NCD981021157_19910423_New Hanover County Airport Burn Pit_FRBCERCLA RA_Final Closure Report - Removal Activities-OCR

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11 I i' PR0JECTS-4/8/91 :3511. FCR
ENSITE PROJECT NO. 10-0-3511
FINAL CLOSURE REPORT
REMOVAL ACTIVITIES
NEW HANOVER COUNTY
AIRPORT BURN PIT SITE
WILMINGTON, NORTH CAROLINA
Prepared for:
New Hanover County
Wilmington, North Carolina
Prepared by:
ENSITE, Inc.
5203 South Royal Atlanta Drive
Tucker, Georgia 30084
April 23, 1991
SITE
ENVIRONMENTAL SITE RESTORATION
April 23, 1991
Mr. Ray Church
New Hanover County
3002 Highway 421 North
Wilmington, NC 28401
RE: Burn Pit Site
Wihnington, North Carolina
Dear Mr. Church:
ENSITE, INC.
5203 South Royal Atlanra Drive
Tucker, Georgia 30084 • l404) 934-1180
ProjectNo.10-0-3511
Enclosed please find four copies of the final Closure Report for the above-referenced site.
The submittal of this report fulfills all of the requirements specified in the contract between
the Burn Pit PRP's and ENSITE, Inc. dated July 11, 1990. Copies of this report were also
submitted to James Kopotic, U.S. EPA, Region IV.
If you have any questions or comments, please contact me at your convenience.
Sincer ly, ~---
ack Scott
Project Manager
JS/pad
Enclosure
PROJECTS-4/8/91:3511.FCR
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INTRODUCTION
In July, 1990, ENSITE, Inc. was contracted by a Potentially Responsible Party (PRP) group
consisting of New Hanover County, the City of Wilmington, Cape Fear Community College,
and the Corps of Engineers to perform cleanup activities at the Airport Burn Pit site in
Wilmington, North Carolina. Cleanup activities included the closure of a surface
impoundment, removal of tanks and other scrap metal, removal of contaminated soil, and
confirmation sampling. The majority of cleanup activities were performed in November and
December, 1990.
BACKGROUND
The Bum Pit site is located on Gardner Drive, near the intersection with Hall Drive near
the west side of the New Hanover County Airport (Figure 1). From 1968 to 1979, the site
was used to train local fire fighting agencies. Various structures were routinely fueled with
petroleum hydrocarbons and set on fire to simulate fire emergencies.
After an evaluation of the site using the Hazard Ranking System (HRS), the site was named
to the National Priorities List (NPL) in 1989 with the aforementioned groups named as
PRP's. In 1990, a sampling investigation was performed by the U.S. EPA, Region IV to
assess potential contamination at the site. A report summarizing the findings of this
investigation is included as Appendix A An Administrative Consent Order was issued to
the PRP's by the EPA on June 21, 1990 outlining removal actions to be performed at the
site.
The site is approximately 4 acres in size and is bounded by Gardner Drive to the southeast
and by woods on all other sides (Figure 2). An earthen-berm "pit", actually a surface
impoundment, was located in the center of the site and contained approximately 12,000
gallons of oily rainwater. The berm of the pit was approximately 2.5 feet above the ground
surface and measured approximately 50 feet by 70 feet. A drain was located at the northern
end of the pit, and the water was periodically released, contaminating a portion of the
ground north of the pit. The site also contained a 10,000 fuel storage tank, a burned 10,000
gallon railroad tank car, two 2,500 fuel trucks, one burned automobile, approximately 1,300
feet of underground pipe, and several cinder block buildings. The underground pipe was
used to supply fuel from the fuel tank to the R.R. tanker, mock airplane, and cars.
REMOVAL ACTIONS
The majority of removal activities were performed in November and December, 1990. Daily
logs of field activities are presented in Appendix B. Removal actions included the following
activities:
♦ Removal and disposal of liquids from the pit and the tanks.
♦ Pipe excavation
♦ Pit closure
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PROJECTS·4/8/91:3511.FCR
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·~ NEW HANOVER COUNTY AIRPORT SCALE Drawn,-.../.BL. J;~~"o580
-as s/Jawn Checked: oc.-;;, 1 1 -I---'-------------------, Date:5.1/3/"o Fig.No. / 1!11 WILMINGTON, N. C. 1 ' /'
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NOT£.· The finished site grading should opproximalt1 the
existing topography and be sloped lo drain lo prevt,n/ ·
stormwaler pom/ing.
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NEW HANOVER COUNTY AIRPORT BURN PIT .
SCALE
WILMINGTON, NC.
Drawn:-18(..
Checked: 0&~
Date: ,!3/r3/'lo
X 30.
DEPT.
Job No.
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Scrap removal
Contaminated soil removal
Sampling
Backfilling
ENSITE and its subcontractor, Law Environmental, Inc. (LEI) mobilized to the site on
November 12, 1990, and began site preparation activities. Prior to mobilization, ENSITE
had received permission from the City of Wilmington to dispose of treated water from the
site at the local POTW. A multimedia and carbon filter system, with pumps and hoses, was
set up adjacent to the pit to treat contaminated rainwater in the pit. The treated rainwater
was to be disposed of in a sewer on Gardner Drive. However, because of viscosity of and
trash in the water, it would not pass through the treatment unit effectively.
The water in the pit and material in the tanks were transported by High Rise Services tci
Cherokee Oil in Charlotte, North Carolina for disposal. Approximately 12,500 gallons of
water were removed from the pit, and approximately 6,000 gallons of water were removed
from the tanks. Removal of liquids from the pit and tanks was completed on November 14,
1990.
On November 12, 1990 excavation of the buried pipe began. The pipe began at the fuel
supply tank and ran approximately 400 feet to a junction box located northwest of the supply
tank. At the junction box, the pipe forked off in three directions, towards the RR tanker,
·the fuel trucks, and the wrecked cars. The pipe was two-inch galvanized steel, and was
severely corroded. The pipe was removed from the site on December 5, 1990, and taken
to Horton Iron for recycling.
After all of the water was pumped from the pit on November 14, 1990, cement kiln dust was
added to wet sludges and soils in the pit to dry up any free liquids. Adequate stabilization
was necessary to allow for proper transportation and disposal. A total of five truckloads of
kiln dust was added to the pit for stabilization. The dust was added to the pit and mixed
with a trackhoe until the wet material was suitable for removal. Solidification was
completed on November 15, 1990.
After all of the liquids were removed from all of the tanks on-site, the tanks and other scrap
materials were removed from the site. On November 12, 1990, the two fuel truck bodies
were removed. On November 13, 1990, the RR tanker was removed. On November 16,
1990, the fuel supply tank was removed. The car bodies and other metal debris was
removed along with the underground pipe. All metal tanks and debris was taken to Horton
Iron for recycling.
On November 15, 1990, excavation and removal of contaminated soils and solidified pit
material was initiated. Removal efforts continued until November 20, 1990, at which time
the crew demobilized for Thanksgiving. The crew remobilized on November 26, 1990, to
continue excavation and removal activities. Removal of contaminated soil was completed
on December 5, 1990. Contaminated soil was removed from an area in and around the pit,
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from two areas northeast of the pit, from an area around the junction box, from an area
around the fuel supply tank, and from an area around the RR tanker. All contaminated
soils and solids were transported by MCO Transport and Willms Trucking to Soil
Remediation Company (SRC) in Columbia, South Carolina for disposal. A total of 3,220
tons of soil was taken to SRC. Itemized disposal totals are presented in Table 1.
After all suspected contaminated soil was excavated, samples were collected from the walls
and floors of the excavations on December 3, 1990 and December 4, 1990. The samples
were sent to Oxford Laboratories in Wilmington for analysis for Total Petroleum Fuel
Hydrocarbons (TPFH), EPA SW846 Method 3550. Concentrations ranged from ND to
6,900 ppm. Analytical results are presented in Appendix C. Because Remedial activities
will be performed at the site at a future date, it was decided not to perform further
excavation at the site at this time.
