. --· "' -:,,, • : :,-.,:,_..-,,;,,_-,-•"
D(T" ., .. c· iPhono,• .•An1/-71i7-"-1'>'>1"-
~-=,a•:.;:.:..:'".'i'•• .. :-::--:::-a·o::;, . .-,-.. --·. .. ,·-,.~;,.,,/:•,..:t:•:<<
'Fxtran:.::··;;;::,SiJ; ~-;-:•(: ::'-:·-·:=·.;,.;-.;•~----=·',:.HM'~t¥/,,.:-;.-,
ci.Osia'to Fecilit{a ID
:;:-··;.>:::
11. U.S. DOT Description (incfuding Proper Sh;pping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U. Unit l'W&111Nt.rnbof':c,-
No. Type YAf'l,j ,')f:<J/-:<{,fJ:.#¥:'f
E 11 -Haz'.:"~~;~:~~~-~~;~;ii;~:;'"~;;;·:o%°i~~ · ,.,,,___ ,,\' F ;o,ifif,'~
N 1-.:N'.:A:...:9~1:_:8'._:9'.__ _______________________ l---:•L· .J'L:l_j.'.:'.Dj,L:T_j_.J•_J•_J•::_2.J'::'.0_j_.:Y__j_::.•~; '::f::!l;::P;:1;::P;:1;::6;:1.1.:J?f ! ~b_. _______________________________ .j_J•~•L+-.L •+J·LL'.L •_i•-~-+·.:.ii~:=•--=·,=··=·--=; =·~=,·=·-=· ~.;:;q,
I
~ c. , I .... j. ~ .. , ... , .. ,.:~
~
l----------------------------------...1.-L 'J'L1-J•_\_.L 'J'LL'J•_\_...:._i-~~i.':':=:::::::::::,;1 \~l
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,:-.; I -I : ·, .. ,· .... _,:;]::_
~=2 I 1?f
d.
' ' ' ' ' ' '
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 79094
18. Ci,fNERA TOR"S CERTIFICATION: t horeby dochHe Iha! lho con Ion ls olthb conslgnmont are fully 11nd accurotolydescrlbod above by proper ahipping nama and ara cl&a.a1ft.-d,
packed. mark&d. and 1a·beled, ond are in HII rospecls in proper condition !or transporl by highway according to appllcable International and nauonal govarnmant ra-gulatjons al'ld
tne law:, or the State of South Carolina.
111 am a large quanury generator, I cer1iry that I heve a program In pleco lo reduce !he volume and toiclclry of waste generated to the dogre111 I have determined lo be economic.ally
prac11cable and that l have selected the practicable method ol treatment, storage, or dl!.posal currently ava.ilable to ma which minlmlr.as tha pras.ent and luiura cn, .. t to human
haalth and !he environment OR, ii I am a smoll quantity ga.norolor, I hove ma.do II good faith effort lo minimize mywe:,te generation and s11!11c1 the bell w1111e management ,,...thoell
tnal is available to ma and that I ca.n nllord.
Printed/Typed Name
Roger L. Coats
I Signature Month Day Year
10,3,3, 1,8,8
T 17. Transponer 1 Ae;1<.nowledgemen1 of Aeceipl of Materials A f--'c:--,'-'="--:,_:,_:,_---"=-"-'----C.:..:..'--'--'--=-'--'----,.,,,------,,------,-------------;c----,--,-,---f
lihP~rin_•~_,r_yp~~~N•~m•~R~-~o-1--Yo.;.R,._l.1.1/hV~oirf-~-L-~IS_ign-at-ure~•r12n~/-fuo,~1-J.~,~,'JJ~~#~%t.:::..::r ___ _cl~~~~~dl';~~/u1Qt.y~~y
, o 18. TransPoner 2 Acknowtedgetnenl of Receipl of Materials • ( / A~;_..:..=cc.::..:.:c.:.,;c.:....cc:.e=::....:..:.;..c.:.;c:...c__:_c.:c.=='---~-----""-----------------------------1
f-T-+:-:P:,ro,-·n_,~_/T_y_p_~"""".N,-a_m,..•"""".:-------------.JII..S-lg_n_•_'"_r• _______________________ _.IM_o_~1,,"'_.._ID.,._~":y-._lY.,.~--1
19. Discrepancy Indication Space
F a '-I .W...LLJ..J/lb!. c ,_! ~~~~/lbs. $ bl pos.·d! /lbs.
'~f---------------~ :x>. Facility Owner or Opera!or; Certilication of receipt ol hazardous materials covered by !his manifest except as noted in Item 19.
l tA ~:::~:y::,:::•9/86) l',cvlous f'<johon, aou Obsolulu 1m
1,::n,a~:: (llcv. 1018")1
Montn Day Yw
I ' I I I •
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & H.uardous Waste Mgt
2600 Bull Str .. \ Columb;a_ SC 29201
Phone: [phone]
I
I
. I
Emergency & Holidays: (803)7J.C-5424
E PRINT or TYPE (Form deslaned for use on elite [12-oitchl tvnewriterl Form A• roved, 0MB No. 2050-0039 E.xc:,ire, 9.30.ga
UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Gonoralor's U.S. EPA ID No. Mnnlloal ,2. Pago 1 Information in !he shaded ateas is no1 Oocumnnl No. I N1 C,D,0,o 7,6,Q,/1, 71 li t,,O,Q,7,1,-7 ° 1 requiredbyFederaltaw,butisbyStalelaw.
3. Generator's Name and Mailing Address
Channel Master
P: 0. Box 1416, Smithfield,
,_ Genera10,'sPhonel 919 I 934-9711
5. Transporter 1 Company Name
Willms Trucki1w Co . Inc.
7. Transporter 2 Company Na.me
9. Designated Facilitf Name and Site Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood. SC 29125
NC 27577
6. U.S. EPA ID Numbe, , s, c, n, o, 7, J, 7, n. o. ?, <1
8. U.S. EPA 1D Number
• ' ' I I I o I I o I I
10. U.S. EPA ID Number
, S, C, D, 0, 71 0, 3i 7, '
D}T. •. ·,Pf>oM·_•. An° /7,;7.,;.~~~~-----:
j:\O~·;,:_v_Tf&n~8 JO .. :·: .-·· '''.·>;:,:..•;"i.' ,;:,_. ;,i·:..,
Fi':=Tn!n::.:: .. ::.:::..;;._,5 ~ i·:·' · -:,,f~-.~.-~ .... ~-·•·fr~-'.
11. U.S. OOT Description (including Propor Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity It Uni! _l waste~-~~:
No. Type 'M/Vri. ·_;J-=\=~i:,~<"'f~f~~)/{·•'.·~~
a. .. Hazardous Waste, Solid, nos ORM-E (,F jO,f,g, !,;
Nl-..!N~A::__:9:_:l::B:.:9:___ _______________________ i,_L•·_f.'.•l+D:..,l.'.T--l--.J'Ll'Ll'L2:J'C.:o+..!y~~'.~j '::::f::::1::P::1::P::1::6::'~iq':
ll b. ;~~ j.M<j.;.·.~v~-.;,.,ti]
.. /i ?i
o 1---------------------------------l--J'LL'-i-J'-ii-L'L'.L '.J'L+-_ _j__-•;_:i:::::::==:::::='~!.::_i:·
~ C.
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~~~~~:~r~~~-~Wiii■
15. Special Handling lns!ructions and Additional lnlormalion
GSX Work Order No.: 79095
,e. CENERATOR'S CERTI_FICATION: I horeby declare that !he conlonlS ollhb conslgnmenl are fully and accuratelyde,crlbed ebove by proper •hipping n•m• and are cla ... nec::1.
p•cked. ma1ke-d, and labeled, end are in 1111 rospocls in proper condilion for 1,ensport by highway eccording to applicable International and national goverriment re,ovlatlona arod
U'le laws of \he State or South Caroliria .
II I 1m a large Quantity generator, I certify th al r have a program In pin co to reduce !he volume and loxlcltyol waste goneroled to tho dcgr&e I have detormiried to b9 economic.ally
J)ract1cable and that I have solocled the practicable method of 1,oolmont. slorago, or disposal currently ovoileb1o lo mo which minimizet the prowint and luture lt\rul \0 F\urnan
health and the environment.: OR. ii I am e smo!I Quantitygenorator, I have medo a good faith etfort 10 minimize my waste goneratlon and select lt\e ~st wa,:o management me~
that Is availab!o to me end thot I cori etlord.
Printed/Typed Name I Signature 1,t;/ ..
Roger L. Coats , -~~~
Month Day Year
1 0, < ,a . 1 I 8, R
T 17. Transporter 1 At;Knowledgement ol Receipt of Materials V RJ--::-,,-,--=--:-:-,----"-----'--------,--;::---:-:--------;,",---,f-r--,-----------,:-:--'c--::----c,--f alt, Pdnled/Typed Name ✓-J 1s;gnature _,# "/ 7/ 7 Montll Day Year
'
~µL~~&-~"--e!=.-~~~-Ll.d~'.t...-::,.-~~::....::=-:---.1--~y,;~~-,___.~/;~~""""7t;f__,,~~,:.....,.~~-------L''L~u·•~~1.JLJ,1,~t~.~v
,_, 18. Transporter 2 Acknowledgemenl of Receipt ol Materials / / .,.. RJC,.C~==:::.::.:.::=====:.:.::=:::.::.::::==--~----------'----....!..-----------------1
I i
4
__ p,_;n-ted_/_Ty_p_ed_N_•m_• _____________ _,1l_S_ig-na_1_ur_• _____________________ .Jtl..O-~J.lll_,1..ID.J~-y.JJl..y-:-'~
19. Discrepancy Indication Space (! ' '-I .J_J,..,__,.__,,__,pbs. ' c_! .J_J,..,__,.__,,__,!lbs.
'I b I jib>. d I !Ibo-
'~f---------------~ 20. Facility Owner or Operalor; Certilicalion of receipt ol hazardous malerials covered by this manHesl excepl u noted in Item 19.
Prinled/Typed Name I Signature Month Day Year
I , I . I ,
PA Form 8700-22 (Rev. 0/86) P,ovlous Ed!llonti nro Obtioloto (DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
E PRIITT or TYPE (Form desi ned lor use on elile 12-ilch ewriler
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Gonorator's U.S. EPA ID No.
NCDO'
M11nllo111
OocunHml No. 4 0 0 7 1 8
3. Generator's Name and Mailing Address
·channel Master
P, O. Box 1416, Smithfield, NC 27577
,. Generalor'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
Form A
2. Page 1
of
Bureau or Solid & Haurdous Waste Mgt
2600 Bull StreeL Columbia, SC 29201
P~one: (800) 7:34-5200
Emergency & Holidays: {803)734-5424
roved. 0MB No. 2050-0039 E.::cpires 9-30-8,8
Information in lhe shaded a<eas is nor
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 ltUnil l'W&.1111-tuaber'.·-+
No. Type 'M/Vri. ;'/Nt~{/..:.!'/J.'f~~~~~
a..~-i....::..." .•.. :~t.}. ~ .;~ ~ ~-•' -~-· ~-:.:........ ····-., --. Hazardous Waste, Solid, nos "oRM:..:E
NA 9189 I D T
d .
.i'Ad611ona! Descript\Qn, f« Materials U,ici<l Above ,,, ·,;,7 .. ,,.,.
-~t~f):,i \:/·.i., ,-:; .: .>.<.-~~;;:::? :, .<:; < ::-:r:::-: ~ ~<:-:-.~ ~-_:: ,;_i.:,\ >, }:Af :1:'.//;1/J:;f li\\hX,.: ~;~\~ /J'IMiiih {iif:: :i '-\?? :1-~ '.! :;L'.~5t1i
a.1£...M.1-I012171714l-!11l10121:i?i('i::u:0-w-1 ·, 1-.__I -'-L-..l.-'
b. L_µ-1 ,-1 , :i;:::r;~:i:;;:;::~: w~i ,-,
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79096
)iF i o,T,'tfi't;
2 0 Y ~1[1Q1Q161J
,a. GENERATOR"S CERTIFICATION: I hereby declare !hat the contents of this eor,slgnment•ro lully and •ccuratelydoscrlbod above by proP41r 1hlpping name and are ct._...ntld.
packed. marked. and la'beled. and are In 1111 respects in proper condition lor transpor1 by highway according to app11cable lnternalionat and natlonat government r911ulatlOl'\a and
. tl"ltl laws of !he Stale of Sou!t'I Caroline.
111 am a large quantity generator, 1 cer1ity that I have a program In placo lo r&duca !he volume and toxlcltyol waste genereted 10 tha de,gr-1 have determined 10 b4 .c:Of'Omk:.alty
pr•cticable and that J have selected the practicable method of treatment, :storage, or disposal currently available to me which mlnimlr.es the present and lutur ■ ttlrMl to human
health and !he environment.: OR. ill am a small quantity gonorator, I heve made a good lailh eNort lo minimize my wa:,te generation and select ttle best wa11■ managem..-il fT'lo■!l'\Od
_thal is availati!e to me and that I can etlord.
Printed/Typed Name Signature
Roger L. Coats
At:1<nowledgement ol Rcceipl ol Materials
Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by lhis manifest except as noted in Item 19.
Printed t Typed Name Signature
a L.I .JJ-1...1.....L
b L..I .L...l....L...1.....1
Month Day Year
0 3 3 l· 8 8
Month Day Year
(J
Monttl Day Year
I'"' C I jl>s.
P"'-d I !lbs-
Monll'I Day Year
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Wa5te Mgt.
2600 Bull Stre,e~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: {803)734-5-42"
LEASE PRUIT or TYPE (Form desi ned for use on ellle 12· itch ewriter Form A roved. 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA 10 No.
N C D O 7 6 0
Meniraal
Oocumenl No.
4 0 0 7 I
P. 0. Box 1416, Smithfield, NC 27577
C. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transponer 2 Company Name
Inc.
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
2. Page 1
ol lnrormation in the shaded a<eas is not
required by Federal law. but is by State law.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
t 1. U.s: DOT Description (incfuding Proper Shipping Name, Hazard Class, and fD Nufflber) 12. Containers 13. Total Quantity 14. Unit l'W&slllNtwbtif·.~f,·
No. Type 'M!Vd '.'}f:,;:~~>~!";:f{i'./~j~j
&;!~•. ~f~-ff~=:~f . ..t~l r,._:_i•~it.. tl:1\:_1_1,~:~~~t.~. ~~ /,k, .. ~, ,.,.r!'. Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T 2 0 y
a.lLMJ-J0121717141-Jld1012hi{ffi\(fcS;;'c.L..i_J-J I I I I 1-1 I I I F&
b. LLJ-1 1-1 .... 1!~i!i:iii;,!\!ild:bbl:.L ........... J:L).. ,,
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 79097
1 a. GENERATOR'S CERTIFICATION: I horoby declare lhnt tho con ton ts ol!hls conslonmenl are fully and accuralely described above by proper a hipping name 1nd are cla....,ne>d.
p•c"ed. marked. and labclcd.Rnd nro in nll rospocls in propor condition !or transpor1 by highway according to applicable lntemelional and nauorial ~o"'ernmenl re,gulatlons and
tr,e laws ol the SI.lie ol South t.:nrolinn.
111 am a large Quantity generator, I cortity thel I have a program tn placo to reduce the volume and toxicity of waste generated lo the dogr&e I have determined lo be econom.cally
practicable and thal I have :selecled the practicable mothod ol treolmenl. storage, or disposal currently available to ma which minimizes Iha pra:s-ent and lutut• U'lrut to human
health and the envi,onmcnt OR, ii ram n small quantitygonoralor, t hnvo mndo a good foi!h etrort lo minimize my waste generation and se!acl Iha belt wuta managemenl mettw)d
That it available to me and thAt I cnn orfo,d.
Printed/Typed Name Signature
Ro er L. Coats
17. TransPorter 1 Ar..:.Knowledgement of Receipt of Materials
Signa1ure ·lf,u_,._
18. Transporter 2 Acknowledgement ol Rcceipl ol Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator: Conlllcnllon of rt1cotpt ol hnuirdous mnlorlals covered by this manifest except as noted In Item 19,
Printed/Typed Name Signature
PA Form B700•22 (r-lov. 9/86) Provious Editions nrc Obsolclo (OHEC 1988 (Rev. 10186)1
•~I~ ....... ~
b._l ~_,_.___.
Month Day
0 3 3; 1
Month Day
jibs. C I
!11>1 d I
Mon!ll Day
Year
8 8
Year
!lbs. pt,,.
Year
South Carolina Department of Health
and Environmental Control
Buroou or Solid & Hazardous Wa,te Mgt.
2600 Bull Stree~ Columbia. SC 29201
Phone: (8-0J) 73'1-5200
Emergency & Holidays: (803)73-1-5""24 .:·~ Ille PR!~ or TYPE (Form desinned tor use on elile !12-oilchl tvnewriler) · Form A roved. 0MB No: 2050-0039 E.Il'>ire, 9-30-88 ·
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo. b Man11•;;,, 12, Pagel lnlormation in the shaded a,eas is not
. WASTE MANIFEST · N,r.,n,0,q,7,<.0,1., 7, J, 1.,0~00~17z,0bl 01 1 requiredbyFe<lerallaw.butisbyStatelaw.
;.;
3. Generator's Name and Mailing Address
Channel Master
'·P, 0. Box 1416, Smithfield, NC 27577
•·· Gene,alor', Phone I 9 I 9 I 9 34-9 711
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, I Box 255.
Pinewood. SC 29125
6. U.S. EPA ID Number
S• C• D• Q, 7, 3• 71 Or Clt ?l 'll .
8. U.S. EPA ID Number
0 I ' 0 I I I O I O I I
10. U.S. EPA ID Number
, S, C, D1 01 7, 0, 3, 7, ~
:;~;:~i~::~~-~.;,::;.1~t?i
:~J~~t;~;,:~~::'.!?'f<--~_,,;~·?{t?~~~$4~
·c/Stl.ht'.T ·,.10· ... , =:-:,·,-·::~.p:.~-~s~f,:
0/i · ·· · a Phont .• .. : on-,,'J,7~ 7;;,o "~~•,.:, · "°'~"'·t · · ·· • o ,., .. , .. , ... ,,, , .. ,. ,,,~.,,,.,,,.,A
'Fkr', -.. -....... ;SPhor;;·/:.;:-ii~c!v:;·~,',;tY:'i:~<:;tf~.:':;";/,o/,"¥,."
:~fa~'~i,;~~~,f;~:::·::;::.\'.:::::::.::~~,; ;;:::;·.--~~:,i~f ~itjl~~~ll~iT~
11,. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity 14. Unit
No . Type 'MN~ .. ·, Hazardous Waste, Solid, nos ORM-E
N NA 9189 ,· ,1 D ,T , I 12 10 y
b. .
' ' ' ' ' I '
' ' ' ' I I I
d.
' ' ' ' I I I
~e!~f:!~~■i-illl
15. Special Handling Instructions and Addilional lnrormation
. ,GSX Work Order No,:
,1 ·~
79098
18. C!N!RATOR·s CERTIFICATION: I horeby declare that the content, olthl!i cOnalgnmentare fully and accuratelydescrtbed above by proper shipping nama and are clu.■'ftN.
packed. marke-d. and lahelcd,and nre in 1111 respect, In proper condition for transport by highway according lo applicable lnlernationel end natlonel government r--oulations aNI
u,e laws ol the Stale ol South t;nrotlna.
t1 I am a large Quantity generator, I certity thal I have a program tn pince to reduce the volume and toidcltyolwaste generated to Iha dog,_ I h■ve determined to boe BCOflOffllcalty
f' '..l pract1cable and that I have selected the practlcable method ol trealmenl. storage, or dlsposal currently avnUab1e to ma which minlmlz.e• tho present and luture lhr-110 hum,&n
hea!tn and !he environment; OR, ii I am a sm111I quantity generator, I hnva made a good laith eNort to mlnlmlte my waste generation and select the boil wa,ta manag■mient method
that ls availabln to me and that I cnn aHord.
· • 11 ~..,...P~r-in-ted-/T_y_p_e<l]N~aumueai::...1 ..... J;.i;!JlJi;s. _______ _.l_s_is_n,_tu_,_•_..:_~•'.::/J;:.:!:;'.!:::::_~:::::,_:_ ;~~/I~~ ..1__~------...lM~o~n~lll~~Oa.i..!y~Y~eari..llt .,. -T "~,·~ /V1!1 ii A , Z7' .... ~ 1 Q, 3• 3. l • 8, 8
~ 17. Transponer 1 At.:Knowledgement ol Receipt of Materials ,, I 1_ftinte<l/Typf' Name
I J,:;, ~ ,1.. S, • -,_, ~ YS°CI" , 2' 18. Transponer 2 Acknowledgement of Receipl ol Materials
I
i Printed/Typed Name
f-19. Discrepancy _Indication Space
, -
Monlll Day Year
· 1/J .:~ .. ':\, I i'o~
Signature Montn Day Year
I , I , I ,
' . ft---_
::;: 20. Facility Owner or Opera!or; Certilicalion of receipt ol hazardous maleria1s covered by this manifest except 8!1 noled in llem 19.
1
I Printed/Typed Name Signature
P;-A Ferm 8700•22 (Rev. 9/86) Previous Editions are Obsololo IDHEC 1988 (Rev. 10/86))
Monu, O■y YU/
I , I , • ,
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Wast! Mgt.
2600 Bull StreeL Columbia. SC 29201
Phone: (BOJJ 734-5200
I
I
I
I
I
Emergency & Holidays: [phone]
t :.I.SE PRINT or TYPE (Form desloneo for use on elite 112-nitchl •·•ewrilerl Form A• roved. 0MB No. 2050-0039 Expires 9-30·118
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo, 0 ManlfootN
1
12. Page1 Information in the shaded arees is not
ST ocumont o. of , ., b F·" 11 b . S WASTE MANIFE N,r.,n,o,n,7,6,0,-1,, 7, 1, 4,0, 0, 7, 2, I 1 requir= Y =8" aw, UIJSby talelaw.
3. Generator's Name and Mailing Address
' Channel Master
•
P. 0. Box 1416, Smithfield,
,.· Generator's Phone f 919 l 9 34-9 7 U
5. Transporter 1 Company Name
Willms Truckino 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
NC 27577
6. U.S. EPA ID Number 'CYStafGif', . .-'• ...... f ID'::\.-: .. : ·.) ;::·/:.-,::.:-:s:,,:,B-:<5-y'~i.<
s, c, n, o, 1, 3, 1, o. a. .,, a. • oTY ·· ,•p1,o,;r: •'-'""'-'.-1i:,1::.,__,,.,_·,,/.,_.,
S. U.S. EPA 10 Numbor ti;o.::::-..>f'···· . It I():\;::·, , -:" .. f,,.:., .:. :·'ftJ_,:.~.-,._,t....,:,.:t,.;
, , 1 , 1 , , , , 1 , FXTnu'l.;~t<'sPJ\oof·:-:1-··,"_.,_., .. h.: .. '.·;~<,,~~'.,"'·•·-<
, S, C, D, 0, 7, 0, 3, 7, ~ 9t ·8 '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit ·•L!W&StllNlnbtit►t
No. Type 'M!Vcl \~(¼St/i:f:'A'?Jf::~1
d.
' ' I o , I I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79099
111. Cl!Ml!AATOA"S CERTIFICATION: I hereby declare lhallhe con1ent1 olthls consignment are fully ■nd ■ccurat91ydescrlbed above by proper shipping n ■m• ■nd ■re ~•-fl.CS. p■clo.■d. marked. ■nd 1■-beted.and are in fill ro,pect, In propor condition lor lran,port by highway according lo appllcabl■ lnlern■lional and n■tlonal gov■rnm■nt r9>Qulat10n1 ■l"d
ui■ t■ws or the Suuo ol South C■rollna.
111 am a largo quantity generalor. I certify thnt I hnvn n progrnm In pin co to reduce !he volume end loxlclty ofwutogenorated lo tho degr-I have determined to be economie■lty
practicable and !hat I ha11111 ,elected the practicable method ol treelmonl, ,tor age, or dispou.l curranlly available to mo which minimh:e:!I tho present and lutur ■ crv-1 IO human
healU'I and the en11ironment; OR. ii I am a small QUantitygonorator, t have mado a good loith effort to mlnlmt.te my waste generation and sotecl tho bell wal\e managemenl tT'l■11'IOd
trial is availat,!e to ma and thnt I can allord.
Printed/Typed Name
Roger L. Coats
I Signature Month Day Year
, 0, 313.,1 r 8, 8
~ 1-1..:7:.., ..:T..:r•:..n:.spo:.::.rt..:•;_r ;_1 :..A:."'..:n..:o..:w..:leo2ge:.m..:•:."..:'..:o..:f A..:•::c..:•..:ip..:I :.of..:M..:'::':.".:;i•::1•:....--~---------------------------------~ I Signature (1 A,, '-Month Day Year ~ Printed/Typeo Name• I,. ,,1~~ r,c1. L d~ ,;J~.I / . IQ ,'tn, / 157",Sl'
A 18. Transporter 2 Acknowtedgemenl of Receipt of Materials
T Printed/Typed.Name I Signature Monlh Day Year
I ' I , I ,
19. Discrepancy Indication Space
• I I I I I I jibs. C I I I I I I Jibs.
b I I I I f f jib>. d I I f f I f , .... F
~1------------~ 20. Facmry Owner or O~eraior; Certlflcallon or racelpl ol hazardous mnlerlals coverod by this man/lest except as noted In Item 19.
Prinled/Typed Name I Signature
: b,. Form 8700-22 (~ev. 9/88) Previous Editions oro Obsoloto [OHEC 1088 Rev. 10/86)1
Month Day Year
I I I ' I '
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Haz.ardous Waste Mgt
2600 Bull Stree~ Columbia. SC 29201
Phone: [phone]
I
Emergency & Hondays: (803173-1-5'24
Form A roved. 0MB No. 2050-0039 Exoires 9-30-68 ~E PRIITT or TYPE (Form desinned for use on elite 112-oitchl lvnewriterl
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N, r., n, o, ~-7. h, o, 1,, 7,
Manlreat , 12, Page 1 lnlormalion in the shaded Meas is nol
Oocumenl No, of . d Fed I 11 t,1 0, n 1 7 1 2, ? 1 require by eral aw. bu! is by State law.
1 Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
( Generator's Phone I 919 l 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, I Box 255
Pinewood. SC 29125
6. U.S. EPA ID Number
, S, C• D• Q, 7, 3,
8. U.S. EPA ID Number
• t I I I I I
10. U.S. EPA ID Number
7, Or q, ?r ~ · IPT """. "'"'•i,;,;: 'f ..
, S, C, D1 01 7, 01 31 7, ' 9. ·B '
11. U.S. DOT Description ·(including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U.Uni! ··t=wa!l'~0
No. Type 'MNrj i/(!(~V<1:!}l}i~1~1
.. a.--~~ [~;~_r:~. :~~'.i~ .. •1.•·~1 .,Y'"'}'
Hazardous Waste, Solid, nos. ORM::E
N NA 9189 , ,1 D ,T , 1 12 ,0 Y
~ b. · '";("'1·t1'"'1
O 1-------------------------------1-.J'__j'c_l~•Lj_L'LIL t.L •..J_._-1,;·:.; =I :::::::::::::::::::.
1
:.:if-1'
~ C.
' ' ' I I I I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79100
,e. GENERATOR'S CERTI_FICATION: I herebydecl11re thel lhe conlents ol lhls con1lgnment ue lullyend 11ccuro1ely dncrlbod above by pro~, ■hipping name and •te cl..-iffed.
pack ad, marked. and labeled. and ere In nll ro1pec1s In propor condition !or 1,ar,1por1 by highway ecco,dlng lo appllcab1a lntarnallonel and n■Uonel ao..,■rnm11n1 r09ulellon• end
I . U,11 lows ot tl'le Stato ol Soulh Carollnn. ·
HI am a large Quantity genera1or, I certify thal I have a p,ogram In place to reduce the volume and 10xlcltyol wa11egeneraled lotha do<;Jr-I ha"e dalermlned tot>. .c:oroom6eafty
practicable and Iha! I h1111a ,alecled tho practicable melhod ol treatment. storage, or disposal currenlly aYeileble to me which minlmltel the pres.an! and lutur• thtNI IO hutnan
he111tr1 and the en..,ironment OR, II ram a smoll Quantityganoralor, 1 have mado a good faith offor1 lo mlniml1e mywasto generotlon and seloc1 the t>e11 •a•t• man•gemenl me~
thal 11 aYailab1e lo me and thel I can etlord. ._
I
Printed/Typed Name I Signature
Roger L. C-... _
Monltl Day Year
10,3,3.1,8.8
T (/. Tr~oorte 1·.At;,c.now_ledgMlenl of Reetipl of Material,s · --\ i J-F,~P;::rin7tt\0f ~y:::pi-.:_~,.:_,:• ~tl::;;•;,-.::;;.,,=,__=:;:_:;KI\;z:_:::J=e.::j'\,\,=,::\'\\\-l'\':---,-lccSi-'gn-at-1-r'.:..,e ~ • .--1-~+-~,--,----,-\➔+-Lu--()-------,-.~~-on-~ltl-:-,""J.Da .-,y-,1,),..-,-Y,-earf'~
• o 18. TransPo~er 2 Acknowledgeme'nl of Receipt of Materials
I
~ t--,P:--n,-_n-led-':-:IT'"y'--ped--N_a_m_e_-"-------'---------T"IS_i_gn_a_lu-,e----------------------M.,-o_n_ltl_..,D_ay--,Y:--ear--l
~-+ ________________ ...... ___________________ .._, . .....,1...,. . .,. ...... ,""--1'
19. Discrepancy Indication Space
~ • I I'"'-'I libs.
b I I'"'-d I I"'-
' 'i-1--------------::: 20. Facility Owner or Operator; Cer1ilic.ilion ol receipt or hazardous malerials cavered by this manilesl oxcepl as notod In Item 19. 11 Printed/Typed Name I Signature
j PA Form 8700-22 (Rev. 9186) Previous Editions nro Obsololo (DHEC 1988 (Rev. 10/86)1
Month Day Year
I , I . ,· .
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt
2600 Bull S" .. \ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
I LE.ASE PRINT or TYPE (Form desianed !or use on elite r12-oilchl tvnewriter)
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A roved. 0MB No. 2050-0009 Expires 9.30.ga
M11nlfoat l,2. Page 1 Information in the shaded arou is nol
required by Federal law, bul is by State law.
I
I
I
I
I
I
I
I
WASTE MANIFEST N, c, D, o, 9, 7, 6, n. 4, 7, Qoc.wmnnl No. ol ],4,U,u,7,2,3 l
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
4. Generator's Phone I 919 I 934-9711
5. Transporter 1 Company Name
Willms TruckinP 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
I s' c, D, Ot 7, 3, 71 n. 9o 2, 'l
8. U.S. EPA ID Numbor
I I I I I I I I I f f f
10. U.S. EPA ID Number
1 St C, D, 0, 7, 0, 3, 7, ' 9t (\
~i,~tt~t\~.~t:tt~1!?i
:~~'.~0l~~~~:,::h/~r;::=t:~(::::;·:··/;'I!:~:~~~::~~-~~~~~~:;¾·,~;
·ctS:taie·f· · ''° ·,·:~::::i::,.;.:-.i_;.;.) .. : .. !.
D/T ..... ·•PhoM····•·•An,/-71',7:,;,.,,•~--
E_(~~-~-l . ·a IO ·
F/Tran~=;.,,• l'tlOOO
lf'sial<i Facility's ID ·••
/?<'.:\\'::
..... · .·. •·''}';:/}: ;:-
. C:.·. •.·
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and JO Number) 12. Containers 13. Total Quantity U. Unit · L'W&Slli~ef.
No. Type 'MNr:J :)(;:-;:;_:i)Y{{-;rS(i~]g'i
d.
I I ' I I ' '
GSX Work Order No.: 79101
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115. GENERA TOR'S CERT1FICATIOH: I hereby declare lhel !ho conlOnlS olthl, conslgnment•re lully •nd accuretelydascrlbed ebove by proper 11'\ipping n1me •nCl are cl.....,fled.
p•c"-ed. marked. and labeled. nnd an, in on rospoCIS in proper condition for lransport by highway according lo applicable lnternahonet end national ,;io-,ernmenl re-;;;ulat10n1 And
tne 1.11 ... , ol tl'lo Staie ol South Carolina.
II 1 am a large quantity generator. I cer1ily thal I havo a program In placo to reduce the volume &nd 10,dcltyol weslegeneraled 10 !he do,gre11 I have determined 10 M aconon,k:any
practicable and that I have selected the praclicablo method of lreatmenl,, storage, or disposal currently available to mo which minlmlu1 the present and lutur• in,ut to huma.n
l'leatth and the environment: OR, ii I am n small quantitygonorator, I hnvo mndo a good laith effort to minimize my waste generation and seloc1 tho bell wauo manag•ment ,,.,.~
lt\al is avai!ablo lo mo Rnd thnt I cnn nllord.
Printed/Typed Name
Roger L. Coats
I Signature Month Day Year
1 0,4 1 0,1 l 8, 8
~ 17. Transl)Orter l At:Knowledgemenl of Receipt ol Materials
I "l,:1!;ltinted/Typi,d NapJ ~ IM/ JI,'. Y?J-1 'I"/'// 1 / ,k,., 1, 1,-,. "'e v
• 1 ~ 18. TransPorter 2 Acknowledgement of Receipt of Materials fl I i Printed/Typed Name
19. Discrepancy lndicahon Space
I Signature
A
f
Month Day Year
,_..,,l;,'111)1/ 19,9
Month Day Year
I , I , I ,
F a I Jibs. e I Jibs. I ~ t-:--~--,-,-,--~---::---,--bj L. ..L..L.-L..,_,....,l'bs. dj L. ..L..L.-L..,_,....,ltbs.
~ 20. Facility Owner 01 Operalor; Certificalion of receipl or halardous malerials covered by this manifest excepl as noled in Item 19.
I Printed/Typed Name . I Signalure
":fit ~~fft\ ~#~~~~~ trt~v. i;tfi:ln,} ,~HWiO\,li t;:t11llo~•! a,o Ob!Ololo ft>lu;q ltltH_I (1101,11. 10/lW)I
Month Day Year
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South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Wa,t8 Mgt
2600 Bull Stre-et. Columbia.. SC 29201
Phone: (SOJ) 7}4-5200
Emergency & Holidays: (W3)7:l4-5"24
I L£.A.SE PRlt-fT or TYPE (Form desioned for use on elite f12-oitch1 tvnewriler\
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A roved. OMS No. 2050-0039 E.tpires 9-30-Ba
M11nllo11t ,I 2. Page 1 Documont No. of lnlormation in the shaded ;weas is not
required by Federal law. but is by State law. WASTE MANIFEST N, r., n, 0, 9, 7. 6, O, I,, 1. J, 4,0,0,7,2,4 1
I 1 Generator's Name and Mailing Address
I' Channel Master
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P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone I 919 I 934-9711
5. Transpor1er 1 Company Name 6. U.S. EPA ID Number 'CJStatt,-f· ··,:·o·• .. ::.·.,·· '"-:··. ·-,>=+•r:
Willms TruckinP Co. Inc. • s, c, o, o, 7, 3• 7, n. q, ?r C\ 0/.T .. . BPhont• .. ·A'"'·7"-'.;."\,.,"\· ·
7. Transporter 2 Company Name 8. U.S. EPA ID Number
' ' ' ' .. ' . I I I 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
, S, C, D, 0, 7, Or 3, 7,
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Nurriber)
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79102
9, 8 '
12. Containers 13. Total Quantity 14.Unit
No. Type 'Mf/o.
11. QIEHERA TOR'S CERTI_FICATION: I hereby declare that tho contents ol this consignment are fully end eccure.telydeacribed above by proP4r ahlpplng n•m• and •r• cla .... ned.
paclt.ed, m••lt.od, and labeled, and are In I'll rospech1 In proper condition lor transpor1 byhlghway according to appllubte lnlarnational and naUonal go,,arr,rnan1 re,gulatlona al"d
u,e laws of \lie Slate of South t.::arollnt1.
111 am a large qu111nhTy gencrolor, I certify th11! I hl!l\te l!I progrnm In place lo reduce the \tOlumfl and todclty ol w1utegt1nt1ratod to the d09r-1 ha"e determined to be econort'lk.atty
practicable and that I h<!l"'e selected th11 practicable method ol troolmont, storage, or dlsposal curumlly available lo me which minimizes the present and lurure U'lrul IO human
heatltl and the environmcnl: OR. ii t .im o smo11 Quantity generator, I hove modo a good loilh elfort 10 minimize my wastll genora\lon and select ttle bol!lat .... a,Ht management~
that is a ... ailable to mo ond thnt 1 con nllord.
Printed/Typed Name
Roger L. Coats
I Signature
17. Transporter 1 Ac..irnowledgement ol Receipt of Materials V
Printed/Typed Name
L<!.o....__ _., ~ /4.,. \Sign~
18. Transponer 2 Acknowledgement of Receipt of Materials
Printed/Typed Name I Signa!ure
19. Discrepancy Indication Space
20. Facility Owner or Operator; Cer1ilication ol receipt ol hazardous malerials coverod by this manifest except as nolod in Item 19.
a ... I .1....1-'-L.J.
b '-I .1....1-'-L.J.
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Month Oay Year
1 0, 4' Or l 1 8, 8
Molj
1
Day Year.
I I r/1-'<.I
Montri Day Year
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C I pi,,,
di l'bs.
V I Prin.1~/Typed Name I Signature
':P::"!. FC,ir1r\ "'i~)''J:?~ ~rl~•.i· ":i'I~~~ ~~1::"'.·\\J.i\S; ~-~1~;-:-,,\~. ~~':': ~P~Hh!h\ trn i!=~ I ~lllO_ (tlov, I Ol 8!i)J
Month Day Year
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I South Carolina Department of Health
and Environmental Control
LEASE PRIITT or TYPE (Form desi ned for use on elite 12-itch cwri!er
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
NCDO 760
Manifest
Document No.
400725
P. 0. Box 1416, Smithfield, NC 27577
4. Generator'sPhooe 919 934-9711
5. Transporter, 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 of Solid & Hazardous Wa.s:e M;t
2600 But! Stiee~ Columbia, SC 29201
Phone: (BOJJ 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Eloires 9-30-Ba
Information in the shaded a<eas is nor
required by Fe-deral law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and 10 Number) 12. Conlainers 13. Tolal Quantity U.Unit · L'Wa111~·:·;.
No. Type W/j '.)(t~,:'.:C:<1·,r(\0/;f
.. a.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
J. Additional 0..0-ipfl¢n, le>< Mntertal, Listed Abovll
J,:;., , ·. -.: ............... >_; . . .. : . ,, , /.:. , ... , . · .: , ;' •: _ ,-; , c r.,, · {(i;;;.,:1iC1:tJ!(jj;;i;J ,ii!JJ.i!!i0i1
:1 );)::; :lix!:I: i:'.if iji)f ;]ft·
a.1.t.MJ-lo12171714l-l111,o,2l•<i:?Hxc.L_t_J-I 1-1 I!-:!
I -I I I !!;;j~:1:i:i:td b+,,J :._I _..,. __ ,_-__ . .._,_,__,I-I
, 5. Special Handling Instructions and Additional Information
GSX Work Order No.: 79103
2 0 Y
. ..• ~A~•--•·''\;l
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1 e. C£N£RA TOR·S CERTI_FICATION: I horeby declare thnl tho contont, ol thl, consignment ara lully and accurately de,cribod above by proper ahipplng name and are c1.__lled.
paCl,,ed. mar~ o-d, and 1tibclcd. antl nro in nll rospoct, in p,opor condition !or tron,porl byhlghwny according I0 11pplicablo internetionol and natlonol governmenl r~ulationa an<I
U'UI laws ot the State of South l'.:arolino.
111 am a large Quantity generator, I cerlity I hat I havo a program In placo lo reduce the volume and to)(fclty ofwulegenaralod lo the dog re. I have determined to b4 eeonomlcalty
practicable and that I have selected the practicable method ol treatment, storage, or dlspoaal curronlly available to ma which mlnimltes the pres.en! and luNt• U'\tNt to human
hea11ri and 11'\e environment on. ii I am n f.mnll quantity gonor:itor. I hove mndo e good lnilh ollort lo minimize my waste generation and ,01ac1 U'\o b-o1t wa,ta managamenl r,,,ecr-oc,
ttia1 1, available 10 mo nnd Uint I con ntlo11I.
Printed/Typed Name
Roger L. Coats
Signature Month Day Year
04 0 1 8 8
Montt, Day Year
)
Month Day Year
. F a I .~ b~,~~~~ Jibs. C I Jibs.
Jibl. d I Jibs.
Mor.:h Day Year
•1---------------~ 20. Faciliry Owner or Operator; Cer1ilication ol receipt of hazardous materials covered by this manilas! except as nolod in Item 19.
Prin!ed!Typed Name Signature
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l~'..t~, . . &,~Cs!-.' .... ... South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hai.ardous Waste Mgt.
2600 Bull StrMt. Columbia. SC 29201
Phone: (SOJ) 734-5200
Emergency & Holidays: (803)73-4-5424
I l'LEASE PRINT or TYPE (Form desianed for use on elite [12-oitchl tvnewriterl ·
UNIFORM HAZARDOUS j'-Gene,alor'sU.S.EPAIDNo.
Form Approved. 0MB No. 2050-0039 Eioires 9-30-sa
Manlleot , 12. Page 1 lnlormation in lhe shaded MOU is nol Document No. ol l . ed b Fed I 1, /11 0 1 O, 7, 2_, A . requ1t y eral aw,butisbyStatelaw.
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WASTE MANIFEST N, c, n, fl, q, 7, r,, o, 111 7,
3. Generator's ~Jame and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
(. Generalor'sPhonel 919 I 9)11-9711
5. Transporter 1 Company Name
Willms Truckino 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.EPAIDNumber C)sia1of· olO·.• ' ·.y•,H?.•
S• Ct Dt O, 7, 3, 71 Ot 'lt -,. a. . D/T 'af'hono ·, ono/71,7..:.,n,.
6. U.S. EPA ID Number .J:i.,~",iit,;;.'·f,a~~a ID-=·:·i•t,,·t,·:.,-: .. •
11. ·U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Container's 13. Total Quantity 1(Ur,i! l'Wasllll~·-,':"."=
No. Type W.N;) />·-.=<<·-:,:::;-r-.r.;·<l1
a.
b.
e.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 79104
,· ,1 D ,T 1 1 ,2 ,0 Y
I ' ' I I I I
'. ' .
,e. GEMERATOR"S CERTIFICATION: I horoby doclato thal tho contents of this con1ignmonl aro fully 111nd 111ccutalelydo1c,ibed above by proper •hipping r.am• and a,111 claaa,fted.
packed. marked, and labeled.and are In nll rospocts in ptopo, condition tor t,an,por1 by highway according to eppllcable lnlern11tion11l 11nd natlonal gov111rnmen1 r.-gul111t10"• •rod
V,e la-, ol tr.e Stn!e ol Soutli l:n,oUnn.
If I am a la,ge quantity generotor, I c11r1ily Iha! I have a program In p1aco I0 reduce !ho volume and toxicity olwaato generated to tha deg roe I have d111tarmlned 10 ti. econo"'4eany
siracucal)le and that I have sel11cted tho practicable method ol treatment, storage, or dlspoa.al currant1y ava.Uab1a 1o ma which mlnlml1111 tha pras-ent and lutur• in,_, tO num.al'\
heat1h and !he environmcnl; OR, if I am a small quantitygor,oralor, 1 have made a good failh eNor1 to mlnlmlta my wa,ie oene,a1Jon ar,d =aelact ttie best wasta managamaf1t metriod
ttiat i, available to ma and lhnl I car, nl!ord.
Printed/Typed Name
,.......,_ lioger L. Coa.,,.t_....----..~
17. T anspor1eri'l A_e;i,;now!ed~meny'"ol Receipt ol~aterials
18. Trans ..: ,.,cKno~edgement ol Receipt ol Malerials
Prin\e<j/Typed Name
19. Discrepancy Indication Space
Signal .
\ ,__,
ign"a l re {)
. 1,(/')_ I -
's::::::::'
Signature
20. Facility Owner or Opera!or; Certilication of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
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b LI .l-J...L.L..J..
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Month Day Year
,o,4,Q,)18,8
.~n<J. ~a1, ~
Monttt Day Year
• I I ' I .
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d I /'i>s.
Month Doy Year
I , I ' I •
I South Carolina Department of Health
and Environmental Control
Buraau .ol S9lid A Haurdous Waste Mgt
2600 Bull Str~l Columbia, SC 29201
Phone: [phone]
I
Emergency & Hol;d,ys: (803)734-5-124
h u:e PAI~ TYPE {Form designed for use on elite r12-pilch1 tvoewriler1 Form Ap roved. 0MB No. 2050-00.39 Expires 9-30-U
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo. 0 Manllo~~ .. 12, Pa,ge1 Information in lhe shaded a<eas is no1
WASTEMANIFEST · N,C,n,o,a.7,6,0,4,7,J,4,0~cA''."172,
0 '71 °1 1 requ;redbyFederallaw.but;sbyStatelaw.
3. Generator's Name and Mailing Address
Channel Master
NC
4. :.~.,~~,-,!~0~,/
4!~9 ,sm~~z:~;if' hi'fiiiY#A!!>S;;'/}Lf:>' ))t.:11:(r;t;L
I'/ 5. Transponer 1 Company Name 6. U.S. EPA ID Number CYsti·ie:Trin'~I IO':/,/·' .... ,-~-,;~,'. <-t:i:=. ,_.~,-:-.. ?~;.,:·,.
II ~JWi!il.Jll]ll_cm~s;__JT!'..!r~uu;c:J:k;jia.In!J:l!!;______i;C;,o~._JI;_rnu;c~. ______ _1_1JiSc1.1J:C1..];1D!i...Q10!t..l17LJ,3Ur71.1.Qi.. n..2L 'li11... 2ii ~Jl1D¥}:ITr!'!i!'"'2'"'!!:' !!!'.!•Lf'Pti'.!?-,.2!' "!!>t.;;>..;.':l: At!Q.;n, 1!,L /J 7, ~ F,, 7'.,;::..C;J.; 1, 1t'.;: "-L"L ,',.;;,~
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7. Transpor1er 2 Company Name 8. U.S. EPA ID Number eyq,·~·i..·i'rtlt\aNVt..r's ID .· · . · : · :·,,,~~:.,. V' ·
I I I I I I I I I f f f F/.T . : -· ·-.. --. ·, Phooe ,t<~···: ······· ··«":l~'('·.1 .. -::.~,:
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125 , S, c, D, o, 7, o, 3, 7, '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Numbor)
d.
15. Special Handling Instructions and Addi!ional lnlormalion
GSX Work Order No.: 79105
12. Containers 13. Total Quantity U. Unit · l'Wa3tli~~,
No. Type 'M/V~ \>'•,'\=~/><1/\{c\>:?i
,-,1 D 1T I I ,2 ,0
I r ' I I ' I
I I I I I I I
y
.· ..... :.= ,.···· .. ~-t ', .I ~-~-~1: .. '..: ,t;
1g_ GENERA TOR'S CERTIFICATION: I horeby declare !hat lho contonis ol this conslgnmanl are lully and eccurately described above by prop.er shipping n•m• •nd ara clas..fl-.d.
packed. marke<l, and la.belcC,, and aro in All rospocts in propor condition lor Transport by hlghwey eccording 10 applicable lntema1ion11.I and n11.tlonal go ... ernmant r..;utat1on1 af\d
tne law:, ol the SI.lie ol Soutti Carolina.
II lam a large c:iuant1ty generolor, I cortity th al I havo a program In placo lo reduce tho volume and lo)(fclty ol wostegeneralod lo the degree I ha"e determined to~ economically
pract1cat>le and Iha! J ha"e selected the practicable me!hod of lreotmonl storage, or dlsposal currenlly av oil able to me which minimlus the present and lutvra tnroal to t"tuman
health and the en ... i,onmcnt.: OR, ii I am a small quantity gonorator. I have mado a good lailh effort lo mlnimlzo my waste gonoratfon and select the bes! waste mana;emant me~
m.al is a...ailat>la 10 me and that I con ot101d.
Printed/Typed Name
Roger L. Coats
I Signature Montti Day Year
1 0,4 , 0, l , 8, 8
~ 17. Transpone, 1 Ac,;,,;nowledgement of Receipt of Materials
I A Prinle1/Tr ,~ame
~.LC-S't1}yH-.... <V("t?h
, • g> 18. Transporter 2 Acknowledgement ol Receipt or Materials
Mon:l'l Day Year
1A ,ll,n ,l 11;6
I -TRE-+--Pr-;n_t_ed_/_T_yp_ed_N_a_m_, _______________ l_s_;g-na_t_u,_• _______________________ .,M_o_.n_tn...,_0_.a_y_.__Y•eat--1 I ' I ' I I
19. Discrepancy Indication Space
F ' ~I ~~~~ptos. 'I c..J-1 ..J-L..L......,!lbs.
I ~\-,---------------bl-~ ~-~~~~l'b,. d I pbs.
~ 20. Facility Owner or Operator; Certilicalion ol receipt or hazardous materials covered by this manifest except as noted in Item 19.
I Pri~t_edJTyped Name I Signature
'EPA Ferm 8700,~2 (Rev. 9/86) Pro-..i(')US Editions nrc Obsololo fDIIEC 1008 (ncv. 10/0G)l
Mon:n Cay Year
' I I ' I '
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardou.s Wa.ste Mgt
2600 Bull $tree~ Columbia, SC 29201
Phone: (803) 7:!4-5200
I
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FE PRl~r TYPE (Form desinned lor use on elite 112-citchl tvnewrilerl
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N, r,, n, 0, q, 7, 6, O, , .. 7,
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
(. Generator'sPhone( 919 I 934-9711
5. Tran.sporter 1 Company Name
\.J'illms Trucki.11° Co Inc.
7. Transporter 2 Company tlamc
Menlreel
Documonl No. ), 1,,o,n, 7, 2• R
I I I I I I I I I I I I
Emergency & Holidays: (803)7:!4-542<
Form Ap roved. 0MB No. 2050-0039 E.roire:s 9-30-88
2. Page 1 Information in the shaded aou is not
of 1 required by Federal law. but is by State law.
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 f::"'fecilily'~:'~'; •,'.' . < "'!\/;:.':./
• s. c, o, o, 1, o. 3, 7, '. 9, a , ~'i:1~;':~/':':,io:i'li.1~tit851,{,
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79106
12. Containers 13. Total Quantity 1( Ur.it l'Waste~·,-~-;_
No. Type 'Mf'j-J I i::}::;:,~·:/<1})\)/(1
1e. GENERATOR'S CERTI_FICATION: I horoby declare lhal tho conlont., ol this consignment are fully and accuralaly described abova by proper ,hipping name and are cla.....,ned.
pac'o.11d, marked, and l11betcd.t1nd nre in nil rospocts in proper c·onditlon tor lranspor1 byhlohway accordino 10 apprlcabte lntern,tional and n,tJonal 00,,,,,nman1 r"Qulaoon• and
tt,11 la .... , ol mo Stale ol Soutn C11rolinn.
111 am a teri;ie quantity generator, I cor1ity that I havo e program in ploco lo reduce the volume and toxicity ot westaooneratod lo tho dogree I have determined 10 be ecC>f'\Om.ca.11y
practicable end Iha! I havo setocted tho practicablo mothod ol trontmont, storage, or dispos.o.l currentty evailablo 10 ma which minimizes the pros.ant and lutvr• tl"lrMI to human
health and !he envi,onmcnt.; on. ii t ;1m n !.mall quanlity ounorator, 1 hove mndo n oood laith ollort lo mlnimlie my woslO genorallon and select tho b-o,t wa,11 manaoamer'II ""°lriod
tnat is available 10 me end lhnt I con nt101d,
Printed/Typed Name
Roger L. Coats
I Signature Mon:ti Day Ye.at
10,4,0,l,8,8
~ l 7 Transoo11er 1 At.:,.;nowledgement ol Receipt of Materials .-.
I ~ 1J'rinted/Typed flame 1 C' L 1s,~ ~• ~ "'-Li, I-~.-,..., r V('o/'"\ _'.--: , , '~ k, ·
~f-'..:8.:.·..:T..:ra::n-F-t1Po::r1::•.:.r.:2.:.A.:c..:kn..:o:.:w:.:l•:::d:eg::.e.:.m::.en..:l..:o.:.l..:R.:.ec:::e..:ip:.:t.:o..:IM=•'.:•:.:ria:.:l:.s ___ ~ ___ /l-1-J----------------------------l
1-i+_P_r_in-ted_'_Ty_c_ed_N_•_m_e _______________ TJ.S_i_gn_._'"_'_._v ______________________ ..Ji"'l...o.t.n ,"'....J,1...0.t.'•-Y .... ,v_~ .... -1
19. Discrepancy Indication Space
F
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.b) po,. d) po,.
•1---------------T 20. Facility Owner or Operator; Cer1ilicalion or receipt ol hazardous materials covered by lhi3 manifest except as noted in llem 19. v1---~-------------'-----~------'--------'--'-------'-----------------l Printed/Typed Name I Signature Month Day Yw
I , I , I ,
••
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz..ardous Waste Mgt
2600 Bun Streel Columbia. SC 29201
Phone: (BOJ) 734-5200
Emergency & Holidays: [phone]
LEASE PRINT o, TYPE ewriler Form Ao roved. 0MB No. 2050-0039 E.xoires 9-30-sa
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UNIFORM HAZARDOUS
WASTE MANIFEST
1. Gencralor's U.S. EPA 1D No. Manllost
Oocumont NO. 2. Page 1
ol Information in the shaded areas is no1
required by Federal law. but is by State law.
3. Generator's Name and Mailing Address
Channel Master
N C n 0
P. 0. Box 1416, Smithfield, 'NC 27577
4. Generato,sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
4 0 0 7 2
6. U.S. EPA ID Number
8 C n O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
~'i~:~~-•-;:t[p:·;:\~i''
a,Stai. ~." .-.,,.,.i .-••. ,• , . .-.. , ,,,-I" .. ,.,.--,.;,.·,
<-4N;,=;-. ' / ,:\~'./)/~h,,f({/\
11. U.S. DOT Description (including Proper Shipping Name, 11:uard Class, and ID Number) 12. Containers 13. Total Quantity 14. Ur,it
WlrJ
LW&>111--·-:' ~~-,,.:",_; ~ j·}:< 1· ;'./i\: / ;~; No. Type ..
Ha~ardous Waste, Solid, nos ORM-E
NA 9189 1 D T 2 0 Y
b.
C.
d.
b. Lu-1 1-1 1~~11:ii:!l~t~w:1 .J:J ... 1... 1
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79107
1e, CENERA TOR'S CERTI_FICAT10N: I hereby declare Iha! tho conlonts ol this conolonmenl are fully and accu,atelydesc,1bod obov-a by proper ahippino nam• and •r• c.la.,,..fl9'd.
pack ad. marked. and labelcC'I. and ore in All rospects in propor condition !or transpor1 byhlohway according to applicable lntornationol and noUonol governm•nt re,gulatlona ari.d
t/"lo taws ol the S'411C o1 Sou!tl ~arolinn.
111 am a lan~e quant,ty gcncr111or, t cor1ify lhnt I havo a progmm in plaC!) lo reduce the volume end loxiclty of waste goner a led to the de-gree 1 have de1ormlne-d to b-e .conomlcatty
pract,cable and that I have se!octcd the practicable method ol trootment. storage, or disposal curronl1y ava,llable to me which minimizes tho pres.ant and lurura U'lreat to human
heollh and the erwi1onmcnt; OR. ii I am a smol1 quantity gonorator, I hovo modo o good leilh effort 10 mlnimlza my woste ganaro!lon and selec1 \he boil woita mana.iamen1 "'9'tr'>Od
t!'lal is available to me and thnt I con nllord,
Printed/Typed Harne Signature -;<&~. -:J: GcLi:i.,
Mor,t'l Day Year
Ro er L. Coats
17. Trans orter 1 A<."'nowledgement ol Receipt of Materials
d tJame ~-1cf21TI
18. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature Monttl Day Year
19. Discrepancy Indication Space • I pi,,. C I !lt>s.
bl pt,,. d I ,,i,,.
20. Facilily Owner or Operator; Certilication of receipt ol h;uardous materials covered by !his manifesl excepl as ~oled in llem. 19.
,PIRl@<llflDf<l N&r!\O Slgni11u,e . i,A~RI/I ti!! vw
EPA Form 6700•22 (ncv. 9/fiG) Prc:vinu:; Editions :-ire Obr.nl!!lo fOH/'.C l!Jfifi (f1cv. 10/00)l
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mi;t.
2600 Bull Sl!ee~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
I DL£ASE PRl~r TYPE (Form desiqned for use on eme [12-oitchl tvnewriter)
. UNIFORM HAZARDOUS 11. Genorato,·,u.S.EPAIDNo,
Form Approved. 0MB No. 2050-0039 Expires 9.30.aa
Mnnlloal
1
12. Page 1 llnforma!ion in the shaded a<eas is no! Oocumnnl No. ol . db f I I ,
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WASTE MANIFEST N, c, IJ, 0, 9, 7, 6, O, , .. 7, J, '•• O, O 1 7 1 J I O 1 require Y edera aw. but rs by State law.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
4. Generator's Phone I 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckin° Co Inc.
7, Traruponer 2 Company Name
9. Designaled Facility Name and Site Address
CSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
NC 27577
6. U.S. EPA ID Number c:" s,i1eriaii'~, 10· •· ·. · ·• ·, "'··', •;y,,.
• S, c, I), o, 7, J, 7, 0, <Ji 21 C\ D:0.Tranic:.,;~i PhoM An-,, /7,c ,_;-,,,-,,-,,.
8. U.S. EPA ID Numbor ·\•Cu•"" Tnt.n.......;.._,a IC) ,. : .· •. ,~,. ~,. ,r·
I I I I I • •· 1 I I I I F>T e, ~ ·:·:·· , .... ·,_· ·· .-<• ..• -d.;.,.~•-:-::.-<i':···<~----
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, '. 9, 8 '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U. Unit l" W&Sfli Nldbcir·,,.~;-
No. Type WJ'/~ :\>:-/-:':<,>~\"::\)/</ft
-I ii
E
a.,. .f.
Hazardous Waste, Solid, nos ORM-E . IF j D! l'jci"j'2:;
• " ;.<";.-
<1, ~, a ,a 161~f
I'
N
I E
A
A
T
0
I A
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A
NA 9189 I I ,2 ,0 y
b.
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C.
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d.
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15. Special Handling Instructions and Additional Information
CSX Work Order No.: 79108
1 e. OENERATOR0S CERTIFICATION: I horoby daclaro thnl lho contont:s ol thl:, conalgnmenl •r• lullyand accurately da:scrlbod abov• by prop,9r •hipping nam• and are cla .... ned,
paci.ad. ma,i.ed. and labeled. and ore in Rl1 ro:spact:s In propor condition !or lran:spor1 by highway according to applicable lnternalionat and nauonal go"'arnmant ra,oulatlon, ar,,d
the ta ... i or trio St.lie ol South C:nrolinn.
111 am a large Cluantrty generator. I cor11ry th al I hovo a program In placo lo roduce the volume and toxicity ol wa,taganeralad lo Iha dograe I have deie1rmlnttd 10 be ecOf'lomlcaUy
prec1,c.able and th al I ha"'e :,eloclcd the practicable method ol lroo\menl. ,10,aga. or dlsposal currently available to ma which minimize:, the prewint and luture t:n,.._1 to human
l'leallh and the environment; QR, ii tam a smo!I quonlitygonorator, I hove medo a good laith ellor1 to mlnimtze mywa,ta generation and ,e!ocl the bas\ waste mana;•mant metf\Od
mat is avai!atlla to me end thnl I cnn oltord.
Printed/Typed Name
Roger L. Coats
I Signature Montn Day Yaar
10,4,0,118,8
17. Transporter 1 Ac;Knowledgement of Receipt ol Materials
Ii 2·nted/Typed llame
/fp,o_u I I Signature Mon:, Day Year
I ' t I I I
0
A
Ii
,a. TransooMr 2 Acknowledgement or Receipt or Materials
Printed/Typed Name I Signature
19. Discrepancy Indication Space
F a I I ~ bl I.. ..L...1....1...1...L
I ~ 20. Facility Owner or Operator; Certifica!ion of receipt or hazardous ma!eria!s covered by this manilas! except as nolod in Item 19. I . ~rinted/Typed Na~e ·•··• I Signature
-b-~ ~~~Y.\ ~ r,t,~:11 ~Hi.:·~ .. \l,~·l!l>! 1 ,, r•~1n11!',_ !:<fill~Hl:; -~~u r~1i:;(1!.:h1 fl )I 11:c_ l!_ltl_il (I luv. 1t•1ttth)J
Monei Day Year
t ' I I I '
pt,,. C I llb,.
pbs di jibs.
Monltl Day Year
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I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Waste Mgt
2600 Bu!! Stree~ Columbia, SC 29201
Phone: (BOO) 734-5200
Emergency & Holidays: [phone]
I LEASE PRINT or TYPE (Form desiQned for use on elite [12-pitch} tvoewri!er)
UNIFORM HAZARDOUS 11. Generalor·su.s. EPA ID No.
Form A1 roved. 0MB No. 2050-0039 Expires 9-30-!8
Manlle11t ,2. Page 1 Information in the shaded a<eas is n01
required by Federal law. but is by State law.
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WASTEMANIFEST N,c,n,o,q,7,6,0,1• 7, 8oc;_unu,nt No. QI 1,4., .u 11,J1l 1
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield,
4.Generalo,'sPhonel 919 I 934-9711
5. Transporter 1 Company Name
Willms Trucking Co. Inc.
7. Transporter 2 Company t!;imc
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 'CY.Staie··;-rar,·.;;.~-ID''.:;: ... :· •'·•:'),:;;:,A;,.-;,,~~-,,.,,.
I SI C1 DI 01 71 31 71 0, CJ, 2J C, o:'f. · · i PhoM i ·.·R01/.7n 7-' .,_ .,..n>
8. U.S. EPA ID Numbor
I I r I I I r r I I I r
10. U.S. EPA ID Number
1 SI C1 Dr 01 7, 0, 31 7, '.
11. U.S.' DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Ouantily U. Unit · l'Wa:di'tuubef>;··
No. Type WJV,J '\;i:-,=~1/,•:::.itJ\~/?f.
I o I I I 1 I
d.
I I I I I I I
15. Special Handling lns!ructions and Addi!ional Information
GSX Work Order No.: 79109
18. CENERA TOR'S CERTIFICATION: I horobydoclnre lhnl lho conlont:s ol lhl:s conslgnmont ere lully and eccurotely described abova by proper 1hipping nam• and ara cla...,fte<I,
pac"-ed. mar"-ed. and lnbelcrt.nnd nro in nil ro:spocl:s in p1opor condi1ion for transport by highwny according to applicable lntern111ionn! and national -;io-.,11rnm11l"lt r.gulat1on1 •nd
I ·. ll'le te ... , 01 the St.lie ol South t.::nrolinn.
111 am a large Quantity generator, I certify that r have a program In ploco to reduce the volume and to,dcltyol wa:stegeneratod lo lhe degree I have determined lo be oconomlcany
,, e,rac11cab!e and I hat I have :selected the practicable method ol troatment, :storage, or dlsposal currently available to me which mlnlmlus tha present and luti.Ha U'\rNI to human
health and the environment: on. ii I am n smo11 qu.intity gonorator, I hovo mndo o good loith ottor1 to mlnimlre mywn:sl8 genoraUon and select the be1\ was:e mana;emenl m.ttiod
mat is available to me and thal 1 con nlford.
I Printed/Typed Name Roger L. Coats I Signature Montn Day Ysar
10,4,0,1,s,s
T 17. Transoorter 1 At;i,;nowledgement ol Rcceipl ol Materials
A
I A Pri~J./Typed Na..,,_ N Ii ,' //. 'c. '-J t/h 1'9/I f' s p
0 18. Transporter 2 Acknowledgement ol Receipt ol Malerials
A
I Signature
T Prinled!Typed Name
I E A
19. Discrepancy Indication Space
I Signature Montn Day Year
I ' I I I I
F a ~I ~...,__~~l't.. c ~I ~---~~l""-
1 ~~• ---,,-------,--------b ,--' L. • ..__._,_......__,/'bl. d I l1t..
~ 20. Facility Owner or Operator; Cer1ilicallon of recoipl ol hnza1dous m;torlals coverod by lhis manifesl excepl as noled in llem 19.
Prinle-d/Type-d Name I Signature
PA Form 6700-22 (Rev. 9/8G) Previous Editions .1rc Obsololo fOHEC 1908 (flcv. 10/ll6)1
Mon,.., o,, Yeat
I , I , I ,
I /::t:f:;\ South Carolina Department of Health BureauofSolid&HazardousWa,teMgt
~ · ':-"'-1 d E • I C I 2600 Bull Street. Columbia, SC 29201 -.-. ~~ an nv1ronmenta ontro Phone: {B-OJ)/34-5200
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~ Emergency & Holidays: {803)734-542•
~E PRINT or TYPE {Form dc,ionod for use on elilo (12-oitchl tvnewritcrl Form A roved. 0MB No. 2050-0039 Expires 9-30-M
UNIFORM HAZARDOUS · 11. Ge.norator'sU.S.EPAIDNo. 0 MnnH•;:.,, 12. Page1 lnlormalion in the shaded a,ea, is not
WASTE MAN I FEST N' C' ll' 0' <)' 7' 6, O, , .. 7, 1' 1,,0 :ri'~f7 3 ,02 °1 1 required by Federal law, but is by State law.
3. G;~:~~:~·~;;;~ ~~ing Address '~L~:Manifast ~ ~ ::;;1]:::rtvr :
P. 0. Box 1416, Smithfield, NC 27577
•· Generator's Phone I 919 I 934-9711
S. Transporter 1 Company Name
Willms Truckinn Co
7. Transponer 2 Company Name
Inc.
9. Oesignate<l Facility Name arid Site Address
CSX Servi cc:; or SC., Tnc.
Route, 1 Box 255
Pinewood, SC 29125
S•C•D• 0, 7• 3• 7, n. Q,?, <l. D/T ·af>t-,oM '_,ono/7,,_:,o~~~--
8. U.S. EPA ID Numbor f:::Qt·~..:·r,a~.......;._,..1 iO ·· =··1,,,?; ~:·
' ' ' ' ' ' ' ' I t I F."-Trun•-et• Pt>ono .. . . . ., .·._,,,,.-,., .. ,. <>".
10. U.S. EPA 1D Number G/Slloto Facility's ID
H.JFaci!lty'! f'rione .)
1 s, C, ll, 0, 7, 0, 3, 7, ' ~ & '
l l. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantify U.Ucil L'W&311Nt,rober>c,
W'JV~ '.<t\i:·=::</f,1/~<~1 No. Type
,· ,1 D ,T I I ,2 ,o
' ' I I > I I
I I . I ' ' ' '
d.
I I I I I I I
1S. Special Handling lnstrucbons and Additional lnrormalion
GSX Work Order No.: 79110
I .
115. GENERATOR'S CERTIFICATION: I hereby declar111 lhel 1he contents ollhls conslgnment111r111 lullyand 111ccur111telyd1111crlbed ebove by prop-.r 1hlpping name and ar• cta.....,neod.
packed. mark&d. and labeled. 11nd nre in nll rospects ln proper condition for transport by highway eccording to appHc.able lnternahonal and naUonal governmel'II regulat1on1 and
tr.• laws ol tri111 State of South Cnrolinn.
111 am a large Quantity genero1or. t cor1ify \hnt I hnvo a progrom tn ploco to reduce the volume end 1o,clcltyol wastegenen11ed to the d&0r-l have determined lo be economic.arty
pract1catile and that I have selocted the practicable mothod or trootmenL storage, or disposal currently avoilabta to ma which minimizes the pres-ent and lurure tt'\r-110 human
l'lealU'\ and the environment; OR, i! I am n small quantitygonoralor, t hnvo mado o good faith ""or1 to minimize my waste generation and select the best waste mana;em•nt metr,od
tf'la1 is availatile to me end lhnt I con nl!ord.
I Printed/Typed Name
1-+-----.:.R::o.::g:.:e::r_:L:..._c:..o:..a:..t.:..s:._ ____ .:...._....Je-___ _:...=:,..,,~~:__~~-=-..::..:.:::::::::.::=-----....l~J.::.J.:::.~..L::..L::~
T 17. Transporter 1 Ac.:Know!edgemenl of Receipt or Ma!erials
I N
R:f-'.C.C.:..:.:;::.:.:....:.:..:.::....::....:;c.c.:..:,c:.._=.c::.:_.c:.::.=:....::....:.::.c::....::....: __ -,-,,-------,,,,_---------,=---------------'-;
Printed IT~ Name ~
P L--.L./-l~MW.~(a~,~-~/4~t:1'---'/4~(.~~~~,t4~:-'l~./c_· _J__..!:::!_~~~~--L~~~~-_]~~'.'.'.Jt£'.l
o 18. Transporter t'Acknowledgement or Receipt ol Materials I il-';;__;P~rin~,~~~,~T~yp~ed.:..:.N~a~m~e.:..:.:.:..:.e==.c::.:..c:.::.=:....::....:.::.:.:==----,-,,------------------------------:----:c-;
I Signature ~.,, cl~ Monlh Day Year
10,4,0,118,8
(..,
I Signalure , /d ~ Montn Day Year -,,, .,., -., ---10, Ud,1'1.f 1P
✓ I Signature Month Day Yw
t ' t ' t '
19. Discrepancy Indication Space • I Jibs. " /lbs. F I f b/ Jibs. d / /'bs.
If---------------~ 20. Facilily Owner or Operator; Cer1ilication ol receipl or hazardous maleria!s coverod by this manifest except as noled In Item 19. I P11nlt<1/Typt<I Noma I Slgnnturo
'I'" ,,um b/00-~~ tllov H/tlll) l'11w1<111•, Ptl1t111111, ,,11: Oh:,ulolt1 /lllll.C JClll/1 (ll1:v 10/lHi)I
Monui Day Year
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 2'9201
Phone: {BOJJ 734•5200
Emergency & Holidays: [phone]
IU.SE PRINT er TYPE (Form desiQnecl for usE! on elite f12-pitchl tvnewriterl · Form Ap:iroved. 0MB No. 2050-0039 E.xpir~ 9-30-88
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo. 0 Manll••1N 12. Pagel lnlorma1;on ;n the shaded a,eu is not
,. ocumenl o. of . d Fed I I .
WASTEMANIFEST. N,C,D,0,9,7,n,0,4,7,1,1,,n,n,7,1,1 1 requ11eby eraaw,butosbyStatelaw.
3. Generator's Name and Mailing Address
Channel Master ·
P. 0. Box 1416, Smithfield, NC 27577
,. Generator's Phone I 919 l 9 34-9 711
5. Transporter 1 Company Nan:,e
Willms Trucking Co. Inc.
6. U.S. EPA ID Number CTStl."te·:f•·,•·>·· ,. 8 ID·' . . ·.,/.,i;>>--'t}-·~.>;
,s,c,n, o, 71 3, 7, Ot 9t 21 9 · oh' ·,Phont,:'iAn-,17~7""-,-,-,-,·.·-'.
7. Transporter 2 Company Name 8. U.S. EPA ID Number E.''o.,i.''(" .. a lO. ',.,.;,,.,,:,.,, ..
I I I I I I I I I I I I F.•Jninaoortt<'s l't,ono ,. '... · ; '""' '°· " '
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
11. U.S. DOT Description (incfuding Prope_r Shipping Name, Hazard Class, and ID Number)
L Hazardous Waste, Solid, nos ORM-E
N NA 9189
b.
12. Containers 13. Total Quantity u. Unil L waste Ntfflber'~=·
No. Type 'M/V~ /~ \·}{; ;/\fi:tV:¥~'.~tf
! i F j d';ffif,~
,· ,l D ,T , , ,2 ,0 Y Tj1f1Q1Q161i
:;;'·;·f1-1
0/--------------------------------+J'L'L+-LI..J.-JILLIL'JI_/--+-)~,,:::::::::=::::::='-'~~-.
C.
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15. Special Handling Instructions and Additional Information
GSX Work Order No.: 79989
' I ' I I
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".'" ~-~-~1:.~ ,\b
,a. C£MERAToR·s CERTIFICATION: I hereby declare !hat !he conlonls olthls consignment are fully and accurately described above by proper •hipping nama and are ctasaoned.
packed. marked, and 1a·beled, and are in nn rospecls in proper condition lor lranspor, by highway ncco-.dino to opplicabte lnh1rnationnl end natlonal government re,;;ulatlon• al"d
U\fl laws 01 the State or Soulh Carolina.
II I am a targe Quantity generalor, I cor1ity the Ir haVe a progrem In placo to reduce 1hevolume and 10111lcltyol wa,1eganen11ed to the de.Qr_ I have de1ermlne<110 b4 .conomlcalty
prac11cabte and that I have selec1ed the pracll~e me!hod ol lrootment. sloroge, or disposal currently avoileble lo me which mlnlml1e1 the pres-enl and lu!\Jre u,,-1 io human
health and the environment; OR, ii I am a smo!I q6d"r\1i1yoencra10,. I hnve mado o good laith e"or1 to minimize my wasla generation and ,elect the boe•t wule management ~tr,od
tf'lal Is available 10 me and thol 1 con .nllord.
l_l-,,_P_•_in-•ed_/_T_ypjed~N!la.!;m;.!e:_:[:,:._£~il~...,.--;_.,., ____ 1_s_ig_n,_,_"r_,_fl!... /~~~~~~::..-·!:'.'. J:.:·:_-~/1::::'.~~ Jr!:: ______ ...JLM2oJ.n.!.tll!.LQDJ.aJyJ.!~Y ..,Jl~ ~ Ro2er L. Coats '/"V,. c7--L.2-t,..?;g-10,4,0,118,8
T 17. Transporter 1 At.:,o:nowledgement ol Receipt of Materials ... 1./
IOR kPr-;nted-/T-yped_N_,m_, .1.::.~~o...f..'-/-1},:_< 1ff.!.,.!-! o:::.fL!_r_LI S_ign-atu...l,r•tJ~0J:J-~(/lc:......).)4.2...:.~'!Cr, --bf-'::i._v_.:.·#_:._y,_~2,-~:__ __ J2 HMo...L~;ll!,tJ2L~~,u•JL.e..j1f~
1 a. Transporter 2 Acknowledgemetit of Receipt ol Materials V
RI----------''-----'-------~------'---------------------------~➔
i_!-_P_n_·n-•ed_,_r_yp_ed_N_•_m_• _______________ l_si_g_n•_'_"r_• _______________________ .. M_o .. ntll_,_o ... _y .... Y_..,._-t f I , I , I ,
i9. Discrepancy Indication Space f __
~ 20. Facility Owner or Operator; Certilicalion of receipl ol hazardous materials covered by this manilas! except as noted in l!em 19.
l Prll'\ttcllf~otd N1M1 I ei1on111ura
A Form 8700•22 (Rev. 9/86) Previous Edilions are Obsolete [DHEC 1988 (Rev. 10/86)]
I
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I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mi;t
2GOO Bull StrMt. Columbia, SC 2'9101
Phono: (8()3) 734-5200
l. Generator's Name and Mailing Address
Channel Master
P. 0. Box lld6, Smithfield, NC 27577
4. Generalor's Phone I 919 ) 9 34-9 711
5. Transporter 1 Company Name
Willms TruckinQ Co Inc.
7. Transporter 2 Company Name
9. Designaled Facil!ty Name and Site Address
GSX Services or SC, I11c.
Route, I Box 255
Pinewood, SC 29125
Emergency & Holidays: [phone]
Form Ap rovod. 0MB No. 2050-0039 E..tpi, .. 9-30-88
M_nnUoat 12. Page 1 Document No. ol 1,4,0,0,7,3,4 I
Information in the shaded a<eas is n01
required by Federal law. bul is by State law.
6. U.S. EPA ID Number
I So Co Do Oo 71 31 7o (1, 9, 2J Ci
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, o, o, 7, o, 3, 7, '. ~-8 '.
D/.T · ..... ·.·· .. ··•f'hon<',:11n1/7fi7-'11·n:,
E}:s,~·;,;-Tran~• o', •-;,. ..•. <,,--.-:,"
F.IT""';=.,-• pt,o;,e :·, ·· · ..... ,, / .. •-.:~,-,.-1\ .. ,,.,.,
11.fracilir;·, P!ione ,, , > ··· . ,· ,,:'<;cwt·
,.,,,,.. -. .": .. so3/ 452~soo3:·;:/
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and 10 Number) 12. Containers
No. Type
13. Total Quantity U. Ur,it l W13!8 !uubetj+
WJV-J \'.f.,\,~(>!H/f.-{\ti
I I I I I I I
d.
I I I I I I I .;_ I
15. Speeiat Handling tnstrucbons ond Additional Information
GSX Work Order No.: 79990
111.. C!MIEAATOR•s CIEATIFICA TION: I horoby decloro lhnt tho conlonls ollhl, con1lgnmont are lutty and accuratolyde1crlbod above by prop.er &hipping n•m• and •r• c.las .. ti.-d.
pacll.ed. marked, and labeled, ond are in nll rospecls In proper condition lor lransport by highway 11ccording lo 11ppllceblo lnlernational and naUonal go.-arnmant r~utauo"'• al"'d
Vie laws ol the Si.au, ol South t:arolir'ln.
111 am a large quantrty genc,olor. I certify thnl I hove o progrnm In ptoco to roduc11 the volume and loxlcltyol waste generated to the d11gr1101 have determined to be economlealty
pract,cabte and tnat I ha.-e seloc!ed tho prac11cablo molho<J of lroolmont. sloroge, or disposal currently a.voileble lo ma which minimizes the pre Mn I and lut1..1ra tnr-1 to humar,
hea!\h ar,d the environment.: OR. ii tam a small quantitygonorator, I hove mode o good faith eNor1 to minimize my wasla generation and select the b<aat waa:e mana;iament m-etf'\Od
trial is avai1ao1e to me and thnl I cnn ta!lord.
I I Printed/Typed Name
Roger L. Coats
I Sign~ture Monti\ Day Year
1 0,4 10,1,s,s
T 17. Transooner 1 Aunowledgement ol Rcceipl of Materials
Printed/Typed tJame / 1 t' J/· ,
v'-' I l l (?
~ 1 a. Transporter 2 Acknowledge men! of Receipt ol Materials
T Printed/Typed Name I Signature
19. Discrepancy Indication Space
I ~1-----------~ 20. FactliTy Owner or Operator; Cer1ilicnlion of receipt ol hilzmdous mnlcrials covcrod by lhi:, manilcsl cxccpl as nolod in llom 19. l Ptintod!Tyood N■mo I Slonaturo
PA Ferm 6700-22 (Rev. 9/86) Previous Editions arc Obsotote [DHEC Hl88 (Rev. 10/86)1
Monttl Day Year
,LJ' '{i ;,. { ,IL st;:
Montl"I 0ay Y641'
I , I , I ,
a l.._._.__._.._,___,J!bs. c .._I ._._ ........ _,___,\rtis.
bl Jibs. di I'"'-
Montn Oay YW
I , I , I ,
I
I
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt
2600 Bult SlI~l Columbia, SC 29201
Phono: [phone]
Emergency &. Holidays: (603)734-5-424 lr-E PRINT o, TYPE (Fo,m desioned for use on elite 112-pitchl tvnewriter)
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form Approved. 0MB No. 2050-0039 Expires 9-30-88
Mnnllo11t 12. Page 1 IJnlormation in the shaded a<eas is not
Documnnl No. of . Fed I .
WASTE MANIFEST N, r., n, o, 9, 7, 6, O, 1., 7, 11 Li,O I O 1 7 1 3 1 5 1 required by erat aw, bu! IS by State ta ....
3. Generator's t~ame and Mailing Address
Channel M;is ler
P. 0. Box 1416, Smithfield, NC 27577
•. Generato,sPhone( 919 l 934-9711
5. Transporter 1 Company t~ame
Willms Truckin~ Co
7. Transporter 2 Company Name
Inc.
9. Oesii;nated Facility Name and Site Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
I S1 C1 D1 01 71 31 71 0, 91 './i Cj
8. U.S. EPA 10 Number
I I I I I I I I I I I I
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, '.
C}Stii.Tra~·.;;,;;,.,,,IO ·• ·'"·'.: ··
IJ/T BPhont ·,.Rn1/71,7-'1111•.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1( Ur,i! t· waste NlRber =~:·
No. Type W'J'/'J :\i·i:\~":,-'<\>_:J\<'{;~·
.. Ha;~-d·~-~-~-W~-st·~-, Solid~·-·•·~;~--c5fil1·~Ec•:~: .. ,v. -.. ,.. --._:IiF\O"i:I·1·ifiJ~
N 1-.:.N:.:.A:....::9..:l.::8..:9 __________________ -:------1µ1u1.:.l+:D.Jl.:.T+J'-1'-1'.'.:2Jl.:'.O+.:.Y~..:•::.::i::F:::r::Q:::1::D:::1::h:::1~·,;·
'jq.~j. \. -i-Q, b.
: ?:~
o i------------------------------+-J.'-11-/_l1-jf---11L 1LL1L:..1 • +---/-· ..c'=1:=::1 ::::1 :=..1 ·~":
" c.
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15. Special Handling 1nstrucbons and Additional Information
GSX Work Order No.: 79991
1&. GENERATOR"S CERTIFICATION: 1 horobydoclore lhnt lho conloni, 0llhls conslgnmonl are fully ond accuratelydescrlbod above by proper ahipping "•m• arid ua cla, .. n..:i.
pacl,,od. ma,~od, and ll'lbc1cd, and ruo in n11 rospc,cb in propor condition for transport by hlghwny nccording lo npplicablfl lnlnrnationnl and n11uon11I goverl"lmenl re,,;iut•Uon• •od
ll'\e laws or the Stale ol South Carolina.
111 am a largo quantity ge1"1er111or, I cortity that I havo a program In placo to ,~ucfl !ho volume and 101dclty ol waste goneraled to tho dtt9ree I have determined 10 M a,conomlc.ally
pract1cable al"ld !hat I have selected lhe practicable method ol trctilment, slorage, or dlspoaa1 currently avoileble to me, which mlniml101 the pre Mini and lu11J1a tnr-1 to l'lum.an
f'laam, and Iha environment; 011.11 I am n 1mnll qunntlty gonomlor. I hnve mndo n oood la Ith e!lor1 lo mlnlml,:e my was le generation and select tne bell""'•"• man•~•manl ,...tl'\Od
ma1 Is available to me and thnt I cnn fllford.