Backfilling activities began on December 13, 1990. Select Construction, a local grading
contractor, provided all fill dirt and provided backfilling services. As fill dirt was dumped,·
the dirt was pushed into excavated areas and graded. Backfiliing activities were completed
on December 18, 1990. A total of 2,680 cubic yards of backfill was imported to the site.
On November 16, 1990, five drums were found on the western portion of the site. The
drums were in poor condition, and were overpacked. The drums were sampled on
November 30, 1990, and all seemed to contain a blue paint sludge. The samples were
composited, and one composite sample was submitted to Oxford Laboratories on November
30, 1990, for analysis. The samples were analyzed for volatile organics, metals, ash, and
BTIJ's. Analytical results are presented in.Appendix C. The drums were taken to GSX in
Reidsville, North Carolina for disposal on April 16, 1991.
The City of Wilmington Engineering Department prepared a blueprint site map, which has
been included in the sleeve of this report. This map shows the previous locations of all
structures and piping at the site. The map also shows the location of all sampling points and
the extent of soil excavation. All shipping manifests and certificates of destruction have
been included in Appendix D.
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17 TABLE 1
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ffi""' l'/J,S T!O<ET I'll ms ro. Tel6 I'll ~ ~ m INVOICE NJ. D ,_
15--tbv-30 I 2c"'53 23. 24 63 23. 24 S;:-066 $442. 26 $35.39 'R6I
R 2070 21. 85 63 23.00 9o038 !!437. 63 $35, 02 $)39
2071 23. 55 E3 23. 55 85068 $448. 16 $35. 86 9:1lE9 I 16-ll\:r,i-90
I' 2078 23. 31 63 23. 31 95158 $443. :.9 $35. 48 95159
2029 17 .. 30 E3 6001?:Jl 163
! 20a1 17. 71 69 6001203152
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2082 15. 67 63 600 I 2030".,S
2033 18. 03 69 6001201164
I' 2084 15. 67 69 6001201058
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2085 19. 28 69 6001201051
2086 15. 28 69 . 6001201166
2087 15. 95 69 6001201162
20S3 15. 63 63 6001201014 I' 2092 16. 41 ES 6001203039 11 2093 21. 58 69 21. 58 95185 !1410.67 532 85 95186
I 2035 2293 63 2293 95180 $436. 36 tl4. 91 95181
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18 2108 17.57 69· 600120104!
I 19 2107 27.60 69 6001203024
11 20 21 iO 25. 57 63 6001201040
21 2109 18. 28 69 6001201031
22 2! 15 17. 71 69 6001203036
I 23 2114 17.45 69 6001203061
24 2117 17. 10 69 6001201042
25 2113 17.56 69 6001201033
26 2116 17. 69 69 6001203135
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27 2112 17. 50 69 6001201032
28 2111 16. 56 69 6001203064
29 2124 17. II 69 5001203042 11 30 2120 25. 46 69 60012030!6
31 2121 17. 93 69 6001201035 I 32 2126 18. 53 69 6001203037
I\ 34 2144 18. 78 69 6001201034
38 2119 23. 83 69 23. 83 95251 $453, 48 $36, 28 g=..252
39 2127 20. 28 63 23. 00 95198 s.l37. 69 S3S. 02 95193
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11 2143 20. 14 63 23.00 9o0!9 $437. 69 535. 02 SBJ20
33 2125 18. '88 E9 6001203156
'1 37 2!59 16. 71 69 6001203065
'I I 39 2155 17. 52 63 600,203089
! 40 2163 18. 64 69 5001203071
I 41 2151 IE. 05 69 6001203043
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43 2162 18. 73 E9 60:X) I 203C':l2
44 2164 18. 72 69 600 I '.103(44
I 45 2166 18. 48 E:9 6001203035
4S 2171 19. 08 E:9 6001203118
I 47 2170 18. 18 69 6001203034
n 48 2173 18. 19 69 600 l 20Y .fil
43 2,74 16. 25 S3 6001203117
! so 2172 19. 19 69 600!203119
I 53 2160 17. 48 63 6001203091 0 27-tbv-!Il I,
I 51 2212 22. 52 75 2100 S:iOO! $437,69 $35. 02 93J02 u 52 2215 25. 91 75 25. 91 95S33 $433. 07 533. 45 9ca34
53 2217 25. 20 75 25. 20 95331 5479. :6 538. 36 9:892
I 54 2214 2126 75 2126 95.."89 5442. 64 535. 41 923()· I
m: 55 2216 2158 75 2l 58 95985 $448. 73 $35. 90 95586
5S 2213 26. 15 75 26. 15 95387 5437.63 539. 81 85988 I' 57 2220 20. 11 75 6001203142
58 2223 29. 01 75 6001203181
m 59 2218 27. 39 75 6001203139
60 2222 28. 15 75 6001203113 I 61 2221 19. 89 75 6001203144
I 62 2224 20. 29 75 6001203147 11 63 2228 18. 85 75 6001203141
64 2219 28. 28 75 6001203145
Ii: 65 276 21. 78 75 6001203148
66 2227 21. 00 75 6001203137
67 2226 28. IO 75 6001203143 I 68 2223 20. 38 75 6001203130 11 69 2234 20. 56 75 6001203140
70 2235 20.57 75-6001203146
I 71 2230 20. 12 75 6001203128
I' 72 2232 20. 12 75 6001203174
73 2231 20. 11 75 6001203191
1· 74 2233 17. 74 75 6001203193
Ii. 75 2240 16. 97 75 6001203183
76 2241 2l 78 75 600122004!
77 2233 19. 18 75 6001203168
78 2238 18. 58 75 6001203138
I 79 2242 19. 78 75 600!203159
80 2253 20. 94 75 6001203166
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81 2254 12. 67 75 6001203179
82 2256 2l30 75 2130 95585 544140 $35. 47 9533,
83 '2:bt 19. 91 75 23. 00 95939 $437, 69 $35. 02 $)()Q
84 2258 21. 53 75 2l00 95997 $437, 69 $35,02 ~ 11 85 22S4 17.1175 6001203192
I 86 2263 IS. 80 75 6001203!94
' 87 2255 21. 11 75 6001203164 11· 88 27o0 17. 56 75 6001203190
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90 2262 2148 75 6001203185 I 91 2259 18. 12 75 6001203188 Ii 92 2208 18. 44 75 6001203175
93 22e3 18. 21 75 6001203182
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17. 78 75
23. 51 75
17. 87 75
24. 15 75
17. 68 75
17. 21 75
18. 50 75
1a 33 75
19. 19 75
20. 62 75
18. SI 75
19. 71 75
27.33 75
22. 71 75
23. 09 75
17. 54 75
22.04 75
16. 18 75
22. 36 75
20.94 75
22 82 75
2219 75
17.70 75
18.40 75
17.76 75
18. 51 75
18.47 75
16. 34 75
16. 59 75
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16. 83 75
16. 56 75
24. 71 75
22.41 75
21. 58 75
22. 47 75
22. 60 75
21.30 81
23. 37 81
21. 66 81
24. 38 81
21. 95 81
22. 18 81
25. 10 81
21. 94 81
19. 16 81
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95343 $437, 69
85939 $437,69
95937 $437. 69
95941 $437. 69
95839 $437.69
95S73 $470. 23
95879 $437, 69
95876 $437. 69
95871 $437, 69
95877 $437. 69
93179 $437, 69
96200 $444. 73
$202 $437. 69
95177 $453. 95
95174 $437. 69
95204 $437. 69
$35. 02
$35. 02
$35. 02
$35. 02
$35. 02
$37. 62
$35. 02
$35. 02
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535. 02
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$35. 58
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$37.12
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95944
95340
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95342
95970
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95:,"72
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95180
96201
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600 I 22'.Xl3S
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6001212016
600 I 22'.Xl 39
6001220040
6001220051
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6001220049
600 122'.Xl48
6001221011
6001221013
600 ! 22'.Xl50
6001220066
6001218015
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6001218012
600!21S'Jl8
6001218014
6001218013
600!219'J03
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147 2330 2S. J7 81 6001219016
148 2332 21.95 81 .2l00 !£249 $437.69 S35. 02 sac..o
149 2333 20. 72 81 2l00 £6251 $437, 69 $35. 02 95252
150 2334 22. 36 81 2l00 9o"253 $437,69 535. 02 SSc.A
151 2335 22. 22 81 23. 00 93215 $437, 69 $35.02 $216
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143 2339 21. 72 81 6001218042
149 2337 17. 31 81 600 l 21;,:e;
150 2341 19. S2 81 6001218085
151 2342 1a 92 81 6001219:Jl6
152 2343 20. 28 81 6001219:Jl7
153 2344 19. 53 SI 6001218051
154 2339 19. 04 81 6001219C65
155 2340 22. 34 81 E001219C64
TOTl'i..S 3219. 88 $16,SSS. 33 $1,350. !'li
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APPENDIX A
PROJECTS-4/8/91:3511.FCR
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INTRODUCTION
SITE SAMPLING INVESTIGATION
NEW HANOVER BURN PIT
WILMINGTON, NORTH CAROLINA
ESD PROJECT No. 90-416
MAY, 1990
During the week of April 9, 1990, John Schoolfield, Environmental Services
Division (ESD), Hazardous Waste Section, and Jim Kopotic, Superfund Emergency
Response and Removal Branch (SERRB), collected surface water, sediment, and
sludge samples at the New Hanover County Burn Pit site, located near Wilmington,
North Carolina. 'This investigation was requested by the Waste Management
Division, SERRB, US-EPA, Region IV.