11 Printed/Typed Name Signature ,/f/". ..,I / _ _J Mor.t1 Day Year
Roger L. Coats •~; -;o/', ~ ,0,4 1 0,1 18,8
+,-,,--~____,:_,,-.,~--'--___,;,,,,_.,~_..;:;,,;;,_----L...J..~
T 17. Transoorter, Ac..:1<nowledgemenI ol Receipl ol Maleria1s v
,-P-,m-n•ed-,~-l-{-~-,m-el-'1-'----Gcc'-->--e-.~-rt.---,-S-ig-n,-,u/rYl-.---lA.-.. ~_L0--:;J,.,.-+----~--.u.,--~-71----.~-o~-:--,<D-,/ay_li'_\-.. r-ir
O 1 a. ransporter 2 Acknowlcd9cmcnt ol Receipt of M:ilcri:ils 1
Rf----------"----~--------,-----------------------------.,,---,,--"1
II li_+-_Pr-in_,_ed_,_r_yo_ed_N_•_m_e ______________ ..... _s_ig_n_,1_u_re _______________________ .,1.1_0 .. n_"' .... _o ... _y~-Y•ear-1
J:. I ' I I I I
.
19. Discrepancy Indication Sp:icc
F I~ ';-f--------------T 20. Faci!ily Owner or 0oe,ra[or; Certili~_~ti~_n~ of rec~ipl ol ha.zar~ous malerials covered by this manifest except as noted in Item 19.
v,......,.=~-,.,.. ..... .,..,~~-~==--=--~--.-=-=---~-----~-----------------
l Pflnifd/Tyoral Niffii !llijHft\Yfi
;r A t-C~m C'"V'-'·~c lh~'I, ~;;::!) t"'.rC".'IOU:. C:JIU~;·1.;. an; r:111:WtOIU 11·, lt:C 1!)88 (flcv. 10/BU)J
• I I ) I I I pbs. C I I I I I I pt,s.
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MQr'll,M 1)1y Yw
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I South ·Carolina Department of Health
and Environmental Control
Bureau ol Solid & Ha:.ardous Was:e Mgt
2600 Bull StreeL Columbia, SC 2'3201
Phone: [phone]
I
I
I
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Emergency & Holidays: (B03)734-5424
~E PR!;;;: TYPE (form desioned !or use on elile [12-pilchl tvoewrilerl Form A roved, 0MB No. 2050-00.39 E.roires 9-30-l!a
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo. 0 Manlr•t:S 12. Page1 lnlormalion in the shaded area, is no1
WASTE MANIFEST N,C,D,0,Q,7,6,0,4, 7, }, 4.o~ci":"7°73,6 °1 1 requiredbyFederallaw.butisbySlatelaw.
3. Generator's Name and Mailing Address As~·••Menif.est" ~Numb«.-..:-. e ... , : ):.':ib/
Channel Master if:JtL\/;/{!i{/(:/i;::J:/1 ·: ... ,; ·--"~: .. -. = .• .-.,:· ;.,:(~-.bJ:)J~>:<:
P. 0. Box 1416, Smitl1field, NC 27577
•· Generalor'sPhonel 919 \ 934-9711
5. Transporter 1 Company Name
Willms Truckin~ Co. Inc.
7. Transporter 2 Company Name
6. U.S. EPA ID Number
• S • C• D• Q, 7• 3• 7• 0. 9t 21 Cl
8. U.S. EPA ID Number
I O O O O o ' ' ' I O I
cPS1a1or· ,ID' •_ .. · •.:.-•,.,,-,.
D)Trant=• Phont ,.c. ono / 71', 7..c ~ ~~ '\·.
i:'::o.:;;:·.:..:=·rii a o .·. =··-!·-.?·., ,c ... · .. _
F:<-Tnin•=• P!,oi-,e :·· . · · · · • · · •· >.-·.• , .-"·
9. Designated Facility tlame and Site A<ldrr.ss 10. U.S. EPA 10 Number ci/st~ii'F.8Cilit/i 10 ·.· • ~·. • ·
CSX Services o[ SC, lnc. ~•;.;,.:;.; .. .;..;;;,;;;~--.;.';.;·.;...~---'--'-C.;.·;.;;·':::.:/.;.':;.; _ _.·-l.
:~~~:~o!, B~~ ;;izs . 1 S1 C, D1 0, 7, 0, 3, 7,' <,\ & '. :titfl~:•~> :;';°8Q3/452'..::%od1f
11. U.S. DOT Description /including Proper Shipping Name, Hazard Class, and ID Numbor/ 12. Conlainers 13. To!al Quantify U. Ucit
No. Type 'M/'1:/.
._----------··· :,FjO,l\9,.-~:,
E Hazardous Waste, Solid, nos ORM-E , :;:
N l-.:.N~A~9:_1~8:'._9:._ ________________________ .:...j._L '.l'~l +D_i,_;_T+J'L'Ll.:'2:..i:•O:..+_Y:,_..J_:J~i::f::l::Q::l::Q:::I 6:::,;i 11~, l ·· ::: :·::,_:~,
0 ~----------------------------1-J'--1'-l--1'-l-1'-1'-1'-1'--+---+2====-i-1 ........ ,.
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15. Special Handling Instructions .ind Addi1ionat Information
GSX Work Order No;: 79992
,e. C!N!RATOR'S CERTI_F1CATION: I hou1by doctiua lhal tho conton1, Ol lhlt con,lonmont .,. tully and accural•lyde,crlbed above by prop,41r 1hlppino r'lar'l'le and ■ra c••·••lle<II.
packod. marked. and labolefi. nnd oro In nit ro:,pocls In prop or condition lor 1r11nsporl byhlohw11y nccordlno to oppllctt.ble lnlern■Tional and nauonal go .. arnmal"ll ra-gvlattol"l• and
l/'\e 1a-s o! tho St.11e ot South Corotlnn.
II I am a 111,90 qu11n1,1y pr.ncrn1or. I cm My thnl I !lnYfJ n p,oornm In plnco to r(),Juco the volumo ond 10,dclly ol wflsloooneratod lo tho deg,011 I have de1ormll"!od lo~ economic.ally
pract,cable and that l havo ,01octed lho prilchcabto mothod ol trontmont. ,10,age, or dl:,po,a,I currently avoilabla lo me which minimi:tes tho present and lvturo lt\r-110 l'lumari
healtri and tho environment; OR, ii I am n smnll quantitygonoralor, I hove mndo n good loilh otfort lo minimize my wasts genoratlon and ,otect the boll was:a mana~ement metJ'\od
trial is available to me and thnt I con nllord.:
Prin!ed/Typed Name
Ro£er L. Coats
I Signature Mor,:!> Day Year
,0.4,0,118,8
T 17. Transporter 1 Au:nowledgement of Receipt of Materials V
Printed/Typed Name p11.,.-ectJ& I e I--e. e I Signatur~ 0
V
~ 18. Transporter 2 Acknowledgement ol Aeceipf of Materials
T Printed/Typed Name I Signature
'
~~:L, Day Y9 I •101 / ,f ,.
Montn Day Year
' '
I , I '
19. Discrepancy Indication Space
F • I I I I I I pt,,. C I I I I I I pt,,.
I~ I~--------------
b I I I I I I P"' d I I I I I I !'""
T 20. Facility Owner or Ope,alor; Ce1tllir,ntion of rcr.r.iril ol hnrnrdoui. m;itori.ils coverOO by this manifest oKCopl unolod in llom 19. I •v '""""'t,p..i~N;m•--·· · ·· ··-_ ·· ·1signature
EPA Form 5700-22 (Rev. 9/86) Previous Editions ore Obsolcto (DHEC 1908 (Rev. 10/86)l
l.lo.'11/1 011 '1NJ
I , I , I ,
I
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0
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-. . South Carolina Department of Health Bureau ol Solid & Haz.ardous Waste Mgl
2600 Bull Street, Columbia. SC 2"9201
Phone: {BOJ) 734,5200 .and Environmental Control
Emergency & Holidays: (S03)734-s.t2•
&<E PRINT or TYPE (Form desioned for use on elite r12-oilchl tvnewriterl Form Approved. 0MB No. 2050-0039 E.xoires 9-30-88
UNIFORM HAZARDOUS 11. Generator's U.S. EPA lD No. Manllo11 12. Page 1 Information in the shaded ;weas is not Do umonl N . ol
WASTE MANIFEST N, r,, Tl, 0, 9, 7, 6, O, 111 7, 1, 1,.0 ,() ,7 ,3 ,7 1 required by Federal law. but is by State la"'.
3. Genefa1or's t/ame and M;ii!ing Add,css i'Sialo MiinHoiit Do<;,.,mool -,, .. i•·
Channel Master
.. ·.:..::.,:':•f .::: ,:,•=.·. ' '=·· ,. •''' :···· ,· ,· .. ,-:<.: .. ; ' . /-,: .,., .. , . · ..
P. 0. Box 14 1 6, Smithfield, NC 27577 B}Slai. Goimlc<'a ID : . ·;·, .
{(!!:jfii:\\}:· . ,,. . .-... ,. Genera!or's Phone ( 919 I 934-9711 \ ,., .. ,,; ... ,,.,::,; .'··\';,,;·.-· ., .,,, .. . .. .. '" ''·':'•-.
S . .Transponer 1 Company Name 6. U.S. EPA ID Numbor C/Stti. Ti-iii;;;.;;;.,,, ID ! .:: : __ ,_ ', '•
Willms Truckinq Co. Inc. • s, C• Tl, Or 7, 3, 7, n, 9,?,C\' D/'T ....... iPho<i.·i.,.•An~/7?.7"'11~~
7. Transporter 2 Company Name 8. U.S. EPA ID Numbor ,;;.; ... ,."'. riaii=• IO .•.•• , .• . "· . .. ''.>:-,·;., :···
' ' ' ' ' ' ' ' ' ' ' ' F/Trnniooitor, Pflooo ._., :;~i·--•:-_,; ·.: :,;
9. Oesignaled Facility Name and Sile Address 10. U.S. EPA ID Number 1'~\~~~i~i:j:f ):1(~:t:-~,0 :;:,:_: .. ; ... . . .;;\);,::-;: GSX Services of SC, Inc.
.-, i'• . ;. : ..
Route, I Box 255 H.iFocillty't Priono · ' . .,: , ,·-it_i.:,:"<V:-~\~-
9, B ' ·' '/; Pinewood. SC 29125 , S, C, D, 0, 7, 0, 3, 7, 5 -Ui)#?.\,i/'.-ii.':.,,,_;,,,:/,,_._, .803/ 452,-5003/::
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Ur.ii l Wa!a ->:'.
No. Type WJ'I> :.~ ;-.~·,: .. ,·. ·:,:\~.;· :(~,:;-}j
.. . -· -·-· ... -_____ .,_.,. ·• -~-~ -___ .r ,'_ I..: ·-·-_\I• .. _ -. -·~ . , _ ... -. ,...:........, .. _____ -----~---,]i F j 0'1l1912 Hazardous Waste, Solid, ORM-E - -. _,. ·--.. nos
NA 9189 ,· ,1 D ,T I I ,2 ,o y )1~10101611
b.
... .. ·:.. .•. ~';-.. >~.::. ---, 1 I I I I ,:.;;_ ,;, .'; t,.;.
' ' ' I I I I : 1 I I I 1 ·
: ...... , .... i !'. C. I I I I ..
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J. Additional~ tor Malerials Usled Abovu '; , ; < ,\ .. '· '.', ,;, : •' . ).,.· " : 11111:i----''"' , -, ,., ❖h=' <, , , /' '";:.'? ,, h < ,, ,,h ~~' ~----~-h\1,>_,<>, ,,, ,0'e < ' __ ,«-.,,<~] ~',' , ,., ~ ,,,.,,, , r ,• -~r.,~.v.t',m,:,.,~{~'"--•1J.',1 ❖<..'1 -~}*~t=-it2~<,,t..,'\~','(~vs,❖,.l:,,"<"'"'-,/•\f•-:{-,":::,~ ., .•_ . ,,.,:., ,,:: , .... _ J.Y:-: ·, ~ , ,,, ,, ,, : :-... :-,' ,_-/:--1(:: ,~ :'<''\.''~>~,,,J_-,r:.-,""''~\~--~:-:·"'":':t. .... ~.::r~\/
a.1.tBJ-I0121717141-lld10121.:;, ·';c.Li_j-1 I I I I 1-1 I I I L, . ·,.
'.;':_-,, .. · .-, "·:;. '•' :;
,_,,<' ,' , ~ ,,i ,.., .. ,
b.Li_j-1 I I I I 1-1 I I I ,,: .. , _dLi_j-1 I I I I j-j I I I I :\', ,'. ,, :;: ,: ·>:,<., ,. . ' ' ,, , ., ,, .•
15. Special Handling Instructions ond Additiona11nlormotion
GSX Work Order No. : 79993
, .. OEN ERA TOR'S CERTIFICATION: I horebydoc1are lhal tho conlonls ollhls consignmont are lutly and accurat&lydoscrtb&d above by proper a hipping nam• and••• ela.t .. lled.
paclo.ed. ma,~t'd. and lebe1ed, end au, in 1\11 rospocls In propor condition for lranspor1 by highway according lo 11pplicablo lnlorn■tion11I and natlonal gov11rnm11n1 r~ulat1on• •l"ld
tne '•""'• 01 tr111 Stale ol South Corolln11.
111 am a laro;io quantity generalor. I cor1ily lhal I havo • program In ploco to reduce thevolumo and lo111lclTyol wastegeneraled to 1h11 degree 1 have determine<! lo 1><t ec::onomlealty
practicable and lhat I have ,elocled tho practicable malhod ol lro11tmanl. sloroge. or dlspoaal currently av11l1able lo mo which minlmi10.t the pteMnl and lurure tnr-1 lO human
haalll'I and !he environment; OR, ii tam II smo!I quontiTygonor:ator, I hnvo mad a a good l11ith enort lo minimize my wa,to generation end solocl tho be•I .... 01111 man•~•ment meU'\Od
lf'lol 11 availa01o to mo ond thnt t con ntlo,d.
Printed/Typed Name I Signa)ure ~\1,,-, ---;=/__, ~c:6
Month Day Yrw
Ro~er L. Coats 1 0' 4 ,0' 118,8
17. Transoor1er 1 A<.:,.;nowledgement ol Receipt ol Materials // 1 Signal~.//4 ~/Typed tfame ~)( J,-,;. Ll,_ Mon~ Day Year
y,. ,1 ///',,"(. /-✓,-', /, L I ,9, / 11("\ ,/'
1g, Transpar!er 2 Acknowledgement of Receipt of Materials
Printed/Typed tlame I Signature Mont"'I Day Yea,
t I I ' ' '
19. Discrepancy Indication Space
• I I I I I I pt,,. C I I I I I I pt,,.
b I I I I I I pt,,. d I I I I I I pt,,.
~-Facili!'I Owner or Opcra1or; Conmc:n11on ol rec.olp1 of h;uardous mntorlnlt covcrod by this manilosl except as nolod in Item 19.
llrlf\1odlf~Dod Name I Signalure Monti\ 0&/ VNJ
I ' I . I ' I ~,, r,., ... *f•••~'~"' lf't'J,, .-,1·,lolA f'll!\'tu\1!, t!,Ull~l.hJ tu,,..I \~l,.i\\l<,1·,1 f1-1IIC:f.'.t I 1li,n (1t11;,. 111.inn,J
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i.tf;.\,(\\\ t' I t ~ .. --~ ..... •-·
-,-:.~,.: ~"~'
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz..ardouS Waste M!;t
2600 Bu!! Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone] I PI.V.SE PRINT or TYPE (Form dcsioned lor uso on elilo 112-oilchl ''"owrilerl
UNIFORM HAZARDOUS I'· Gonoralor'sU.S.EPAIDNo.
Form A
Manlloal 12, Page 1 Ooxumnnl No. ol
rovod, OMS No. 20S0-00l9 E,~ir~ 9.30.aa
Information in lhe shaided ateas is no1
required by Federal law. bul is by Stale la•.
I
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WASTE MANIFEST · N,r.,n,o,9.7.r,.0,1 .. 1,1, t,,0 ,U ,7 ,3 ,8 1
3. Generator's t.iame and Mailing Address
Channel Master
P. 0, Box 1416, Smithfield,
4.Generaio,·,Phone( 919 I 934-9711
S. Transponer 1 Company Name
~illrns Truckin~ Co
7. Transpor1er 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pine~ood, SC 29125
NC 27577
~\~~:!,~ Oocumenl Numb«:'.:/\/'.<,•_:._·,•,; __ ._~.-.:.\.·_/· .•. :: .. ,·.•.·· //(/ \\i-+::;:c/,}L-: \/.:~\ , , __
6. U.S. EPA JD Numbor
, s, c, n, o, 7, 3, 7• n. o. ,. <>
8. U.S. EPA ID Numbor
• ' I I I I 1 I 1 I I I
10. U.S. EPA ID Number
tt Faci!tty'i Prione
, S, c, D, o, 7, o, 3, 7, : g, 8 ' \-kI:';F'.E ,•,•·· .
11. U.S. DOT Description (including Proper $flipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1C. Unit l'Was!litMnbef>':
No. Type WJV-J ·)>·->i;/'."'.~}-:'._i/-='r//t-~-
I G a. Hazardous Waste, Solid, nos ORM-E liF:j.O"(I"f'g,;,, E ·• :(:
I
i~b-. ..:N:::'A'.:...:..9.:1,::8,:_9 _________________________ ..j....J'L·_,l.'.l..j'.:D'....L:'T:..).._LILl.1.'.:.'2.l'.::'.0..j....:_Y~i-:,'l),!;::,~=-":::D:::,::;Q:::.,::::,=:=-:~:tl::
A . ~.,·
T ~ W oj__ _______________________________ ..j..._L'L'+-.l'-'~LILI.L'.J'Lj__ _ _j_;_•·~•1:=:::::!:=::::=I~•··~• I AC. I ·, I ',,i
f--------------------------------------l--'L.L •_j._J•_i..J•~L'-'L.l'-i--..i...:..; 1:::::=::::::::.11J~
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15. Special Handling ln::.tructions and Additional Information
GSX Work Order No.: 79994
1e. GENERA TOR'S CERTIFICATION: I horeby declare Iha! lho contonts of this consignment are lullyand accuretelydoscrlbed above by p·,o~r;h;'ppiriii'na~;e end ere clas .. tle-d.
packed. ma,i.ed. and ll'l.br.lcd. nnd aro in nll rospocls in propor condition ror transpor1 byhighwny according 10 applicable, international and national government r~ulatio•-.s and
tritl laws ol lhe St.lie ol South ~arolinn.
111 am a tarc;ie quan\lfy gener111or. I cor1ily \hi\! I hnvo a progrnm In ptoco to roduce !he votumo nnd to,dclty ol wnsle ganeralod lo 1he dc,gree 1 have de1ermlne-d to be .conomlcally
prect,caole and thal I have salocted lho practicable mothod ol lroolmont. ,tornge. or disposal curronny available to me which minimize• !tie present and luture U"lr-t IO human
heo!Ui and the environment; OR. ii I aim a r;mnll quonlitygonornlor. I hnvo mndo o oood loith oNort lo mlnimlJ:e my wasl.U gonoratlon and soloct !tie boil w11t1 management metnod
mat i1 ava;labte to mo nnd thnt I cnn nllord. •
Printed/Typed Name
Rooer L. Coats
I Signature Month Day y..,.
10,4,0,118,8
~ 17. Transoorter 1 Ac.Knowledgement ol Receipt of Materials ;;
~ Printed/Typed Name /) ISig~~_luro7 // Mon:n Day Year
~ 1-:-::-~-L. /C'2;J.7;;,~£-~ 7FE:'-'. -''.::~~,e;7(L::-l-.-.-:-:--:-.--_J__.::'-"'--714¼: i, -;,ic.i:'~v,i,,L='.' ~A-·'"'------------....ll!'...l..;a.J ~ 1-'-a_. =-T_ra_n_s:..."°c-"...:••_r c.2_A_c_kn...:o_w_le:...d:.g_em....:..e"1.....:o_f _R_ec_ee,:ip:...f...:o_f M_al-'-e'-ria:..l:..s ---,-,_..,,//,,_'l ____ ..,,_ ("-/ ___________________ _
10• tJ, 0 JI 5?,
~ Printed/Typed Name I Si~n.Afirc
F ..
C
I L
19. Discrepancy Indication Space
•1----------------~ 20. Facility Owner or Operalor; Certilication of rCccipt ol hazardous materials coverod by this manliest except as noled in llem 19.
Printed/Typed Name .1 Signaluro
a~I~ ...... ~~
b~I~~~
po,,
pi,,,
Month Day Ye,ar
I , I , I ,
' I I""'
di po,,
Montn Oay YNI
I ' I , I .
I South Carolina Department of Health
and Environmental Control
Bureau or Solid & Ha.z.ardouS Was:e Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
I
I
I
I
Emergency & Hondays: [phone]
Form Approved. 0MB No. 2050-0039 E,plres 9-30-aa ll.EJ.SE PAI~ TYPE (Form desianed !or use on elite f12-pitchl tvnewriterl
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N, r., n, o, q, 7, 6, o, 4, 7,
Monllost
1
12. Page 1 ocumnnl No f
l' 1,. 8' 0 '·7 I 3 I 9 ° 1
Information in the shaded Mea.! is not
required by Federal law, but is by State law.
3. Generator's ~Jame and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Genmtor'sPhone( 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckin~ Co. Inc.
7. Transporter 2 Company Name
9. 0esigr.ated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
·ar~,.~tor'alO;::, ,_.,.· :.,.,-·,:·· ···· .. ,.J>':.~'.,
N(fbYUh:ifh//:b)')-\)/"t=i-::_. r · :~:;:-, .. ,_. )i:-!/¥.'/ --. -.::'.·
6. U.S. EPA ID Number c/siaieTraii'=• IO.\.:. ., _. .... · ·.:, ... ,,,. ,.·,, ..
's, c, n, o, 7• 3, 7, n, 9, 21 Cl • li}f 'if'hoM .,· .. Ono /7~7.:~~~~.
8. U.S. J:PA ID Numbor
o • o I o • • • • I I '
10. U.S. EPA ID Number <:i:c61"1.iF;ciliiy'1 JO .. '':L . ·• . .-·. :•'
, s, c, n, o, 7, o, 3, 7, ' 9i !\ '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity U. Ur,it
No. Typo 'MN>
d.
I I I I I I I
...... , ..... , ... '
iL-.Li -11-Li _,, ·!i '.b
·l I I , I I \l .. ,
•:,l
• LI .....Ll-'-iJ.i -1! :<"
I I I I I I I :: ' I I I ,~:;
i'~onm Ot$Q'tptl¢n! f~ M_~!E:-~~-~\~s(~:~~ i~N'..:,);); ,\. :;.,:--::,''(,'_ .. :,:, .. ~iF(', -~<:,,-'\!;/_:, h'~~,;\\'._-: ,,:~ ::~ .;:·. .. ·:-:// ~:,r\~Jt'm Uaad /tmte,:: ;}t~<~\
a:' lE..iR.]-lo , 2 11 , 1 , 4 1-11 , 1 , o ', ·21 ,;_.:;; -.. ;;; c. Lu-I:,,;_;:_ ... __ •·_·:,_-•_,;,::<,, ,:_._-_'
1
1_•·_?
1
f t,;t· -,, · .... , .....
1
1 .. ·.r:ilri1f; '..:,,:: ''i·•·. :;_ \ '' ··· · :{:Ji; . ::,:; __
b. LLJ-1 , , , r 1-1 r , , H%\i> \d:LLJ-1 . . . . -... ·.: 1,wi,:, ;; . , . _. .'._,y·,5 ;,.,, .-
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 79995
,e. Ci EN ERA TOR'S CERTI_FICATION: I horeby declare lh11! !ho con ton ts ollhls consignment are tu Uy and accurately described above by proper •hipping n•m• •nd ara c;las .. fl-.d,
packed. marked, and labeled, end are In R!I rospecls In propor condition lor transport by highway according to applicable International end naUonat govern men\ ,..,_ut1u0ns and
U'le lews of !ho Stale ol South t:;aro1inn.
111 am a large Quantity generator, I cortily \hRI I havo a program In ploco 10 reduce the volume and toxicity of waslegeneraled lo the d~ree I have determined 10 be oconomlc.ally
pract,cable and that I havo selocled lho praclicablo method ol lroolmont. storoge, or dlsposal currenlly available lo me which minimlu,s the present and lutvra tnr-1 to human
riealth and lhe envi,onmcnt; OR. ii tam a small quanlity gonoralor, 1 hnvo modo o good loilh effort to mlnimlzo my waste generotlon and select the b-esl was:e rr,ana;;iemenl m,etnod
mat is available to me and that I con ollord.
Printed/Typed Nanie
Ro9er L. Coats
I Signature Mor.tn Day Year
10,4,0,118,8
T 17. Transoorter 1 A(;,.,,nowledgemenl of Receipt ol Materials
R j--'-;;-,'':-'-;-';'-',--';-:=.:......=......::c..:c.=.c..::.-==...:..:.---,.=:-:----------::::---7r------==--;:'--;;:-::-:7
liµ:,/n,µ_.'~~,r~~~;,___w~~~me/V~~,/'J~/,~,tK,~rL,k:::.._ __ _1_1s~;g~~at~ure'.:..Lf,Q~•-~~-~-.......J./'--=.·J~'!_t},~,,~./~ ____ JL;a..'.:il.CJ..!..llL~
O 18. lra'nsporter 2 Acknowledgement ol Receipt of Materials
Mon=i Day Year
•,,.,, r • - / I J,)i'
Rl-'-~.:::.,;._c_:___:_.c_:_:.c..c'-..;:.;...;_;__~c.:...c__:__c...:. ____ ~ ________________________________ _
I i.-4--P-ri-nt_~_IT_y_p_~_N_,m_• ______________ _il_S_lg_n_•_'"_r•-----~------------------.1...-'--'--'-'-.,_-i
19. Discrepancy Indication Space
Monltt Day Year
I ' I I I I
a J I 1 i i 1 Jib,. cJ i I 1 i I Jit,,.
bl 1 I I I I pbs. d I i I I I I Jib,.
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid &. Haz..ardous Waste Mi;t
2600 Bull Street. Columbia. SC 2"3201
Phone: (80J) 734-5200
I
I
I
I
I
I
Emergency & Holidays: (803)73-4•5-!24
l'T:;S::E~P~R~IN~T~o~•-;TY::!.;P~E:-:;-;-(Fio~•_:,m~d~c~s~in~n~ed?:::l~or~u~s~e;_;o;:n;_eTl:,:ile::_'~ [1:!2,:i·Pi::ii~tcc;h:i.JI~ tvn::_ew::.:,:•i~l•::,•l:_ _______ -:-:--:--:---r:~:-'F~o!!rm::_::A,:pi:,r::o::,_:ed:,:,"O~M::::;Bc,:N_::o;;,_:2~0;!50~-:!:00:::::_39:!,_:E.,!£:pi~•es:!,;9t·~JO~-M~
UN IF ORM HAZARDOUS 11. Genora!or's U.S. EPA ID No. Manllo111 12. Page 1 Information in the ,haded a1eas is not WASTE MANIFEST N, C, I), 0, q, 7, 6, 0, 1 .. 7, ], 1,.o~o":"f;1,~o 01 1 requircdbyFederallaw,buli,byStalelaw.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
,. Gene,ato,·, Phone I 919 \ 9 JI, 9 711
5. Transporter 1 Company Name
Willms Trucki1w Co -Inc.
7. Transporter 2 Comp.any 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
I SI C• ]), 0• 7• ), 7• 0• 91 21 (}
8. U.S. EPA ID Number
I ' ' ' 1 ' ' ' 1 I I I
10. U.S. EPA ID Number
11. ~.S. DOT Description (including Proper Shipping N,,mo, ll.11.ird Class, and ID Number) 12. Container, 13. Total Ouantiry 14, Ur,it l W&.m ~ -•:-,
No. Typo 'Mflo :•-,.·:";""-'·C:i:h
ta. Haz-a'Y(fous Waste, Solid, nos ORM-E .\iF1D'ji~·9,d/
N ~_::N::A:.....:9'..:l..:8'..'.9~ ______________________ __ji-J•-· _J•,:l_J'.:D_j,T~-1'-1'-1':.2.1,::_0-I-Y.:__-l-'i..:1:::"::1:::D::1:::D::1:::6:.11..l]
(
E b. ··! j.~ .. ,,,. __ ._..-._·, .. ~--;--;;:
·· iY
I I I I I ' ' ; I I ,:
A ~c-. ---------------------------i--1_!_-+-1.-J-_!_..L.L.Lf--~:::::=: __ =_:=:2.j
._ 'L.--1.-1l ----1.----1I . •
I I I I I I I ::1 ,~:
d.
I I ' ' ' ' '
15. Special Handling Instructions ilnd Additional Information
GSX Work Order No.: 79996
,e. CENERATOR'S CERT1F1CJ,,T10N: I horoby declare that !ho contents ol lhi, con,ignmonl are lully and accurately described above by pro~r ahipping name and ere ctasa,t1..:1.
packed. mar~ ed. and 1ahc1cr:1. end are in all ro,pocls in proper conc:lition for lran,port by highway according to applicable lnlernationol and natlono.l go"ernment r~ulat.1on1 and
u,e 1a ... , or trio St.11e al Soul:h Carolinn.
II I am a tar~e ciuant1ty gencro1or, 1 cor1ily thall h11vo o program ln ploco to reduce Iha volume and 1oxlcltyol wa.slo generated to the d&groe I ha"o determined 10 t,,,o oconomically
practicable and u,at I ha"a selected tho practicable method ol troatmonl. ,1oroge, or disposal currently avoilable 10 ma which minimizes the present and lutvra ui,_t to hum.an
hea11n and !he en"i,onmcnt; OR. ii I am a sma11 quantity gonorator, I hB\IO m11,do o good loith otfort to minimize my wa,to generation and ,alee\ U"lo b<ss\ wa,:e l"!".al'la;amen1 ""9tr>Od
rtial is a"ailablo 10 me and thnt I con ollo,d.
Printed/Typed Name
Ro£er L. Coats
Signature Monei Day Year
t0,4,0,1,8,8
~ 17 ,.,.-r1' nslOf'ler 1 At:Know1¢'gAtnenl ol Receipt ol Materials
A 'A }#,J;edrla~.I ,#
, , -Jt. ransooner 2 Acknowledgemenl ol.Uceipl ol Malerials i Prin!ed/T yped tJame l/ Si9n;iturc
//
r1/ Mont"I Day Year
I
F
A
I
19. Discrepancy Indication Space
~1--------------~ la. F1c1ht"f Owner or Opcralor: Ccrtific.iUon of rccoipl ol hn.u11dous mnlcrials covcrod by lhis manifesl except as notod In Item 19.
PtlnlldlTy~td Nam, , Slonnturo
IPA Form 8700·» 1n•v 0/00J l',ovlou, Edlllons nro Obsololn [DHEC 10081ncv. 10/06)1
l , 1 , I ,
a '-I LJ....L...1....J_Jpto,. cJ '-LJ....L...1....J_/pto,.
b I /Jb3 d I /I"'-
Month Oay YNJ
I . I , I ,
I
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hau.rdous Waste Mi;t
2600 Bull Stre-eL Columbia: SC 29201
Phone: (BOJJ 73'-5200
Emergency & Holidays: (803)73-4-5424
E PRINT or TYPE (Form dcsioned for use on elile 112-pilchl tvocwriter) Form Ap roved. 0MB No. 20S0-0039 &oir~ 9.30.e,a
UNIFORM HAZARDOUS 11, Generator's U.S. EPA ID No. D Monlr•r~ ,2. Page 1 Information in the shaded .... ., is not
WASTE MANIFEST N' C' !), 0' q' 7' 6, O, 4, 7, ], 4,0 ~ci":'7°74 ,1 °1 1 required by Federal law, but is by Sialelaw,
P. 0. Box 1416, Smithfield, NC 27577 ·a/ll1it.•f~lo<'al0/ .. ·.•.,• '"'.' .. '..·".• .... '.' .. ·.·.··.• .. ·.•'•:.·.·,,.··.,,.·.·• .. •
'· Generator'sPhOne{ 919 ) 934-9711 '()Si\i}:U :-.., •-· v-.,
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 CYstl'.te:rran·•~e 10 ··,--: · ',:;< -~;_;
• s, C, fl, O, 7, 31 7• n, 9, ?i Ci 'IJ}Tnw=sf>hoMi. An1/11,1.:1111.
8. U.S. EPA ID Numbor
I I I I O I ,· I I I I 0
10. U.S. EPA ID Number
IS, C, D, 0, 71 o, 3, 7, I ~ B '.
11. U.S. DOT Descrip!ion (including Proper Shipping Name, 11,u.ird C/,1ss. and ID Number) 12. Containers 13. Total Quantity lt Ur.ii L W&St:I Nttnbw ···
No. Type 'MNcJ. ·;. ·· ··:>· 'i',i•i\
a. . ' i F j o·j l19j';,;
Hazardous Waste, Solid, nos ORM-E ... , •.
N l-..'.N:;A~9:,:l:.,'.8'..,:9'....., _______________________ µ•L· .J'l:l+DJ•t:T...j...J'-1'-1'..'.:2J'.::'.O+..'.Y-J..::!..!j l:::'::l:::D;:l;::D;:l::6:::l,2~]~· f b, ; I ' ··•'-··' -;~;
o 1-------------------------------l-.!1-11_jL1Ll-L1L1 L1 L '-l--~C.:: 1::::::::::::::::::.' .;;'·;.J
A C.
•
I
I ' ' I I I I
d.
I I I I I I I : I
J. Mditor.al 0..0-ipt1¢,13 '"' MntenatsUstcd Above. : · ···· · · ·. 'i:{V id•Y:J'ii
:···:; ... •, .
3:'1p·' ,w 1·..:·1o··;2· j 7 I 7 .,.41 ::.1·1 I {· ,'o ,·'2·f \;\; }i;t[!i 2j ' j 'j~y·· ::db
b. Lu-1 ,-, , ;1ir:::i:011::ii d. Lu-I
1 S. Special Handling lnstrucb'ons and Additional Information
GSX Work Order No.: 79997
115. CENERATOA•s CERTIFICATION: I horobydoclare lhlll lho con Ion 1, Ol lhi:, conslgnmont are fully nnd 11ccurntolyd11scribed above by proper 1hipping nam• and ar• cla:,,a,l1aod,
packed, ma,~ ed. and 1a·bclcf1. nnd 11ro in 1111 ro,pocls in propor con1lition tor trnn,porl byhighwny according to applicable interna1ionol and national oo..,arnment ra-;utation, •M
tfle 1a ... s 01 the State ol South C:orolinn.
ll I am a large Quantity genero1or, I certify thal t hnvo a progrnm In ploco to rt1dUCt! !ht! volume and toxicity ofwuteg11ner11!ed lo the degret1 I h11v11 dotarmlne,d to be economic.arty
pr•ct,cable and Iha! I ha,..o setocted tho practicable method of lronlmonl. ,1ornge, or dbpos.al curu,nl1y available to me which minimizes \he pro,en1 and lutvro tl'"lr-11.0 r11.1man
heanr, and the envi,onmcnt: OR. ii tam a small quantity gonernlor, I hnvo mado o good lnilh eNort lo mlniml111 my wa,to generaUon and :,elect u,e ti-es! ""asie ..,...,ana;amant ,..,..tl'\Od
tt'lal is available 10 mo nnd tlinl I cnn nllord.
Printed/Typed Name
Roger L. Coats
I Signature Mor.::, Day Yw
,o,4,0,1,s,s
~ 17. Transporter , A(;1mowledgemenl of Receipt ol Materials
I P. PrintM/Ty;,ed tlame /· r ( . I ~ ~,., ,,,,n 'LI' /,) ( "7),::} ,/! (D, e,-L'= [CJ. li)turo / /// /_(j /1. , /Z Ji{) Mon::-. Day Year
I"'' ilv,, l I R,?i
~ is. Transpor:/r 2 Acknowledgemenl of Receipt ol Materials / I r
I ~--+--P-ri-nt_ed_/_T_y_ped_N_•_m_c _______________ j_S_ig_n_,1_u_r• ______________________ ....,,1.M_o_.n_m...,__D_.•_Y..,__Y.,ear-t
p
I , I , I ,
19. Discrepancy Indication Space
F 3 .._I _._,,_..._._,,_,po,, c .._! _._,,_._.._._,Po,,
f, b I pt,,. d I po,,
l. ' 1---------------~ 20. Facility Owner or Operator; Cer1ilication ol receipt ol hazardous malcrials covctod by this manilosl oxcopl as notod in llom 19. l Printed/Typed Name I Signntu,o
PA Form 8700-n (Rav. 9/86) Previous Editions nrc Obsoloto (DHEC 1008 (nev. 10/86))
Mon:n 01y YW
I , I , I ,
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Wasta Mgt.
2600 Bull Street, Columbia. SC 29201 ..
Phone: (803P34-5200
UNIFORM HAZARDOUS 1. Generator's U.S. EPA 10 No.' Manlteet Oocumonl No.
WASTE MANIFEST N c D o 7 6 o 1400742
3. Generator's Name and Mailing Address
Channel Master
,}P. O. Box 1416, Smithfield, NC 27577
,.'Generato~s Phone [phone]
5. ·Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company _Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
S C D 0 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Number)
Form A
2. Page 1
of
Emergency & Holidays: (803)73'-s.'24 •!
roved. 0MB No. 2050-0039 Ex r~ g:3()..aa
lnlormalion in the shaded areas is no1
required by Federal law, but is by State law.
·11;;1r=.;~~~j~~~
::~111~;;;/~~hl:~)l]~ii#MI·
.. .. . ·-~--,~r';o,i,lff~
E 'Hazardous Waste, Solid, nos ORM-E ,il ij;
N 1-.::N~A:...;::9_:l:::_8~9 ______________________ -4-..L..114:'...l;T:..j..J_..L..l.:2~0+-y.:...!;'tl::!..·· !=lf=:IP::i::P~1::fi::'2.· ·l
b. • ~,. ·ii·11·~~-,
;-i
T "'' ,., t I
o J-...: ___________________________________ .J...-...1..-1_-I-..L.-J._JLL.J._J_+---l.i.•·:.'!:::::=::::::::::!f.;,,:;;f;--_
"j-,Jfil
I ' ,I C.
d.
,.
-4":•,'::~ ..
15. Special Handling Instructions and Additional Information
' -~· /GSX Work Order No.: ., . .,. 79998
1 L ·GENERATOR'S CERTI_FICATION: I hereby daclaro th al the content, ol 1h11 consignment are fully and accurately described above by pro~r shipping name and ate da9sifted.
~cited. mailo.ed, and labeled, ,md are in All rospecta In proper condillon lor 1,anspor1 by highway according to appllcable lnlarnatlonal and nauonal govarnmaMI rt,gulatlOf"la and
, the lawa 01 the Sui.le 01 South Carolina.
, HI am a large quantity generator, I certify that I have a program In place to redueethavoluma and toxicity Cl waategenarated 10 thedogree I have determln.ct 10 be~
":; ~precticable and Iha! I have selected the practicable method ol treatment, alorage, or dlspoael currently available to me which minimizes the praNnt and lu1ure thr .. 1 to human
:;..;health and the environment: OR. ii I am a small quantity generator, I heva mado a good laith affor1 lo minimize my waste generation and Hlact the bell wute managemenlmetnod
: . thal 11 available to me and the.I I can e.ttord.
·:, Printed/Typed Name
Charles R. Hansen
Signature CJ ~ Month Day YMI
0 4 0 6'8 8
t 7. Transporter 1 At:Knowledgement of Receipt of Materials
#cFo
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Month Day Year
19. Discrepancy Indication Space
-'.; . .;-._1~·i·~ , .. . ,
~ ~-, .. --:-
Owner or O eralor· Cer1Iflcallon of recel I ol hazardous malerlals covered b this manifest except as noted In Item 19.
Typod Name Signature
A Form 8700-22 (Rev. 9/86) Previous Editions arc Obsoloto (DHEC 1988 (Rev. 10/86)]
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz.ardous Wute Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: (SOJ) 734-5200
Emergency & Holidays: [phone]
~E PRl~r TYPE (Form deslaned for use on elite [12-oitchl "'"ewriterl Form A roved. 0MB No. 2050-0039 Exnires 9-30-88
UNIFORM HAZARDOUS I1 •. Generator'sU.S.EPAIDNo.
· WASTE MANIFEST N,r.,n,O,<J,7,~·0,4,7,
Manlleat -~ 2. Page l O,...,oc~menl ~o. ol ],4,LIIL],,._ 1
Information in the shaded ateas is not
required by Federal law, but i:!I by State law.
3. Generator's Name and Mailing Address
Channel Master
··P. 0. Box 1416, Smithfield,
, .. '.Generator's Phone I 919 I 9 34-9 711
NC 27577
ifi~=1~t~tffi~ltt
:t~1;~::;0t~~1;~ri~lr %,tM~i~t.~~
5. Transporter 1 Company Name
Willms Truckin~ Co Inc.
7. Transp0r1er 2 Company Name
9 •. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood. SC 29125
6. U.S. EPA ID Number
• S • C• D• Q, 7• 3• 7• n. g, 21 ~
8. U.S. EPA 10 Numbor
I I I I I I I I I I I I
CJ$ta"i;··_;,---~-,,, .. ,-.. , ·~--·1·10 :):,.;,·--,;',_'. ~ l):?;f. ·:;d-~ :~w11tv:·"f1;
D/T ·· · il'hoM .',,onH.7~7.i"\"\"\"\·-,.i.
t"•.,;.;t;.;;=;, o .,,.., ..... , . , . .,. , .... ,.,,..,,;;·,;;..,.;.:
FXTrBnAMrl.,'a PhofW ;.,:->=--·•.·.•·.,._,.,.,,. r, ;-' .. :,,,-,~~~h~~'l:
10. U.S. EPA ID Number ;,~~;11:~~:~~ir'.:~·til,i~:ii\({:'.r·;i1t#tf?i.tt~~
I Sr Cr D, o, 7, 0, 3, 7, ' ~ 8 ~ :~;i0~!;~);,:E;r;'~oizii21~g?;i
11. U.S. DOT Description (incfuding Proper Shipping Name. Hazard Class, snd ID Number) 12. Containers
No. Type
C.
I ' ' I I I I
d.
I I I I I 1 1
15. Special Handling Instructions and Additional lnlormation
'..GSX Work Order No.: 80096 •
18. Ql[H[RATOR'S CERTI_FICATION: I hereby declare lhat1ho con1ont1 olthls conalgnmenta,a fully and accuratelyda1crlbed above by pro~r shipping name and are ~fled,
pac1'.ed, marked, and labeled, and are In All rosp&cla In proper condition lor transport by highway according lo appllc.ble lnhun•tlonel end netlon•I goverr,,,,•nl regul•tlons and
v,e laws ol lho St.ate ol Soulh Carolina. ·
i1 I am a largo Quantity generalor, I cortity that! have 1111 program In placo to reduceu,evolume and to,;lclty orwastogenaratedtothe degree I have determln9d to be .conomk&Jty
.~ practicable and Iha! I have ,erected lho pracllcable method ol treatmenl. slorage, or dlspoaal currently available to me which minimizes tho presenl and lurure tnrut to human
, health and the environment: OR, ii I am a smell quantity generator, I have mado a good faith eM'ortto minimize my waste generation and select tho belt wa11e managem.,,t mea'IOdl
tnal is available to me and the! I con afford. , I I //Plnted/'.mm• ,,-t 7:1/f/_,_,,t> Charles R. Hansen
Signature;:,' f.~ /L.. Month Day Year
10 ,4 lJ .6 i', /3
i 11'. Transporter 1 Ac.;1mowledgemenl ol Receipt of Materials
" I ftgfited_JTyped J.J"m"' A /J? ·
' ~l'M.v/.,.rcH 1////Y'k,:;-1t1-ne,
• , ' ~t 1 It Transponer 2 Acknowledgement of Receipt of Materi8ts
'
T Printed/Typed Name
19._ Discrepancy Indication Space
~ry• 4112 A/,~~
. r/ /
I
Month Day Year
vi./_/,,,, ,/4 I;?' fl
Signature· Month Day Y eat
I , I , I ,
F •, ',,. , • I
-, ""-,. • b IL..LIU-1....L
~ 20. F1cil1ry Owner or Operator; Certmcatlon of recalpt of haiardous molar/a ls coverod by this manifest excepl as noted In /!em 19.
Printed/Typed Name Signature l,. Form 1100-22 (Rev. 91861 Previous Edlllons nre Obsololo (DHEC 1966 (Rev. 10/66))
jibs. e I l!!>s.
!lbs. d I , ...
Moolh Day Year
I , I • I '
I South Carolina Department of Health
and· Environmental Control
Bureau ol Solid & Haz.ardous Wute Mgt
2600 Bull Stree\ Columbia, SC 29201
· Phone: (BOJ) 734-5200
Emergency & Holidays: (803)734-5-12•
E PRINT or TYPE [Form desianed for use on elite U2-pitchl tvnewriter) Form A l"lfOVed. OMS No. 2050-0039 Expire, 9-30-88
UNIFORM HAZARDOUS 11. Genoralor'sU.S.EPAIDNo.
WASTE MANIFEST N,c,n,o,g,7,6,0,1 .. 7, I,
Menlroet .12. Page 1 Oocumenl No. of 4-0-0-7,4,4 1
Information in the shaded a,eas is nol
required by Federal law, but is by State law.
3. Generator's Name and Mailing Address
Channel Master
·: P. 0. Box 1416, Smithfield,
•.' Ge~eralor's Phone f 919 I 9 34-9 711
5. Transpor1er 1 Company Name
Willms TruckinP Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX ~ervices of SC, Inc.
NC 27577
6. U.S. EPA 10 Number
• S • C• D• O• 7• '• 7• n. g, 2> q
8. U.S. EPA ID Number
I I I I I I I I I I I
10. U.S. EPA ID Number
ll:Z1.~~1~l:::!{;:;:;0?i!~!¥:
:;;~;t/,1~t;:~~t~~;;~¾lf1~t~t;:~)~~1Z£.,1;
c:l · 10'...' · -~ :r.;-".:-,::o.'~-~-t-".'fl:~
D.'.T .· i Phone ',.,i•Qn~ /7~ 7-'-;;.;;·,,·:,'.
, ;ti:uata·l' .. a l0-:,.,·-, i ... 1-~'-., :. =:~-r.•,~,i,h?-: .. ~~
F/r~.ts· Pf'-.one w:.,eii .. ",~:;•,,,.;._~~ i. )/-... ,-1~~~-:,i~;
:~~~:~o!. 8~~ ;;i2s , s, c, n, o, 7, o, ~ 7, '. ~ 8 '.~=t~rft;1;&-Jti3/J~~t~\1fji
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1'. Unit :t'y;i&Stil ftnber~
No. Type 'MN~ ;1{t:i:H~<'";\f#t\1ffe.~
a.,_, ---·-··-•'., ,· ___ ,·, ..... --·----·--
Hazardous Waste, Solid, nos ORM-E
N NA 9189 ,· 11 D ,T , , ,2 ,0 Y
b.
C.
' ' ' ' ' ' '
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 80097
1e. 01!:NERATOR'S CERTIFICATION: I horebydeclare thatlhe content, olthl, con•lgnmenl ara fully and accurately described above by proper ahlpplng name and a,ac&---'ftN.
P•C"-ed, marked. and 1aheled.and are In nt1 rospect1 In propor condllion lor transport by highway according to appllcab1a lnlarnatlonal and naUonal gov•rnm•nt ra,gulatlon• and
11'1• laws ot 11,e State or Sou!h Carolina.
111 am a large quan!ity generalor, I certify lhal I have a program In placo to reduce the volume and toxicity olwaategeneratod to Iha da,gree I have determined to b9 .conomk.alty
practicabte end that I have selecled the practicable method of treo.tment. s1orage, or dlsposal currently available to me which mlnlmlu,a the presenl and lutura tnrut 10 human
health and tho environment: OR. ii I am a small quantltygonorator, I havo mado a good faith erfor1 to minimize my waste generation and selocl tt,o boil waata management n,,eti,od
tnat Is available to me and tliat I can atlord.
l-1--:....Pn-·n-1ed-/T-y-ped_N!;~~~::!:!.!r:al~e;..:s:...!R~.~H;,:a~na!;s::;e!;.n~-----LIS_ig_n_•_•u_,e-'-~d::>/.:i_,,~J,~::._...t./.::.._.1.~~"'·t:::::;::;:;;:::::::.::;;.. _____ •LM.;~:i.nth..:4!1.:,~~•_;r6~,,"-~!;)..,~8
~ 17. Transponer l Ac.. ... now1cdgcment ol Receipt ol Materials
Prinled/Typed Name ._ 1
--rc5° .,.-,~ )N, /,,,1 v / )"lq'S"~ r'
Month Day Year
-=t:t-Z Zlo, rll c, G,1 <1-1"'
A ~1 .. s.c...T .. ,a .. n,.;•:.P0 .. rt .. • .. '' .:,2_A,.;c .. kn .. o .. w .. led:.:.,9.:.•m-=•n .. l,.;o .. l .. A• .. c .. e_,iP .. 1,.;o .. l M .. • .. • .. •1 .. ia .. ls:_ __ ...,. ______________ ./'------------,,,-.,---::---,c--l
'
T .. ,__P_n_·n-led_/_T_yp_ed_N_•_m_• _______________ ls_i_g_n•_•u_,_• ______________________ ...JM._on.L.th...J'-0'-ay_,,_Y_oar._◄
19. Discrepancy Indication Space ' " v 20. Faciliry Owner or Operator; Certirica!lon of recelpl of hazardous materials covered by lhls manifesl except as noled In llem 19.
ftrinttd/t1pt'd Nam, r Signature I,. Form S700,22 (Aov, 9/86) Previous Editions oro Obsololo fDHEC 1966 (Rev. 10/66)]
I , I , I ,
a ._! .,__,,_._.L-L_,i'bs. c ._! ..__.,_._,._._.,!11&
b I I'"' d I , ...
Month Day Year
I , I , I ,
I South Carolina Department of Health
and Environmental Control
Bureau al Solid & Hazardous W.ute Mgt.
2600 Bull Stree~ Columbia, SC 29201
Phone: (B03) 734-5200
Emergency & Holidays: [phone]
E PRINT o, TYPE (Form desioned for use on elite r12-oilchl tvnewriter) Form A roved. 0MB No. 2050-0039 E,pires 9-30-SII
UNIFORM HAZARDOUS 11. Genorator',U.S.EPAIONo.
WASTE MANIFEST N, r,, Tl, o, q, 7, n, o, , .. 7,
M11nlfoet ; 12. Page 1 o 1 nt No ol ], 4,8,1\:")', 1,, 5 1
lnlormatlon In the shaded Meas is not
required by Federal law. bu! is by Stale law.
3. Generator's Name and Mai!ing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone I 919 I 9 34-9 711
5. Transporter l Company Name
Willms Truckino 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 10 Number
~ii;;t~i:~~,~t~i!Qifil~l
:it~'.;t~~!~0)({J'.~0?~:\~it~Ll~~1{Mt~*
'C?Stata··f···· ·e·l);y,::.,:-1··:;:=·.:,>•=V,t: :,->_q::;?}-A;r:·1i;
S • C• D• 0• 7• 3• 7• ,.,, °' 21 'l O:'.l '·" ... '"' i'P!iont·:,):.yqn-,. /-7 ~ 1::C1.1..1. 1./-:e;
~,;.;,,,.;-1·'" ii'lo:, ,:•+,,JA<o'i,,\
FYTnin•~s Phoof =)1•·.,, .• ·· =··,·=·'~~-~ ;-.'-c:.-t;~-~>~>i:·:.r.i...i;,-;;
8. U.S. EPA 10 Number
1 o I 1 I I I I I I I
10. U.S. EPA 10 Number
, S, c, D, 0, 7, 0, 3. 7,
;~I :~~;~~~{-~;~:2:::tr:+r~:\:~::-; ~ _:,._:: U-'.~;t:i11~i:~1~ri.
~ -s ~ :lii!~~\~t1~~:::1~iitlWlb1il4~--~,~!~1ll
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Ouantity 14. Unit
No. Type WtNrl
a.
Hazardous Waste, Solid, nos ORM-E
N NA 9189 ,· ,1 D 1T I I ,2 ,0 y
I
T R
b.
I ' I
C.
I I '
d.
I I I
I I I o
I I I I
I I I I
.,""•"
=X'
'.fJ_ I
15. Special Handling Instructions and Additional lnlormalion
.GSX Work Order No.: 80098
,e. GENERATOR'S CERTIFICATION: I hereby deClaro that the contents olthls conslgnmontara lullyand accurately described above by proper ahlppll'IQ rtame and aractas.ift-.d.
packed, marko<I, and 1a·beted, and are in nll respec1111 In proper condition lor transport by highway according to appllcable lnlernationat and natlonal government re,gulatlOl'I• •NII
1/'le laws ol lha State of South t.::a,ollnn.
111 am a large quantity generator, I cer1ity lhal I have a program In place to reduce the volume and toxicity of waste generated lo Iha degr-1 have d111ermln8'd to be econombtty
prac11cable and !hat I have setecled the practicable method of traalmenl. storage, or dlspoaal currenlty available to me which mlnlmiz.ea the praMnl and luture tt"lrNt to h\.lman
health and !he environment; OR, ii I am a small quantity generator, I have mado a good failh eNortto mlnlmlz.a my was ta generation and select the boeal walla management m,etrlod
that Is available to ma and ttial I can atlord.
Printed/Typed Name I Signalure ~./4 2/ Month Day Year
Charles R. Hansen R' 1 0, 4, 0, 6, 8, 8
17. Transponer 1 A<:.'l.now1edgemenl ol Receipt ol Materials
Printed/Typed Name/) 7) ./4,, ~ ~,,,,.-r.i.. J .... _... J . .7.: r
I Signature ,✓,: J• /,l__ll,, Mone/. Day rr
I ' .l/)1
R 1-1..:a_. _T..;ra:..n.;;spo;_;_rt..;e_r ;;.2_A.;.ck..:n..:o.;.w..cl•..:d.;g:.em_ec_n_l..;o_l A_e.;.c..:e..cip_1 _ol_M_a:..l.;.er_ia_ls'---,-:::-:---------------/-------------,-:--,-,---;:--:::--1
T Printed/Typed Name I.Signature· Month Day Year
t 19. Discrepancy Indication Space
i ____ -----,,---,--.--
~ 20. Facilil')' Owner or Ope,ator: Cor1lflc&llon or recolpl ol hunrdous mnterlats coverod by this manlfosl except es noled In llem 19.
PrinltdlT1Pl'd N1rt11 I Signature l,. ,o,m UO<l,fQ Ino,. 010011•10,lous ~a,110,,. ore obsololo 1011cc 1ona (Re,. 10/8611
l ' I , I ,
'I libs. CI libs.
b I pt,,. ., I""-
Monlll Ooy y..,
I ' I • I .
I
I
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 &ill s" .. \ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays.: (803)73"-5-424 -E PRINT or TYPE [Form desioned for use on elite r12-pilchl tvnewriler) Form A nroved. 0MB No. 2050-0039 Expires 9.30.ga
UNIFORM HAZARDOUS 11. GenoralorsU.S.EPAIDN.o.
WASTE MANIFEST N, r,, n, 0, 9, 7, 6, 0, 1,, 7, l•
Mnnlro11t ,.J 2. Page 1 Oocumonl No. of ,,. 0, 0, 7, ,,, 1
lnlormalion in the shaded a<eas is not
required by Federal law. but is by Stale law.
1 Generator's Name and Mailing Address
Channel Master
.P. 0. Box 1416, Smithfield,
•· Generator's Phone I 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckinr, 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• n, O• 7• 1, 7• n. <Jo 21 'l
8. U.S. EPA 1D Number
' • • ' ' ' ' ' I I I
10. U.S. EPA ID Numb-Or
,S, C, D, 0, 7, 0, 3, 7,
~1;;;~;;;~:=~j:~-:~s~tir~-~5;~,-
::i~~;~t:~it;;;;~0~IJt:;2t;tl)}~ti~~~ ·cq 'I()::/;:,·/,·· '1 j:',.' ·c:;ti;1 .. ,i''J:;~\.""·'!U
0/T-iPhoM.,·. s:i.n'l/-,&.-,~1.~'l,··<:'.
j::lfo.:..-_,T° a lO. '.--,<,._:,, ... ::?~-,,,:t~~-.:...;:,1:~\
FNTni' · -,v ..... · · · 'a·· Pr'ionf ·-d ,~;:·;/,:; · i,~-;t·~Y<,t ,w.~:~_~'.:::,;..,..;,.,.-
ii:i\t;~;s~d:~~t;:wi:i'~I: ::_:_::.~-:~·:_' : .. ; :::;_;:rh:::~:n;i;?j~i(
fjf;~::!;:~i~~!t~~:~~tS~'.J1613'i.t3~t~~ll~
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers
No. Typo
' ' ' ' ' ' '
d.
0 I ' I I I <
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 80099
,e. GENERATOR'S CERTIFICATION: I hereby declare lhellhe contents ollhl:!1 consignment are fully and accurately described above by proper shipping name and arec1...,ffed.
packed. marked. and 1a·beled, and are in all rospects in proporcondlllon lor transport by highway according lo applicable International and natlonal govarnmanl r~ulatlona arid
vie la*s ol \he St.ate ol South Carolina.
tT I am a large civantity generator, I cer1ify Iha! I have a program In placo to raducelheYOlume and toxicity olwa1tegeneraladlo !he d~ree I h•v• dalarmlned to be economk:alty
practicable and thal t have se1ec1ed !he pracUcable malhod ol treatment, storage, or dlsposal currently available lo me which minimize, the presenl and lutur• au-110 human
l'lealth end Iha environment: CA. lfl am a 1motl quantity generator, I have made a good faith ertor1 lo minimize my waste genera lion and salec1 trio bell wait• management~
trlal Is available to me and that I can attord.
Printed/Typed Name
Charles R. Hansen
Signature/v"' ~..,L. Month Day Year ,o .4 {J ,6 ~ ,8
T 17. Transponer 1 Au::nowledgemenl ol Receipl ol Materials
IR I--: ';!l'Pc:-.-,ted-':-::/T:-y-ped-:-:,N,-am_e_-'-----'-/7------rS::-iigg-~n:-. -.--/-_------------------:M-:-o-n"'"lh::;,--:~D=-a-y--:Y:-ear--t
_hi }-,. ,l.,nc.,,,,-<-· C~ ~ .h'U<°L ,o /"z::.-t..,<r.L _a .Jfr I X1 ,<fulcA"c
~ "18. Transponer 2 Acknowledgement ol Receipt of Materials l Prinled/Typed Name Signature Month Day Year
I , I , I ,
19. Discrepancy Indication Space
' 20, Ficilitv Owner oi Oi>elaloi: Cettili6allOR ., ID!OIPI ., I\UftfOO"* mol8flftil oo•trOII n, !hid n11nllotl .,cop! 11 noled In llom 19.: Li..,_.,_.,_.__._~::: : .. : .J...1..-'L..L...L...I::
V .
l Prlnltd/Typed Name Signature
_ .. ~ ~~:~ i,,tr,e,,_.. ,u.-•.r-1} ,-,cv,ous t:OiI,ons arc vuSOIOIO /UI I:(.; ,~ad (HOV. 10/86)1
1. South Carolina Department of Health
and Environmental Control
Bureau of Solid & Haz..ardous Waste Mgt.
2600 Bull S"eo\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE (Form deslnned for use on elite [12-pitchl tvnewriter\ Form A roved. 0MB No. 2050-0039 E.ipires 9-30-88
UNIFORM HAZARDOUS 11, Generator's U.S. EPAID No.
WASTE MANIFEST N, c, D, O, q, 7, 6, O· '· 7. I·
Monlfeal 12. Page 1 8ocumenl No; of 4• • 0 • 7, 4, I ·1
Information in the shaded areas is not
required by Federal law, but is by Stale law.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4.Generato(sPhonef 919 I 934-9711
~~i:~,~:=~~,~:;.~;::;tfi{m!~~k$:.
i~at~:~KJBY~iS~?fSUili~~~~ir~
5. Transporter 1 Company Name 6. U.S. EPA ID Number
Willms Truckin~ Co-Inc. • S • C• D• 0• 7• 3• 7• fl. <Jt 2l <\
8. U.S. EPA ID Number 7. Transporter 2 Company Name • • • , , , • • • 1 1 , F/irffl~M ets Pf',aot·.).:--i:-,"-''·'·~.,-;_~-f;/-:..-t~~-"~~-~-..... ;_.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood. SC 29125
10. U.S. EPA ID Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, snd ID Number) ,2. Containers 13. Total Quantity !(Unit ·"l'_Watlttnblr:~
No. Type 'MNd i/f\~ftft1\?'¥f¾.~
L
I I ' ' ' ' '
d.
I I I ' ' ' '
is. Special Handling Instructions and Additional Information
GSX Work Order No.: 80100
15. CENERATOR'S CERTIFICATION: I hereby declare lhallhe contents Ollhb consignment are fully and accuratalydescrlbed above by proper 1hlpplng name and are cla.u.ifted.
packed. marked, and 1Bbeled.and are in 1111 respect:. in proper condition for lran:iport by highway according to applicable International and naUonal govarninen1 re,outadon• &l'ld
U'le laws of Iha Stale or Soulh Carolina. ·
If I am a large Quantity generator, I certify lhal r havo a program In placo to reduce the volume and toxlcltyofwaategeneratedto the d&Qr&e I have dat.,mlnod 10 be ec:onomlcalty
practicable and that I have Hlected the practicable method of treatment. storage, or dlspoMil currently available lo me which mlnlml:tiu the pres.ent and lutura U'lrNI to human_
health and Iha environment: OR, II I am a small Quantitygenorator, I have made a good faith effort to minimize my waste generation and select ttia boe11 wuta management~
mat Is available 10 me and 1he.t I can aHord.
1-1--P-ri_n,_ed_l_T_yp_ed_;N~•!lm::!e:E.:!~~~....!!~~~-----_ILS_ig_n_•_'"_r•_t.:, /,::i··
7a::i: /:."!:::!:::!. / __ LS. ./4?..__.!;J:!~ /=:::==:::;,; ___ .....ILM.!::o'.l.nlh.'.'..l..!:'.ioaL.y~;;.Y:i,oar~ Charles R. Hansen /;,,/;_.~-/..., /( , 0, 4, 0, 6, 8, 8
~ 17. Transpor1er 1 At:Knowtedgement of Accelpl of Materials : • ·
Ptia)':dlTyped Nam; /) 1Signatu,r2.-,. /, J'/). • J -_ IJJ.A. /7 Monlll Day Yur ·W , JI ; a,,, 5 tnQ. //SYi . IA/, .,. ✓-•• J/J ,r-.<;,l'),'1~;;
R 18. Transporter 2 Acknowledgement ol Receipt ol Malerials -
i4-_P_n_·n-led_l_Ty_p_ed_N_•_m_• _______________ LIS_ig_n_•_lu_r_• _______________________ ,1IM_o_~1,lh_,._I0,.~1,y_.,_ly_,:"--f
f 19. Discrepancy Indication Space
F •·I
(1-....,....------....,....--,---b 1'-'-.1..
v 20. Facility Owner or Operator; Certilicalion of receipl of hazardous materials covered by this manifest excepl as noted in flam 19.
PtinledlType-d Name I Signalure 1 .. ,o.,., 1100,U tR••· D186) P,ovlous EdlUons are Obsoloto (OHEC 1068 (Aov. t0186JI
J J J J J jibs " I J J J J !lbs,
J J I J I pt,,. d I I I I I I , ...
Monlll Day Year
I ' I ' I '
. -----·--·· -
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste Mgt.
2600 Bull Stree~ Columbia. SC 29201
Phone: [phone]
E PRllfl or TYPE (Form des! ned for use on elite 12-ilch
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
(. Generalo~s Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
Manlfoat Document No.
400748
10. U.S. EPA ID Numoor
S C D 0 7 0
Emergency & Holidays: (B03)734-542(
Form A roved. 0MB No. 2050-00J9 E.xpires g.30.a3
2. Page 1 Information in the_· shaded areas is nol
ol required by Federal law, but is by State law.
11:~,~~~%:~-=~dS:~@l~~~¥.
t~~;~tiYjWtlC;:~~;::I~1~~;;~~~~
F/f ·Pl>oiio..:;,
ct/stilii F eei!ity'a ro.•.·:• "· ••·• ·•
%1i!NH){\{/L/:?Mt/X(:-;:/I
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Conlalnors 13. Tolal Quantity 14. Unil l"WallllMaberj'fe
No. Type VNV~ Y(:i\i)/i1.(¼JtJ:~1 ...
t.
., .......
/~· (
:it'·
d.
·,s. Special Handling Instructions and Additional lnlormation
.GSX Work Order No.: 80101
, IS. C!MERATOR'S CERTIFICATION: I hereby declare that theconlenls of this con1ignmanl era lullyand accuratelyde1crlbod above by proper shipping nama and ara cJu.aiffad.
packed, marked, and 1a·beled,and are lrl all rospeets In proper condition for lran1por1 by highway according to appllcable lntarnatlonal and natJonal government re,gulatloM and
tf'la laws ol tho State ol South Carolina. ·
HI am a largo quanttty genera1or, I certify that I have a program In placo lo r&ducethevotuma andto,clcltyol waategeneraled to Iha degr-1 have delarmlne-d to be economk:alty
pract,cable and 1tiat I t,ave solocled the pracllcabte method ol treetment. storage, or dlspoaal currently available lo me which mlnlmltaa lhe pres.en! and lurura u,,_, to human
haal1h and Iha environ man~ OR, lfl am a a mall quantity gonoralor, I hove made o good lalth effort to minimize my waste generation and s•lacl th• bell wa11a l'l"lanagam.,,1 ~
that la avai!at,lo to me and lh11I I can ellord.
Printed/Typed Name
Charles
cknowledgem
Name
19. Discrepancy Indication Space
Signature
Signature
20. Facitiry Owne, o, Operator; Cet1ilie:a1l0n or receipt or hrunrdous mnterlals covered by !his manilest except as noted in /!em 19.
PrinltdlTyptd NiHftO 8t{lnaluro
A Form !700•22 (Aov. 9/86) Previous Editions nre Obsoloto jOHEC 1988 (Rev. 10/86))
a I jibs.
bJ jibs.
Month Day Year
0 4 0 6 8 8
Month Year
Montn Day Year
CI libs.
d I Jibs.
M8~1/1 t y..,
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste Mgt
2600 Bull Street, Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form dest ewrller
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generalor's U.S. EPA ID No.
3. Generator's Name and Mailing Address
Channel Master
N C D 0
. P. 0. Box 1416, Smithfield, NC 27577
( Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Oesignaled Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
I 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
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
a. •... l.l ~..,;. ,_e..Jt....:-.<'.~d.~.~ :?!t~!!.'.l::~1~.•~.J:..'.'._l:,.t.1:. ~.:•.'_•~-.J..i: _____ '". --·
Hazardous Waste, Solid, nos ORM-E
Form A
2. Page 1
of
Emergency & _Holidays: (80J)7J,C-SC2'
rovDCI. 0MB No. 2050-0039 E.x res 9.30.e,a
Information in the shaded iW'HS is nol
required by Federal law, but is by State law.
F/:=T . .. s=·-~·:).,,/-:a~ :·.,,,.:.;:>-·r,->'.,:,!'"·j~·:f:.i?~~:h·,,:;-
iifl;~;};f :~;.;;0:;;~;i;;;f :~::,f.i)!:i\'.~;-i :;:,1i;:1:;~1¥riJltt{
12. Containers 13. Total Quantity U. Uni ·l'Wa18,.._~
No. Type WtJW. :iPH~\.;~;;fts::10~~
N NA 9189 l D T
::'=:~~-:F.~;:or-r,~~
2 0 Y ~lf)QJQ161I
b.
C.
d.
15. Special Handling Instructions and Additional Information
CSX Work Order No.: 80102
16. GENERATOR'S CERTIFICATION: I hereby declare lhat lhe contents olthls con:11lgnmenl are lullyand accurately ducrlbed above by proper ahipping name and are Clauifl.-d.
packed. marked. and la.beled,and are In 1111 ra:11pact:11 In pro par condition ror lran:11port by highway according lo appllcable lnternallonal and national government re,gulationa and
1/"te laws cl the Stale ol South Carolina.
It I am a large quantity generator, I cer1ity that I hava a program In pleca to reduce the volume and todcltyofwaatagenarated to the deg,_ I have determined to~ .conomlcalty
i:,rec11c:abte and trial I have 1elacted the practlcable method or trealment. storage, or dlspoul currently available to ma which mlnlml;r;e1 the present and lurura 11'\r-t lO rwman
health and tha environment; OR, ii I am a ama11 quanlltygonorator, I havo made a good lalth elfor1 IO mlnlml10 my waste gonora1Jon and ao1ecl the boll wa11a managan,ent meuiod
thal 11 avarlat:ito 10 mo and 1h01 I con nlford.
Printed/Typed Name
Charles ·R. Hansen
17. Transponer 1 Ac,;,mow!edgement of Receipt of Materials
Printe<j/Typed Name t. c. £ , D& fv 0 c. /Z.ftY
Printe<j/Typed Name
19. Discrepancy Indication Space
Signature
nalue /J' 0 a,t£2 C.
20. Facility Owner or Operalor: Cer1mca!lon of rocorpt of hnuirdou1 moIorlal1 covarod by this manlfosl oxcepl aa noled In Item 19.
PtttltNtTrPH Nlfflfl Slgn.11iu,e
A Form 8100~22 (Ae..-. 9/86) Previous Editions l'lro Obsoloto (DHEC 1988 (Rev. 10/86))
a I....._-'-'_,_.,_
b lu...J...J....Ll
Month
0 4
Month
jibs. ' I
!Ibo. d I
Mo,\OI
Year
8
Year
Day Year
libs.
!lbs.
Doy y..,
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt ·
2600 Bull Stfee~ Columbia. SC 2'9201
Phone: [phone]
Emergency & Holidays: (803)734-5-124
ltEAsE PRINT or TYPE (Form desinned for use on elite [12-pilchl typewriler\ Form A □roved, 0MB No. 2050-0039 E,:pires 9-30-88
UNIFORM HAZARDOUS I'· Generalor'sU.S.EPAIDNo. 0 ManU••l-, 12-Pagel lnlormalion in lhe shaded a,eas is nol
-WASTE MANI FEST NI r. ID I O I 9 I 7' 6, o, /,. 7, 1' 4. o~°l\':"1715,001 °1 1 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. Gene,a!o~sPhoner 919 I 934-9711
5. Transporter 1 Company Name
Willms TruckinD Co. Inc.
7. Tran~poner 2 Company Name
6. U.S. EPA 10 Number
•S• C• D• O• 7• 3• 7• "-g, 21 ~
6. U.S. EPA 10 Number ,
o I -I I I o O I O I I I
10. U.S. EPA 10 Number
-~l:!~1~~~:~,r;;;;i!lfl\~¥
·11~~~~~~~i+t~f~{:~~:::~~~:~~Wff~~1~l¥~
'CJStiif.:':•f' ···= iJO ',:<->r·.;'= . .-~ 0,\_' ·: >>:::~~-.v-~;
0/T .-. I PhoM ·, . ·.: ti;n "l , .-, ~ .,~ 1.1.-'1 "\\,:,.
ri!j-'<-'f 1110,l!!';.-,_ h-,,ioi ---,,,;,,,V'Si-(-;,i\\
.Fkf--······ s' Ph6r,;,·-&7-A,, ··:·,,-=;· ~-:--~:>',~tf!">f,~¼_t~-~'~'-;<:-
-;it:tj:i ~:%~!:~~=:;l;/\ '= ·=·,· -:·t ,1/:d;;;1~~~1~; 9. Designated Facility Name and Site Address
GSX· Services of SC, Inc.
Route, I Box 255
Pinewood. SC 29125 , s, C, D, o, 7, 0, 3, 7, ' 9, s : t;1!1~:0-l:~!':;!':'}tisb3)i;;~!!~~~i~
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity 1tUnil
No. Type Wot/~
I ,1 D ,T I I ,2 ,0 y
I I I I I I I
C.
I I I f I I I
d.
I I I I I I I
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 80103
15.. GENERATOR'S CERTIFICATION: I hereby declare lhallhe contents ollhlsconslgnmentarolully and accuratelydoscrlbod above by proper •hipping name 1r,d are cla.aaiflecl.
packed. marked, and la'beled, and are in 1111 rospocts in proporcondlllon lor transport byhlghwayaccordlng lo applicable lnlernallonal and national government r.gulatlona and
tr,e laws ol the S1ate ol South Carolina.
111 am a large Quantity generator, I cortily that I havoa program In placo lo reducothevolumo end toxicity ofwestogeneralod lo the devr-I have determined lo be e,co,,oml,calty
pract,cab1e and thal I have selecled tho pracUcable method ol lrealment. storage, o, dlapoa.al currently available lo mo which minimizes tho present and lutute ai, .. 1 lO human
heallh and the environment: OR, lrt am a smnll ciuantlty generator, I have mado e good faith orfortlo minimize my waste genera1lon and select &le be,t wa,te managemenl ,,,.t:hod
that 11 available 10 me and lhnl I cnn nllord.
I Prinled/Typed Name !Signature 4 ,/ / ,,_
4-,,...,, ___ ....\Ci.!:h~a!,:r;Jl;.!e:.!:s:..J:R~ . ...!:H~a~n~s~e.!]n"---..,...--L-/..-/,Jf"'::.:t;~' /i.C! ,,.._A..-:;;:::::;:__L;;. ,r_....Jt./-::0'~-~ "~;:;;::;• ::::;:;;:::;;;;;,.. ___ L.!;l..!;~
T 17,,Tnmsporter 1 Ac,nowledgement ol Receipt ol Materials/ ., (} ,-/
I~ (P'jnled/TypedName ·/ ,,,----. i ;J ISi~,ur• 1 x ·-fl~ J K -'fA--i /vy, n •"-l I, -----. _,, 1--1' //1 if~,.,£.-,-,,,,,,_,,,,// ./ __>,.,-,,, D )' ,
o 18. TransP4i1er 2 Acknowledgement ol Aec'eiJ)t 01 Materials ' / RJ--=-,"--'-:..e,,-'--';__;--'--'-"'-...C.:.'-C.C'-'-'-'-'C.....:...;.c"'-..:....:..------,-::,-----/'----------------------:-:--:--,,-
i·;, 1---,P-"_"'_ed_'?;.Y_P_ed_N_a_m __ e _______________ ,_J\_s_ig_n_•_'"_r_e;:_ / _______________________ ..1,_L...L..J.
t 19. Discrepancy Indication Space
Monltl Day Yw
1 0, 4, 0, 61 8, 8
) Mro/..r, Dai I r.1• I /, [),VI
Monlh Day y..,
I , I , I ,
pi,,, CI libs.
I'"'-di I'""
MOt,111 Day y..,
I , I . I '
: al~.wu...1--~
11------------b IL..L.J...1--L..L ~ 20. Fac1hry Owner or Operalor, Cert1r1catlon of receipt or llntCJrdou, m1Uerlal1 covarod bv 1h19 manifest except as noled In llem 19.
· Pflf\lOdltJP'"' Nilftl . , Signature
IA Form 8700-22 (Rev. 9/86) Prevoous Ed1l1ons are Obsolete [DHEC 1988 (Rev. 10/86)1
I South farolina Department of Health
a~d Environmental Control
Bureau al Solid & Haz.ardous WcUte Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
I
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Expires 9-30-88 t J.SE PRll<T or TYPE (Form desioned for use on elile 112-nilchl tvnewrilerl
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N, c, D, O· o, 7, 6, o, b, 7,
Manliest , 2. Page 1 Document No. ol 1 ), 4,0, 0, 7, 5, 1
Information in the shaded &tt!U is not
required by Federal law. but is by Stale law.
3. Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
4. Generalor0sPhonef 919 l 934-9711
5. Transporter 1 Company Name
Willms Truckino Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc,
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
, S, c, D, o, 7, 3, 7• n, o. " <> •
8. U.S. EPA ID Number
I I I I O O , I I I I I
10. U.S. EPA ID Number
. , s, c, D, o, 7, o, 3, 7, '.
1t1;1;:~i;m1,~::~~~J;~;l!l~i
:;i~~~~p:f /:itt(;IJ} ,~1}~0{~'\t.~tf~i~~
C}SbhiT 1 !0':,/. ,. ,.,,,, ,,,·,,;:.y ,•,;
D7T 'il't>ono .. An117,:.7;,i~~~~··
t:\ a:.:.;;,.;.'"_,.-a· o ; : .. ;_~--~_,.,. ". -. , ..,, : , .,. , ·~1c,'t,./.::-'<-•{;-.:-1s
. F/.T;..;.:;..MA;;iB"· Phcifw-::):::;:;-..-. ::· ,.!-,;t ~ ;,·-~'tJ~i~«;.~,~~':",f
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
No. . Type
13. Total Quantity 14. Untt l'Wasll,.._\'1:
'MfV,j Y~H~~)tftiffft<f~
a.
A C.
' ' I , I I I
d.
' ' I I ' ' '
15. Special Handling Instructions and Addilional lnlormalion
.GSX Work Order No.: 80104
18.. CENERATOR'S CERTIFICATION: I horaby declare lhal the contents olthls consignment are fully and accuratelydascrlbed above by proper 1hipplng nam• and a,a cJasaifted.
packed. marked, and lahelcd, and are in A-II rospecls in proper condillon lor transport by highway according to applicable lnternalional and naUonar government r-.gulation• a1'd
tne laws ol the $\ale ol South Carollnn.
!fl am a large Quantity generalor, r cer1ify !hat I have a program In place 10 reduce the volume and todcltyol waste generated to the degrH I have determined 10 be economically
practicable and lhat I have selected the practicable method ol trealment, slorage, or dlspoaal currently available to ma which minimizes the preMnt and lutur• tntMt IO human
h•arth and the environment; OR, 111 am a sma11 Quantity generator, I have made a oood faith effort lo mlnlmlza my waste generation and select tna bo■t wa11a managem-,,1 m.O'>Od
!ha! Is available to ma and that I can affo,d.
Month Day Year
I I I , I .
19. Discrepancy Indication Space
• I l't>s. C I libs.
b! !lbs. d I ,, ...
v 20. Facility Owner or Operator; Cer1ilicalion of receipt of hazardous malerials covered by this manifest excepl as noled In Item 19.
Prinltd/Typed Name I Signature
... Fo,m 1700-22 fAov. 0/M) r,ovlous Edlllons nre Obsololo (DHEC 1908 (Rev. 10/86))
Month Doy y..,
I ' I , I .
-·----·-
I
_,.fiP~•d_.,·. ,-~ .~ ~ca-,·"I:\~ ~
. '. ·:-1--~t..~: m;:_"',"'-"", ~ ~
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste Mgt.
2600 Bull Stretit. Columbia. SC 29201
Phone: [phone],00
Emergency & Holidays: (803)734•542'
l~E PRINT or TYPE . (Form designed for use on elite r12•citchl tv"'ewriter)
UNIFORM HAZARDOUS 11. Genorator'sU.S.EPAIDNo.
Form A orovod. 0MB No. 2050-0039 Expires 9-30-68
Manifest I 2, Page 1 Information in the shaded a<eas is nol
WASTE MANIFEST N. c, D, O, q, 7, 6, o, , .. 1, I, 4. 3~c():'1]~15t0z1 ol l required by Federal law. but is by State law.
3. Generator's Name and Mailing Address
' Channel Master
P. 0. Box 1416, Smithfield,
•· Generoror'sPhonel 919 I 934-9711
5. Transporter 1 Company Name
Willms Truckin<> Co Inc.
7. Transporter 2 CC?mpany Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood. SC 29125
NC 27577 fW;t~:::&ili~1t~:;ttr;s§l~i~~t~
6. U.S. EPA ID Number 'C]~h,,' .. ,.,.. 'K)\,.;::.,;;-, .. ~ 1-·:,, ·: \:~;t.Jif'~.V-'i~
S• C• D• Q, 7• 1, 7• n. g, 21 q 0/T IPOOM::,;. 0.n-:t/7~"7..:,"" ... "'!"l.'".i.
8. U.S. EPA ID Number ri$0i~'.f""' i. lO :\~:::--·~:-'· i·'.,--:!,.<;i\'· ;,:.~;~,~~:;,r .... ~
• ' ' ' ' ' ' ' ' I I I
"t="Nf· •=-"""'··--,-·•~ .. ·s,~--=&-"":;·;;.,_i-..:;·,,.,,;.;.,Y,"~{~ J~i•:cr~-
10. U.S. EPA ID Number
, S, C, D, 0, 7, 0, 3, 7, ~
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, snd ID Number) 12. Containers 13. Total Quantity ttUnil
No. Type 'MIid
,· ,1 D 1T , , ,2 ,0 y
I I I I I I I
C.
' ' ' I O O O
d.
0 I I I I I I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 80105
,a. QENERATOR'S CERTIFICATION: I hereby declare thal lhe con1on1, olthl:1 consignment are furtyand accurately de,crlbed ebova by proper 1hlpplng name and are cJ•-ft.CS.
packed, markod, and 18beted, ar,d are In all respocta in proper condition tor transport by highway according 10 apptlcable lnlornalional and t"laUonal go ... •rnm•nl re,gulaUona aftd
U'lo laws ol tha Stato ol Soulh Carolil"III.
It I am a large quantity genera1or. I certity that I have a program In ploco to r~uce the volume and to1dcl1y olwaategeneratod tothada,gr-I ha..,o da1ermlne-d 10 be ocon,omk:.alty
practicable at"ld lhal I ha..,e aolacled tho practicable molhod ol treatment. storage, or dlspoul curranUy available to mo which mlnlml.us the pros.en! and luture lt\r-1 to human
hearu, and Iha environment OR, ii I am a smo11 quontltyganoralor, I have mado a good faith effort lo minimize my waste genorallon and so1ect tho beat waato mal'lagomenl method
tnat 11 available to mi, 11nd thnt I cnn nllon"l. ·
l+...:.P_,_in-ted-'T_y-ped_N,:;~:,:~~::,:r~l!,;:e:,,:;_s__!:R:,:·_.!H;,:a:!;n;!:s~e~n------l'S-i-gn_•_,u_r•_{.r:./2~"' /~·t.'~ ·::!~/...t./~-~M'_~Zl·~r...::o::::!aa:;;;;;;;;;;;:= ... ----•LM~~~'~.;th4:1"~~J.'ay.!:6~•;~,:'1;;:·8~
T 17. Transponer 1 Ac;,cnowlcdgement of Receipt of Materials i 1-=~-'-ri.:.n ;,:,:r:.;:.'7.:.::r-'-,-'-~-'-•m-'-:--====-'-:s'-"~-'"-:_;c.:C=f,-'-$-ir-r---,I-Sig_n_alu-,e-~--\-').----,\ .... c--,,-~---.... \ ~""'~,!01. ..... _-_-_ -_ -_ -_ -_ -_-_----.M-z,ow_th_. ,-;-~"-1,.--.i;Year-i;.)