BACKGROUND
The site is located on Gardner Drive, west of the New Hanover County Airport,
Wilmington, North Carolina (see Figure 1). Although termed as a "pit" (i.e.,
a relatively deep hole in the ground) the burn pit does not extend below land
surface, and is of earthen-berm construction, roughly 2.5 feet above the ground.
The pit is located in the northeast center of a four•acre tract once used for
fire training exercises. The north side of the pit contains a valve which was
formerly used to drain water from the pit onto the ground.
SITE HISTORY
The New Hanover Burn Pit was constructed around 1968 and was used from approxi•
mately 1968 to 1979 by the Cape Fear Technical Institute for fire training
purposes. The institute burned jet fuel and gasoline in the pit. Water was used
to extinguish the fires. The Wilmington Fire Department also used the Burn Pit
from 1968 to 1976. The Fire Department burned jet fuel and drainage from
petroleum fuel tanks, and used water, CO2 , and dry chemicals to extinguish the
fires. Fuel oil, kerosene, and oil from oil spill cleanups were also reportedly
burned in the pit. The pit has not been used since 1979.
At the time of this investigation, standing water was observed in the pit. An
air monitoring survey, taken with a photoionization detector (PID), conducted
_ ar_o~nd pit and within the pit, did not register a reading above background.
GEOLOGY AND SOILS
The New Hanover Burn Pit lies within the southeastern part of the Coastal Plain
of North Carolina, at an elevation of approximately 31 feet above NGVD. Local
soils are representative of Lower Coastal Plain soil conditions. Leon sands
comprise the main soil series at the Burn Pit site. This soil has a rapid
infiltration rate with moderate to high hydraulic conductivity, estimated to
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be greater than 10·3 cm/sec. The hydraulic conductivity of the subsoil, however,
is dependent on the degree of development of the organic hardpan that is commonly
present. There are two sources of ground water in the area of the site. One
source is the upper surficial groundwater, which is approximately five feet below
land surface. The other source of water is from the sandstone aquifer in the
PeeDee formation. This aquifer is approximately 50 to 80 feet below land surface
in the area of the site. There is no continuous confining layer between the
sandstone aquifer and the upper surficial groundwater.
ANALYTICAL RESULTS
A surface water sample (SW-01) was collected from apparent rain water that had
accumulated in the pit, and a·sediment sample (SD-01) was collected from the bot•
tom of the burn pit. A tank sludge sample (TS-01) was collected from "bottoms"
residue that remained in an above ground storage tank located on the east side
of the property. Sample locations are shown in Figure 2. The data are sum•
marized in Table 1 and Table 2. The complete data are attached as Appendix A.
The pit surface water sample was analyzed for volatile and extractable organic
constituents, PCBs, pesticides, metals, BOD5 and COD. The pit sediment sample
and tank sludge sample were analyzed for volatile and extractable organic
constituents, PCBs, pesticides, metals, and the toxicity characteristic leaching
procedure (TCLP) constituents. The samples were collected and handled in
accordance with the Engineering Support Branch Standard Operating Procedures
and Quality Assurance Manual (April 1986). Samples were analyzed according to
the Analytical Support Branch Operations and Quality Control Manual (June 1985).
Alphabetic letters attached to the right o~ some of the reported analytical data
values are. data qualifiers indicating the following:
J ESTIMATED VALUE
N PRESUMPTIVE EVIDENCE OF PRESENCE OF MATERIAL
A AVERAGE VALUE
U MATERIAL WAS ANALYZED FOR BUT NOT DETECTED. THE NUMBER
IS THE MINIMUM QUANTITATION LIMIT
In the following discussion, "NPDWRs MCL listed metals" -refers to those metals
which have drinking water "Maximum Contaminant Levels (MCL) 11 standards listed
in the National Primary Drinking Water Regulations (NPDWRs).1
TARGET ANALYTE LIST RESULTS
S~mple SW-01: The surface water sample collected from the pit had a BOD 5 of 17
mg/1 and a COD of 510 mg/1. Three NPDWRs MCL listed metals were detected i.e.,
arsenic (44 ug/1), barium (260 ug/1), and lead (180 ug/1). The lead value
exceeded the NPDWRs MCL standard of 50 ug/1. Two extractable organic compounds
were detected; hexadecanoic acid, methyl ester (lOOJN ug/1), and
methylheptadecanoic acid, methyl ester (50JN ug/1). One purgeable organic
compound was detected at a trace concentration (0.66J ug/1 trichloroethylene).
No pesticides or PCBs were detected in the sample.
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Sample sD,Ol: The sediment sample collected from the burn pit contained six
NPDWRs MCL listed metals ranging in concentrations from 0.10 mg/kg of mercury
to 540 mg/kg of lead. No extractable organic constituents were detected (at
minimum detection limits of 100,000 ug/kg). Five purgeable organic compounds
were detected ranging in concentrations from 45, OOOJ ug/kg ethyl benzene to
900,000JN ug/kg trimethylbenzene. No pesticide or PCB compounds were detected.
Sample TS-01: The tank sample contained six NPDWRs MCL metals ranging in
concentrations from O. 10 mg/kg of mercury to 860 mg/kg of lead. Fifteen
extractable organic constituents were detected in the sample ranging in
concentrations from 300,000JN ug/kg of (dimethypropyl)benzene to 20,000,000JN
ug/kg of dimethylnaphthalene. Five purgeable organic compounds were detected
ranging in concentrations from 26, OOOJ ug/kg o-xylene to 300, OOOJN ug/kg
trimethylbenzene. No pesticide or PCB compounds were detected.
TCLP RESULTS
SD-01 METALS ANALYSIS: The TCLP metals analysis of sediment sample SD-01
detected three NPDWRs MCL listed metals in the extract·i.e., arsenic (21 ug/1),
barium (1,800 ug/1), and lead (20 ug/1).
SD-01 EXCTRACTABLE ORGANICS ANALYSIS: During the TCLP extractable organics
analysis procedure, sample SD•Ol was found to separate into a solid phase and
a liquid phase, each of which were analyzed separately. The solid phase TCLP
extract contained. 20 extractable organic constituents ranging in concentrations
from 4J ug/1 of fluorene and phenanathrene to 200JN ug/1 of atrazine. The liquid
phase TCLP organics analysis detected no•-E!:xtractable organic ·compounds.