, 1 ~~1~a:...:.T=••="='Po::.::.rt=•~r2:..:..:A=ck~n=o~w~led~g•=m~•=n~t~o=IA~•=c=•=ip~to=l~M=•='•=•~i•=l•:__ __ ~-----------'-.:::..J _________________ ....,. ___ -4
I ~-I--P-n-·n-ted_1_r_yp_ed_N_•_m_• _______________ 1s_i_g_n•_lu_,_• ______________________ _.M._on,1,th-''-O••Y_._Y_ear._◄ r I , I , I ,
19. Discrepancy Indication Space
~ f,__ ________ _
~ 20. Facility Owner or Operalor; Cer1ilicallon of receipt of hazardous maleriar, covered by !his manifest except a.!I noted In llem 19.
Ptll'lttdtT,Ped N•m• 'Signature
~A Form 8700-22 (Rev. 9/86) Previous Edllions nre Obsolete (DHEC 1988 (Rev. 10/86)!
Month Day YNI
I , I , I ,
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste M'gt
2600 Bull $tree~ Col!Jmbia. SC 29201
Phone: [phone]'
Emergency & Holidays: {803)734-5-424
IWE PRINT or TYPE (Form deslnned !or use on elile U2-oitchl tvnewriler) Form Ap roved. 0MB No. 2050-0039 Expires 9-30-88
UNIFORM HAZARDOUS 11. Goneralor's U.S. EPA ID No. 120:;<•,::~~~},0 I 2. Page 1 lnlor,malion in Iha shadad_ a,aa, is no! WASTE MANIFEST N,C,D,0,0,7,6,0·'" 7, !, 4,U,O,7,:,,31 of 1 requ11edbyFederallaw,bultSbyS1atelaw.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
,.' Generalor's Phone f 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• D1 Or 71 31 71 Ot 'lt " a
8. U.S. EPA ID Number
' ' I I I I ' ' • ' '
10. U.S. EPA ID Number
, S, C, D, 01 71 01 3, 71 '
·~~~~;;:~t-~t\itfli!i~~-
liffil~0~t\1:~iti?:i;~~ff~1f:'qf£~
Fhf ~-... .. s· ~-:,:,\· ,,.,,,.,•:•<: ·-.·. · ~ j·-·r: .'·'-,:.,1 f•/,~.:V·:-,;.::.'.'<-r
~~~i~~t ?:~~'.-?-~'.:~;-~,;::,~~-':.:.:~:.::~'.,;·:.: ~-: .::-i_\~'-~;·,it;~~~~~~~1~}iti
11. U.S. DOT Description (including Proper Shlppfng Name, Hazard Class, and ID Number} 12. Containers 13. Tolal Quantity ltUnll L' W &ill ,.._t,
;/(+':;>,'.;(fi;i_i~:~1 No. Type 'MN~ .. ' Haz~;dous Waste, Solid, nos ORM-E
N NA 9189 .-,1 D 1T . , ,2 ,0 y i b.
I ' ' ' I I I
R C.
' . ' ' I I I
d.
. ' ' ' I I I
15. Special Handling Instructions and Addilional lnformalion
GSX Work Order No.: 80106
11!1. CENERATOR'S CERTI_FICATION: I hereby declare thal the contant:11 olthb consignment are lullyand accuratelyde:11crlbed above by proper shipping name and arecta.uift..:S.
packed, marked. and labeled, and are in all rospact:11 In propor condition for lran:11port by highway according to app11cablo lntomatlonal and national govarnl'Tlenl r..;ulatlon• •M
U'lfl law:11 ol tho State of South Carolina.
It I am a large Quantrry generator, I cer1ity Iha! I have a program In place to reduce the volume and lodcltyol wa:11tegenerated to the degree I have dolarmlnod to be economblty
practicable and th al I have selected lho praclicab1a method ol lre11tmant. storage, or dlspos.al currenUy available lo ma which minimizes Iha preS<enl and lutura ui,_t to human
health and 11,e environmenl: OR, 1ft am a small Quantirygonarator, r have mado a good lallh effort to minimize my waste generation and ,e1ecl the bell wa11a management n,,etJ'lod
that Is availat,le to ma and that I cen afford.
(L.1-..:..;P;_r_in_,ed_'_T_yp_ed_~:;:•~;C:::~r::;l!:.e=-:s:....!R~. ~H;_::a~n~s::_e~n'--_____ ilS_i_gn_•_tu_r_•_~!a::~1/:l;:l!,.:'iaa/4~::..,_,/c,,_t,//;:!,,r! '·::;:;:!;:::;;;;;;::==::...-----.l.:::i...::Jl.:
T 17. Transporter 1 At.1mowledgemenl of Receipt of Malerials
Month Day Year
1 0, 4, 0. 6, 8, 8
Month Day Year
~\J~~ ~ ... ,,._ .. ~\..i I ·'· \. } ~~ I 0,~/1() ,C, I i,c?
18. Transparter 2 Acknowledgement ol Receipt of Materials '\ IA Printed/Typed Name . • \ .... ! Siarf~ure r-..._ '-
i+--P-ri_n,_ed_,r_y_p_ed_N_•_m_• _______________ _,l_s_;g_n_•_tu_r_•_· _____ '---..J ___________________ ,1,...,...1
f 19. Discrepancy Indication Space
Month Day Year
I , I , I ,
v 20. Faci1iry Owner or Operator; Cer1iricalion or rccolpl ol hazardous materials coverod by this manifest except as noted in llem 19.
Prinltd/Typtd Name . I Signature
IA Fo,rn 1700-22 (Rev. 9186) P~e,;ous Editions nre Obsolele (DHEC 1988 (Rev. 10/86)1
• ,._I .L..Jt....1...L-'-
b~ ,1 ~~~~
pto.
pt,,. C I libs.
d I I'""
Monltl Day Year
I ' I ' I .
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt.
2600 Bull Stree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: (803)73-4-5-42'
E PRll-ll or TYPE (Form desioned for use on elite 112-oitchl tvnewrilerl Form A roved. 0MB No. 2050-0009 Expires 9-30-88
UNIFORM HAZARDOUS 11, Generator'sU.S.EPAIDNo.
WASTE MANIFEST N, c, D, o, o. 7, 6, o, 6, 7,
Manlleal , 12. Page 1 Oocumenl No. I
1·6·0·0•7•5•6 ° 1
lnlormation in the shaded aieas is not
required by Federal law. bu! is by State law.
3. Generator's Name and Mailing Address
Channel Master
. P. 0, Box 1616, Smithfield, NC 27577
•· Generator's Phone I 919 I 936-9711
l~i~i;;:tt:~l=.::/f;tJt!ldi
:~J=;~!:A ?ij#:=~titiJt~~l(~tA{;~t~1tfil;
5. Transporter 1 Company Name
Willms Truckino Co Inc.
7. Transpcrter 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'1Sliie
S• C• D• 0• 7• 3• 7• n, <Jr:>, 'l. D:'.T.
8. U.S. EPA ID Number t\o....;'f ...
' • • • • • ' ' I I '
'Flif ,;: .,., hY: ••• , 'ii' Pho,ne·-;x,~,~-A:~''.; ·.,:,;.;, r,~,.--.... :;,-~:';.";i~".':f
10. U.S. EPA ID Number i1~i:;~~'.~;M~:i.i:,::J ,;.\')i-'.A• ;:·;1/}if:;t;i;i~~~\;
, s, C, D, 0, 7, 0, 3. 7, ' 9, 8 '
11. U.S. DOT Description /including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers 13. Total Quantity ll.Unil
WVVr/. No. Type
,· ,1 D ,T I I ,2 ,0 y
I I I I I I I
C.
I I I I I I '
d.
I I I I I ' •
15. Special Handling Instructions and Addilional Information
GSX Work Order No,: 80107
11. C£MERATOR0S CERTIFICATION: I hereby declare that the contents olthls conalQnmentara fully end eccuretelydescrlbed above by pro~r a hipping narne and are cl..-ifl9d.
packed. marked, and 18be1ed.and are In"" respects In proper condition !or transpOrt by hlghWay according to applicable International and national governmel'\t r90u1at10f'la and
the laws of the State ol South Carolina:
II I am a large ciuan1,ry generalor, I certify thal I havo a program In placo 10 rltducothovolumo end toxlcltyolwesteoenoralltd to the do0r-I have delermlned lo be ecCH\Om'-calty
p,ac1,cao1e arid that I have selocled the p,actlcabto method ol troMmftnt. storaoo. or disposal currently avaUabla to mo which minimize• lhe preaenl end future lhr-1 to h...-n
health and tho environment: OR, 111 am a smo.11 quontitygonoralor, I hova mado a good lo.Ith erfor1 to mini mite my waste oenorallon and selacl the bet! wa,to management~
tna1 ls available 10 mo and thnl I con nllord.
I Printed/Typed Name
Charles R. Hansen I Signature /?/ ~ ~ 2L.._ .• Month Day Year
,o,4,o,6,s,s
T l 7. Transporter 1 Atimowledgemenl ol Receipt of Materials " 1---::--'-'-'-'::-'--'----'-==-==:.:.:.:......=:.c:..._:_ __ _,~-----------"------------,----=--,,,--i
I /5nted1Typed/Name . !Signature /l _ _,,;,. /. _ #.,, 'Month Day Year
'n .r ti , (/4,h) /, 4-YYI J /--/ ~ l<._ ,.,._. .,._,c,,,r 1& LI • l'.l fo I ff'i f
g 1,'::8.:..;T.:,ra::n.::•:::=::::: .. r:,:1:,.:.:A::ck::n.::o::w::l::ed::,9c:•:::m.::e::.n::.t :::ol:,:R.:,e::c::e::!ip::l..:o::.I ::M:::•:::••::.r:::ia::1•:....--~-------~,£.. / _____________ ~-------------~
JT \--•P-rin•t•ed•/•T•y•ped--N•••m•• ________________ j_s_ig_n_,_tu•r•• ____ , ____________________ ..1,M.o.lnl.tt,...I-Dl.ay...1.y • ..,.l..-j ., I , I , I ,
19. Discrepancy Indication Space
ii--,-'----,,----,--~ 20. Facility Owner or Operalor; C0t1.Hlcallon of receipt ol haurdous molor/11I, covered by !his manifest u:copl H noted In Item 19.
I Prmltd/Typtd N1rnt I Slgnalu~e
A Form 8700-22 (Rev. 9/86) Previous Editions arc Obsolete IDHEC 1988 (Rev. 10/86)1
a !......._.....__._.__,l'bs. c lw....L..1..w..Jllbs.
b I jibs. d I Jibs.
MijAl/l PII VM/
I , I I ,
I South, Carolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)73'-5"'24
11..EA.sE PRIITT or TYPE (Form desh:med lor use on elile f12-oitchl .._, ... ewriter)
UNIFORM HAZARDOUS 11. Generalor'sU.S.EPAIDNo.
Form A "roved. 0MB No. 2050-0039 Expires 9.30.aa
Manlfoal
1
12. Page 1 lnlormalion in the shaded a<eas is not Document No. ol . ed b I WASTE MANIFEST N,C,D,O,q,7,5,0,1,.1, I, 4,0, Q, 7, 5, <; 1 requtr yFederal aw,bulisbySt.alelaw.
l Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
•· Gene,alor'sPhonel 919 I 931,-9711
5. Transponer 1 Company Name
Willms Truckinrr Co. Inc.
7. Transponer 2 Company Name
9. Oesignaled Facility Name and Sile Address
GSX Services of SC, Inc.
Route, I Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number cJSti.,;.·-ID',<·;· ., :_:-:·:..-.~.1 ,J,tt.#;~'•!;
, s, c, n, o, 7, J, 7, n. <1i ?i C\ · on· -iPhont ,, .. ,.,An'lt-1i;1i'l"l-"l"l>.,,
8. U.S. EPA ID Number fi?O,;.;:-~-_:f• ... ,.·· .... 8;'1:j:: .;,:~-r;,,,.fr:·¼<~i~\·
I I I I I I I I I I I I F>rnm~-~~a'Phor,e'.s::;'' ·.y·'.:.?"':.=·',.,h~':t'iC;;-::~ .. <;:
10. U.S. EPA 10 Number
, s, c, D, o, 7, o, 3r 7, '.
11. U.S. OOT Oescriplion (including Proper Shipping Name, Hazard Class, and 10 Number} 12. Ccintaine"rs
No. Type
13. Tot.alOuantily U.Untt •l'Wa.llNlr!ibei>t
YNVrJ Y\'.({(i.\~:tt-#¥!¾1
C.
' . I o o I I
d.
' ' I I I • '
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 80108
1e. CiENERATOR"S CERTIFICATION: I horebydeclarethal the conlonls of this con1ignment ere lullyand accurately described above by proper shipping name and are cla.saifted.
packed. marked. and la°beled. and ore In 1111 rospocls in propor condition !or Iran sport by highway according lo appllcable lnlarnaliona1 and nallonal govarnment •~uletlon• •NI
!/'le taws ol the State ol South Carolina.
II I am a large quantity generator. I cor1ity Iha! I hevea program In placo lo reduce the volume and loxlcttyol wostegeneraled to Iha deg•-I have de\ermlned 10 b9 .c:cw,omlcalfy
pract,c,1ble end that I have selec1ed the practlcabte method ol lu1otment. storege. or dlspoa.el currently evaUeble to me which mlnlml:te1 the present and future a-.,-110 ru.unen
haallh and the environmen~ OR, lfl am a amol1 quanlitygonoretor. I hove modo a good laith ""Ort to mlnlml:t" my wa=ate gen"ratlon and =aelocl O'le b,611 walte management melhod
tl'lal 11 ■ v ■ilab!e 10 me and thn1 I con nllord.
II I. ~-P,,r-in-tod-/T_y_p_ed_N.!,aJ:m!.leU:.~~li.:_!:!1!:Q§.~'-------l_si_g_n•-•u_r_e -~/_;!,fl::;'/~--:!:::::: /:.....£.:S./# _ _.,'::1; ~~ /:::::::::::::==-----lMJoa!Jn,_lh~!,;!DJ.a.!:y ~y~..,~ _ Charles R. Hansen l>l'...,a .• ~ ft:.. '?Za-i 0, 41 0, 61 8, 8
~ l 7. Tran1poner l Ac.:1cnowledgement ol Receipl of Materials
I ~jrf yped Name -/) 1
. ;u:• ,,,/u/ l,zM"n~ Mt/Jt?
, , R fa. Transparter 2 Acknowledgement of Receipt U'Matetiats
T Printed/Typed Name
, I Signature
-,
Month Day Year
I I I ' I '
Month Day Year
I , I · , I , I ~ 19. Discrepancy lndicaIion Space ~ a ._! .L.J.....L......,_..,!lt,,. c ._I .L.J.....L......,_..,!lbs.
I bl ,, ... di , ...
~ 20. Faciliry Owner or Operator; CertHicatlon of receipt ol hnzordous motortals covered by this maniloSI oxcopl as nolod In llom 19.
PNf\tfoittrPH Hitt\• I Signature · '
~A Form 8700-22 !Rev. 9/86)_ Previous Edilions nrc Obsotcle [DHEC 1988 (Rev. 10/86)1
Month 0.y Yur
I I I ' I I
I
,t#t"i?~-~;-1 ~ .~ ,. . .W::.Y '.\ ' :~-h
~-
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: {B03)734-5""24
~E PRl~r TYPE {Form deslnned !or use on elile 112-pitchl lvoewriter)
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A roved. 0MB No. 1050-0039 E,oires 9-30-11.1
Manlleat ,I 2. Page 1 Document No. I Information in the shaded a<eas is n01
required by Federal law. bu! is by State law. WASTE MANIFEST N, r., ll, o, q, 7, 6, 0, 4, 7, 1' 4, 0' 0' 7' 5' 6 ° 1
3. Generator's Name and Mailing Address
-Channel Master
P. O. Box 1416, Smithfield,
•· Generato~s Phone I 919 I 9 34-9 711
5. Transporter 1 Company Name
Willms Truckino 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
NC 27577
6. U.S. EPA 10 Number
• S• C• ll• 0• 7• 3• 7• n. g, 21 Q •
8. U.S. EPA ID Number
1 I 1 1 ' ' ' ' I 1 1
10. U.S. EPA ID Number
, S, c, D, 0, 7, 0, 1. 7, ' 9, 8
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
C.
I 1
d.
1 I
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 80109
:~;;~~0'.~-if~1\(;:j:;:~~1t:~/S~?;~f~~~~%~
cv~·-..::.··: ··in =:. ;.;;:.: :.;-· ·, ,~·:, ": :..::; / ,,.t1-,+.;,:;-" i?.:
orr••,,,,, .. , ··a·PhoM'i "-),Qn~/.-,t:..7~-i-1·'1''\",<=
1(, ...... ,.. ....... ... .. ii. o:::. · .:. ='!i~t~t~-:·:..H>~t<
F.\f .. .. . . . II P!>oi\o :,).--'''·" '. .... ,. ,; " ,"'.,·,, ,,.,..,, ",,;,;,;,
1 -1 I I '
' ' ' ' '
;{·j···
·,::t. '·
10. GE:Hl!:AATOR'S CERTIFICATION: I hereby declare that the contonts olthl11 con,lgnmonl are fully and accurately do1crlbod above by proper ahlpplng n•m• and •r• cJ&Nifted.
packed. muked, and 1a·beled,and are In nil rospocla In propor con<Jltion lor 1,anspor1 by highway according to app11cablo lntarnatlonel and natlonel govern man! r.-gulatlon• and
tne l•w1 or the State ol Soulh Garollna. ·
It I am a largo quan,,ty generalor, I cerlify that I have a program In place lo reduce the volume and toJClcltyol wa1tegeneratod to the deg,_ I have determined to be economically
pr•cticatilo and !hat I have ,elected u,e practlcablo method of treatment. storage, or dlspos-al currently available lo me which mlniml:tas the pras.ont and lutvr• tr'lrMI to human
h•alth and Iha environment.: OR. ii I am a &moll quanlitygoneralor, I hove mado a good lailh ottort to mlnlmlte my waste generation and select Iha be11 wa11e management metnod
that Is availat!le to me and the! I can allord.
I +--P-rin_t_ed_/_T-yp_ed_N;:a::,m:,:e:.::_::.;:.::,__:;,,:_,:::::;.::;:.::,_ ______ 1_s_,g_n•_'_u,_e __ :;;;:::.41:::! d~::!:!;:.,tf_.(J. __ _.~ ,,Ii:! /.:!::;::!;::::;:::=.;;;; ___ _JLM!!oJ.n.!thU.:~O,La,!;y~Y:l.earWl4 _ Charles R. Hansen Cc;:.,...,,k-/ ½..,.,.. 1 O, 410,618, 8
~ ~1,;.7.:., ,;.T,;.••::.n::•::.PO::.rt.::e.:.• .:.1.:.A::'.::'n.::o,;.w.:.led:..:.eg.:.em,;;:;en.::t.::o.:.l ,;.Re::.c::•.::ip,;.t:.,ol.:.M,;.•::.'.:.••c:i•c:'s:..__ __ ~---------------------------------i
Printed/Typed Na'.:/2 ISign~klfb\, j), Month Day Year
__.:::/o4_ ,/£, /.,.2__ Y ( )',-o, :::.U.~A ,,.., , 1/·, <7,/41 rJ:-P
o 18. TransDOrter 2 Acknowledgerr(ent of Receipt of Malerials // /f ': i-:,;::...P~ri::n,c:ed:::::/T:.:y::pc.ed:..:.N::a:::m,;.e:.::.;;::ce=::::::..:::.:.::.::::.c:..:::.~:;::=:::..__ __ ~1-S~ig_n_a_tu./,r.t.e------,U'-/-------------------M-o_n_,n_...,.O_a_y_"y-..,-I
I , 1 , I ,
19. Discrepancy lndicalion Space
'~-~ 20. Facility Owner or Operator; Certilicatron ol rocoipl of hnzardous molorlols covered by !his manifesl except as noted In Item 19.
PrltUN/TypN N•m• I Signature
LA Fo,m 8700-12 (Rev. 9/86) Previous Editions arc Obsolete fDHEC 1988 (Rev. 10/86)!
a ,__! .L..J...L.1-1..Jl'bo. c 1..I ,._,__.....-'-'!lbs.
b I pt,,. d I I'""
Month Oat Yu,
I , I , 1 ,
I
~► ... -;. .~ ·_y ,,,
·~-..
SoutlJ Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Street Columbia. SC 29201
Phone: (BOJ) 73-4-5200
Emergency & Holidays: {B03)734-5-(24 lrE PRINT~r TYPE (Fo,m do,lgned lor use on ellle 112-ollchl "'"owrllorl Form A roved. 0MB No. 2050-0039 E.rnlres 9-J0-8.!.
UNIFORM HAZARDOUS 11. Generalor'sU,S,EPAIDNo, 0 ManU•~l-, j2. Page1 Information in lhe shaded.,,., is not
WASTE MANIFEST N,C,!),0,9,7,6,0,4, 7, I, 4,o:o~:i7s.°o/l 01 1 requiredbyfederallaw,butisbyStatelaw.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
, ... Generator'sPhone( 919 I 934-9711
5. Transporter 1 Company Name
Willms TruckinQ 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 C-'1 ID
S, c, D, O, 7, 31 71 Or Q, ?i Cl . DtT .. • ... iPflono\,,;nn11.1i:.~..:.••-~~·,,,_
8. U.S. EPA ID Number
I I I I I I I I I I I I
10. U.S. EPA 10 Number
"FXf''' ... ,, 'S·~·-:::~·;:-.i:>',, <'·-~,;-.,.?,_,,-;-',.',t·j~i~:-'~'.·W'<=<
:i~i1~~:V:t;:Wi~1i1~;;'.ii[lii:f:~i;:::f:;;:'.:::1::i~::~1~::ffji~£J~t{
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number} 12. Container, 13. Total Quantify 14. Unit l'Was11,..,;t,,;i+
No. Type YrWrJ. Y(ti)·:,.\~[f-F.V)t~f~
a--·•" ... •.::'.•~l"•"'"::"'' •••.'~!I• --~•-'• ..• :.'}'."
Hazardous Waste, Solid, nos ORM-E
N NA 9189 , ,1 D ,T , , , 2 ,0 Y
b.
C.
1 I ' I I I I
d.
' ' ' I I t I
15. Special Handling Instructions and Additional lnformalion
· GSX Work Order No.: 80ll0
15. CENEAATOR'S CERTIFICATION: I hereby declare that tho contents olthb conalQnmenl are fully end accuralelydescrlbed above by proper ahlpplng nama and are ci&aaitlec:I.
packed, marlo.ed, and lllbeled, end are in nil rospects In propor condition tor lransport by highway according to app11cable lntarnatlonal and natJonal govornmenl re,guletlon• el'ld
U"le laws ol tha Stale ol South Carolina.
II I a~ a large qu11nl1ty generator, I certify !hat I hava a program In piece to reduce theYOlume and 10,clcltyol waste generated to !he d.,..;iroe I have delermlnod to b41.conom1calty
precticabte and Iha! I have selected Iha practlcablo method ol lreatment. storage, or disposal currentty avallabla to me which mlrilmlr.e1 lha pr a sent and future lhr-1 to 1''11.iman
heatlh and Iha environm~Cnt: OR, 111 am a small ciuanlitygeneraior, I have mado a good 1111th eMort to mlnlmlr.e my wa,te genera lion and :,elect the bell wa1te management moalhod
ttlal Is available to ma and lhal I can alford.
l+_p_,._·n-ted_l_T_y_ped-~~•.!:!;~:a.!r:.!l~ea.;s!...R~-...!:H!_!a~n!!s~e!::n~-----·-LIS_ig_n_•_tu.,..,e...a6~%~!.:·.,L::::::· :::,,,=·~~,:_-,1,/:£..~· ~";:•:::!:::::==:::.------'LM.'.:~:J.n•l!l..:4!J'l..;O:;.DL.•Y~6.L!:';!J.'":'.!s~
~ i-.:'.:.7:.,. :.T'::':::n::spo:::."::•:..' 1:.:.:.Ac::·'::.n::o::.w::led::=.g•::m::•::n::l::.ol::A.::•::';::'::ip.:.t o:..l.:.M::•::t•::•:::i•:::l•:__ __ -r:::-,H/\f-. -----.~',1-7:___,.....,,.,'--------------:-:-::--=---::--i
. :J")tlr~·,t,i,,Fr"'L.t-t?.~ ISigt~J.;, £-d( //; :,.r;/)~G.~
A i.:'.:8.:...:_Tr::•:::::ri1po::::n::er:..:2::A::c::k::.n::o.::w::1ed:zge::m::e::n::.l::.ol::A.::•::'::'::iP:..I Of::_:M::•::te::r:::i•:::l•:__ __ ~.J/_,.,:_-'_' _______ _;.: C-J::_ _________________ _:. ___ ~
T Printed/Typed Name I Signature Month Day Year
' . I , I ,
19. Discrepancy Indication Space
F
fr--------~ 20, Faciliry Owner or Operalor: Cer1ilica!lon of ,acolp1 0f.hnzt1rdou1 MDlorl1l1 coverod by 1h11 m1nife1I except II noled In 11am 19.
PNf'ltfflTt-'""' Nafflf ./; I S!g~~ture-;, . •.
~A Form 8700-22 (Rev. 9/86) Previous Eclilions arc Obsololo fOIIEC 1088 (Rev. 10/86)1
• I I I 11bs. C I ,~
_b I I· I I I'"' d I , ...
....... o., ,..,
I ' I · , I .
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haz.ardous Waste Mgt
2600 Bull S~ee\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
~E PRINT or TYPE (Form desioned for use on elile 112-oitchl rvnewriterl
UNIFORM HAZARDOUS 11.Generalor'sU.S.EPAIDNo.
Form A nroved. 0MB No. 2050-0039 Exoires 9-30-88
Manlreal :I 2. Page 1 Information in the shaded areas is not
WASTE MANIFEST Nr c, n, o, 9, 7, 6, O, , .. 7,
Oocumonl No. or . ed b Fed I I b . I· 4.Q. Q. 7,51 8 l requ1r y era aw. ut1sbyStatel1w.
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
,. Generalor's Phone I 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
NC 27577
6. U.S. EPA ID Number
1 S, C• Dr O, 7r 3• 7r n. Clr 7, ~
8. U.S. EPA ID Number
I I f I I I t I I I I I
10. U.S. EPA ID Number
, S, C, o: 0, 7, 0, 3. 7r '. 9, I'\ '
i\~~1~:'~til:t:1im~~.
~t~~:~~~!f:~f:{J~:>;t\?~~-1~~~0;¥
C!Sbii,"i''··· • ... a IO':./•,:F·,,.: I s;·,; ": >>>:~_.·\}-:i-f~• .. ~-{1;
DfT ·•·· ··· •. i PhoM·:/:c,ono}..7~ 7;,;.'l ':1-':l ':I>.•:
~rci,-:..;.❖_:.;-·•,,,. ,-•• , -a·o ;:~\,;,,. ;. ,-=!=~-~,; =·· =:~-r~,,_{;:-:., .. <-J..;r
F>Tfflnl~11 Phont <-= -.. ··"·, . .-❖ -. ;s-,~1:tw:h·:f~:-~~=<-!),0<
;~I1~~:~,1;tt_';~::~-~'.~-!;\;:::'.:{-;~:--.-.-, ::_~:=,,::::-,:;:.:::~~~-~;}~·~;~·:
:lil!~'.~{~~i:!t!~K:~2/ti'b~·/Z~,-~f!t~li,
11. U.S. DOT Description (including Propor Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity U.Unil
No. Type 'M/V~
. a.
r. rl D ,T r r r2 ,o y
I 1 I I r ' '
r I r I I I I
d.
I I I ' ' ' '
15. Special Handling Instructions and Addilional lnlormalion
CSX Work Order No.: 80111
18. CENERATOR'S CERTI_FICATION: I horeby declare Iha! lhe contents ollhlsconslgnmentare fu11y and accurately dosc:rlbod abOv• by pro~r •hipping narne and •r• c:Ja..,fled..
pack.ad, mark~. and labeled, and are In all rospecta In proper condition lor transport by highway according lo apptlca.ble lnternalional and nauonal g0varnman1 r--.iulallona and
u,e laws ol the State ol Soulh Carolina.
lfl am a large Quantity gene1a1or, I certify Iha! I have a program In placo 10 1ttduce the volume and 10,dcltyofwa1legeneraled lo the d&grH I have determined to be ec:onornlcalty
praeticab!e and Iha! I have a elected the pracUcable malhod ol treatment, storage, or dlspoul currenlly available to me which minimizes the pru11n1 and luiura tnroal to human
health and \he environment; OR, 1rt am a smoll quanlitygonorator, I havo made o good laith effort to minimize my waslo geneuatJon and select l:he t>est wuta management method
that Is available 10 me and that I con afford.
l Printed/Typed Name !Signature /7 / Month Day Year
~,,-:,-----C:::.h~a~ra.;l!;,!e;,,:s:....!:R:..:·~H:::!a!!n~s=-en~_,..,....--L--~A~xti· _. ~::.a.a .~/!a:......:.K.:::· :..,_"-,~:::::·· ~:l::::===-----l'LO~,,i.;4:!J, 'L.:O~, r.,:;6;1, 1.,:;8~r8
~ 17. Transporter 1 Ac.:1<nowledgemenl ol Receipt ol Materials
P~T~.l:7 <-.q;?~.A, /
A 18. Tran.sparter 2 Acknowledgement ol Receipt o~aterials
T Printed/Typed Name I Signature ·
' fl
V
Mon 1./,lh Dav Year I t·.r
I ,_.. U I~
Month Day Year
I • I r I r
19. Discrepancy lndication Space
F a I !'bs q pi.. i L...L..L...1---'--'-' L...L..L-J ........... t bj jlbsd! ,..._
~ 20. Facility Owner or Operator; Certificalion or receipt ol haza;dous malerials covered by this manifest except as noted In llem 19.
Prinled/Typed Name I Signature
L.,. Form 8700,22 (Rev. 9186) Previous Edlllons nro Obsololo (OHEC 1988 (Rev. 10/86)1
Month Day YMI
I , I , I ,
I l~~r\ South Carolina Department of Health
~ and Environmental Control
Bureau ol Solid & Haz.ardous Wa,te Mgt.
2600 Bull Stre-et. Columbia, SC 29201 Phone: [phone]
Emergency & Holidays: (803)7l4-542,
bE PRINT or TYPE rForm desicinecl for use on elite U2-pitch1 typewriter)
f UNIFORM HAZARDOUS 11.Generalor'sU.S.EPAIDNo.
Form A :'!roved. 0MB No. 2050-0039 E.xoires 9-30-88
WASTE MANIFEST N, C, D, 0, q, 7, 6, O, 1 .. 7,
Manifest
1
, 2. Page 1
Oocumanl No. ol ], 4,0,0,7,5,9 l
Information in the shaded a<eas is nol
required by Federal law, bul is by Stale law.
5. Transporter 1 Company Name 6. U.S. EPA 10 Number ·ct State"·. '•,v ·,, ·;:·pj=:=. · \ ::-.-·." '.:.:·,:..;x,;➔-~''!'?;
1--'W"'i""l"'l""m""'-s_;.T.,_r_,,u"'c"'k"'i-'-n,..,Q._,C,,o'-'• .,.___I"-'n"'c"'-'-. -------''w"<J''ccC"'"'-D"-"'-:-"'OL.!.,7L,..!L 1,J.7-'-',0,"-'q,,w2,,.__qa· --'l-1-:~';;i'JJzt•...,~ ',, :. an, 17~ 7_;_ 11·'·''" •
7. Transporter 2 Company Name 8. U.S. EPA ID Number • UJ:. «\-:,:,. i, ::,1,<':·, .:. =·:,~~ ... r~::'-J'-'.;-..::,,:f~
I I I I I I I I I I I f F>Tnir'l~sPtwi.=_;.",i-·····..:·•:"',-.,,,,1~"1 ◄;->'i•""'(
10. U.S. EPA ID Number 9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125 , s, c, D, o, 7, o, 3, 7, '. 9, !\ '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1( Unit -1-=wast:11·ftM'IN'\,j,
No. Type· 'M/Vd. ;~:~f>:SL>¾·f}f¥~t~
j a.~Haz;rd~~~~-i~f!~:~:~t;iIJ·::~: ~~·:· ~a~~~~·;\~~ll~:~·.-~-_'~•~r -~ ( -_,\ _-.. .' '• ... ·· __ i •• ~ ;-:~I F-~;-'dli"fifr~
N NA 9189' , ,1 D ,T , , ,2 ,o Y ;1,E,D1Q161"!:
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~ ,_,; I I I I I~~
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d.
' ' I I I O 0
15. Special Handling Instructions and Additional lnlormation
·csx Work Order No. : 80112
,e. 01:NtAATOA'S CERTI_FICATION: I hereby declare thalthe contents olthl■ conalgnmenl are lu1lyand accuratelyde■crlbod abova by proper ■hipping name ■nd a,e cl...,ntld,
P•cked, m.,ked, •nd labeled, end are in all raspacla In proper condition lor transport byhlghwey according lo apptlc..ble lnlern•llon•I •nd n•Uon•I go ... ernm•nl regul•tlona ar>d
troe law■ 01 lhe SI.ale ol Soulh c.:;11,olln•.
If I am 11111,ga qu■nuty generator, I certify thal I have a program In place to roduce the..,olume and to,o:lcltyol waste generated lo the deg,_ I h■..,o de1armlnod lo b9 .COl"Offl~lty
Pr■c11cab10 1nd that I ha ... e setec,ed the practicable method ol lrontmont. storage, or dlspoaal currently available to me which minimizes the pres,ant and lurura tn,_, IO l'luman
l'le■tth and the en..,i,onmcnt; QR, II I am a r;moll quanlitygonoralor, t have mado a good lallh allort to mlnlml1e my waslo ganeraUon and select the be11 wute management ,,,.tnod
tt'lal Is a ... ailable 10 me and lhnt I can atlord.
11 Printed/Typed Name !Signature ,. / , / Month Day Yw
-l-----....:C::.h:::a:.:r;.::l;,:e::.s:...:.R:.:-_;_H:::a:.::n:.::s:.::e:.::n:_ ____ i._ __ -"/2"'~::!-:7.ala"...,;!;;,,.,/4.,.~::!:::c.--'Y~-Ct.A:f"~,,,.__tL~•!;•:;:•::::•:=:::::_ ___ .u, •Ow_· '.!!4u•~0w_,_.6u, •.s;8:.,.•.s;84
T 17. Transporier l AtKnowledgemenl ol_Receipt ol Materials
R f-'-c----'-:,-'-----'--'--'-''--'---""'-'"-'-'-'--...:..._;_ __ _,-::,--,-------r--------:::----------,-,--,-----::,--:-:--f
I ' Prinled/Tyrl!.'' 11 , , e <;'M H//_f ISignalure ;(,/ ll#/~,, -a,. ,, ,, .7>~':z.;:r;;
, , ~ ~,:a:. ~T=••=n=•=Po=r1=e~r ~2:A~ck~n~o=w~le~d=g=•m==•n=l=o=I ~Re=c=6Ji~•P:I :o~f M=•~l=er=i•=l•==~=~==:=======~=~===~~=:~~~=====:.__,..:~~======================~=~=!~===~~==~~-1
JT_..,._P_"_"_led_/T_y_p_ed_N_•m_, ______________ j_s_ig_n_•_'"_'•_· _______________________ M_o_.n_lh __ □_.•_Y_.__Y,.ear-1
I I I ' .. '
19. Discrepancy Indication Space
-~---------~ 20. Facility Owner or Operator; Certificallon of receipl ol h:izardous malerlals covered by lhis manilesl except as noted In Item 19.
I
, Prinltd/Typt-d N1mt I Slgnalure
PA Form 8700-22 (Rev. 9/86) Previous Edilions arc Obsoloto jOHEC 1988 (Rev. 10/86)1
MOtlth Day YNI
I I I ' I '
I
I
I South cJttlina Department of Health
and i:,,vironmental Control ·
Bureau of Solid & Hazardous Wa,te Mgt
2600 Bull Stree\ Columbia, SC 2'3201
Phone: (8-0.3) 734•5200
Emergency & Holidays: (803)734•5424
~E PR!;:, TYPE (Form deslnned lor use on elile 112•Dilch1 "'"ewriler)
UNIFORM HAZARDOUS ,1. Generalor'sU.S.EPAIDNo.
Form A roved. 0MB No. 2050·0039 E,pires 9.30.sa
ManUoat
1
, 2. Page 1 Information in the shaded areas is not
required by Federal law, but is by Stale law. WASTE MANIFEST N-r. n-O· q, 7, r.. o, 1 .. 7, 8o<;_u"l!'nt N'l\ ol 1,1 •• ,u.t,6,u 1
3. Generator's Name and Mailing Address
Channel Master
P, 0. Box 1416, Smithfield, NC 27577
4. Genera!o~, Phone I 919 l 9 34 9 711
5. Transponer 1 Company Name
Willms TruckinP 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 ID Number
• S, C• D• O• 7• 3• 7• 0. Clo 7' q
8. U.S. EPA 10 Number
o O O I o O O I O I O I
10. U.S. EPA ID Number
, s, c, D, o, 7, 0, 3t 7, '.
'cJ:s:ta·te'·t····· ·110<=;;:..,., · i· "(,-.' ·: ·"':·1:J::#'i-,.P.~'!.·'·1,.;;
0/T •. i Phont ',,'. ·A0° /.7 ~ 7.:,-, 't't -,•.,.,, •"°''"''(''"' .• ·10::c:, ;,.. ,·,,;,ii-,, . .-!..;,,
F>Tl'&ir;;.:..::..: ... ..,-11 ~ :~;.:·.,;, ····.·;-,~:!• ;--.·.-:>·1~~/4:-'.:'.,'~"".
,;:,:~_llliiFaci1ii{,10 •· · · ·• ·· ... · e:','.'.-'/tiL•
·:·,, .. ·,· :·.:_: _: ,; , .. :-. ·,; "''·':"''"=".•
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
No. Type
13. Total Ouantily 14. Uni! :X:W.asta~t?
'MN~ ~~e(.~~\Y-:t;~;Jt;f½
. L.... ··---Hazardous Waste, Solid, nos ORM-E
N NA 9189 I I ,2 ,0 y
" b.
I I ' ' ' ' '
d.
I I I I I ' '
15. Special Handling Instructions and Additional lnlormalion
GSX Work Order No.: 80113
115. CENERATOR'S CERTIFICATION: I horeby declare th11.I lho contents olthls consignment 11.re fully and accurately described above by proper 1hlpplng name and at• clasailled.
paclo.ed. mark&d. and le.beled. and are in nil rospocls In propor condillon lor transport byhlghw11y according to appllc.ab1e International and national government r99ulattons and
l/"le laws ol the State ol South Carolina.
111 am a large Quantity generator, I cor1ify Iha! I have a program In placo to reduce the volume and t0Jtlcltyofwa1tegenerated to the d11t9ree 1 have dotormlned to tMt econom.cally
practicable and tnal I have selected Iha practlcablo molhod ol 1roalment, 1torage, or dl:,po!MII curronlly available to me which mlnlmlzot tho preunt and luture in,oat 10 human
health and the environment: OR, ii I am a smo11 quanlltygonoralor. t hove mado a good faith effort lo minimize mywa:,te generallon and select the beat w11ta manaoemenl "'9tnod
trial is available to ma and 1hat I con ollord .
.
: ·-+--P-•i_n,_eo_r_r_y_ped-N~•~m~e~;:.;~~.:....!!:;!!;~.!!..------l-s_,
9
_n_•'_u_,e __ ~~ A~/::::::.:::. /....!~-..t.::s.aiaaaaa::::a;;;:!.:::=:::..----.J.M~oln~ttt:..L~Dia~y:i;~Year.r.::~ ~ Charles R. Hansen ~ £' U,,___,, 10,4,0,618,8
~ 17. Transporter 1 At;Knowledgemenl ol Receipt ol Materials
· , ~;nteo/Typeo Name /: I' / 1s;gr)81vie
-1/./1 ,A,,. a/, 77,4;1{)f",1-1-/etct -1/,,
, , 18. Transporter 2 Acknowledgement of Rec'eipl ol Materials R . I i Printed/Typed Name I Signature•
I 19. Discrepancy Indication Space
/ J/
F
~ ' l;-1----=--,c------,-----,--~ 20. Facility Owner or Operator; Certi!icalion of receipt ol hazardous malerials-covered by this manifest except as noted in Item 19.
Printed/Typed Name · I Signalure
i LA Form 8700,22 (Ao,. 9/86) Previous Editions arc Obsolclo (DHEC 1988 (Rev. 10186)1
Monltl Day Year
I , I , 1 •
• L,I ~_._L.J.._,pbs ' c,J ~__.__L.J.._,!lbl.
b I Jibs. d I , ...
Month O.y Year
I , I , I ,
I
I <'";i';?~~-~ """""-"\., ' -~ l ·..-. '1 -·· \~ ~
. )
South Garolina Department of Health
and Environmental Control
Bureau or Solid & Hazardous Waste Mgt.
2600 Bull Stree~ Columbia, SC 29201 .
Phone: (8-0.'.lf 734-5200
Emergency & Holidays: (80JJ73-4-S.C24 lr,e PRUIT-;;, TYPE (Form do,lqnod for use on elile 112-oitchl tvnewrilcrl
UNIFORM HAZARDOUS 11. Generator"sU.S.EPAIDNo.