. . .
SD-01 PURGEABLE ORGANICS ANALYSIS: During the purgeable organics TCLP analysis
of the sediment sample SD-01, a solid phase and a liquid phase were encountered
and both analyzed. The solid phase TCLP purgeable organics analysis detected
nine purgeable organic compounds ranging in concentrations from 59 ug/1 ethyl
benzene to 900 ug/1 acetone. The liquid.phase analysis detected ten purgeable
organic·compounds ranging in concentrations from 7JN ug/1 diethylmethylbenzene
to 300JN ug/1 dimethylundecane.
SD-01 PESTICIDES/PCBs ANALYSIS: No pesticide or PCB compounds were detected in
the TCLP analysis of sample SD-01.
TS-01 METALS ANALYSIS: During the TCLP metals analysis of sample TS-01, an
aqueous phase and an oily Phase were analyzed. The aqueous phase analysis
detected three NPDWRs MCL listed metals i.e., barium (1900 ug/1), arsenic (32
ug/1), and lead (950 ug/1). The oily phase contained two NPDWRs MCL listed
.met~ls i.e., lead (5.6J mg/kg2 ) and barium (14J mg/kg).
TS-01 EXTRACTABLE ORGANICS ANALYSIS: During the TCLP extractable organics
analysis, three phases were encountered, a solid phase, an aqueous phase, and
an oily phase. The TCLP analysis of the solid phase identified 11 extractable
organic compounds ranging in concentrations from 28 ug/1 of pyrene to 2,000JN
ug/1 of methylcyclohexanamine in addition to 16 unidentified compounds. The TCLP
analysis of the aqueous phase detected nine extractable organic compounds ranging
'2 ... ·The ":es,.\lts for. ;.~is .samrl~ .were !"~?Orted i:1 mg/kb 1qecause. cha density
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in concentrations from 230J ug/1 of chrysene to 25,000 ug/1 of 2-metyl-
naphthalene in addition to 19 unidentified compounds. The TCLP analysis of the
oily phase identified eight extractable organic compounds ranging in
concentrations from 140, OOOJ ug/1 pyrene to 30,000, OOOJN ug/1 dimethylnaphthalene
in addition to 18 unidentified compounds.
TS-01 PURGEABLE ORGANICS ANALYSIS: For the TCLP purgeable organics analysis,
a solid phase and a liquid phase were analyzed. Nine purgeable organic compounds
were detected in the solid phase ranging in concentrations from 17J ug/1 benzene
to 3000JN ug/1 dimethylundecane in addition to four unidentified compounds. The
liquid phase contained eight purgeable organic compounds ranging in
concentrations from 35,000 ug/1 ethyl benzene to 400,000JN ug/1 trimethylbenzene
in addition to 5 unidentified compounds.
TS-01 PESTICIDES/PCBs ANALYSIS: No pesticide or PCB compounds were detected in
the TCLP analysis of sample TS-01.
'
~EPA
FIGURE 1
GENERAL LOCATION MAP
NEW HANOVER BURN PIT
WILMINGTON, NORTH CAROLINA
APRIL, 1990
-----,.-,,-.---·
~
PIPELINE
---

-

-
BERM / ROAD
TANK CAR
BURN AREA
0-
Q
AUTO
BURN
AREA
9
-... " ,,
\\
AIRCRAFT
BURN AREA
' ' ,,
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APPROXIMATE
/ SITE BOUNDARY
( \ ' \
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aw-01 "
BURN SD-O1
PIT
SUPPLY~
TANK /
TS-O1
FIGURE 2
APPROXIMATE SCALE
SAMPLE LOCATION MAP
NEW HANOVER BURN PIT
WILMINGTON, NORTH CAROLINA
APRIL, 1990
75 150
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TABLE 1
TARGET ANALYTE LIST ANALYTICAL DATA
NE\l HANOVER BURN PIT
\JI LHUIGT ION, NC
APRIL 10, 1990
SU-01 S0-01
BURN PIT BURN PIT
UATER SEDIMENT
04/10/90 04/10/90
1230 1320
NPOURs MCL HETALS1 UG/L MG/KG
ARSENIC 44 6.8
BARIUM 260 520
CADMIUM 3.2
CHROMIUM 25
LEAD 180 540
MERCURY 0.10
SELENIUM
SILVER
INORGANIC ELEMENTS UG/L MG/KG
COBALT 3.0
COPPER 120
MOLYBDENUM 8.6
NICKEL 11
TIN 9.2
STRONTIUM 36 33
TITANIUM 33
VANADIUM 18
ZINC 20 310
ALUMINUM 190 1500
MANGANESE 550 170
HG/L MG/KG
CALCIUM 8.7 5400
MAGNESIUM 1.8 420
IRON 35 12000
SODIUM 26 110
GENERAL ORGANIC PARAMETERS MG/L MG/L
BIO-CHEMICAL OXYGEN DEHAN0,5 DAY 17 NA
CHEMICAL OXYGEN DEMAND 510 NA
**************************************************••--·········
*_.FOOTNOTES***
1 • 40 CFR, Part 141, National Primary Drinking Uater Regulations,
Maxim.in Contaminant Levels, (July 1, 1989).
NA NOT ANAL YlED
J ESTIMATED VALUE
N PRESUMPTIVE EVIDENCE OF PRESENCE OF MATERIAL
MATERIAL UAS ANALYZED FOR BUT NOT DETECTED
SUMMARY ~
TS-01
TANK
SLUDGE
04/10/90
1420
MG/KG
3.3
450
0.54
8.5
860
0.10
MG/KG
1.2
17
1.4
3.8
2.9
7.8
14
12
180
180
53
MG/KG
800
130
3400
940
MG/L
NA
NA
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PAGE 2 TABLE 1
TARGET ANALYTE LIST ANALYTICAL DATA
NEij HANOVER BURN PIT
EXTRACTABLE ORGANIC COMPCIJNOS
2-METHYLNAPHTHALENE
NAPHTHALENE
FLUORENE
PHENANTHRENE
Hexadecanoic acid, methyl ester
Methylheptadecanoic acid,methyl ester
(Oimethylpropyl}benzene
1-Methylnaphthalene
Ethenylnaphthalene
Oimethylnaphthalene(S-isomers)
Trimethylnaphthalene(6-isomers)
Propenylnaphthalene
Methylphenanthrene(4-isomers)
Dimethylphenanthrene(4-isomers)
Trimethylphenanthrene
Petroleun product
2·Unidentified C~unds
PURGEABLE ORGANIC COMPOUNDS
TRICHLOROETHENE(TRICHLOROETHYLENE)
TOLUENE
ETHYL BENZENE
(M· ANO/OR P·)XYLENE
0-XYLENE
TRIMETHYLBENZENE (3 ISOMERS)
ETHYLHETHYLBENZENE
TRIMETHYLBENZENE
PETROLEUM PROOUCT
.. *FOOTNOTES***
NA NOT ANALYZED
J ESTIMATED VALUE
N PRESUMPTIVE EVIDENCE OF PRESENCE OF MATERIAL
MATERIAL UAS ANALYZED FOR BUT NOT DETECTED
WILHUiGTtON, NC
APRIL 10, 1990
sw-01 50·01
BURN PIT BURN PIT
WATER SEDIMENT
04/10/90 04/10/90
1230 1320
UG/L UG/KG
100JN
SOJN
N
UG/L UG/KG
.66J
45DOOJ
47000J
900D00JN
100000JN
N
, -·._.
SUMMARY
.,
Ts-o,
TANK
SLUDGE
04/10/90
1420
UG/KG
4.2E6
680000J
340000J
700000J
3D0000JN
3E6JN
1E6JN
2DE6JN
10E6JN
2E6JN
3E6JN
3E6JN
200000JN
N
4E6J
UG/KG
100000J
60000J
26000J
300000JN
N
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I
I ARSENIC
BARIUM
COBALT
i NICl(El
I LEAD
VANADIUM
ZINC
I ALUMINUM • MANGANESE
CALCIUM
MAGNESIUM 1, IRON
I SOOIUM2
POTASSIUM
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TABLE 2
!CLP DATA SUMMARY
NEU HANOVER BURN PIT
\,HLMINGTON, NC
APRIL 10, 1990
SD-01
BURN
PIT
SEDIMENT
SAMPLE
04/10/90
1320
UG/L
21
1800
24
41
20
8
500J
340
1600
210000
5300
94000J
1400000
TS-01
TANI(
SLUDGE
AQUEOUS
PHASE
04/10/90
1420
UG/L
32 .
1900
18
37
950
25
850J
400
210
19000
4800
12000J
1500000
4000
i
If,; IJ ···················································-···-·····
I
TS·01
TANI(
SLUDGE
OILY
PHASE
04/10/90
1420
MG/KG1
14J
2.5
5.6J
7.6
62J
23
j*** FOOTNOTES**•
I. . ·· THE RESULTS FOR THIS SAMPLE UERE REPORTED IN HG/KG BECAUSE THE DENSITY OF THE MATERIAL UAS NOT SIMILAR TO UATER. I · SODIUM VALUES FOR THE EXTRACTS ARE LIKELY BIASED HIGH DUE TO THE SOOIUM CONTRIBUTION FROM THE EXTRACTION FLUID.
NA • NOT ANAL YZEO ·
1 J EST !MATED VALUE
I PRESUMPTIVE EVIDENCE OF PRESENCE OF MATERIAL 1·1 MATERIAL \JAS ANALYZED FOR BUT NOT DETECTED
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TABLE 2
TCLP DATA SUMMARY
NEY HANOVER BURN PIT
' \JILMINGTON, NC
I '
APRIL 10, 1990
SD-01 S0-01
I
I
PIT PIT
SEDIMENT SEDIMENT
SOLID LIQUID
PH.ASE PHASE
' 04/10/90 04/10/90
I 1320 1320 I cATRACTABLE ORGANIC COMPOUNDS UG/L UG/L
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2-METHYLNAPHTHALENE
NAPHTHALENE
ACENAPHTHENE
FLUORENE
PHENANTHRENE
PYRENE
CHRYSENE
2-METHYLPHENOL
DIMETHYLCYCLOHEXANAMINE
ETHYLOlHETHYLPYRIOINE
CYCLOHEXANEHETHANOL
TR I METHYLPHENOL
DIBUTYLACETAMIDE
TRIMETHYLPHENYLETHANONE (2 ISOMERS)
DIMETHYLBENZENEOICARBOXALDEHYDE
ATRAZINE
1-METHYLNAPHTHALENE
DIMETHYLNAPHTHALENE
TRIMETHYLNAPHTHALENE
METHYLCYCLOHEXANAHINE
PETROLEUM PROOUCT
OIMETHYLNAPHTHALENE (2 ISOMERS)
16 UN I DEN"t IF I ED COMPOUNDS
19 UNIDENTIFIED COMPOONDS
18 UNJOENTIFIED COMPOUNDS
5 UNIDENTIFIED COMPOUNDS
-*•FOOTNOTES*"'*
NA MOT ANALYZED
J ESTIMATED VALUE
67
64
4J
4J
100JN
30JN
20JN
20JN
20JN
90JN
20JN
200JN
70JN
40JN
60JN
100J
M PRESUMPTIVE EVIDENCE OF PRESENCE OF MATERIAL
MATERIAL WAS ANALYZED FOR BUT NOT DETECTED
·~
TS-01 TS-01 TS·01
TANK TANK TANK
SLUDGE SLUDGE SLUDGE
SOLID AOUEOUS OILY
PHASE PHASE PHASE
04/10/90 04/10/90 04/10/90
1420 1420 1420
UG/L UG/L UG/L
1400 25000 6500000
330 4500 1100000
1100 350000JN
170 700000
270 5900 2300000
28 580 140000J
230J
110 570
1000JN
1000JN
1000JN
2000JN 8000JN
N N N
3E+07JN
30000J
300000J
3E+08J
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IGE 3
JRGEABLE ORGANIC COMPOUNDS
ACETONE
METHYL ETHYL KETONE
BENZENE
2-CHLOROETHYLVINYL ETHER
TOLUENE
ETHYL BENZENE
TOTAL XYLENES
ETHYLOIMETHYLBENZENE (2 ISOMERS)
BUTANOIC ACID, HETHYLETHYLESTER
METHOXYHETHYLPROPANE
TETRAMETHYLBENZENE (2 ISOMERS)
DlMETHYLUNDECANE (2 ISOMERS)
ETHYLOIHETHYLBENZENE
TETRAMETHYLBENZENE
OIETHYLMETHYLBENZENE
OIMETHYLUNOECANE
METHYLDOCECANE
OIHYOROMETHYLINDENE
OIETHYLBENZENE
METHYLOCTANE (2 ISOMERS)
TRIMETHYLBENZENE
METHYLNONANE
ETHYLMETHYLBENZENE
~ UNIDENTIFIED COMPOUND
5 UNIDENTIFIED COMPOUNDS
'*FOOTNOTES***
NA NOT ANAL YZEO
J ESTIMATED VALUE
N PRESUMPTIVE EVIDENCE OF PRESENCE OF MATERIAL
MATERIAL UAS ANALYZED FOR BUT NOT DETECTED
TABLE 2
TCLP DATA SUMMARY
IBI HANOVER BURN P 1 T
UILHINGT0N, NC
APRIL 10, 1990
SD-O1 SD·D1
TClP TCLP
SOLIDS LICUtD
PIIASE PHASE
04/10/90 04/10/90
1320 1320
UG/1. UG/L
900
SOUR
67 17 J
NA NA
59 23J n
200JI
200JII
20JN
60JN
300JN
90JN
100JI
7 JN
200JI 100JN
200JI 80JN
20JN
TS-01 TS-01
TCLP TCLP
SOLIDS LIQUID
PHASE PHASE
04/10/90 04/10/90
1420 1420
UG/L UG/L
830J
SOUR 130000J
17 J
NA NA
150J 160000
35000
250000
SOOJN
100JN
3000JN
1000JN
400JN
1000JN
100000JN
400000JN
BOOOOJN
100000JN
1000J
1000000J
U MATERIAL UAS ANALYZED FOR BUT NOT DETECTED, THE NUIIIIER IS THE MINIMUM OUANTITATION LIMIT
R QUALITY CONTROL INDICATES THAT DATA ARE UNUSEABLE, COMPOUND MAY OR MAY NOT BE PRESENT
RESAMPLING AND REANALYSIS IS NECESSARY FOR VERIFICATION, THE VALUE IS THAT REPORTED BY THE LABORATORY
~
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FIELD ACTIVITY DAILY LOG
FIELD ACTIVITY SUBJECT: o oYP-Prr
DESCRIPTION OF DAILY ACTIVITIES A,"!IJ EVENTS:
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CHANGES FROM PLANS AND SPEClf-lCATIONS, AND
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WEATHER CONDITIONS:
PERSONNEL UN SIH.:
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FIELD ACTIVITY DAILY LOG
PROJECT NAME New Hanover Countv -Burn Pit I PROJECT NO. 59-0580
1.-IELO ACTIVITY SUBJECT: to,vT.
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LAW.ENVIRONMENTAL INC.