Form A orovod. 0MB No. 2050-0039 E.,pires 9.30.1511
Manlleal 12. Page 1 lnlormation in the shaded areas is not
required by Federal law, but is by State law. WASTE MANIFEST N, c, n, O, o. 7, 6· o, '· 7, J, Document No. of 4·0·0•7,6,1 1
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generat~r·, Phone ( 919 \ 934-9711
5. Transi:,orter 1 Company Name
1/illms Truckin•• Co
7. Transporter 2 Company Name
Inc.
9. Designale<I Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood, SC 29125
6. U.S. EPA 10 Number
,s, c, I), o, 7, J, 7, n, 9i 2J 'l
8. U.S. EPA ID Number
I I I I I I I. 1 1 I I I
10. U.S. EPA 1D Number
, S, C, D, 0, 7, 0, 3. 7, '
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, snd ID Number)
o.::'=' .~_I-,i~• J· •. ., ~ r,•' .• , '"•-
I ,1
I I
I <
d.·
I I
15. Special Handling Instructions and Additional lnrormalion
GSX Work Order No.: 80114
. "\)"Qt";t,i,''f"''··· ii 10:~-,.i<v,;_,;:;<::;,,"::~t~~ ...... c....;..,:f(
F/=Tn!r\;~~e Pf'IOOe ::;(.:--,;, .... , .•,,;·~<!'~·/,:,.,-i~<1;(~'f.,..,;~:
D ,T ' I ,2 ,0 y
I I I I I
. I ' I I '
' ' ' ' '
1e. GENERATOR'S CERTIFICATION: I horobydocla,o that the conlonts of this consignment a,o fully end accurately ducrlbed above by proper ahlpplng name and o,o clualflec:l.
packed. ma1ked. and tabt1led. and are In 1111 rospocts In proper condition lo, 1,anspor1 byhlghway according to appllcable lntarnatlonat and national govornman1 ra,,gulaaon, •t'ld
tho lows of Iha St.ale of South Cn,otlna.
111 am a largo quanhty generator. I co11ify that I have a program In placo to reduce tho volume and toxlcltyol waste generated 10 Iha degree I have determined to be .eonomlcalty j • practicable and tt'lal I have ,oracled tt'lo practicoblo method ot lreotment. ,10,age, or dispose! currently avallablo lo mo which minlml101 Iha present and lutu,o tn,_1 to r,u,nan
I,. health and the environment OR, II ram n smnll quanlitygenoralor. I hevo medo a good laith ettor1 lo minimize my wasla generation and select tho boil w111te management method
,\ · trial is available to me and \hal I con afford.
\Printed/Typed Name I Signature /,J ./ ,,, ., / Month Day Year
Charles R. Hansen /'/, // / J'/4_ 1 0, 41 0, 6• 8, 8
T 17. ,:r~nsporter l AtKnowledgement ol Receipl ol Malerials / J I ir'-::P'f,i~\:"c·ed-:::IT~"'-:-,"-n'= _1/4"-'.,,:",,""'.,.e-=~=,Q:.:c.c:../1c:;;,f=(c..._n-...-,,I S::--ign-;atu-,o---i~,,......,,-,y,,.,...,n---f--t~'--~-A7'/ ~---;~-;--lo~:-:::~-;J-;:-?'J,-y-; ,t:::-~-t
' o 1 a. TranS~rfer ·2 Acknowledgement of~eceipt of Materials / Rf-:c...C..:==============----.-----------_.l.'--------------,----l ·T • Printed(Typed Name !Signature Month Day Year I; I' I, I'
· ,~· ·, 9. Diserepant:iy lndicalion Space ~' i: : . ' P. l .. _ ..... ,,
~-\
,~• 20:· Facility Owner o;.Operator; Ce:r1ilic11tlon at r11• .. •I~1 af h1mirdn111 mnlnrl11l1 coverod bv lhi, manifest excen! as .noted In llom 19.
' ~· ,ti~ltn'IIH)fha~ ~n,o · 1 Signature . \ I
l:>A~f.~·rm 6700-22 {Rev. ~/86) Previous Editions arc Obsololo [OHEC 1988 (Rev. 10/86)1
. ' '
a ._J _._. ...... ,._.__,l'bs. c 1 ....... ...., ....... _,_,Jlbs.
bJ pi,,. di I I'"'-
a
I ,~ . So,l;lth Carolina Depahment of Health
. .,._ __ , and Environmental· Control
Bureau ol Solid & Hazardous Wiute Mgt
2600 Bull Strool Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
.PLEASE PRINT or TYPE (Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generator·,
Form A
2. Page 1
of
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a,eas is nol
required by Federal law, but is by State law.
I
I
I
I
I
I
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I
I
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator"s Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA 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)
d ..
~S. Special Handling Instructions and Additional Information
GSX Work Order No.: 72792
:it~~~~:t~5t{;~lf~ifi
;~#~~~1;~;lflf ~~:l~+1:t~~ft:J}tt,zti1
16. -GENERA TOA 'S CEATIFIC/4. TION: I heroby declare lh11I the contenls ol thl, consignment are fully ond accurately described above by prop.er shipping n11m11 lll'ld ar• claa,a,11..:1,
packed. marked, and labeled. ond nro in nil rospoct, in proper condition !or lronspor1 by highway according to applicable International and natJonaJ government regulations and
Ule laws ol lhe Stille ol South Carolina,
111 am a large quantity generator, I certify that 1 have a program ln place to reduce the volume and toxicity or wutegenerated to the d&gr&fl I have determined to be economically
practicable and that I have selected the practicable melhod of treatment. s\orege, or disposal currently available to me which mlnlmlze1 the prnent end lut\H0 throal to human
health and the environment; OR, ir lam a small quantity generator, I have made a good lalth etlortto mtnimlze mywa,ta generation and select the beet wait• management m,ethOd
thal 11 available lo me and lhat I can etlord.
I h-+.;.__,,Pr-int_ed_:t::rf~ft.,::_::R:_:l:_:E:S:_.:_:R:_:·_:_H:,:_A:_:N.:_:S:_:2.:._N:..:__Ls_ign_•t-ure....J:.~!!:::::::::::,.....:«'~ ... ¼d,.~:::;;::•;:::::;=----~~~on~th~Dai.!~:1.!:'.~w~7
I
~ 17. Transporter 1 Ae;1<nowle<lgement ol Receipt of Materials
A Pnn~Name r ~ a C7 h i1 c°:) e ,,,, e /✓2-/? p
Sign8lur
o 18. Transporter 2 Acknowledgement of Receipt ol M3terials-· Rf----'----'----"------'--------~----------'-<.----------------------1 I 1-i-+--P-rin_t_ed_/_T_y_ped ___ N_•_m_e_-______________ .._S•-·9-na_i_ur_• ______________________ _.M_o_n._th_._D_,a._y_.__Y_.w--4
19. Discrepancy lndicati~n Space
F
If ,,_ _____________ _ a JL..L.J..J..-'--'-'llbs. c ._l _._._ ...... _.__.l'bs.
b I jibs. d I jibs.
T 20. Facility Owner or Operator; Cer1ilicafion of receipt of hazardous ma!erials covered by this manifest except as noted in Item 19.
l y~~=--c==~="-"===~--~ Printed/Typed Name Signature Month Day Yw
, EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
I
. :./
South Carolina Department of Health
and Environmental·Control
LEASE PRINT or TYPE (Form desi ned lor use on elite 12-itch ewrlter
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. :~ Manifeet
, Document No.
3. Generator's Name and Mailing Address
Channel Master
N C D 0
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
7 6 0 1 4 ·_o o 3 1 1
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
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays.: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Jnlormation 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 JD Number) 12. Containers 13, Total Quantity 14. Uni!
No. Type W\No
a. Hazardous Waste, Solid, nos ORM-E
NA 9189 I D T 2 0 Y
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72793
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are lully and accurately described above by proper 1hlpping nam• and er• cla.»ifled,
packed, marked. and la.baled, and are in all respects in proper condition tor transport by highway according to applicable lnlarnaUonal and nation al government r-.gu1atlona and
the laws ot the S1a1e ol South Carolina. ·
If I am a large Quantity generator, l certify that I have a program In place to reduce the volume and toxlcltyol wastagenerated to the degree I have determined to be economlcally
practicable and thal I have selected the practicable method of treatment storage, or dlspoa.al curranUy available to me which minimizes tho present and lutur• thrMI to human
healtl'I and the environment OR, ll I am a small quantity generator.I have made a good laith effort to minimize my waste generation and select the beat wute managem•nt me1hod
that is available to me and thet I Can atford.
Printed1Te1-fJm L ES R . HANS :: :J ,, Signature
-·j, Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification ol receipt ol hazardous malerials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
Month Day Year
~?~?!?.?
Month Day Year
a !....._....._.....___,Pbs. c ._I ..__._....._......,Pbs.
b I pbs. d I jibs.
Month Day Year
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: [phone] I PLEASE PRINT or TYPE (Form desi ned for use on elite 12-writer
UNIFORM HAZARDOUS 1. Generetor'sU.S.EPAtDNo.
Form A
2. Page 1 ol
roved. 0MB No. 2050-0039 Ex ires 9-30-8.!1
Information in the shaded a<eas is not
required by Federal law, bu! is by State law.
I
I
I
I
I
I
I
I
I
I
I
I
F
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield,
4. Generator·, Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7 0 9
8. U.S. EPA 10 Number
10. U.S. EPA ID Number
SCD07037
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.: 72794
16. GENERATOR'S CERTIFICATION: I horoby doclaro that tho contents 01 this cons!gnmont are lully and accurately described above by proP4tr a hipping nam• and are clas.aifled.
packed, marked. and labeled, and aro in 1111 rospocls in proper condition !or hansport by highway according lo apptlcable lnlernalionat and nallonal government r~ulation, and
the laws ol the State ol South Carolina.
111 am a !arge quantity generator, I cortity I hat t have a program In ptaco to reduce the volume and loxlcltyol waste generated to !he dttgree I have determined to be econonilcaJty
practicable and lhat I have selected lhe practicable method of treatment. storage, or dlsposal currently available to me which minimizes the preaent and lutura threat to human
health and the environment; OR, If I am a small quanlitygeneratoi. I have made a good faith effort to minimize my waste generation and select the bell waate management melt\od
that is available to me and that I can afford.
Printed/TC1-f~ L ES R. HANS'::I\J· Signature ~ f ·/d.,. ~
Signature
Signature
19. Discrepancy Indication Space
Month Day
Cl 7-<
Day
Year
?. ;>
I~ • i......._.._._.._._~Pbs. c lw...L...L..._,__,pbs.
bl jibs d I jibs ,,_ ______________ _
::; f-20_. :;-F
7
ac.,.il_ity'c=O_w_n.cer.,.o_r ... Oc.cp ... e ... ra_to'--r. ... C'--e'--rt-il_ic_at_io_n_o;_l.;.re:..;c..;e ... ip.;.t o;..l_h.;.a __ za_r_do ... u_s_m_a,,te:::r.:ia.:1• ... c..;o.;.v•c..r.:.ed:..b'-'y'-t'-h--'is_m ... a_n __ ife.cs;.t.:.•' ... ~:.:•.:.Pt ... •:.:• ... n ... o ... ted..:....in.;.;.tt•:..m...;.19;_·---------,-,-----,,.--i
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EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete {DHEC 1988 (Rev. 10/86)]
I " South Carolina Department of Health
and Environmentat·control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734•5424
LEASE PRINT or.TYPE (Form desi ned for use on elite 12· itch Form A roved. 0MB No. 2050-0039 Expires 9-30-88
F
A
C
I L
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Oesc_ription (including Proper Shipping Name, Hazard Class, and ID Number)
a.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
jl~:~ ~l'i:-~/:tli!~ ::~i:i!]!!illl1\!l~I i l:i:i:illli;im;i \;j;i~!:\li~fi:i:f !ii.!i!ll!!li!liI!l!•:'L., .. :,
a. lE..Jl:lj-10 I 2 I 7 I 7 , 4 1-11 I 1 I O I 21 q;,?WX! C. Lu-I 1-1......,___,_.,__,
b.LLJ-1 1-1 1J!;:/:::,i:tdw~J I !-!
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72795
2. Page 1
of
1 D T
Information in the shaded areas is not
required by Federal law, but is by State Jaw.
2 0 Y
16. GENERATOR'S CERTIFICATION: I horobydoclare that tho contents ot thisconslonmentare fully and accurately described above by proper shipping name and are cl--.ified.
packed, marked, and lo.boled, and are in an respects'. in proper condition lor transport by highway according to applicable International and national government r..gulatlons &l"ld
tho tows ol tho State ol South Carolina.
111 am a large quantity gonerotor, I cortity that\ have a program In place to reduce the volume and toxicltyol wastageneratod tothad&gr-I have determined to be oconomlcalty
practicable and that I have selecled lhe practicable method ol trealment. storage, or disposal curranlly available to mo which minlml:r:e1 tho preMnl and future tnr-1 to human
health and tho environment: OR, ii I am o small Quantity generator, I have mado a good loith eMort to minimize my was to generation and selecl the boat waate management method
Iha! is available 10 me and that I can afford.
Signature
17. Transporter 1 Ac.:,.mowledgement of Receipt of Materials
Signature
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
Year
J';
Month Day Year
3'i o7
Month Day Year
a 1...I J...J....1....1...J..JPbs. c 1~~...._.~I~
b I !tbs. d I !Jbs. ,,_ _____________ _
~ 20. Facility Owner or Operator; Certification ol receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/861]
I
I
I
I
I
I
I
South Carolina Depaitment of Health
and EnvironmentalControl
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. , ·~ Manlfe11t
•Document No.
WASTE MANIFEST N c D o
3. Generator's Name and Mailing Ad~ress
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 Sito Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood, SC 29125
0 3 1 4
6. U.S. EPA ID Number
S C ll O 7 3 7
8. U.S. EPA ID Number
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)
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 72796
Form A
2. Page 1
ol
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is riot
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I horuby docloro lhnl lho contont, ol lhi, con,lgnmont are fully ond accurotety described above by proper shipping n11m11 and are clauifl..:i,
packed, marked, and la be lad. and ore in n11 ro,pocts in propor condition lor 1ronspor1 by highway according to applicable International and natlonal government re,gulatlona and
the laws ol the Slate ol South Carolina. ·
111 am a large quantity genoretor, I certify that! have a program In place lo reduce the volume and toxfcltyol wastogenaralod totha degree l have dolarmlnod to be economically
procticabla and that I have selected the practicable method of treatment, slorage, or disposal currently available to me which mlnlmlua tho present and lutura threat to huma.n
health and the environment;OR, lfl am a small quantity generator, I have made a good lelth effort to mtnlmlze mywasle generaUon and select the betl wute management rnethOd
thal is available to me and that I can afford.
Prinl"tmWC.ES R. HANSEN Signature u~ /? Month Year
[??
T 17. Transpo r ·I( wl m of Receipt ol Materials
I N
R: f-~--'-':::"-'-:-:--:-"-'=.....:..:.c::......c:=:.:..c........:_;_:::_ __ -,-.,,,-.,---,r-----,,-+,-,------------------
printed/
p k...J:..1!.fe-~e,e:.~'11l!.~/~""~----J_j~E5~Jc.~~---------1.i~~R.!
Year
R,7
o ~ Transporter· 2 Ackno·w-ledgemerit of Receipt ol Materials Rf--::-c-'-':::-'---:-:--'-'-"-.....:..:.c::._;=:.:..c.-_;_:::.. __ -,-.,,,---,---------------------------,-
l1-i-+--P-ri-nt_ed_/_T_y_ped_N_a_m_• ______________ ..J._S_ig-na_t_ur_• ______________________ ,_1_r....l...J....L-
Month Day Year
19. Discrepancy Indication Space
F It 11-,---::---,-:----------
•LI ...... ...I... ......
bLI~ ...... ~
jibs. C I
jibs. d I
Month
T 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted In Item 19.
l y~~====-=;:;==~==::..:;;_--Printe<I/Type<I Name Signature
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
I jibs.
jibs.
Day Year
I
I
I
I
I
I
South Carolina Department of Health
and EnvironmentalControl
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: (BOO) 734-5200
Emergency & Holidays: (803)734•5424
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. ,.> Manifest
.•· Document No. 2. Page 1 lnlormatiori in the shaded areas is not
· WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
1400315
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D 0 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a
of required by Federal law, but is by State law.
jfl*' ';'o','f1·g"t~ Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T 2 0 Y :=~11E 1010 I 61~:K
C.
d.
1:;tr-'.:,~~-~;.:~;~{~~:11;!:;:;.;~h;;::lt4:~~;'J!~!!.!l1,-~:li~:1,::~~!!"l;'!~:!:t:t1:1::1~
a1£.BJ-10,2,7,714l-lli11012l!MT)1%/Jitc.LLJ-1 J J J J 1-1 J J J I;@
b.LLJ-1 J J J J 1-1 J J J 1lt~i!ii;UJ!t{~LLJ-J,1,,J--L,, ,,[!~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72797
, 6. GENERATOR'S CERTIFICATION: I hereby declare Iha! !he contents ol this consignment are fully and accurately described above by proper shipping name and are ciasailled,
packed. marked, and laheted,and are in ell re!lpects in proper condition for transport by highway according to applicable International and national govemment r~ulatlona and
the taws ol the State ol South Carolina.
11 lam a large quantity generator, I certify that I have a program in place to reduce Iha volume and toxicity of waste generated to the degro. I have determined to be economically
practicable and that I have selected the practicable method ol treatment. storage, or disposal currently available lo me which minimizes the present and lutura tnraal to tluman
neallh and the environment; OR, II I am a small quantity generator, I have made a good raith attort to minimize my wasta generation and select the b<o1t wa11a management melhod
thal is available to ma and thal 1 can afford.
lµ.._P,_lnted-/-TyCJ-!l:....:.:.~..:_R.:_::L:_:E:.,:S~R_. _H..:,_A_N..:,_S..:_E _N·__JLSlg-nat-ure....!..:~~;!:::::!~;f',:;_.£_/z:,.~~::• ===---....l.;;lL.l:~
T 17. Transparter 1 Ac,;Knowledgement of Receipt ol Materials
Month Day Year
09::l.?-~?
I N
::'.s 1--:-c--':--::--------"-----c::~---------r:::--,--------------------------,.,.---,,--
P f:-:--;p:;-inl..ted~H,!_y~~~--dNabamJ.•~•,£~:i::·=a-,a::···,-;,?·.'.:M~-lf-:~~~/'..,S=;;-'.a.--"'---_JLS_ig_n•_'"_'"_...J..&~~~::..'.:~=--.!~~:t:!~~~::_ _ _J[QiiLJ~~
Month
l:>9
o 18. Transporter 2 Acknowledgement ol Receipt of Materials
R -'-__ ..;__....:._....:.....c._;=-'-----'-'--'---'--'---~------------------------------l 1-i-4 __ P_n _n t_ed_/_T_y_p ed_N_a_m_• ______________ ...1,_S _I g-n a_t_u r_•----------------------.-i-l-"-,.,L.
Month Day
19. Discrepancy Indication Space .~ L
I 1---------------
aj....,_.L..L..L..J.
blw....L..L..L..J.
jibs. C I
pbo. d I
T 20. Facility Owner or Operator; Certilicalion of receipt of hazardous materials covered by this manifest except as noted in Item 19.
l v~====~===~--Printed/Typed Name Signature Month
EPA form 8700·22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
Day
Year
Year
jibs.
pbo.
Year
I
' oe=-, ~r/1···· ~ .,. .r.~ !~:{,~ • South Carolina Depa'rtment of Health
and Environmental· Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull S~ee\ Columbia. SC 29201
Phone: [phone] ~ IP~E PRIHT or TYPE (Form desiQned for use on elite. r12-i:ilchl tvnewriler)
UNIFORM HAZARDOUS 11. Generator'sU.S.EPAIDNo.
Form A
• ··• Manifest J2. Page 1
Emergency & Holidays: [phone]
nroved. 0MB No. 2050-0039 E.xoires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by Stale law.
I
I
I
I
WASTE MANIFEST N, C, D, 0, q, 7, 6, o, , .. 7, , , Q.ocJlm~nt f'lo. ol
1 1, 41.U, U, J, 11 6
3. Generator's Name and Mailing Address
Channel Master
P,· 0. Box 1416, Smithfield,
4. Gene,ator'sPhone( 919 I 934-9711
5. Transporter 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, 1 Box 255
Pinewood, SC 29125
NC 27577
6. U.S. EPA ID Number
• S • C• D1 O, 7, 31 71 Ot o. ?. "
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and 1D Number}
ciStaieY··••--··•··.,, 101/:<-, ·••····>··,·•••••A<··•••·•+ orr · ,. ... · · af'tioiit'FFA""''-;~ ,2~.i:"'"'";;
I~-a Hazardous Waste, Solid, nos ORM-E :tf\F(tfifflf',1
I A
i~b-.~N~A~9~1~8~9 _________________________ ~J.•·_J.114D::_i,T=--i-1•_1•_J·•.:2~,L:O+~Y:._f;4i;.::',~::.::'~~-='.::?::':::~_::!'.!~j;;t•·
12. Containers 13. Total Quantity 14. Unit ·<l\Wala~\+·
No. Type WIN~ gy!{d\\{f<r~gft~ff
~ 1--------------------------------~L 'J'~f-L'~L 'J'-.J'LL'-1---+!:;_; ;: :::::~:;:,;:~::;;j;i I A c. ) ' . ' ... · 'fil)
~-------,----------------------l-L'L1.j_J1_.j._11_11_JI_J'L~-µl2
11
~'-:::=•=··=··=--·=••i·
12,~;
I
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~u, ,:/
d.
' ' I I I I l
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72798
16. GENERATOR'S CERTIFICATION: I hereby declare that lhe con1ents of this consignment are fully and accurately described above by proper shipping neme end are classified,
packed, marked, and la.beled,and are in all rospects in proper condition for lranspor1 by highway accordlng_lo applicable inlernalional and natlonal govemmenl regulatlona and
the 1aws ol tha Stale ol Soutt'I t:arolina. ·
If I am a large quantity generator, I certify that I have a program ill place to reduce the volume and lox I city ofwaslageneratod to the degree I have datarmlned to be oconomlcatty
practicable and th al I have selected the practicable method of treatment. slorage. or dlspoaal currently avaltable to me which mlnlm!zes Iha present and luture llUNI to human
health and the environment OR. II I am a small quanlitygenerator, I have made a good faith effort to minimize my waste generation and select the bell wa,te management method
that Is available to me and that 1 can afford.
·~__:______:___::__:.:...__:_:.:..:.:.:.:.~l__~~~..L:I:t!.===------1.;~~
Prinled/Q't'f/(ftl ES R. HANSEN I Signature // .L.,,..,,C ,.(7 ./../ Month Day Year
. 1 /2 71-<'' S'i li'; ?
II / T 17. Transporter 1 A<.:xnowledgement of Receipt of Mate~ia1s /1 I ,
Printed/Typed Name ft/4~~);.. j._ !Sig~/ tf~ /. / Month Day Year
.L ~ ----./. , 1P,"f,v,'l 1:;','? .~ p
18. TranspoMr 2 Acknowledgement of Receipt of Materials , / 0 Ri-:-::-'-"==:::..:===========::.:...--~----+------------------------1 I I-R~-,--P-n-·n-1ed_'_T_y_ped--N-•m_• ________________ ls_i_g_n•_•_u_r• ___ , _____________________ ..1,M_o"'n"th-'-Dl.ay_._v_ear.,_-I I , I , I ,
I
,,
A C
I
L
19. Oiscreparicy lndica)ion Space
,,_ ______________ _
a IL..J...JL..J...JL..J...Jpbl. c IL..J...J...J...&-'-'ilbl.
b I !lbs. d I jibs.
~ 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
I ..,_.._,,_P-ri_n-:led=/T:-y-:p-:ed-,::N-•m_•...,.=,-,,-.,...--,=-,,-,----,.,--,---,,.J,,S,,ig,-n_a1_u_,e ______________________ ...1M_o_n1,,th....r-DL.ay...l.-Y.leatl...J
C I ' I ' I •
EPA Form 8700-22 (Rev. 9/86) Previous Ed1t1ons are Obsolete (DHEC 1988 (Rev. 10/86)]
I
,c,_,..,-_
.-'6£ /~. -!~~~~tj > ~
South Carolina Department of Health
and Environmentar·control
Bureau of Solid & Hazardous Wa,te Mgt
2600 Bull Stree~ Columbia. SC 29201
Phone: [phone]
Emergency_ & Holidays: [phone]
IPLE.lSE PRINT or TYPE (Form desi ned for use on elile 12-ilch wriler
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo. Manlfoat
Form A
2. Page 1 or
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded Meas is not
required by Federal law, but is by State law.
I
I
I
I
I
I
I
I
I
, Document No. WASTE MANIFEST N c o o 7 6 o 1400 17
3. Generator's Name and Mailing Address
Channel Master
P.-0. Box 1416, Smithfield, NC 27577
,_ Generalor's Phone [phone]
5. Transpor1er 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
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)
d.
15. Special Har:\d!ing Instructions and Additional Information
GSX Work Order No.: 72799
16. GENERATOR0S CERTIFICATION: I horeby dectarelhal the contents ofthi.s consignment are lully and accuretolyde.scribed above by proper a hipping name and are clasaifled,
packed. marked. and la."belcd.and are in all ro.specl.s in proper condition tor transport by highway according_lo applicable lntarnalional and national government regulabonaal"ld
tne laws of the State of South Carolina.
Ill am a large Quantity generalor, I certify !hat I have a program In place lo reducethavotume and toxlcltyol wa.stageneratod lo the deg,_ I have determined to be economically
practicable and that I have :,,elected the practicable method ol trealmenl .storage, or dlspoMI currently avoileble lo ma which mlnlml:i:e, the pre.sent and future throat to humen
heal!h and the environment.: OR. II I am o small quantity generator, I have mado a good laith effort to mlniml:i:e my we.ste genera lion and .setecl the beat waate managamanl method
that is available 10 me and that I con afford.
·~-P-rin-led_'C_ff_A_M_E_S_R_._H_A_N_s_E_N_,_.1,s_ig-nal-ure...;C.~¾=:;;;:..,/4:......;__;_;/f7~~:;;..:-=::::::::=:;;....• _ _;_...i:M;;;::ionu:lh~~•.!:..;-rJ.....17
~ 17. Transporter 1 At:1<nowledgement of Receipt of Materials
A Printed/Typed Name ~ f n .. tLi!Y. . ~--I Month Day Year
o . Transporter 2 Acknowledgement of Receipt ol Materials
I
~l-'~P~n~-n-\ed=/~T~yp_ed::.;_cN~a~m~e====.:;_.c:.:=.:.:...cc=='----,-S~i-gn_a_\u_r_e _______________________ M_o_n_lh __ D_a_y __ Y_ear-1
t-+-~ ...,......._ __________ _._._..---"--'--!
19. Discrepancy Indication Space .~ L i ~20~;-:F~a;c;;1;;1y~~O=w=n;e:r o;r=O~~pe;r~a;,o;r::c;o=rt=i1;1c;a;u;on::-::o;;f r::•::<::•l:,:P;_I o::f.:h::az=•=r::d::o::u•:..:.cm;;;•;;••c,rl::•=l•c:c::o:.:v::•r::ed=-:b:.cy.:lh:::l::•.;;m:c•:;.n::;lf::e•::•.:•::•::<•::P::•.:•::•.;;n::ol::ed::.:ln::_.::ll::;•m:::..:1.:9:..-----------------!
' ~~~P-r-in_t~ed~/~T:-y~p~ed""'N'"a_m_•,,..,"""..,,.-.,...-,,-,,,,-----,,,---,,--,:,.,.,e,Si"g_n_al,.u-re-----,,-,-------------------..J.M-o_n._lh__._D1,,e_y.i..-Y.1,oar-'
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolele [DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental· Control
E PRU<T or TYPE (Form desi ned for.use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generator's U.S. EPAID No.
WASTE MANIFEST N c D o 7 6 o 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4.Generator'sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc .
. Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number)
d.
Form A
2. Pago 1
ol
~~:nf.j:!t~~i~l~~~il;;;il~:!E5~:;tl:!~~!~!li!~~1T~'!~ll·1~I:11~l!~~;l
b. u_j-! 1-1 I :::'''~:'2
~ d: Li.J-: I I 1-1 ... _J:1i
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72800
Bureau of Solid & Hazardous Wa,te Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holiday~ [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a<eas is not
required by Federal law, bu! is by State law.
16. GENERATOR'S CERTIFICATION: I hereby doc1n.re that lho contents of this consignment are fully and accurately described above by proper shipping nam• and are cluaifi9d,
packed, marked, and labeled, and are in all respects in proper condition tor transpor1 by highway according to applicable International and national government regulatlona and
tr,e laws of the State ol South Carolina. ·
If I am a large Quantity generator, I certify that i have a program ln piece to reduce the volume 8nd toxicity ol waste generated to the dog,_ I have determined to be .conomlcalty
praclicable and that I have selected thti practicable malhod of treetment. storage, or disposal currently available 10 me which minlmltH tho present end future lhr-t \0 human
health and Iha environment: OR. lfl am a small quantity generator, I have medo e good faith aHort to minimize my waste general.Ion and se1ec1 the beat waale managemenl method
!hat Is available to mo end that I can atford.
Prinled/~~$.fil.ES R. · HANSEN Signature
f Materials
Printed/Typed Name
19. Discrepancy Indication Space
Month Day Year or z .P.P;?
Month Day
8 11...L.JL..L.J'-,L.Jpbl. C .... , ........ ...., .... llbl.
bl jib> d! ptis.
11---------------T 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed·Name Signature Month Day Year
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)}
I South Carolina Depa.ttment of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Str .. \ Columb;a. SC 29201
Phone: [phone]
Emergency & Hol;days: [phone]
E PRINT or TYPE (form desl ned lor use on elite 12· itch ewrller Form A roved. 0MB No. 2050-0039 E.x Ires 9-30-Ba
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 o
3. Generator's Name and Mailing Address
Channel Master
P, 0, Box 1416, Smithfield, NC 27577
4. Generato~, Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA 10 Number
SCD070
2. Page 1
of Information in the shaded areas is rlot
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Number} 12. Containers 13. Total Quantity 14.Unit :'LiWUlll~~i¼
No. Type WtNrJ. :JtW/H/tN1~1}iff
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
~~m~~m :'.~~~11:ii~1i:1}J~j~~~:-~:~!~~1~~111~~'1!!\~1,r!11~1~!!=1iti
.-.'~li1ii:l!i~L~W:J ,' ... ),-J .. • ,. _,.1!!! b.LL_j-! . ' ..... ~ .......... ,., ..
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72908
''ITF ';'61'i1'lf~
2 0 Y l1E1Q1Q1fi1I
18. GENERATOR'S CERTIFICATION: I hereby declare that the contents otthlsconalQnm0ntarelullyandacCuratelydescrlbed above by proper ahlpplng name and ar• clauifted.
packod, marked, and la°beled,and are In all respecta in proper condllion tor transport by highway according to applicable lnternallonar and national govamment r99ulatlona and
the laws ol the Stale or South Carolina.
111 am a large quantity generator, I certify that I have a program In place to reduce the volume and 1oxiclryol waste generated totha d&gree I have determined lo be economlca.tty
practicable and that I have aalected Iha practicable method of treatment, storage, or disposal currenlly available to me which minimizes the present and future lhroat 10 human
health and Iha environment; OR, ii I am a small quantity generator, I have made a good leilh eHor1 to minimize my waste genaraUon and select the baa I waata managam•nl method
tl'UII is available to me and thal I can afford. ••
Printed/Typed Name ROCER L COATS Signature d ~ Month Day Yea,
(f
eceipt of Materials
. Transporter 2 Acknowledgement ol Receipt of Mat rials
Printed/Typed Name Month .Day Year
19. Discrepancy Indication Space
a I pbs. C I pbs.
bl pbs. d I pbs.
20. Facility Owner or Operator. Certification of receipt of hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Ferm 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86))
.~ L
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Ha.z.ardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734•5424
writer Form A roved. 0MB No. 2050-0039 Ex ·res 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generalor's U.S. EPA ID No.
3. Generator's Name and Mailing Address
-Channel Master
,;_ P. O. Box 1416,
,: Generator's Phone 9 1 9
Smithfield,
934-9711
C D O 9 7 6 0 4 7 1
NC 27577
6. u:s. EPA ID Number
2. Page 1
ol l
5. Transporter 1 Company Name
Willms Truckin Co. Inc. S C D O 7 3 7 0 9 2 9 7
7. Transporter 2 Company Name
9. Oesignaled Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
8. U.S. EPA ID Number
10. U.S. EPA ID Number
Pinewood SC 29125 SC DO 7 0 3 7 5 9 8
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
Hazardous Waste, Solid, NOS ORM-E
.. NA 9189
b., . .'
15. Special Handling Instructions and Additional Information
·csx Work Order No.: 72909
1 C M
Information in the shaded areas is not
required by Federal law, but is by State law.
l 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol this consignment are fully and accurately described above by proper shipping nam• and ara clus.itled.
packed. marked. and la°beled. and are In all respects In proper condilion for transport by highway according to appllcable international and national government re,gulatlon• and
the laws ol the State of South Carolina.
111 am a large quantity generalor. I certify that I have a prOQram In place to reduce the volume arid IOxlclty ofwa!ltegeneratod to the d~ree 1 hava determined lo be econom~lly
practicable and that I have selected the practlcable method ol treatment, storage, or dlspoaat currently avallable lo mo which minimizes tho present and lutvre lhr-t lO human
health and the environment; OR, Ill am a small quantity generator, t have made a good la Ith effort to minimize my waste generation and !ltllect ttie best walla management method
:. tha!,,I• available to me and that I can afford.
0 PrinleoCttAA't [ S R. HANSEN Signature Month Day
09.:?
Year
R.?
17. TransPQrter 1 At1<nowledgemenl of Receipt of Materials
Signature
18. TransPQrter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature. Monlt> Day Year
19. Discrepancy Indication Space
'I Jibs. C I Jibs.
bJ 111,,. d I Jibs.
I 1---------------T 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest excepl as noted In Item 19. YfC-'~..:....."'-=--,..,C....;.:..:.......;..;...:....._;......;.....;.__:..;=:..:.:..===cc,:.:,C.::C:...:==============---------prinled/Typed Name Signature Monlt>
EPA Form 8700-22_ (Rev. 9/~6) Previous Editions are Obsolete [DHEC 1988 (Rov. 10/86)1
Day Year
I South Carolina Depaftment of Health
and Environmental Control
Bureau ol Solid & HazardoU3 Waote Mgt
2600 Bull str .. \ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)73'-5-424
E PRIHT or TYPE (Form desi ned for use on elite 12-itch writer Form A roved. 0MB No. 2050-0039 E.x ·res 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D O 7
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
(.Generato~sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Oesignaled Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
1
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 Cfass, and ID Number)
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
2. Page 1
ol Information in the shaded areas is not
required by Federal law, but is by Stale law.
-;i:li~i~::~:::;:t~;~l1~it~!~lr~;~i:
mr;t~~t~~i~t~~~t~~~::~(j/~:!tTil~!~}l~~;;f
fik'f~-':~~~f\fj
,}f
~~:~:H:~.:1
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 72979
16. GENERATOR'S CERTIFICATION: I hereby declare thatthacontantsolthls consignment are fultyand accuratelydeacrlbed above by proper 1hlpplng name and are cl&Nifl~.
packed. marked, and la'beled.and are in all respects in proper condillon for transport by highway according 10 applicable lnlernaUonaJ and national govemment regulation, and
the laws 01 the State of South Carolina. ·
111 am a large quantity generator. I certify Iha! I have a program in place to reduce the volume and toxlcltyofwaategoneralod to the deg,_ I have determined to be economblly
practicable and thal I have 1elected lhe practicable melhod of lroatment. storage, or dlsposal currently available lo me which minimizes the preaent and luture thrNI to hurne.n
health and the environment OR, 111 am a smol1 quantity ganeralor, I have made a good lallh eflort lo minimize my wast& ganeraUon and salacl the be1I wa1te management mo1hod
e.t Is available to ma and that I can afford.
Printed/Typed Name ROGER L. COATS Signature ~
17. Transporter 1 At;Knowledgement of Receipt of Materials
Printed/Typed Name l ·c::Sc7 r/ 11 S (}J C//J-I
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator. Certification of receipt of hazardous materials covered by this manrfesl except as noted in t1em 19.
Printed/Typed Name Signature
I I ............ .....
bl._._ ...... .....
Month
0
(>
Month
jib!. C I
pbs. d I
Month
Yea,
Day Year
pbl.
!lbs.
Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPAID No.
WASTE MANIFEST N c D o 7
l 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 True kin Co ·rnc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
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)
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
•' CSX Work Order No. : 72 980
Form A
2. Page 1
of
12. Containers
No. Type
1 D T
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (8-03)734-5424
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a,eas is not
required by Federal law. but is by State law.
2 0 Y
HS. GENERATOR'S CERTIFICATION: I hereby declare thal lhe conlents ol thlsconslgnmenl are lully and accurately described above by proper shipping name and arectau.ifled.
packed, marked.and labeled. and are in e11 respects In propercondilion tor transportbyhlghwey according to applicable International and natlonal govomment regulatlons and
the laws ol the State ol South Carolina.
· 111 am a large quantity generator, r certify that t havoa program In place lo reduce the volume and to,i:icltyol waste generated lo the degr-I havedelermlned lo be oconomblly
practicable and that I have selected lhe practicable method ol treotmont, storage, or dl,posal currenUy avoilable to mo which minimizes the present and future tht-1 lO hurT\110
health and the environment;OR, 111 am a small quantity generator, r have made a good faith aNort 10 minimize my wa,te ganaraUon and ,elect the beat wa,te managem•nt method
that is available to me and thal I can aNord.
Printed/Typed Name
RO.CER L. COATS
Signature
17. Transparter 1 At:Knowledgement ol Receipt of Materials
Printed/Typed Name Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete IDHEC 1988 (Rev. 10/86)1
Month Day Year
8 ... I .._,_...__._......_.!lbs. c lu..J...J.._...._,pbs.
b I libs. d I l1bs.
Month Day Year
I
. ··n.
£
IBC'""A<SJI'.-..;,
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Ha.z.ardous Waste Mgt
2600 Bull Street, Columbia, SC 29201
Phone: [phone]
Emergency & Holiday,: [phone]
LEASE PRINT or TYPE (Form desi writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. ,-.• .-i • Man1rea1 2. Page 1
.. : Document No. al lnlormation in the shaded areas is not
required by Federal law, but is by State law. N C D O 7 0 0 3 2 3
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generato(s Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 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
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
b.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72981
~~~:~::~-~~:,~:~i~_:;:~~~:~1:e;t;;~:;i~
;~;~;:~t:~~~tf~;r;is1;;;:;:w:~;-:1:;:tyf}!~'t~~:;'.~i~
12. Containers 13. Total Quantity 14. Unit (L{Wala,.._;W
No. Type 'MN~ {P{'YiW?~f~[e-mail]'
1 D T 2 0 Y
, 6. GENERATOR'S CERTIFICATION: I hereby declare that tho conlonls ot this conslgnmont are fully and accurataly described above by proper ■hipping name and ara cla.NJfl9d,
packed. marked, and la'boled,and are in all respects In proper condition lor transport by highway according to applicable Jnlernallonal and nation al gov.rnment r99ulatlon11 and
the laws ol the State ol South Carollna,
111 am a large quantity generator; I corllty that I have a program In place to reduce Iha volume and loxlcltyolwastagonaratod lothadegr-1 have detarmln9d to be aconomlcally
praclicabte and lhal I h11,,..p ,alactad tho prncllcable method ol troatmant, ,toraga. or dlsposal currently available to ma which minimizes tho present and future thrMt lO human
haat1h and the environmcrt: OR. II I am o a molt quantltygonorolor, I he,vo mado a good lalth enortlo mini mite my"'!'astogenaratlon and select tho bail wa1te management method
that is available to me an(j thal I can afford.
Prinled/Typed Name . OGER l, COATS Signature
17. Transporter 1 Aumowledgement of Receipt of Materials
Signature
of Receipt ol Materials
Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification of receipt of hazardous malerlals covered by this manifest except as noted In ttem 19.
Printed/Typed Name. Signature
Month Day Year
a i...._.....__._._,Pbs. c l .................... l'bs.
b I pt,,, d I pbo.
Month Day Y81J/
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
I South Carolina Depaitment of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt.
2600 Bull S~ee\ Columbia, SC 29201
Phone: [phone]
E PRINT or TYPE (Form des! ned for use on elile 12· itch writer
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
NCDO 7 0
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generato(s Phone 9 1 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number.
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
_Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72982
Form A
2. Page 1
of
Emergency & Holidays: (803)73-4-5-124
roved. 0MB No. 2050-0039 Ex ·res 9-30-88
lnlormatlon in the shaded a<eas is not
required by Federal law, but is by State law.
i~'.:;;~:::=::~~~i:,f=:ff:~~tffy~~t1l;·
~tJ~i~~'._h:J\H:'f :{!f ~;t~~f :1:'.::::7tt~lt~4:~1/'.
12. Containers 13. Total Quantily 14. Unit ;(':.w.-Nuialw';S
No. Type · Wt/Vr). liflt{ffrWJ£ft¥:£4½f.f'.
1 D T 2 0 Y
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol thlsconslgnmontarelully and accurately described above by proper shipping n•m• and arecla .. ifled.
packed. marked, and la'beled,and are in a11 respects in proper condition tor transport by highway according to applicable lnternatlonal and netlonal governmantrOQulallons and
ttle laws ol the Slfl.le ol Soulh Carolina.