FIELD ACTIVITY DAILY LOG
,. NO. 0 C, ? -'
-< j "' SHEET or-·
PROJECT NAME New Hanover Count, -Burn Pit PROJECT NO. 59 -0580
FIELD ACTIVITY SUBJECT, 1',,'J/";,(.. •
DESCRIPTION OF DAILY ACTIVITIES ANIJ EVENTS, SKETCH I ' .,. ,
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FIELD ACTIVITY DAILY LOG
PROJECT NAME New Hanover Count, -Burn Pit
l'IELD ACTIVITY SUBJECT: WA'::f("E. F1y,<M'10
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PROJECT NAME New Hanover Count -Burn Pit PROJECT NO. 59 -0 5 8 0
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PROJECT NAME New Hanover Count, -Burn Pit PROJECT NO. 59 -0580
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PROJECT NAME New Hanover Countv -Burn Pit I PROJECT NO. 59 -0580
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PROJECT NAME New Hanover County -Burn Pit I PROJECT NO. 59-0580
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PROJECT NAME New Hanover Count, -Burn Pit PROJECT NO. 59 -0580
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PROJECT NAME New Hanover Count, -Burn Pi! PROJECTNO. 59-0580
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PROJECTNAME New Hanover County -Burn Pit I PROJECT NO. 59-0580
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11
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I APPENDIX C
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I 11
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I PROJECTS-4/8/91:3511.FCR
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..... :1. ' ,-:.__ ________________________________ _
Oxford Laboratories, Inc.
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
Analytical and Consulting Chemists
1316 South Fifth Street
DATE RECEIVED 11-30-9 O Wilmington, N.C. 28401
DATE REPORTED 12-12-90 [phone]
90\'/646 5
PAGE 1 OF 5
P.O. # 3511-13
SAMPLE DESCRIPTION: DRUMS 1-4 (62300)
1. DRUMS 1-4 COMP
I Dichlorodifluoromethane, PPM
Chloromethane, PPM
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D
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Vinyl Chloride, PPM
Bromomethane, PPM
Chloroethane, PPM
Trichlorofluoromethane, PPM
1,1-Dichloroethene, PPM
Methylene Chloride, PPM
Trans-1,2-Dichloroethene, PPM
1,1-Dichloroethane, PPM
2,2-Dichloropropane, PPM
Cis-1,2-Dichloroethene, PPM
Chloroform, PPM
•.
RESULTS
.:1..
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
Oxford Laboratories, Inc.
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
DATE RECEIVED
DATE REPORTED
90W6465
Analytical and Consulting Chemists
1316 South Fifth Street
11-30-90 Wilmington, N.C. 28401
12-12-90 [phone]
PAGE 2 OF 5
P.O. # 3511-13
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I SAMPLE DESCRIPTION: DRUMS 1-4 (6230D)
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1. DRUMS 1-4 COMP
Bromochloromethane, PPM
1,1,1-Trichloroethane, PPM
1,1-Dichloropropene, PPM
I Carbon Tetrachloride,· PPM
Benzene, PPM
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1,2-Dichloroethane, PPM
Trichloroethene, PPM
1,2-Dichloropropane, PPM
Bromodichloromethane, PPM
Dibromomethane, PPM
Toluene; PPM
1,1,2-Trichloroethane, PPM
Tetrachloroethene, PPM
RESULTS
....1
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
44700
<200
<200
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Oxford Laboratories, Inc.
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: .LINDSEY HADDOX
DATE RECEIVED
DATE REPORTED
90W6465
Analytical and Consulting Chemists
1316 South Fifth Street
11-30-90 Wilmington, N.C. 28401
12-12-90 [phone]
PAGE 3 OF 5
P.O. # 3511-13
SAMPLE DESCRIPTION: DRUMS 1-4 (6230D)
1. DRUMS 1-4 COMP
1,3-Dichloropropane, PPM
Dibromochloromethane, PPM
1,2-Dibromoethane, PPM
Chlorobenzene, PPM
Ethyl Benzene, PPM
1,1,1,2-Tetrachloroethane, PPM
H-Xylene, PPM
P-Xylene, PPM
0-Xylene, PPM
Styrene, PPM
Isopropylbenzene, PPM
Bromoform, PPM
1,1,2,2-Tetrachloroethane, PPM
·-
RESULTS
<200
<.200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
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••
Oxford Laboratories, Inc.
.,
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
DATE RECEIVED
DATE REPORTED
90W6465
PAGE 4 OF
Analytical and Consul ting Chemists
1316 South Fifth Street
11~30-90
12-12-90
5
Wilmington, N.C. 28401
[phone]
P.O. # 3511-13
SAMPLE DESCRIPTION: DRUMS 1-4 (6230D)
1. DRUMS 1-4 COMP
1,2,3-Trichloropropane, PPM
N-Propylbenzene, PPM
Bromobenzene, PPM
1,3,5-Trimethylbenzene, PPM
o-Chlorotoluene, PPM
p-Chlorotoluene, PPM
tert-Butylbenzene, PPM
1,2,4-Trimethylbenzene, PPM
sec-Butylberizene, PPM
p-Isopropyltoluene, PPM
1,3-Dic~lorobenene, PPM
1,4-Dichlorobenene, PPM
N-Butylbenzene, PPM
•,
RESULTS
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
<200
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Oxford Laboratories, Inc. Analytical and Consulting Chemists
1316 South Fifth Street
DATE RECEIVED 11-30-90
DATE REPORTED 12-12-90
90\'16465
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
PAGE 5 OF 5
P.O. # 3511-13
SAMPLE DESCRIPTION: DRUMS 1-4 (6230D)
1. DRUMS 1-4 COMP
1,2-Dichlorobenzene, PPM
1,2-Dibrorno-3-Chloropropane, PPM
1,2,4-Trichlorobenzene, PPM
Hexachloro-1-3-butadiene, PPM
Naphthalene, PPM
1,2,3-Trichlorobenzene, PPM
RESULTS
<200
<200
<200
<200
<200
<200
Wilmington, N.C. 28401
[phone]
BRUCE A. BABSON, CHEMIST
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Oxford Laboratories, Inc.
DATE RECEIVED
DATE REPORTED
90W6464
Analytical and Consul ting Chemists
11-30-90 1316 South Fifth Street
12-19-90 Wilmington, N.C. 28401
[phone]
PAGE 1 OF 1 DEC 2 6 \990
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY HADDOX
SAMPLE DESCRIPTION: DRUMS 1-4 COMPOSITE
1. D~UHS 1-4 COMPOSITE
RESULTS
BTU/lb
Ash, @ 750 C, %
--1.
2752
80.06
<,05
36.0
92.5
330
.086
1. 52
P.O. # 3511-13
Arsenic, as As, Wt/Wt PPM
Barium, as Ba, Wt/Wt PPM
Cadmium, as Cd, Wt/Wt PPM
Chromium, as Cr, Wt/Wt PPM
Lead, as Pb, Wt/Wt PPM
Mercury, as Hg, Wt/Wt PPM
Selenium, as Se, Wt/Wt PPM
Silver, as Ag, Wt/Wt PPM <1.00
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Oxforo. Laboratories, Inc.
DATE RECEIVED
DATE REPORTED
90W6514
Analytical and Consul ting Chemists
1316 South Fifth Street 12-4-90
12-12-90 Wilmington, N.C. 28401
[phone]
PAGE 1 OF 4
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
SAMPLE DESCRIPTION: 20 SOIL FOR TPFH
1. SOUTH TRENCH
2. SOUTH WALL BURN PIT
3. WEST PIT WALL
4. NORTH PIT WALL
5. EAST PIT BOTTOM
6. WEST PIT BOTTOM
RESULTS
Total Petroleum Fuel Hydrocarbons
using SW846 3550 with GC/FID
as #2 Fuel Oil, PPM
P.O. # 3511-15
OEC 1 4 1SS'.'I
--1.
<10 164 <10 6910 400
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Oxford 'Laboratories, Inc.
DATE RECEIVED
DATE REPORTED
90W6514
Analytical and Consulting Chemists
12-4-90 1316 South Fifth Street
12-12-90 Wilmington, N.C. 28401
[phone]
PAGE 2 OF 4
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
SAMPLE DESCRIPTION: 20 SOIL FOR TPFH
7. MIDDLE PIT BOTTOM
8. EAST PIT BOTTOM
9. SPILL AREA
10. CENTER TRENCH/ SO. OF J. B.
11. JUNCTION BOX BOTTOM
12. JUNCTION BOX SIDES
RESULTS
Total Petroleum Fuel Hydrocarbons
using SW846 3550 with GC/FID
as #2 Fuel Oil, PPM
•.
P.O. # 3511-15
..2 ..2. _!_1 -11.
1240 2530 829 122 67.2 <10
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Oxford 'Laboratories, Inc.
DATE RECEIVED
DATE REPORTED
90W6514
Analytical and Consulting Chemists
12-4-90
12-12-90
1316 South Fifth Street
Wilmington, N.C. 28401
[phone]
PAGE 3 OF 4
n
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ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY HADDOX
SAMPLE DESCRIPTION: 20 SOIL FOR TPFH
13. SMALL BURN PIT SIDES
14. SHALL BURN PIT BOTTOM
15. EAST TRENCH
16. CENTER TRENCH
17. WEST TRENCH
18. RAIL TANKER BOTTOM
RESULTS
I Total Petroleum Fuel Hydrocarbons
I using SW846 3550 with GC/FID
as #2 Fuel Oil, PPM
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•.
P. 0. # 3 51.1-15
__ll J.1. -1§.
<10 2600 <10 304 <10 34.5
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Oxford· Laboratories, Inc.
ENSITE INCORPORATED
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
ATTENTION: LINDSEY MADDOX
DATE RECEIVED
DATE REPORTED
90W6514
Analytical and Consul ting Chemists
12-4-90 1316 South Fifth Street
12-12-90 Wilmington, N.C. 28401
[phone]
PAGE 4 OF 4
P.O. # 3511-15
SAMPLE DESCRIPTION: 20 SOIL FOR TPFH
19. RAIL TANKER SIDES
20. SMALL BURN PIT TRENCH
RESULTS
_ll ~ I Total Petroleum Fuel Hydrocarbons
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using SW846 3550 with GC/FID
as #2 Fuel Oil, PPM
·-
<10 <10
BRUCE A. BABSON, CHEMIST
;203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
404} 934-1180
'--' STA. NO DATE TIME
I l'Rx. lr301JI
~ nquished by: (Signafute/
STATION LOCATION
CHAIN OF CUSTODY RECORD
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Relinquished by: (S,fj/natvre}
Relinquished by: (S1Qnature)
I Wa1e,IWHlew11er
Date/Time Received by: (Signature/
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Oa1e/Time Received by: (Signature}
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IISTRIBUTJON: Each time a sample is relmqu1shed, the person relmqu,shmg same shall keep bottom copy.
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Misc. I
REMARKS/TAG NUMBERS
- - - --- -
CHAIN OF CUSTODY RECORD
5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30084
[404) 934-1180
PROJ. NO. PROJECT NAME lQ
351\ New l\qt'\/)\)P..-('""".\.., Bvr"' P:-1-~ ~;:;;,,.,;,,.,:.=-,...l!.=~===~===l--"':..:....:..:....'-!..!....._-, :<
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,elinquished by. (S,gn•tur•J. Date/Time Received by: (Signature)
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[)1$TAIBUTI~~: Each \1me a sample 1s relinquished, the person rehnqu1sh1ng same shall keep bottom copy.
I Waler/Was1ewater
Date/Time Recei~ed by: (Signature)
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I SoillSed I SldglWasle I Misc. I
REMARKS/TAG NUMBERS
.,
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5203 S. ROYAL ATLANTA DR.
TUCKER, GA 30064
( 404) 934-1180
DATE\.
~ "' STA. NO TIME ~ ~
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STATION LOCATION
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CHAIN OF CUSTODY RECORD
' . I Wate,IWastewauir I SoillSed I Sldg1W1,1e I Misc. I
REMARKS/TAG NUMBERS
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eliflQUIShed by. (S1gn,iure/ Date/Time Received by: (Signature} Relinquished by: {Signs/rm:) Date/Time Recei~ed by:(Signa1ure/
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DISTRIBUTION: Each time a sample 1s rehnqu1shed, the person relinquishing same shall keep bottom copy.
liiii . ----

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D APPENDIXD
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I PROJECTS-4/8/91:3511.FCR
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NOR.TH CAROLINA HAZARDOUS WASTE MANIFEST
· (form d .. igrltld for us• on 11/ir,1 (12-p,tchl lyp11writ~r.J
UNIF RM HAZARDOUS
WASTE MANIFEST
1. Generator's US EPA ID.No.
NO
3. Generator's Name and Malllng Address
NEW HANOVER COONI'Y ( Pick Up) ENSITE ENVIRONMENJ'AL,
5203 South Royal Atlanta, 'fucker, GA 30084
4, Gene,otor, Pnone ( . 404 ) 934-1180 Jack Scott
5, Transporter 1 Company Name 6.
9. DesJgnateCI Facility Name and Site Address 10,
Iaidlaw Environrrental Services (TS) , Inc.
Route 11, !bx 3, Reidsville, NC 27320 NCO
T Description {Including Proper Shipping Name. Ha!ard Class. and f .. !ti~<\ rd o.,.S l>Jc; s Sol,clj ,.,_o?. · R.~ 01<11~1
( I'.)
b,
C.
d,
US EPA ID Number
15. Special Hand I Ing I nstructlons and Addltlonal I nformatlon TRAILER NJ: 36£ IS<./ Eirergency Contact: 1-800-535-5053-598
Pick Up: New Hanover County, Gardner and Hall Drive, Wilmin on NC 28401 16. GENERATOR'S CERTIFICATION: I hereoy declare 1ha1 the con1en1s ot 1h1s cons1gnmem are fully and accura1ely descnbed above by proper shrpp,ng name and are c!assdied. packed, marked, and labeh!d, and are 1n aU respeCIS in prGper cornhtion lot uansoon by highway according 10 applicable in1erna11onal and national government regulations. and all applicable stata laws and regi,lations.
111 am a large quan1i1Y generator, I cerufy 1ha1 I have a program 1n place 10 reduce the volumeandto•1ciry ol waste generated 1O1hedt!9reel havedelerm,ned to be 8 economically prac11cabte and 1ha1 I have selected !he prac1,cable mechod of 1rea1men1. storage.Of disposal currently ava,lable 10 me which m1mm1tes the ptesont and a future 1t1rear 10 human neallh and the env1ronmen1; OR. 11 I am a small Quan111y generalor, lhave made a good fa11h effon lo m1n1m11e mywas1e9enera11on·and sale-ct 1. the bes! waste mana ement method rha1 1s available 10 me and Cl'lat I can afford.
Printed/Typed Name
·"/\i) . "'n~ Monrh
I t 17. Transporter l Acknowledgement of Receipt of Materials .R ~ 1--P_"_"_'P'.,.:'::c;Tc...Y.!P{._::•d:!;::..;€__;,m=:o:__LC:::_:'.'i_-/Lk',.:\:_.:_' . .:'.v'\~5~--------L_J~:::'.,.,d::!:l(...'~~~~!:.,;~~~-------.l!M::'.o1n.'.:,n1'.l,:/:_OJ.j,62J]~'.J•l,:'.;__j
l~,11_e_.T::-'~'-"-•P_o-c:rt~•-•_2-,-A~c-k_n_o_w_1e_d_g_e_m_,_n_1_o_f_R_•_c_e_1P_t_o_f_M_a_1_,_,_1,_1_, ___ -,r-:c-------------------------:-:-----=------t Printed/Typed Name Signature Montl"I D•r Ytt•r
I -+-i -------L...------'---'--'-'-~ 19. Discrepancy lnalcatlon Space I .