111 am a large Quantity generator, I cerlify the ti have a program In place to reduce the volume and toxicity of waste generated to Iha dagr-1 have determined to be economically
practicable and that I have selected the practlcable method ol treatmenl storage, or disposal currently available to me which minimizes the present and future th,_t lO human
health and the envlronment;OA, lfl am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the bl,st waste management ~thod
. that is available to me and that I can afford.
Printed/Typed Name ROGER L. COATS Signature Month Yeat
17. Transporter 1 Ae;Knowledgement of Receipt of Materials
Printed/Typed Name
1'-f/7u.1t 0 -1-/' A
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I P~ 'I p~
bl jibs. d I jibs..
20. Facility Owner or Operator; Certilicafion of receipt ol hazardous materials covered by !his manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
I
I
I
I
I
I
F
• A_.":"'..,_ ~· South Carolina Depa'rtinent of Health
and Environmental Control
Bure.au ol Solid & Hazardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E, ires 9-30-88
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. /,.' Manlreat
·:· Document No.
WASTE MANIFEST N c D o 7 6 o 1400325
l Generator's Name and Mailing Address
Channel Master
· P. 0. Box 1416, Smithfield, NC 27577
4. Generato(s Phone [phone]
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125.
6. U.S. EPA 10 Number
S C D 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
d.
2. Page 1
of
j~:~.t~:;-~::~:1\1~!!l!·11:11~1~!11!!i~~~i;'~itt:1i!·~!l!!~~f:'!;!!!!ii~=1!;~:!!:1::~!:!~l1i!
a.l.!:.ili..J-1012,7,7,41-11J110121ick)!)fridt<-LLJ-1,,,, 1-11,, J:it,
b. W=l 1-1 J!ilt!l1!:i[illl~:W::J. , ,_,_ 1-L,, , ,,,J!!~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72983
Information in the shaded Meas is not
required by Federal law, but is by State law.
1 e. GENERA TOR'S CERTIFICA. TION: I hereby declare that tho conlenls or this, consignment are lolly and accurately de,cribod above by propcir •hipping nama and ara cla-,11.0.
packed. marked, and labated,and are In all ro:ipocts in proper condillon for lranspor1 by highway according to applicable lnternelione1 and naUonal governmanl regulation• arid
tho lawS ol lho Stale ol South Carolina.
If I am a largo quanUty generator, I certify !hat I have a program in place lo reduce the volume and 1oxlclty olwa•togenerale<I to the dogree I have determined to be economically
practicable and tflel I hav11 sotectod the practicable method of lroat_ment. 1lorage, or dlspoul currently evailable 10 me which minim lie• the preNnl and future tnr-t to hum.on
heatlh and lhe environment: OR. II I am a smoll quantity.oonoralor, I have mado a good laith effort to minimize mywa:,lo generation and :,elect the bell walle managemenl mothod
that Is available to me and lhal I can afford.
Month Day Year
If a j......__........_.......__.Jfbs. c ._1 ......__._._..__.Jfbs.
b l Jibs. d I Jibs. ,,__ ______________ _
T 20. Facility Owner or Operator; Certification ol receipt ol hazardous materials covered by this manifest excepl as noted ln Item 19.
I Yt-----'--,,-,-,--'--'------'-~--'--~-'----~
Printed/Typed Name Signature Month Day Ye.at
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolole [OHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control·
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columb;a. SC 29201
Phone: [phone]
Emergency & HoHdays: [phone]
I.EASE PRINT or TYPE writer Form A roved. 0MB No. 2050-0039 E.,p;res 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
t Generator's U.S. EPA ID No.
NCDO 760
•·. ~ ~ • Manifest ' :· Document No. 1400326
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 919
5. Transporter 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D 0 7 0
2. Page 1
ol
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
No. .Type
a
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
1~~~~~; ~~l:!i;s;li:: :~:1 ::,,1: 1'1f ~r [1l1t11:~:::w:::;:;:::~;,::::1:!l;:1;:_f~1:i:1::;::
tt.iliJ 10,2,7,7141 11,1,o,2Lu,,,vyw ·Lu I I I , , t Ix,
b.W=I . 1-1 1.Jlllfll[l1ll!ld:W:::J ... t 1:::1 .. 1 Jilt
15. Special Handling Instructions and Additional lnformalion
GSX Work Order No.: 72984
Information in the shaded Meas is not
required by Federal law, but is by State law.
2 0 Y
16. GENERATOR'S CERTIFICATION: I horebydeclore lhnl the conu1nts ofthi:, consignment ere lully and accurotelydeacrlbed ebove by proper •hipping n•m• and areclaaaihed.
pecked. marked, and 1ebeled.end are in nll rc,specla in propercondilion for Iran sport by highway 11ccording lo appUcable lntern11tlon11I end n11tlonat government r.gulatlona end
the law• ol the Stale of South Carolina.
, 111 am a large ciuanlity generalor, I certify the! I have a program In place to reduce the volume and tcixlcltyol waste generated lo tho da,gree I have determined lo be economically
practicable and that I have selected lhe practicable method ol treatment, storage, or dlsposal currently available to me which minimizes the present and lutur• throat to human
health and the environment: OR, 111 am a smnll quantity generator, I have made a good faith effort lo minimize my waste generation and ae1actthe bell waa1a management method
that is available to me and that I can afford.
Printed/Typed Name · ROGER L. COATS Signature
Signature
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt of hazardous malerlals covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
Day Year
Monlh Day Year
a lu....1-1-..L...L..,P"" ' .... I .1-1-...... ........,P""
b I jibs. d I jibs.
Monlh Doy Year
EPA Form 8700-22 (Rev. 9/66) Previous Editions are Obsolote {DHEC 1988 (Rev. 10/86)1
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous WcUte Mgt
2600 Bull $tree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. . ">• Mnnlfeat
.rOocument No. WASTE MANIFEST N c D o 7 o 1400327
l Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
2. Page l
of lnlormation in the shaded areas is not
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 1•. Unit iqV!_~-~i~}1i
No. Type WtN':A Ytre+->i~:ttffJ,:(~~
a.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72985
GENERATOR'S CERTIFICATION: I hereby declare thal the contents ot thlsconslgnmentarafullyand eccurately described above by proper ahipplng name and erecl~n..:t.
packed, marked, and la'beled, end ere in a11 ro:tpects in proper condillon for transport by highway according to eppll~bte lnlarnaUonal and natlonal governmentreguletlon• and
the laws of the Si.ate ol South Carolina. ·
111 am a large quantity generator, I certify that I have a program In place to reduce thevoluma and toxicltyol waste generated lo Iha deg,_ I have determined to be economlcalty
practicable and thal I have selected the practicable method ol treatment, :ttorage, or disposal currently available to me which mlnlmizea Iha present and lutu,e lhr-t to human
health and the anvironment;OR, lrl am a small quantity generator, I have made a good faith effort 10 minimize my waste generation and select the baa! waste management meO'lod
that is available 10 me and that I can afford.
Printed/Typed Name ROGER L. COATS Sig~ature
T 17. Transporter 1 Atamowledgement ol Receipt of Materials
Printed/Typed N~. _,-
/
Printed/Typed Name Signature
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt of hazardous malerials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signatur~
EPA Form 8700•22 (Rev. 9/66) Previous Editions are Obsolete (DHEC 1968 (Rev. 10/86))
Month Day
• IL..1..J.....L...1....1..Jl1bs. c 1 ....... ~ ......... ~l'bs.
b I jibs. d I jibs.
Month Day Year
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: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. , •• 1 • Maniteat .; Document No. WASTE MANIFEST N c D o 7 6 O 1400 28
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Genera1o(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 0 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D 0 7 0
2. Page 1
of Information in the shaded a<eas is not
required by Federal law. but is by State law.
ii!il;im;;i~;:~{1~:~:!ijJfj}~ij~~[~;:
;N;;~~i~~J~~~:}~1\t~t~'.r~:;t::~f=~Jifr;~+~
11. U.S. DOT Description ~nc/uding Proper Shipping Name, Hazard Class, and ID Number} 12. Containers
No. Type
13. Total Quantity 14. Unit /L\Wa19Ninl,ei)\h
MNrJ. It!{%\h}t}?1gJ}ift'
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72986
1 D T 2 0 Y
1 e. GENERATOR'S CERTIFICATION: I hereby declare lhal 1he contents ol this consignment are fully and accurately de1crlbed above by proper ahlpplng name and are cla..,lled.
packed. marked. and tabeled.and are In all respects In proper condition lor transport by highway according to applicable lnlornalional and natlonal government ra,oulabona and
U"le laws ol the Stale of Souttl Carolina. · -
U I am a large Quantity generator, I certify that I have a program In placo to reduce Iha Volume and lo1t!cltyol wastaganarated to the d&gree I have determined lo be economically
praclicab1e and that I have selected !he practicable method of treatment, storage. or dispose! currently aveUable to ma which minimizes the praaenl and future lhrMI to human
health and the environment.: OR, II I am a small quantity generator, I have mad a a good faith effort to minimize my was le generation and select the bell waate management method
tl'\a1 Is available to ma and that I can afford.
Printed/Typed Name ROGER L. COATS Signature
17. Transpor1er 1 Ac.:,mowledgeme
Year
i )
Signature Month Day Year
19. Discrepancy Indication Space
aj /lbs. C I /lbs.
b I /lbs. d I /lbs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)]
I
F A
C I
L
I
South. Carolina Depar'tment of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. Manifest Document No. WASTE MANIFEST N c D o 7 6 o 1400329
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 919
5. Transporter 1 Company Name
Smithfield,
934-9711
Willms Truckin Co Inc.
7. Transporter 2 Company Name
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
SC DO 7 3 7·
B. U.S. EPA ID Number
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
a.
b.
C.
d.
Hazardous Waste, Solid, nos ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 72987
Form A
2. Page 1
of
1 D T
Bureau of Solid & Hazardous W~te Mgt
2600 Bull Street Columbia, SC 29201
Phone: (8-03) 73'1-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x ire, 9-30-88
Information in the shaded a<eas is nol
required by Federal law, but is by State law.
2 0 Y
~~~TF:·;,.!o~;:rt9ll~~:
:'.:liE ,o JP I 6 J~\¥
1 e. GENERA TOR'S CERTI_FICA TION: I hereby doc la re that lhe conlents ot this conalgnmenl are fully end accurately described above by proper shipping name and era cleaalned,
packed. marked, and labeled, and are In au respects In proper condition lor transport by highway according to applicable International and national government re,gulatlon• and
U'le laws ol the St.ate ol South Carolina.
If I am a large Quantity generator, 1 cortify that I have a program In place lo reduce Iha volume and toxicity olwaslagenaraled lo the de,gr-I have datarmlned to b'9 economlcally
prsct,cable and lhal I have 1111toct11d tho prn.cllcabla method ol lroatmonl alorago. or dlapoaal currently available lo mo which minimizes tho proaenl and luture l/"lr-110 human
health and the environment: OR, 111 am a small ciuantirygoneralor, I have mado a good laith effort lo minimize my wastageneratlon and aalect the bell wa11a management method
that is available to me and that I can afford.
Printed/Typed Name R L. COA1S. Signalure
17. Transporter 1 At:Knowledgement ol Receipt ol Materials V
Printed/Typed Name Signature --c,
19. Discrepancy Indication Space
~ 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted In hem 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I
. '
South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST . N c D O o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generato(sPhone 919 934-9711
5. Transporter 1 Company N3.me
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
Bureau of Solid & Hazardous Wasle Mgt
2600 Bull $tree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number} 12. Containers 13. Total Quantity 14. Unit ~;~s~·~Hi
No. Type WtNrJ. -/?fi:)';}?}/'.'Rl~:Jf:,qff
Hazardous Waste, Solid, nos ORM-E
NA 9189 1 D T
~;t~i~;~1~:1~i~!::l:1::!!!'!l,;1ll,:!l!!ll~~!~l!!!!:0i•lt!r,ll~!:!!:1~!1llf:;;:!;!!!~;!!!~E{!::!
a.l:f...ili.J-l0J2J7J7J41-fldJ0J2j ;M'\;c.LLJ-1 f-f i)}f
b. W::1 1-1 J ~',U\lf:ii;kJ,i~:L,.1,.,J::J "'·'···" 1:1 ,,,, ······ .1!1i
15. Special Handling Instructions and Additional Information
GSX Work Order No.:72988
2 0 Y
'•• ',••.-·,.,,_, ''~•··; ·,:J, .... ....._...,__.__, .. ,·ti~.·
~Jti..... ).I
115. GENERA TOR'S CERTI_FICATION: I hereby doclero that tho conlents of this consignment are fully and accurately described above by proper •hipping name end are ctaWfled.
packed. marked, and labeled.and are in a11 respects In proper condition tor transport by highway according to appllcable lnlernational and national government re,gulatJor,a and
the laws ol the State ol South Caroline. ·
111 am a large Quantity generator, I certify !hat I have a program In place to reducothevolumo and to:idcltyol waste generated to tho d&gree I have determined to be economlcally
practicable and th11t I have selecled the practicable melhod ol trealment, slorage, or disposal currenl1y available lo mo which minimizes the present and lutura throet to human
haallh and Iha environment; OR, 111 am a small quantity generator, I have made a good faith effort 10 mlnimtze my waste generation and select th• bo•I we•t• manag•m•nl method
that is available to me and thal r can afford.
Printed IT yped Name Signature 7A
Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I l'bs.
b I jibs. d I 111>s.
20. Facility Owner or Operator, Certification or receipt ol hazardous materials covered by this manilas! 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)]
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Wa,te Mgt
2600 Bu11 Stree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 E, ires 9-30-88
. , UNIFORM HAZARDOUS
WASTE MANIFEST
l Generator's Name and Mailing Address
Channel Master ·
P. 0. Box 1416, Smithfield, NC 27577
4. Generato(sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
10. U.S. EPA 10 Number
SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
C.
d.
2. Page 1
of
12. Containers
No. Type
!!:~~~~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73125
Information in the shaded Meas is not
required by.Federal law, but is by State law.
13. Total Quantity 14. Unit i:::\/::~-~'~'¼J
VNV~ !\\('ti;:-.t:t:e~t=ttiW:t
115,. GENERATOR'S CERTIFICATION: I horebydaclarethal the contents of this consignment a.re lully and a.ccuratelydescrlbedabove by proper ahlpplng name end are claaadled,
packed, marked, and labeled. and are In nll respecla in propercondi1ion tor Iran sport by highway according 10 appllcabla lnlarnallonal and nallonal govarnment regulallon• and
uie laws of !he State ol &oulh Carollna.
If I am a large Quantity generator. I certify that I have a program In place to reduce the volume and toxicity ofwaatageneralad to the davr-I have determined lo be oconomk:ally
practicable and that I have selected tho pracUcable method ol treatment. storage. or dlspo!lBI currently available to mo which minimizes Iha pre..ant and luture thr-1 to human
heallh and tho environment; OR, If I am a small quantity gonoralor, I have made a good faith effort lo minimize my wasllt genera!Jon and select the beat w111ta managemenl method
that Is available to me and that I can afford.
Printed/Typed Name ROGER L. COAT~ Signalure
17. TransPorter 1 Ac.:1..:nowledgement of Receipt ol Materials
Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
'I libs. C I libs.
b I jibs. d j jibs.
11---------------T 20. Facility Own·er or Operator, Certification of receipt of hazardous materlals covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolele (DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Wasle Mgt
2600 Bull S•ee\ Columbia. SC 29201
Phone: [phone]
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D 7
l Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone 9 l 9 9 3 4-9 7 11
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, l Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
Form A
2. Page,
of
Emergency & Holidays: [phone]
roved, 0MB No. 2050-0039 E;t ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
-~t~f~;:~1~!W!~~i:~~?!t~JtJJ!:~;~::
;1;;;~~i?lit.~1~!11~~i1i:i~~:i\f!i~1¥¥·
12. Containers 13. Total Quantity U. Uni!
No. Type WI/Ve/.
. Hazardous Waste, Solid, nos ORM-E
N NA 9189 I D T 2 0 Y
b.
C.
d.
i~;~;~:,•!ii~:IE
a. II:.MJ-IO I 2 I 7 I 7 I 4 1-I l d I O I 2 I c. LLJ-LI -'---'--'-1.....J
b. ~=L. I J;~;;;~1,illt~:W:::J ,1 ,,, _,,11:1
15. Special Handling Instructions and Additional lnformalion
GSX Work Order No.: 73126
6. GENERATOR'S CERTIFICATION: I hereby declare that Iha contents of this consignment are fully and accuratelydascrlbed above by proper ahlpplng name and are cluaiflod,
packed, marked.and laheled,and are in all respects In proper condition !or transport by highway according to applicable International and natlonal govammant reQulatlona and
the laws ol the State ol South Carolina. ·
If I am a large Quantity generator, I certify that I have a program In place to reduce the volume and toxicity ol waste generated to the di,gree I have determined lo be economk:alty
practicable and that l have selected the practicable method ol treetmant, storage, or disposal currenlly available 10 me which minimizes the present and future lhroal lO human
health and the environment OR, 111 am a small quantity generator, I have made a good lalth a Mort to minimize my waste generation and aelacl the beat waala management method
that Is available to me and Iha! I can otford.
Printed/Typed Name ~OCER l. coA,:~ . Signature Month Day Year
Jo
T 17. Transporter 1 AtKnowledgerrient ol Receipt of Materials
Printed/Typed Name Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
I I pbt. ' I pbt.
b I !lbs. d I I jlbL
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Hem 19.
Printed/Typed Name Signature Month Dey 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
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
writer
1. Generalor's U.S. EPA ID No.
NCDO 760
Form A
. • ,.._,.Manlfeat 2. Page 1
Document No. of 1400333
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transparter 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 0 7 0
Bureau of Solid & Hazardous WiUle Mgt
2600 Bull Street, Columbia, SC 29201
Phone: [phone]
Emergency & Holiday~ (B03)734-5424
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnlormation in the shaded areas is not
required by Federal law, but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit
No. Type 'MNr,
a.
C.
d.
~!~~;~~~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73127
16. GENERATOR'S CERTIFICATION: I hereby declare that Iha contents ol this consignment are lully and accurately described above by proper ahlpplng name and are clasaiflocl,
p,a,cked. marked. and labeled, and are in ell respects in proper condilion tor transport by highway according to applicable International and nallonat government re,gulatlona and
tho laws of the State ol South Caronna. ·
111 am a large quentity generator, I cer1ify thet I have a program In place to reduce the volume and toxicity ofwaategenerated to the degr-1 have determined to be economically
practicable and lhal I have selected the practicable melhod ol treatment, storage, or disposal currently available to me which minimizes the present and future threat to human
health and the environme.nt;OR.111 am a small quantity generator, I have made a good faith etfor1 to minimize my waste generation and select the beat waste management method
that Is evailablo to me and that I can afford.
Printed IT yped Name RO.CER L COAI~
gemenl of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
Signature
Month Day Year
a lu...L.L.L..J...1llbs. c I
bJ ptis.dJ ,,_ _____________ _
T 20. Facility Owner or Operator: Certification ol receipt ol hazardous materials covered by this manifest except as noted In hem 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolete (DHEC 1988 (Rev. 10/86)]
I , ~~\
-~
South Carolina Department of Health
and Environmental Control . ..
E PRINT or TYPE (Form desl
UNIFORM HAZARDOUS
WASTE MANIFEST
1 Generator's Name and Mailing'Addiess
Channel Master
ewrller
1. Generator's U.S .. EPA ID No.
NCDO 760
P. 0. Box 1416,
.C. Generator's Phone 919
Smithfield,
934-9711
NC 27577
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site A~~ress
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number)
a.
Hazardous Waste, Solid, nos ORM-E
Form A
2. Page 1
of
Bureau ol Solid & Hazardous Wa,te Mgt
2600 Bull Street, Columbia. SC 29201
Phone: [phone]
Emergency & Holiday~ (803)734-5-124
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is nol
required by Federal law, bul is by State law.
ilffrTil'f l~g'f~~
N NA 918.9 1 D T 2 0 Y :'\lif IQ IQ 1 6 ,I
C.
d ...
!!~~~T:-~
15. Special Handling Instructions and Additional lnlormation
I
GSX Work Order No.: 73128
16. GENERATOR'S CERTIFICATION: I horebydectarethat the contents of this consignmont are lullyand accurotelydescribed above by proper shipping name and are claaajfled.
packad, marked, and lahe1ed, and are in all respects in proper condition !or transport byhlghway according to applicable International and natlonal government regulaUona and
the laws ol tho Stale ol South Carolina.
If I am a large cwantity generator, I certify that I have a program In piece to reduce the volume and toxicltyol waste generated to the do,gree I have determined to be oconomlea.tly
practicable and that I have selected the practicable method of treatment. storage, or disposal curranlly avollabla to ma which minimizes the present and future thr .. t to human'
heel th and the environment; OR. II I am a small Quantity genen1tor, I have made a good la Ith eNort to mtniml:te my weste generation and select the beat waate management method
that \1 available to me and that I can aNord.
Printed/Typed Name ROCE~ L. COA'l] Signature _Month Day Year .ta
owledgemenl of of Materials
M/1',S Signature
f Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I jibs. C I jibs.
bl pbs. d I pbL
20. Facilify Owner or Operator, Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10186))
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAtDNo.
WASTE MANIFEST N c o 7 o 1
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generate~, Phone 9 1 9 9 3 4-9 711
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
B. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and ID Number}
L
c:
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73129
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
2. Page 1 Information in the shaded Meas is not
of required by Federal law, but is by State law.
:~;~~~;:~:=~i:::f'.~:~~~f~):qti~~l;,::.
~~~~~~?~~!1:8;15~'.~~~~~~k1&~h~i,::
, 6. GENERATOR'S CERTI_FICATION: l hereby declare that !he contents ot this conalgnment are lully and accurately described above by proper shipping name and era claaaillad,
packed, marked, and labeled.and are in all respects in proper condition for transport by highway according to applicable intarna1ional and naUonal government ra,g1,,1lat.lona and
ttle lews ol the Stale ol S01,,1ttl Carolina. ·
111 am a large Quantity generator, I certify that I havo a program In place to reduce the volume end toxlcltyol waste generated to the degree I heve delermlnod to be oconomlcalty
practicable and lhal I have selected the praclicable melhod of treatment, storage, or dlsposal currently available to me which minimizes the pres.ant and luture three! to human
heallh and the environment OR, ii I am a small quantity generator, I have made a good faith eNortto minimize my waste generation and select the beat waste management method
that 1, available to me and that I can afford,
Printed/Typed Name RO.GER L. COAI~ Signature ~
T 17. Transporter 1 Ac;Knowledgemenl ol Receipt of Materials
Printed/Typed Name ,L,
Printed/Typed Name Signature Monlh Day Year
19. Discrepancy Indication Space
a I Hba. C I libs.
bl pbs d I pbs. ,,_ _____________ _
T 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Piinted/Typed Name Signature Month Day Yw
EPA Form 87D0-22 (Rev. 9186) Previous Editions are Obsolete [DHEC 1988 (Rev. 101861[
I .ar1~-
~
South Carolina Depar'tment of Health
· and Environmental Control
E·PRINT or TYPE (Form desi ned for use on elite 12-ilch ewriler
UNIFORM HAZARDOUS 1. Generator's U.S. EPA 10 No. ··'~Manliest Document No. WASTE MANIFEST N c D o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generato~, Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
S C D O 7 3 7
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping' Name, Hazard Class, and ID Number)
a. Hazardous Waste, Solid, nos ORM-E
3 3 6
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnlormalion in the shaded areas is not
required by Federal law. but is by State law.
N NA 9189 1 D T 2 0 Y
b.
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73130
16. GENERATOR'S CERTI_FICATION: I hereby declare that the contents ot lhlsconslgnmenlarafultyand accurately described above by proper •hipping name and are cla-ifl-.d.
packed, marked, and labeled, end are in all respects In proper condition tor transport by highway according toappllcable International and national governmon1 r~ulatlon• and
U'le laws ol the Slate or South Carolina. ·
It I am a large quantity generator, I certify that I have a program In piece to reduce the volume and toxicity ol waste generated to the dog roe I have determined to ~ economlcalty
practicable and lhat I have selected the practicable method of treatment, storage, or disposal currently available 10 ma which minimizes the presenl and lutur• thrMI to human
health and the environment: OR, if I am a small quantity generator, I have made a good faith aNor1 to minimize my waste generation and aotecl tho beat waa1a management method
that ia available 10 mo and thal I can aNord.
Printed/Typed Name ROGER L. COAT~ ,6;; Month Year
/a
17. Transponer 1 Ac.amowledgement ol Receipt of Materials
Printed/Typed Name "Ju,_ J'll1, 5{),J
Montl'l
I
18. Transponer 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
a I pbs. C I I I libs.
b I jibs. d I I ·1 jibs
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noled in Item 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Streei Columbia, SC 29201
Phone: [phone]
Emergency & Holiday~ [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generalor'sU.S.EPAIDNo.
WASTE MANIFEST N c D o 7 o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 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 ID Number
S C D O 7 0
11. U.S. COT Description (including Proper Shipping Name, Hazard Class, and 10 Number)
a
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73131
2. Page 1
of lnlormalion in the shaded areas is not
required by Federal law, but is by State law.
;iti~~i~:~I;:~rt,it!:!;fft~Jji~,
;l-~t~~~~~i;\~~~~¼i;\1?~t!ft~~;~2.J~f df
12. Containers
No. Type
1 6. GENERATOR'S CERTIFiCA TION; I horoby declare that the contents of this consignment are lutty and accurately described above by proper 1h!pplng name and are cla..,fled,
packed, marked, and la°beled,and are In all respects in proper condition !or transport byhlghwayaccord!ng to applicable lnlernalional and national govarnmant ra,oulatlon• and
tha laws ol the State ol South Carolina. ·
111 am a large quanhty genarolor, I cortily Iha! I havo a program In place to reduce the volume and toxlcltyol waste generated to the degree I have detormlnod to be economlcally
procticable and that I have selec1ed the practicable method ol lreatment, storage, or dlsposal currently available to me which minimizes tho present and lutura throat to huma.n
tlealth and Iha environment: OR, 111 am a small quantity generator, I have made a good laith effort to minimize my waste generation and aolect tho bolt wa.to management method
that 11 available to me and that I can afford. ·
Printed/Typed Name RQCER L. coA-r:S. " Signature
er 1 Au:nowledgemenl ol Aecei t of Materials
Printed/Typed Name Signature
, 9. Discrepancy Indication Space
20. Facility Owner or Operator, Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
Month
/,0
Month Day Year
a.__! .._.__._.__.....jllll c ._I .._._..._.,..._.jllll
b I !Jill d I !Jill
Month Cay Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/861)
South Carolina Department of Health
and Environmental Control
E PR/HT or TYPE (Form desi
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
writer
~-Generator's U.S. EPA ID No.
NCDO 760
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Ph~ne 9 1 9 9 3 4-9 711
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services or SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Cfass, and ID N11mber}
a.
C.
d.
Form A
2. Page 1
of
~tt:;t:1~1;;.=!~:~l~i~I1!~l:li,•·~f!1,:tii.~1~ii::2:!~i!1:l1{1!2~:i!J11!1i111.~i1!:1!~!1i,~~r~!1~:
a.lE...MJ-10,2,7,714l-lli110121\tj\'.![i.]X<-l-i.J-I,,,, 1-1 1,, Lw
.... [i[;~j]]i,i! !i! . d. Li_j-1 I 1-1
15. Special Handling Instructions and Additional Information
, GSX Work Order No.: 73132
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-s.c2,
roved. 0MB No. 2050-0039 Exp;re, 9-30-88
Information in the shaded a,eas is no!
required by Federal law, bul is by State Jaw.
1 6. GENERATOR'S CERTIFICATION: I hereby declare th al the contents of this consignment are fully and accurately described above by proper •hipping name and era claaaifittd.
packed. marked, and 1a·baled,and are In all respects in proper condition lor transport by highway according toapplicabla lnlerna1lonal and national government r99utatlona and
tne laws ol the Stale ol South Carolina.
111 am 8 large quanlity generator, I certify that I have a program In place to reduce the volume and toll.fclty of wuta generated to tho dog roe I have determined to be ec:onomlcalty
practicable and that I have selected the practicable method of troetmont storage, or dlsposal currently avellablo lo mo which minimize• tho preaenl and lutur• thrut to human
health and the environment; OR, ii I am a small quantity generator, I have made a good laith effort to mlnlmlH my waste generation and select the beat waate management method
that Is available to me and that I can ati'ord.
Printed/Typed Name RO.GER L COATS Month Day Year
l C Cl/
Printed/Typed Name ,, Signature Month Day Year
19. Discrepancy Indication Space
a I I l'bl CI Jibl
bl !lbl d I
""" 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manrfesl except as noted in Item 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700•22 (Rev. 9/86) Previous Editions are Qbsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No.
WASTE MANIFEST N c D o o 1
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
C.
d.
15. Special Handling Instructions and Additiorial Information
GSX Work Order No.: 73133
Form A
2. Page 1
of
Bureau ol Solid & Hazardous Waste Mgt
2600 8"11 Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays:_ [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a<eas is not
required by Federal law, but is by State law.
;~rt.-.~ ... t·f:j'l-1~t
;:-:·;..
16. GENERATOR'S CERTIFICATION: I hereby declare that the cor,ter,tsol lhls conslgnmentare fully and accurately described above by proper •hipping name end are cl--..fled,
.packed, markod, and ta"beled,and are in all respects in proper condition for transport by highway according to applicable International and national government re,gutatlona al"ld
tne laws ol the Stale or Soutt'i Carolina. · ·
II I am a large quantity generator, I certify that I havo a program In place to reduce the volume and toxfcltyol wastaganerated to the degr&e I have determined 10 be economleally
practicable and that l have selected the practicable method ol treatment, storage, or dlsposal currenUy available to mo which mini ml us tho present and future throat to human
heallh and Iha environment; OR, 111 am a small quantity generator, I heve mado a good laith effort lo minimize mywasl.ogeneratlon and select the beat waata management method
that la available to mo and thal I can afford.
Printed/Typed Name ~O.CER L. COATS..
Printed/Typed Name
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature
Month
I "'
Month
Month Day Year
a l._._......_........__,jlbs. c ._I .._._._...._..,Pbs.
b I pbs. d I pi,,.
Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete IDHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
E PRIHT or TYPE (Form desi
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generalo(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
SCD070
11. U.S. DOT Description (including Proper Shipping NafTle, Hazard Class, and JO Number)
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73134
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: (8-0J) 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
16. GENERA TOR"S CERTIFICATION: I hereby declare that !he content!! ol this conslgnmenl are lully and accuralely deacribod above by proper •hipping name and ara clanilllld,
packed. marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable International and natlonar government re,,gulatlon• and
the laws ol lhe State of South Carolina.
111 am a large quantity generalor, I certify that I have a program in place to reducelhevolume and to,dclty ofwastegeneralod 10 !he d&gr&e I have determined to be economically
practicable and that I have selec1ed the praclicable method ol treatmenl storage, or disposal currently available 10 me which minimizes the present and future thr-t to human
health and the environment: OR, JI I am a small quanlitygenerator, I have ma.do a good lailh effort lo minimize my waste generation and select the best wa1te management method
th.Ill is available to me end that I can afford,
Prinled/Typed Name RO.CER L. COATS
17. Transporter l Ac.:Knowledgemenl of Receipt of Materials
Pri eplTjped Nai,e V.. A;,_ J'
1c,l1f1MI MJ'/#p,'....,
Printed/Typed Name
19. Discrepancy Indication Space
Signature
Sig~alure
20. Facility Owner or Operator, Certification of receipt of hazardous malerials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
• I
bl
Month Day Year
Month Day Year
I o e, I ,Yo?
Month Day Year
jibs. C I jibs.
jibs. d I jibs.
Monlll Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obso_lote (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays.: (803)73.4-5424
Form A roved. 0MB No. 2050-0039 Ex ·res 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator"sPhone 919 934-97111
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
1
,"• Manliest Document No. 0 0 3 4 1
6. U.S. EPA ID Number
-SCD0737
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID NumtJ:er)
a.
d.
2. Page 1
of
~!!~~!!~
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73135
Information in the shaded a,eas is not
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I hereby declare Iha! !he content1 ollhl1 con1ignmen1 are tullyand accuratelydeacrlbed above by proper shipping nam• and ara clanill9d,
packad:ma,ked, and 1a'beled, and are in all respacts In proper condi1lon for 1ran1por1 by highway according to applleabla inlernatlonal and natlonal government r.gulatlona and
the law1 ol the State ol South Carolina. ·
Ill am a large quantity generator, I certify that I have a program In p!aco to reducelhevotume andto,:lclty ofwastegeneratad lo the degree I have determined to be economlcally
practicable and that I have selected the practicable method ol treatment. 110,age, or dlspoaal currently available lo me which mlnimi:r.es Iha present and future three! to human
health and the environment OR, If I am a small quantity generator, I have made a good faith aNort lo minimize my wa1te generation and aelect the beat waate management method
that ls available to me and that I can aNord.
Printed/Typ~ Name Signature
Signature
Name Signature
19. Discrepancy Indication Space
a I !Iba. C I pbl.
bl jibs. d I jibs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700~22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)1
! ,/·
I
I
,.
~.-{~,.
11\c~A<~J ·~. ~ .,.:
South Carolina Department of Health
and Environmental Control •
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Streel Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE (Form desi writer Form A roved. 0MB No. 2050-0039 Expires 9-30-88
•:.·Manliest 2. Page 1 UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No. ·
N C D O 7 6 0 Document No. ol 1400342
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
•· Gene,alofs Phone [phone]
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
10. U.S. EPA ID Number
S C D 0 7 0
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73136
Information in the shaded a<eas is nol
required by Federal law, but is by State law.
, 6. GENERATOR"S CERTIFICATION: r hereby declare that lhe contents ol this consignment are luUy and accurately described above by proper shipping name and are claaaine<I.
packed. marked, and labeled. and are in all respects in proper condition for transport by highway according to applicable International a.id national government regulation• and
tho laws ol tho Stale of South Carolina. ·
111 am a large quantity generator, I certify that I have a program In place to reduce tho volume and to,dclty ofwastageneraled to the dogr-I have determined to be oconomlc.lly
practicable and that I have selected the praclicable method of treatment storage, or disposal currently available to me which minimizes the present and future thre.at to human
health and the environment OR, ift am a small quantity generator, I have made a good faith effort to minimize my wasta generation and select the best waste management method
that is availat:Jle to me and lhal I c!ln afford.
Printed/Typed Name RO'CER [ (.:O.AJS,
17. Transporter 1 Ac.:,mowledgement of Receipt of Materials
Printed/Typed Name
. J, t,,
Acknowledgement of
Name
19. Discrepancy Indication Space
· Signature
Signature
a L.I -'-'--'-.L..1.-'p1>,. c ,__I .,__.__._.__._.!lb,.
b I p1>,. d I Pb,.
T 20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
P~nted/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolole [DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE {Form desi ned for use on elite 12-itch writer
UNIFORM HAZARDOUS 1. Generator·,u.S.EPAIDNo. , ,.:• Manlfeet
Document No. WASTE MANIFEST N c D O 7 6 o 1400343
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generato~, 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
SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
C.
d.
15. Special Handling Instructions and Additional lnlormation
GSX Work Order No.: 73137
Form A
2. Page 1
of
Bureau of Solid & Hazardous Waste Mgt
2600 Bull $tree\ Columb;a, SC 29201
Phone: (BOO) 734-5200
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a<eas is not
required by Federal law, but is by State law.
1 6. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol thla consignment are luUy and accuralaly described above by pro par •hipping name and are c1--,11~.
packed. marked. and la°beled,and are in all respects in proper condition lor transport by highway aeeordlng to applicable International and n11tlonaJ governmenl ragutatlon• and
tne laws ol the Stale of South Garolina. · · ·
If! am a large Quantity generator, I certily that I hove a program In place to reduce the volume and todcltyol wasleganeratad lothedogree I have determined to be aconomlcally
practicable and that I have selected the praclicab1e method of treatment, storage, or disposal currently available to ma which minimizes the present and lutura thrNt to human
health and the environment OR, II I am a small quantity generator, I have made a good la Ith effort 10 minimize my waste genoretlon and aelact the beat wute managemenl method
tnat i• available to me and that I can afford.
Printed/Typed Name ROGER C COATS < • a
Month Year
L cJ
Month Day Year
/ ;: .P>
Printed/Typed Name. Signature Month Day Year
19. Discrepancy Indication Space
• I fibs. C I fibs.
b I jibs. d I 11bs,
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 Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull S•ee\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
E PRINT or TYPE (Form desi ned for use on elite 12· ilch writer Form A roved. 0MB No. 2050-0039 E,: ires 9-30-88
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
l. Generator's U.S. EPA ID No.
N C D O 7 6 0
. -• .. •Manliest 2. Page 1
Document No. ol
1 4 0 0 3 4 4
P. 0 •. Box 1416, Smithfield, NC 27577
•.Generalo~sPhone 919 934-9711
5. Transporter 1 Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
6. U.S. EPA 10 Number
SC DO 7 3 7 o· 9
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)
Information in the shaded a<eas is not
required by Federal law, but is by State law.
E a. Hazardous Waste, Solid, nos ORM-E :'if(f{6t'ff9f~~
N ~_:N:,:A~9'.cl'..:8::.9::.__ ________________________ -J---1.....l'.1:...j'.D:'.-1.T➔....l.....l.-1.'.:2.l:'.O+_.:Y:..._i,:.\:!,'j!::1f:;;;10~• 0~1~6:.l'.:;:@q•
0 ~b-·---------------------------------~..L--1-l-L.J-.L-1...J_L.J---+:fj~;l.!':'='"::;'t=···, ... =··-=;·=,~·=1=~=· ·~:~!!~,
t{•, ,-,•, j M•, ,•1~ C.
~f:_i I 19-i~, " .. --'-'-.._-'_·A';
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73138
16. CENERATOR"S CERTIFICATION: I hereby declare Iha! the contents oflhis conaignmenl ere lullyend accurately described above by proper shipping name and ar11 clasaified,
packed, marked. and 1a·beled, and are in all res pacts In proper condition tor transport by highway according to applicable International and natlonal government regulatlona at'ld
tho laws of tho State ol South Carolina.
111 am a large quantity generetor, I certify !hat I have a program In place to reducethevotume end toxicity of waste generated to the d&Qroe I have determined lo be economically
practicable and that I have selected lhe practicable method ol treatment, storage, or dlsposal currently avo.Uable to me which minimizes the pres.on! and future thr-t to human
health and the environment; OR, if lam a small quo.nUtygenorator, I have made a good faith effort lo minimize my waste generation and select the beat waate managem11nt method
that ls available to me and that I can afford.
Printed/Typed Name ROGER L. COATS Signature
Signature Month Year
d'.7
Printed/Typed Name Signature Month Day Year
19. Discrepancy ln'dication Space
a ... ! ....,_.1,...1._. pbs. C I !lbs.
b ... I~_.._.._,_ pbs. d I pt>s.
20. Facility Owner or Operator; Certification of receipt ol hazardous malerials covered by this manifesl excepl as noted in Item 19.
Prinled/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/861]
I
-~.":"'-
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y 'A '. ·;-or
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone] . ,_
UNIFORM HAZARDOUS 1. Generator's U.S. EPAtD No.
WASTE MANIFEST N c D o 7 6 o
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416,
•· Generator's Phone 919
5. Transponer 1 Company Name
Smith.field, NC
934-9711
Willms Truckin Co Inc.
7. Transporter 2 Company N.ime
9. Designated Facility Name and Site Address
CSX Services of SC, Inc.
Route, 1 Box 255
Pinewood sc·29125
27577
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA to Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID.Number)
a
Emergency & Hcilidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded a<eas is not
required by Federal law, but is by Stale law.
12. Containers 13. Total Quantity U. Unit
No. Type 'MNrJ
:i{;p'',6';i,'9"(l1 e Hazardous Waste, Solid, nos ORM-E ,,; :2
N 1-.::N:::A~9~1~s:.:9~-----------------------!-1-11:._i:nJr:.+-1.-1._i:2::..1.:o::+...:Y:__1,;I;.1:::' E::::' a::!:, D:::•:::fi:::•:,:rj:~·· ' . :·,-:<·:;.·.~~-~4-0;'.
::,:; ''---'-J....J._Jl >:::Cl
6i--------------------------'-----~LL+-L+-L.L..L.L-J---f::~t1::!:::!:=!;=!1Cl~j '.(~t··-· ~ j 0 I ··,1
b.
C.
%b .... ,_,.,., ~--~••wJ\t
d.
b. LLJ-!
15. Special Handling Instructions and Addilional Information
CSX Work Order No.: 73139
'
1 6. GENERATOR'S CERTIFICATION: I horoby declare lha1 !he contents ol this consignment are fully and ec:curatoly described above by proper shipping name and ere clanill~.
packed, marked, and laheted,and are in all respects in proper condition for transport by highway according to applicable lnlarnational and national government regulation• aro-d
tna laws ol 1he Stale ol South Carolina.
lfl am a ta~ge quantity genera\or, I certify that I have a program In place to reduce thevolumeand !old city of wastegeneralod I0lhad&gree I have delarmlnod to be economically
prac1icable and Iha! I have ,etecled the practicoble melhod of treatment, ,1orage, or dl,posal currenlly available to me which minimize, the preMnl and lutura threat to human
health and the environment; OR, 111 am a small quantity generator, I have made a good laith el'tortlo minimize mywa,te gener8Uon and ,elect the beat wute management method
that is available to me and thal I can al'tord.
Printed/Typed Name RO.GER C COATS Signature
T 17. Transporter 1 Ac..:,mowledgement ol Receipt of Materials
Printed/Typ~,•
c,A__.-/'
Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
'I pi,,. e I pi,,.
b I pbs. d I l'bs.
I T 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by !his manifest except as noted In hem 19.
Printed/Typed Name Signature Month Day Year
EPA.Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete {DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator'sU.5.EPAIDNo.
WASTE MANIFEST N c D O 7
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416., Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD07037
11. U.S. DOT Description (including Proper Shipping Name. Hazard Class, and ID Number)
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73140
Form A
2. Page 1
ol
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree~ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 Ex ires 9-30-88
lnformBtion in the shaded a<eas is not
required by Federal law, but is by State law.
16. GENERATOR'S CERTIFICATION: I horoby declare lhot the contents ollhi, consignment are fully and accurately described abova by proper ahlpplno name and ere clasaillod.
pecked. marked, and la°beled, and are in all respect, in proper condition fortran:,port by highway according lo applicable lnl11rn111iona1 and naUonal govornmonl regulations and
lhe laws ol lho State of Soultl Carolina. ·
111 am a large quantity genorotor, I curtily ttmt I have a progrom In placo to reduce the volume and to)l(lclty of waste generated to the degree I have delermlnod to be economically
practicable and that I have selecled the practicable method of treatment, ,tor age, or disposal currenUy available to me which minimize a tho present and luture throat to human
health and the environment: OR, ii I am a small quantity generator, I have made a good lailh errort to minimize my waste generallon and !IOlect the be al waate menagemenl method
tt,at ls available 10 me and that I can afford.
Prinled/Typed Name ROCER L COATS Signature Month Day Year
0 02-·
17. Transporter 1 Ac;imow1edgement of Receipt of Materials
!'I
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
'I Jibs. C I Jibs.
b I Jibs. d I Jibs.
20. Facility Owner or Operator, Certification of receipt of hazardous ma!erials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Dey Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (form desi ned lor 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 O 7 6 0
.:• Monllosl
Document No. 1400347
P. 0. Box 1416, Smithfield, NC 27577
4. Generators 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
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a
Form A
2. Page 1
ol
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull S~ee\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)73-4-5424
roved. 0MB No. 2050-0039 El< ires 9.30.aa
Information in the shaded a<eas is not
required by Federal law, but is by State law.
Hazardous Waste, Solid, nos ORM-E :f,f,'o~'i-1'9",'! ~ 1-..:N:.:A:....:9:.:1~8:;9:_ ______________________ -J_j_J::_l -1D:::...iT::....J.-1.-1.-12:..LO::+-Y:_-1,:'il;i,:::1 E:::::1 D:::::f D::,;::I 6:::.;1hz:.i'.' ~l':''"~'·'i~f·:1
d.
i'~Mditionai ~-tor•'Maierk1~"UGted).~\}{iFf\ ' '' ·:+::.:\.}./.lI.1::.i.:.r.U.}.:i.'..l.i.I.:i.l.t.i.:.g::.:JI?lSiii};m_: .. :,_.:_ .. :._i._::,i:,: .. ,·.:.l_•·•.; .. ;.,:.·,• .. ++> ';_}.:_·:.~.1.'.i_i.•.:'.
1,:.·:.t.(.i.j;;+ :!Ji:i:i(LL.,.:: i./:-:) ,:: ;: .:',:; ;:~;::;::;;i).\\i'. :':::-:.--)·:.:;::J)::,:\t.::},:;,;,.:,c'.iil3}::f ;::}iih:1:@irt;:i:lrl.irJM\ff:,;/}L,:i1iAWLr;:iW/t · · · · · ·
a lPJH..]-IO 12 17 17141-111l10121:w+/t:;c.LLJ-I I I I I 'f'.'.'.j' ; .,•·•wr:·1:
I -._I --'--''-......... 1 .. -'. I ~!//i[~i'i!11'[ d L+J :-I __ .. .J=J 1Ji! b.LL_J-J
15. Special Handling Instructions and Addilional Information
GSX Work Order No.: 73141
;;;rf~-t~~~,-.t~:·1:Jf.
t::; I~~
16. GENERATOR'S CERTIFICATION: I hereby declare thal tho conlonts ol thlsconslgnmontaro lully and accurately described above by proper 1hlpplng name and arecl•sa•lled.
packed, marked, and taheled,and are in all rospects in proper condition lor transport by highway according to applicable lntarnational and natlonal goYarnment regulatlons and
lho 1aws ol tho State ol South Carolina. ·
If I am a large quantity generator, I certify that1 have a program In placo to reduce the volume end toxicity of waste generated lo the d&Qroe I have determined to be economically
practicable and that I have selected the practicable method ol treatment, storage. or dlspoMI currently evaltable to me which minimizes the present and futur• throat to human
health and the environment; OR, If tam a small quantity gonerolor, I havo mado a good faith effort to minimize my waste generation and select the beat waata management mothod
that Is available to ma and that I can afford.
Printed/Typed Name ROGER L. COATS Signature
T 17. Transporter 1 At:1<nowledgement of Receipt ol Materials
rin~ed~Typed N~~ .
Printed/Typed Name
19. Discrepancy Indication Space
20. Facility Owner or Operator, Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature
EPA Form 8700•22 {Rev. 9/86) Previous Editions ore Obsolete (DHEC 1988 (Rev. 10/86)1
Year
Month Day
a L-1 J..J...J...L..L.Jpbs. c .__I .__._......__._.!lbs.
bl !Jbs dJ pbs.
Month Day Year
I South Carolina Department of Health
and Environmental Control
E PRINT or TYPE (Form desi ned for use on elite 12· itch writer
. UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's U.S. EPA ID No.
N C D 0
. ·.;·Manifest
Document No. 0 0 3 4
Bureau al Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone].
Emergency & Holiday~ [phone]
roved, 0MB No. 2050-0039 Expires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
13. Generator's Name and Mailing Address
Channel Master I P. 0. Box 1416, Smithfield,
4, Generalor'sPhone 919 934-9711
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7
B. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7
11. U.S. DOT Descriplion (;ncluding Proper Shipping Name, Hazard Class, and ID Number)
Hazardous Waste, Solid, nos ORM-E ~iJi~/o';ffif';'~ ~ ~!N'.:A~9'..:1~8~9'.,_ _ _;_ ___________ _:_ ________ -lJJl:..+D:'..J.T'...j.....L....LJ:2:.1'.0'...!,....:Y~j.;1;!J!::' f:::;:I D::;::I D::;1!;:fi::;l~'!l:J•
a.
b, ){'':'::::.E:, :·;;.~~,.,._-,fi·
=~·d I I I 1~:ti
6 ~---------------------------------+..LJ_j~L.j.....L--L_j_L.j..._4:;'.;~11J=:::::=::::::::1~!;.:t~Jj \iTi~----,· ····=rA~1··-1~~i
i\, I¾'.
C.
I"• ..•. :~,,
'''"'' d. ···•cj___._.~._.,
b. l_i_J-!
, 5. Special Handling Instructions and Additional Information
GSX Work Order No.: 73142
16. GENERATOR0S CERTIFICATION: I hereby declare lhetlhe contents ol this consignment ore fullyond eccurstely described above by proper 11hlpplng name and are clas .. 11..:t,
packed. marked. and labeled.and are in all respects in proper condition lor transport by highway according to applicable lntarnalional and netlonal government reQutatlona and
trio laws ol 1ha State ol Soulh Carolina. ·
111 am a large quantity gonorator, I cortily 11ml I hnvo o program In ploco to r&duco tho volume and to)(Jcltyol waslegeneraled to Iha de-gree I have determined to be economicalty
practicable and Iha! I have selected the practicable method ol lreatment. slorage, or disposal currently .11.voilable to me which mlnlmlzu lhe present and lutura threat to human
haallh and the environment; OR, ii I am a small quantitygonoralor, I have made a good lailh eNortlo minimize mywasl.e generatlon and selecl the beat waste management method
that is availatila 10 me and that I can afford.
Prinled/Typod Name RO,CER L. COATS Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Monlh Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsolote (DHEC 1988 (Rev, 10/861)
I
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0
A
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A
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South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator"sU.S.EPAIDNo.
WASTE MANIFEST N c o o
3. Generator's Name and Mailing Address
Channel Master
· P. 0. Box 1416, Smithfield, NC 27577
4. Generator"s Phone 9 I 9 9 3 4-9 7 11
5. Transporter 1 Company_ Name
Willms Truckin Co Inc.
7. Transpcrter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood SC 29125
I 4
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA 1D Number
SCD07037
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number}
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 7 JI{]
Form A
2. Page 1
ol
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x. ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
16. CiENERATOR'S CERTIFICATION: I hereby declare lhatlha content, ol thl, conalgnmen1ere lulty 11nd 11ccur11telyd111crlbed above by proper 1hlpping name and are clallllifleod.
packed, mark&d. and labeled,11nd are In all respects In proper condition lor transpor1 by highway according toappllcabla lnt11rn11tlonal and natlonal government r9gulatlona and
the laws ol lhe Stale ol South Carolina.
111 am a large quantity generator, I cer1ify that I have a program In ptaco to reduce Iha volume and todcltyol waaleganeraled to the d&gr-1 have determined to tMa economlcally
practicable and thet I have selecled the practicable method ol lreatment, storage, or disposal currently aveitabla to me which minimizes tho presont and future three! IQ hum.n
health and the environment; OA, ii ram a small Quantity generator, I hove made o good faith eNor1 lo minimize my waste generation and 1el11ct the bait wa1te management method
that Is available lo me and that I can aNord. ·
Printed/Typed Name L. l~.-is Signature d
,
{:'r~-l. Month Day Year
'--~ .e, /(&cµ:_,\.. a a f"
17. Transporter 1 A(;1mowledgement of Receipt of Materials ' ,
Print_ed/T ped N'!l°~7iJ
';., 4/?r) I'. /;.,,,
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Yea,
19. Discrepancy Indication Space
• I !lbs. C I !lbs.
b I l'bs. d I l'bs.
20. Facility Owner or Operator; Certification of receipt of hazardous materials covered by this manifest except as noted In Item 19.
Prinled/Typed Name Signature Month Day Year,
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
I South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-l!a
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
,. Generator's Phone 919
Smithfield,
934-9711
5. Transporter l Company Name
Willms Truckin Co Inc.
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route, 1 Box 255
Pinewood, SC 29125
NC 27577
1
6. U.S. EPA ID Number
S C D O 7 3 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
SCD070
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a.
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73144
2. Page 1
of
12. Containers
No. Type
Information in the shaded Meas is not
required by Federal law, but is by State law.
13. Total Quantity 1( Unit ;::~_:}~-~.,t_4~~f{1:'.
'MfVrj /1f!1h4i:it~tf!Jtt.
16. GENERATOR'S CERTIFICATION: I hereby declare that Iha contents ol this consignment are lully and accuralelydescribed ebove by proper shipping no.me and are clo.-lied.
po.eked, marked. and laheted. and ara In all raspecls in proper condilion tor transport by highway according to appUcable lnternatlonel and natlonal government regulalion• at'>d
tne laws of the State ol South Carolina.
111 am a lerge quanliry generator, l cer1ily that t havo a program In placo to reduce the volume and toxicity of waste generated to the degree I have de1ermlned to be economically
practicable and that l have selected the practicable method ol lreatment, storage, or disposal currently available to me which minimizes the preaent and luture thr-1 to human
health and the environment; OR, If t am a small quantiry generator, I have made a good faith effort to minimize my waste generation and select the beat waate managemenl method
that is available to me and \hat I can afford.
Printed/Typed Name ROGER L COATS Signature
gement of Receipt of Materials
Printed/Typed Name
19. Discrepancy Indication Space
20. Facility Owner or Operator; Certification ol receipt ol hazardous malerials covered by this manifest excepl as noted In Item 19.
Prinled/Typed Name Signature
Month Day Year
a LJ .L.J...W...lJJlbs. C '-J ..__._..__.__._.Jibs.
b I Jibs. d I Jibs.
Month Day Year
EPA Form 6700-22 (Rev. 9/86) Previous Editions arc Obsolete [DHEC 1988 (Rev. 10/86)1
:·•~-;~1~1·,1·:• ' !!/:< •. ~ .,~ -~ .. •J, '
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardou, Waste Mgt.
2600 Bull Stroe\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
'' ,~_ri,i,w'e PRINT or TYPE (Form des! ned for use on elite 12· Itch writer Form A roved. 0MB No. 2050-0039 Ex res 9-30-88 ' . ,.,,:· ... UNIFORM HAZARDOUS 1. Generetor'sU.S.EPAI0No.
"'" ,: WASTE MANIFEST c D o 9 7 6 o 4 7 l 4
5. Transportf!r 1 Company Name
· ··Willms True kin Co. Inc.
7. Transporter 2 Company Name
d. \4.1•t\,,;; _,.. '
15. Special Handling Instructions and Addilional lnlormation
>,
!t1,GSX Work Order No.: 736~/
,•.,
6. U.S. EPA ID Number
SCD07370
8. U.S. EPA ID Number
2. Page 1
ol l Information in the shaded areas is not
required by Federal law, but ls by State law.
· .,:.i.;'lt, 18. GENERATOR'S CERTIFICATION: I hereby declare that the contents ol this consignment are fully and accurately deacrlbed above by proper ahlpplng name and are daMitled. •1 •· •. packed, marked, and la'beled, and are in alt respects in proper condition for trar:,sport by highway according to appUcable lnlornatlonal and national government r-aulatlona al'1d ht '.~ · aie laws ol the Stale ol South Carolina. ·
::1-.; '.. ./(HI am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waateganerated to the d11>gree I ha..,. determined to be ~ty
;.~ •• F-~J~ \t practicable and that I have aalected the pracltcable method ol treatment, storage, or dlspoaal currently avallable to me which mlnlmitH the preMnt and future tlVMI to human
•• , ~ 1 ~ :_;;,health and the environment; OR, 111 am a small quantity generalor, I hava made a good la Ith effort to minimize my waste generation and select the beat waste rnanagem.nt method ;' · ~-,.i .1:·aiat la avaitabla to me and that I can afford.
_.,, ___ ·'1"11_•:l--l,--·' .. ·_P_n_nt_ed_,_r_y.;~:..:;~'• .. m,•;;;;. __ .:.~..::.:..:;;..::.:~----...l-s_,g_n_•t_u_r•_..,;._;;.,od;::..,._ _ _.;"-;;,.:--.,;/l;;.,;':..:;;,,:, .J__;;... _____ .,1M"',:::'.on,1.th2.l.'-I.U..:.J~ ,_,, /)<.c r L. Coa_ ·f5 LEJ-o.,l&-.
i T 17. Transporter 1 Ac:1mowledgement of Receipt of Materials R F.,..c,:=.:...c:.;._;._...;_...;_..:..:.,:.:_'-:__.'-'-=--'-'=;;..:_----r,c------,,,,---------------.,.,.--.--,,---:-:---1
A Printed/Typed N~L . Signature i ~ ..... -=--_·4 (./'::71..17'!111~,~~~e~/;2!-~· ::::::--.J1..1__S;f1~2.......,.:!~~~~~:..:::.__JJ_.!!2.J1~Jl1
; 'Y; ! i.;1.:8.:.P.:.T~::.~:.:~ed::'P0::,T.:.rty::::.:~::A:.::::.k::.;:::.::w.::l•::d~g•::m::.•::n::.t:.ol:.:R.::•::c.:••=·p:..t o::f:.M::.:•::t•::•::.:i•=l•:..._ __ ~S-ig_n_
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/_ f;_,::i:t + ~20.,,.,...,F,.a-ci"lity--,O"w_n_e_r -or-0=-p-e-ra-,o-r.-. C-:-e-ru"'·"r,c-a"'tt-on-of receipt of hazardous materials covered by. this marii1est except as noted In Item 19 . . '.' I• v t--,\-, P,..n'"·n-ted~,T,..y_ped_N_a_m __ e--~------'--------,-S-i-gn-a-tu-re __ .,_ ____ -'-'--------------M-on-th--Da-y--Y-..,-t
.,,,..~.....,,.,,.,.,..,,,..,,,......,..~,,,......,...~,,,,,..--,,.,.....,---,,,,,.,,,,...,.... _____ .,... _____________ 1,,,.,,1,..J...l,....i....&-1
··,. EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/86)1
I ~¢"1
, ...... ,
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt.
2600 Bull Streel Columbia, SC 29.201
Phone: [phone]
Emergency & Holidays: (803)73-t-5424
I PLEASE PRINT or TYPE
UNIFORM HAZARDOUS
WASTE MANIFEST
writer
1. Generator's U.S. EPA ID No.
Form A
2. Page 1
of 1
roved. 0MB No. 2050-0039 Ex ·res 9-30-88
Information in the shaded a,eas is not
required by Federal law, but is by State law.
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0 R T E R
F A
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3. Generator's Name and Mailing Address
Channel Master
C D O 9 7 6 0 4 7 1 4
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
6. U.S. EPA ID Number
:~1:~{~~~~~1~i~~!11t(~~-Tiffi ,--w~te~·--,.-. ,·,l)·/Pt~~:J\rS1-;:t,~'&~~'i-~ 5. Transporter 1 Company Name
Willms Truckin Co. Inc. S C D O 7 3 7 0 9 2 9 1 owt·····•····· .•~::,;,: so3 ,:.:16-1"'3333:
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Address
GSX Services of SC, Inc.
·Route 1, Box 255
Pinewood SC 29125
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7 5 9 8
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Number) 12. Containers
No. Type
a
b.
C.
d.
Hazardous Waste, Solid, NOS ORM-E
NA 9189
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 73'65"0
1 C M
~,r~-~~',';:.Fl~:~,1~-, ~/
1 &: GENERA TOR'S CERTIFICATION: I hereby dec1•re th al the conlonts of this conaignment •re fully end •ccurately de1crlbed •bove by proper •hipping name and ate cl__,n.cl.
packed, marked, and 1o·beled,and are in atl respect■ In proper condition lortran1por1 by highway according to appllcable lnlarnationat and n•tlonal govamment r9gulaDon• alld
U'le laws 01 the Slate ol South t;arotlna.
If I am a large quantity generator, I cerUty that I have a program In place lo reduce the volume and toxicity of waste generated to th• deg,_ I have determined lo be .conom6calty
practicabta and th•t I h•v• 1olocled the practicable method ol treolmant, storage. or d11poNI currently available to me which minimize■ the preMnl and lvture lhr-1 to hv"'9n
healtt1 and lhe environment; OR, II I am a small quanllry generator, I have made a good lalth etlort IO minimize my waste generation •nd 1e1ecl the boil wa11a management rne1hod
that is available to mo and thnt I can otford.
Prinleetlf'AMES R. HANSEN Signature Day Year
'&"7
17. Transporter 1 Aumowledgemenl of Receipt of Materials
Monlh Cay Year
Printed/Typed Name Month Cay Year
19. Discrepancy Indication Space
a I pt>s. C I pt>s.
bl pbs. d I pbs.
20. F4cility Owner or Operator, Certiricalion ol receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Doy YNI
EPA Form 8700-22 (Rev. 9/86) Previous Edillons are Obsolete (DHEC 1988 (Rev. 10/86)1
I v~i··.;., ,. C.,o' ", .,
IL:'!21,:,J'""-
. ..
South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgl
2600 Bull Stree~ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
Form A roved. 0MB No. 2050-0039 Ex ires 9-30-88
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Manifest Document No. 2. Page 1
WASTE MANIFEST c D o 9 7 6 O 4 7140035
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D 0 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
s c·n o 7 o 3 7 5 9 8 5
of 1
Information in the shaded ateas is not
required by Federal law. but is by State law.
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Untt
No. Type 'MNd
L ·\· ,.;.Hazardous Waste, Solid, NOS 0RM-E
NA 9189 1 C M 2 0
b.
C.
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 739/fl
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are clasaifl~.
packed. marked. and labeled.and are in atl respects in proper condition for transport by highway according to applicable lnternalional and nallonal government regvlatlon• al"ld
ttle laws or the State of South Carolina.
111 am a large qvanlity generalor, I certify that I have a program In place to reducathevotumeand loxlcltyofwastaganerated tothadogree I have detarmlnod to be economk:ally
practicable and that I have selected the practicable method of treatment, storage, or dlsposal currently available to ma which minimizes the present and lvture thrMI IO hvmen
health and the environment; OR, ii ram a small quantity generator, 1 have made a good faith effort to minimize mywastogenera!Ion and select the bes! waste managemonlmethOd
that Is available to me and that I can afford.
Printed/Typed Name /{/ . 'n .. 0 .je,r L. C,!)a.:f-s Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I pbs. C I pbs.
b I !lbs. d I 11bs.
20, Facility Owner or Operator; Certlficellon of receipt of hazardous materials covered by this manHast a,capt as noted In ham 19,
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete (OHEC 1988 {Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 Bull Stree\ Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-5-424
IPL.EASE PRINT or TYPE (Form desi ned !or use on elite 12-itch ewriter
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
Form A
2. Page 1
_of 1
roved. 0MB No. 2050-0039 Ex ires 9-30-88
Information in the shaded areas is nol
required by Federal law, but is by State taw.
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WASTE MANIFEST c D o 9 7 6 o 4 7 1 4
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416, Smithfield, NC 27577
4. Generator's Phone I 919 934-9711
5. Transporter 1 Company Name 6. U.S. EPA ID Number
Willms Truckin Co. Inc. S C D O 7 3 7 0 9 2 9 7
7. Transporter 2 Company Name 8. U.S. EPA ID Number
9. Designated Facility Name and Site Address 10. U.S. EPA ID Number
GSX Services of SC, Inc.
Route I, Box 255
Pinewood SC 29125 SC DO 7 0 3 7 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Cfass, and ID Number)
d.
12. Containers
No. Type
1 C M
!~~~::r~~Fi
15. Special Handling Instructions and Additional Jnlormation
·.rcsx Work Order No.:
~). '.) 74111
2 0
1 6. GENERATOR'S CERTIFICATION: I hereby declare that the conlents of this consignment are lully and accurately described abOve by proper shipping name and are clu.aiffed.
packed, marked, and labeled.and are in all respects in proper condition tor transport by highway according to applicable international and national govemment r-outatlonaand
u,e laws ol the State ol South Carolina.
If I am a large quantity generalor, I certify that I hove a program In piece to reduce the volume and loxlcltyol waste genera led to the dagr&e I have determined to be ac;onomically
practicable and that I have selected the practicable methOd of treetment, slorage, or dtsposal currently avellable to me which minimizes tho present and future thrNI to human
health and the environment CA, II I am a small quantity generator, 1 have made a good lo Ith effort to minimize my waste genarallon and select the best waste management~
that 11 available to mo and lhn.l I can afford. I .,, Prin~/gT!~ f~meCoa ts Signature _ ~ /" ...L. ~~.::..:....:::::~~~____L-...:._::;;~....:;.;";32'.::::..., .. ~L#-,;.~-~,.,t.=:=;:_·· __J~~
Year
T t,c:,mowledgement of Receipt ol Materials ljF-:~:;?+===:..::::::===-~-J-,-.-=---,,---=2'-----=;;-=,~"='-,,~-------,-;-::--=-__,,,--i
o 1a Transpofter 2 A knowledgemenl ol Receipt of Materials Al-'.:.....~c.:..,c...;.c::,c;.:_..:..,:__cc.:.,:.:,_;;__;_;_......cc..:,_;,_;;__;_;.:..... __ ~ ________________________________ -1 I .-i➔--P-rin_t_ed_/_T_y_ped_N_a_m_e ______________ ..1,_S_ig-na_t_ur_e ______________________ ...1 .... 1.-..,_..1.,..,1....1~
Monltl Day Year
19. Discrepancy Indication Space
F Ir • I !fbs. e I 1 ·1 !fbs.
bl !fbs. d I I I !lbs.
•1---------------T 20. Facility Owner or Operator; Certification ol receipt ol hazardous materials covered by this manifest except as no led in Item 19. Yl--::-,C"."'-:-,:-C..,.,....;.:c.:...;...:....;,c_ ___ _;_:..:..:c'-'-........C'-----,-::,-C::....:C:....:=.C..C._;__;__;_;;_;,=c.;,,;;:..c.:=,;;;,,;=.c.:.;,-------:-,-.,---,----,.,--
1'==~=-p-ri-nl::ed::/::T:-y'::ped~N::a-m_e~0:::,~-,--.~~---::,-..-,-,:,:-:1:,:,S':,ig,-n,:al,:U,:re-,,,---,--,,,,.,---,---------------..J-i...J...I..J...J~
EPA Form 8700·22 (Rev. 9/86) Previous Editions are Obsolete {DHEC 1988 (Rev. 10/86)1
Month Day Year
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: [phone]
IPL.EASE PRINT or TYPE (Form desi ned !or use on elite 12-itch ewriter
UNIFORM HAZARDOUS 1. Generator's U.S. EPA to No. Manlro11t
Oocumenl No.
Form A
2. Page 1
ol l
roved. 0MB No. 2050-0039 Ex ire, 9-30-88
Information in the shaded a<eas is no!
required by Federal law, but is by State raw.
I
I
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WASTE MANIFEST N c D O 9 7 6 O 4 71400355
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 91 9
Smithfield,
934-9711
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA 10 Number
;~~~:o!d B~~ ;;i 25 s C D O 7 0 3 7 5 9 8 5 W!f::slr-)~i\[Jl!:l:t'1a11'1}[1g'~~,rr<1
I G .. .,f'tF'i'ot'1;"§,1-t E Hazardous Waste, Solid, NOS ORM-E 'ii ,i;,. I ~ ~b-. ....:N:::A:.:._::.9:.1..:8:..:9~--------------------------+.....I.....JLl!;.j..~Ci.::M~.L..LJ.:.2~0:'.j..._Y!,_j.:t:ll,!::~=,~=;= ... ~='.._=.;:;~="=:~i~i
ol----------------------~µ_i_.j....;W,-1-_l_LL-l---~:=::±::::.;;:j I R c. !(i" J I I~
1 -----'--------------------------1--LL-l-L-l-LLLLt--U1
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d.
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15. Special Handling Instructions and Additional Information
GSX Work Order No.: 74112
16. GENERATOR'S CERTIFICATION: I hereby declare 1h01 the contents ollhis consignment are fully and accurately dascrlbed above by proper shipping name and areclasadled.
packed. marked. and _labeled, end are in all raspects in proper condition lor transport by highway according to applicable lntarnalional and nallonal government regulations and
the laws of the State ol South Carolina.
If I am a larga quantity ganeralor. I certify that I have a program In place to reduce the volume end 10:idcltyol waslegenerated to Iha degree I have determined lo be economically
prac11cable and that I have selected the pruclicab1e method ol treotmonl, storage, or dlsposal currently available to me which minimizes the present and luture lhr .. t lO human
health and the environmenl;OR, If ram a small quantity generator, I have made a good laith oNortto minimize mywosle generotlon and select tho bell wa110 management melhod
thal is available 10 me and that I can oNord.
Printed/Typed Name Signature Month Day Year
Ro er L. Coats
Signature
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I pbs. • I pbs.
bl pbs. d I pbs.
20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by this manifest except as noted In Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions nre Obsolotc (DHEC 1988 (Rev. 10/86)]
I "~"\ 1..,;~·{,,\ '
~
South Carolina Department of Health
and Environmental Control
Bureau of Solid & Hazardous Waste Mgt
2600 Bull Street. Columbia, SC 29201
' Phone: [phone]
Emergency & Holidays: [phone] " ............ .,'
IP~e'PRINT or TYPE {Form desi ned lor use on elite 12· itch ewriter
. . UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo. Manifest
Document No.
Form A
2. Page 1
of 1
roved. 0MB No. 2050-0039 Expires 9-30-68
lnlormation in the shaded a<eas is not
required by Federal law, but is by State law.
I
I
I
I
WASTE MANIFEST c D o 9 7 6 o 4 7 1 4 O O
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
5. Transpot1er 1 Company Name
Willms Truckin Co.
7. Transpor1er 2 Company Name
Inc.
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125
6. U.S. EPA ID Number
S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7 5
11. U.S. DOT Description (incfuding Proper Shipping Name, Hazard Class, and JO Number)
IG a Hazardous Waste, Solid, NOS ORM-E
12. Containers
No. Type
::,~';'ii;"hi"t,"g~
E
N
I E
R
A
T
0
I R
I
I
I
I
I
NA 9189 1 C M 2 0 y cq1 F1 O, 0, 6,zy
b. ~,f t''l'~~l
<\1 .. 1 I~:,
C.
d.
15. Special Handling Instructions and Additional lnlormation
' GSX Work Order No.: 74194
i6. GENERATOR'S CERTIFICATION: I hereby declare thal the contents ol this consignment are fully and accurate1ydoscribod above by proper shipping name and era cia»ified,
pacl<.ed. marked, and labeled, and ore in all respects in proper condition !or transport by highway according toappllcab1a lnternallonal and national government regulations a/'\d
the laws of the Slate ol South Carolina.
If I am a large Quantity generalor, I certify Iha! I have a program In place lo reduce the volume and toxlcltyol wastoganaratod to Iha dOQree I have determined to be oconomlully
practicable and that I have selected tho practicable method cl treatment. storage, or disposal currenlly available to me which minimizes the present and !uh.Ire lhreat to huma.n
health and the environment;OA.111 am a small quantity generator, I have made a good laith eNot1 to minimize my wute generation and select tha beat waste management method
that is available to me and the! I can nfford . . 1 , Printed/Typed Name l-.j....:_ _ _!R~o~e~r__!L:.:0.JC202,:a!;!t,:::s __________ .L ___ ,C.::;:~z';!;:1;;..._~~;.....1~:!:~:!:~----..l6~~-a._Jlf;:i,1
Signature -d ~ Month Year
I
~ 17. Transporter 1 Acamowfedgement of Receipt al Materials
~ P9nted(Typed ~=-.
~ V\J. ::X::.Ct..VV\CL
Signature .·~ fo99 Month Year
I
o 18. Transporter 2 Acknowledgement of Receipt of Malerials Rf----'-------"-----'-------~---------------------------------1 T Printed/Typed Name . H~ ..,....,,,.... ______ _____.__ ________ _.....~..._
19. Discrepancy Indication Space
Signature Month Day Year
'I pbs. C I pbs.
b I jibs. d I pbs.
F •~ L lf-------------'---T 20. Facility Owner or Operator; Certification of receipt ol hazardous materials covered by lhis manHest except as noted In Item 19.
l y~----=---'-.c..;_c__~~~-'--"==~-----1 Printed/Typed Name Slg~ature Month Day Year
E~A Form 8700-22 (Rev. 9/86) Previous Editions nre Obsoleto (DHEC 1988 (Rev. 10/86)1
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Wa,te Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: (803)734-542.C I PLEASE PRINT or TYPE (Form desi ned for use on elite 12· itch ewriter
UNIFORM HAZARDOUS 1. Generator's U.S. EPA ID No. Mnnifeat Document No.
Form A
2. Page 1
of 1
roved. 0MB No. 2050-0039 E.x ires 9-30-88
Information in the shaded areas is not
required by Federal law, but is by State law.
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F
A
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L I T y
WASTE MANIFEST c D o 9 7 6 0 4 71400357
l Generator's Name and Mailing Address
Channel Master
P. O. Box 1416,
,. Generator's Phone 9 1 9
Smithfield,
934-9711
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
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 Number
S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7 5 9 8 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) ~2. Containers 13. Total Quantity 1( Unit ;·'L-'Wata~·-,\_
No. Type WtNrJ \(\){f(\i{f.'l,$/#j{fj
d.
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 74244
16. CiEHERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are tullyand accurately described abOve by proper ahipplng name and areclauifled.
packed. marked, and 18beled,and are in a11 respects in proper condition tor transpor1 by highway according to applfcablo International and national government ro,oulatlons and
tha laws ol Iha Stale ol South Carolina.
111 am a large quantity generetor, I cer1ify that I havoa program In place to reduce the volume and 10,,:lcltyof wastagonorated tothedogree I have determined to be oconomlcally
procllcable and that J have selected the practicable method ol treatment, storoge, or disposal currently available lo me which minimizes the present and future lhreal to human
health and !he environment; OR, 111 am a small quanllty generator, I have mode a good laith etrortto minimize my waste generation and select the beat waato management method
that is available to me and that I can afford .
Signature Month Day Year
. Transporter 2 Acknowledgement of Receipt ol Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I !lbs. e I !'bs.
bl !lbs. d I l'bs.
20. Facility Owner or Operator; Certification of receipt ol hazardous malerlats covered by this manifest except as noted in Item 19.
Printed/Typed Name Slgnal_ure Month Day Yw
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolete [DHEC 1988 (Rev. 10/8611
I South Carolina Department of Health
and Environmental Control
UNIFORM HAZARDOUS 1. Generator"sU.S.EPAIDNo. Manuea, 2. Page1
~--W=A~S~T~E~M~A~N~l~F~E~S~T--~~C~D~0~9~7~6~0~4~7~1~4~00
~Q~um~3~n~sN.s~·~of l
3. Generator's Name and Mailing Address
Channel Master
P. 0. Box 1416,
4. Generator's Phone 91 9
Smithfield,
934-9711
5. Transporter 1 Company Name
Willms Truckin Co.
7. Transporter 2 Company Name
Inc.
NC 27577
6. U.S. EPA ID Number
S C D O 7 3 7 0 9 2 9 7
8. U.S. EPA 10 Number
9. Designated Facility Name and Sile Address 10. U.S. EPA ID Number
GSX Services of SC, Inc.
Bureau ol Solid & Huardou.s Waste Mgt
2600 Bull Street. Columbia, SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
roved. 0MB No. 2050-0039 E.x 'res 9-30-88
Information in the shaded Meas is not
required by Federal law, but i3 by State law.
Route 1, Box 255
Pinewood SC 29125 s C D O 7 0 3 7 5 9 8 5 fa!:i.fh#Jili/;d/MU)!:Ji'so3'i''45
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total Quantity 14. Unit }V,\Aiatl·~(f-
No. Type 'MN~ !'.~\?i{C/YtJitr:rKf'
a. Hazardous Waste, Solid, Nos·oRM-E
NA 9189
GSX Work Order No.: 74245
l C M
~~f:1·~-p,~·,'6,~fi~'9t:~
2 0 Y ;\j I F1 01 0, f>iw
16. GENERATOR"S CERTIFICATION: I hereby declare that the contents ol thlaconslgnmentarefully and a.ccura.tely descrlbod a.bovo by proper shipping nam• and ar• classified.
packed. marked. and laheled,and are in at1 respects in proper condition !or transport by highway according to applicable International and naUonal government r-.gulaUons and
the laws ol the State ol South Carolina.
111 am a large quantity generator. I certify that I have a program In place to reduce the volume and toxicltyol waste generated to the d&groe 1 ha\fe determined to be ec:onomlcalty
practicable and that I have selected the practicable method ol treatment. storage, or disposal currently available to mo which minimizes the pras.ent and fut\lro threat to human
health and !he environment; QA, U I am a :small Quantity generator, I have made a good laith ettort to minimize my was le generation and select the bell wa.11111 ma.nagom•nt method
that is available to me and thal I can afford.
Printed/Typed Name Signature G~ Month Day Year
Roger L. Coats I " 3 " [?'{7
17. Transporter 1 Ac:,mowledgement of Receipl al Malerials
Printed/Typed Name ~?'C: ~#'9c
Monttl Day Year
I
18. Transporter 2 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
• I pbs. ' I pbs.
b I jibs. d I jibs.
20. Facilily Owner or Opera!or; Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Edilions are Obsoloto [DHEC 1988 (Rev. 10/86))
I South Carolina Department of Health
and Environmental Control
Bureeu ot Solid & Haz.ardous Waste Mgt
2600 Bull Stree\ Columbia. SC 29201
Phone: [phone]
I PLEASE PRINT or TYPE (Form desi ned for use on elite 12· itch writer
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
Emergency & Holidays: (803)734•5-124
Form A roved. 0MB No. 2050-0039 Ex ·res 9·30-88
2. Page 1 Information in the shaded areas is not
required by Federal law, but is by State law.
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WASTE MANIFEST c D o 9 7 6 o 4 7 1 4
3. Generator's Name and Mailing Address
Channel Master
P. O. Box 1416,
,. Generator's Phone 91 9
5. Transporter, Company Name
Willms Truckin
7. Transporter 2 Company Name
Smith field,
934-9711
Co. Inc.
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 D O 7 3 7 0 9 2 9 7
8. U.S. EPA ID Number
10. U.S. EPA ID Number
S C D O 7 0 3 7 5
11. U.S. DOT Description (including Proper Shipping Name, Hazard Class. and ID Number)
d.
~~;~;~:;~,i~15rl:~iit*?!~l!:!!iJ1f1~~,Jlll[(fti:!l!~~I~lJltlr~~~
a.~-101 21 7, 7, 41-1 )1 IJO tl}h':tiW+:,,,c.LLJ~J J J J J 1-J J J J Hi)!
b 4.,J:-:1 1-1 . dLLJ-;-1 .,,,, . ):I."''"' ,
15. Special Handling Instructions and Additional Information
GSX Work Order No.: 7'/'-f3o
of 1
, 6 •. GENERATOR0S CERTIFICATION: I hereby declare that !he contents ol this consignment are fully and accurately described above by prop.r shipping name •nd •r• claaai~.
packed, mark~. and labeled, and ere in ell respects in proper condition lortranspor1 by highway according to applicable tntarnational and national government r.gulationa and
tne laws ol the Slate ol South Carolina.
111 am a l■rge ciuantity generator, I cer1ify !hall have a praoram in place lo reduce tho volume and todcltyol waatogoneral..:t lo tho dogrH I haV'8 determined to be economicalty
practicable and that I have aetecled the prectlcable method ol trealmont. aloroge, or dlspoaal currently avallable to mo which minimizes the pra-nt and luture thtNfto huffl9n
heallh and the environment; OR, HI am a small ciuanlity generator, I have made a good la Ith effort to minimize my waste generation and aaloct tho boat waata managa~t metf10d
that is available to me and that I can otford.
Printed/Typed Name _9 7
· /'\_. ll :J e_,-
~ 17. Transporter 1 Ae;,mowledgement ol Receipt of Materials
A Printed/Typed Name ; 011t, ~ :J,/),._J
~ 18. Transporter 2 Acknowledgement ol Receipt of Materials
~ Printed/Typed Name
A
F ..
C I
L
19. Discrepancy Indication Space
Signalure
Signature
Signature
11---------------~ 20. Facility Owner or Operator; Certificalion of receipt of hazardous materlals covered by this manifest except as noted In hem 19.
Printed/Typed Name Signature
EPA Form 8700•22 (Rev. 9/86) Previous Editions are Obsolete (DHEC 1988 (Rev. 10/86)]
•._I~ ...... ....
b._l ............ ....
Year
8'7
Month Year
'ifr
Month Day Year
pbs. e I pbs.
Pb!. d I !Iba.
Month Day YNI
I South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Hazardous Waste Mgt
2600 8"11 Stree\ Columbia. SC 29201
Phone: [phone]
Emergency & Holidays: [phone]
PLEASE PRINT or TYPE (Form desi ewriler Form A roved. 0MB No. 2050-0009 Ex ires 9-30-88
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UNIFORM HAZARDOUS
WASTE MANIFEST
1 Generator's Name and Mailing Address
Channel Master
1. Generator's U.S. EPA ID No.
N C D O 9 7 6 0 4 7 1 4
P. 0. Box 1416, Smithfield, NC 27577
4. Generator's Phone [phone]
6. U.S. EPA ID Number
Manlleal
Ooc_JJmenl No. 0U3bV
2. Page 1
of 1
5. Transporter 1 Company Name
Willms Truckin Co. Inc. S C D O 7 3 7 0 9 2 9 7
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
GSX Services of SC, Inc.
Route 1, Box 255
Pinewood SC 29125
8. U.S. EPA ID Number
10. U.S. EPA ID Number
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 14. Uni A\Wa18Nwiibei'iif
No. Type YNV" ?fff!Vfttf&£%0flff:
d.
15. Special Handling Instructions and Additional lnformalion
GSX Work Order No. : 7 '-/'-/ 3 /
16. GENERATOR'S CERTIFICATION: I hereby declare that the contonls of this consignment are lullyand accuretalyde,cribed above by proper 1hlpplng nama and are clasaifle<t.
packed. markod. and labeled.and are in all respects in proper condition tor transport byhlghwey according to app11cable lnlernationel and national governmentr9gulatton1 and
the laws ol the suue ol South Caronna.
111 am a large Quantity generator, I certify !hall have a program In place lo reduce the volume and toxicity of waste generated to the degree I have de1ormlned lo be oeonomlcalty
practicable and that I have selected the practicable method of treatment, storage. or dtsposal currently available to me which mlnlmlzaa the present and future lhr-1 to human
health and the environment; OR. ii I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the boat waste management method
that is available to me and that I con alford.
Printed/Typed Name 1-:_:1 L [ .J. _ "--"-5 er-. " .xt')
19. Discrepancy Indication Space
Signature rJ/
/~e1..
• I
b I
Month Year
1
Month Day Year
l1bs. CI jibs.
jibs. d I pbs.
+ ~2-0-. -F-ac-i-1ity--,O_w_n_er_o_r_O,..p-e-ra-to_r_; C,-•-rt-il"ic_a.,.tio_n_of receipt of hazardous materials covered by this manifest except as noted In Item 19.
l y
Prinled/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 9/86) Previous Editions are Obsolelo fDHEC 1988 (Rev. 10/86)1