I I !
j • 20, Faclllty oWner or Operator: certification of receipt of hazardous matedals covered bY this manifest except u noted In item 19. I Printed/Typed Name
I, EPA '°""-~~~;~;. ~-' ,"c"~'./~l.?:.u~ .. s~--~~-;,:Q~ .. l~T.::;'~;~~~::..:.A::.R::E~O;;B::S.:.0.:L::E.::T:E:: . ..;..=;;a.:....----=-"------------------------'--"-'-'--'-'~-'-----'---
Signature Monr,1 Oar Ye•r
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CHEROKEE RESOURCES WASTE MATERIAL MANIFEST
I Generator·s US ~?A iO So.:
NC1)?31).P39S7 •
IJ~Mrair:.r"~ ~ame and ,~ailing .Address
I Page 1
of
1 ,177 l
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HIGH ~)SE SER~lCE COM?A~Y, rue:, RT 5 ,-/!E RO'/ STER l<r)AD, LE LA.\/0, !IC ?. J J 5 1
IH91
Tran;porter 1 Company Name . . .
1/lG/J ~JSE Sl:R'/lCE CO,i.".,\/11/, . . ·; . ' .. ,. . . . . --, . · .. •:
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CHEROKEE RESOURCES WASTE MATERIAL MANIFEST
Generator·s US i:?A ;Q so.:
NC O •} .~ J :< J 3 ,J ·j :
G~n~ratr::r"~ Sam~ anC 1.Aa,iing .Addre$S
~!IGH ~7iE S~~Y-1CE COtl?AJJ, Iil~.
CHEROKEE RESOURCES INC.
1201 _Berfhill Rd._ .
l'.:harlotte, .NG 28208_
7 .t .. s '(fOT .. Ce~cr.iPt!Ort (ln~!u•a'(n;Q
.hio "iri 1--/am~:·Ha a;~ ··1-~-;
·. TIMEOUT ,. : .. , '·':. ,. -..... .
US E?A iO ·"o.:
L:S E?A ;o No.,
US E?A 10 No.,
Pl<;& 1
ot I
1 J 77 J
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. " . . ,:, • ... -'·.' . ' .·:' :,: . -~.: ,\ ., , :• .. : : ;.; , ~::--1·~•-' ·: •,;:,,-,;:-,' .. •· -' ~ • ;:; ; . \:-(-• .. • ,, . ·. '.'. :.."_ '~'.:. . .. .-:, ",-, •_ ... : .. : .. ' .,. • • •• .' . •,,:c·,": •• :'.'.· ·._; _,,._:·· , :: .:·.,'•I;;:; :· . \.
GENE:=IAT_OA 'S CERTIFICATION: I he"r8b'y declare· that the Contents·of this cOnsigriment are fully and accurately: described aboYe b -~,
'p~oper shipping. name.· ~nd _are cl~ssifi.ed,.packed, ~ar~~d, and labeled, and areJn all resP:~cts in prope_r. co~d:i_tion f~r t~_na~port by_ .-.·.·:· _highway ~ccord1ng to applicable 1nternat1onal and national governmen.t regulat1ons. . •. •.)' · ·. · -:~ °' . · -: .· ·. · .•: ··•. :··-.. ·· . '":-.·· :.
· .. :.·: ,:.".:.;-.·.~:··-~;.->:.; .. _·::;;~,;:·.·.·.:...·,~,":··./•;.,-.:.::;•:·;::·_.·~·:."·:•-· ·:.·-:.:._;,::,.:·.•;,.a· · . .-:.,::.·.;.·_-.. :.·;·~·:.•~/ .. · ;. =:···:·•-:;•.· .. -·_.;" .,: :; -,-~•:·.:,.:_-_,;·-.
If I am a large quantity genera.tor, I certify that I ha_v~ a program in place to reduce the volurrye and tox1c;:1ty of waste a generated to the _. degree! have determined to be econom1callt practacaOle an_d _that I have selec:~d the pract1cble method of_ treatment, storage, or· .. : ·,
di~posat currently available to in(iwliich min1mize·s the present and future threat to human health and the environment; OR, if !_am a · small q_uantity generator, l_hav.e r_nade a good faith effprt to mi~imize_my waste generati_?n _and se_le~t th_~ best waste ,:,,~.n~ge_r:n.~nt , · · methoo that 1s available to me and that I can afford.. · ' · ;, •
PrintedjTyped Name
' ,I ·t ,-:_,, '~: p ,L ,i .J, .
r~nsporter_ ri 1: Acxnow!ecgement or; ee:e1pt 01.,
~r1n~ed/~ype_~--~~-':1e .. : . ~·. ,_ .-:_ ::,, .. : . .: . _· .. ,_
THO.'i\s iiA11k r ils
ransporter .-12: ckncwieagement o
Print_ed/T1P:d Name : ·-· · :· _.: .. ·:·.
: . :·_<;· j:(.• \~//-:'" -:· .. :
.'/":
' . ---·-·-· ------·~ ··--· ···-·-
. Signa~~/e
. -t : / :',;)~---~--/: ·
,/)
/!;-. --,•
:.:..·oa1e·. ...... . .
11/1 i/18
/IS)gn~~?::·\ _.•·.
.. ;.// .... -.·, --~~
:-. .".Dilte: ._'.:.( .
·1·11hl10
Signature
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CHEROKEE RESOURCES WASTE MATEF.IAL MANIFEST
I ~enerato,·s US =?A :o .•:o.:
.'·JC D q J ,J :? .l J :_i :; i
s~r.'!ra:r;r'~ Same and t.Aailir,Q Address
111 '-~ H :~ IS E SE:<. 11 ICC CO,'.{?,\ ri 'I ,
(IP}
T:an;por:~r , Company Name US C?l. tO ."+c.:
HI(;~ R1SE ·sE~VICE CO~fPAN1/, I~IC. :, C 09 l ·.' i ~ 3 ·J 5 J
CHEROKEE RESOURCES INC. . . US E?A 10 ~o.:
i 201 Beryhill Rd.• : ·
Charlotte, NC .28208. '7 4 . . . . .
. Sludge.
uGuid ...
as
1 )7 i 1
J' ,, ,l(.
· · PourldS _·.
i c~. f<Js
,.-1 Gallons
,· .. Tons -·
~~\:!J~i;~~}Jltt:,0Yt~•~(\!{\t?~:;:,.\.:ff-'·:,'\i:)"\:'~~t1!~;)!:·t}II::·,_.'.t_/:'.::'.}Jp~f~t?/}i\:,,,/;
' •''. . ·.:,•.
Special Handling ln_structions,_Addi_tional Information; & Discrepancy tn,dication::
f-'••·::cI,...>.:..}"') ..... t.:c;'-: ._f-..... /.::.:q..c} ..... Yc,:'f_._;, ..... i'"ic;.t ..... } ..... /~:e_._k ..... -I ...... : ..... i ..... { ..... it ..... I'. ..... t ..... f ..... l"-/ ..... i~ ..... :4 ..... i ..... \-"0.'-·~•"-;
1
..... t"'J.,;;f'-J"'"}..,c!/,..,/_b....:··~::.:;:c'·, . .:..~"cc/.,.;;,_:t:..,\.c.'.,c")_·,:,},::.'.f.,.L"'{i.:.:\l"'\"",:"'~.~:..,,;-:-'t"'}'-\'-':(.'"".:._;'.:.:.:\:...'· ·"':. _· ·""-'-'--'-. -'-: '."-i-'-1;: :t;.
,'. ·•·.•:.·:-, , .. ,,,:•··,.·.·;,:_•.,_:\-'..:· • c·•,•:· -~-,:_.,,•"'.:••;··•·:,,,:-4·.\~·,·>,;-·{;":. ,\•;._·:,', .·.•.:.~.--:-· •·:-:.:..;.,_'_.··~-•.· .. ·._-.. :,·.,.·.·•·;,;-_ •_-·_._ .. , ·• .'''.,·,,',·: ,, . · .-···., y;·~:
· .. GENERATOR'S ·cERTIFICA T.ION:· I her-eb·y decl.ir8 that the cOnt"ents of this· cof'lsignriient are fUlly a:nct aCCuratety:'described above b
i • proper shipping_ nam~ _and_are.cl<1;ssifie_d,_pack_e_d, mar~ed, and labeled, and are.in all_respec~s in_ pro_ per co~ditlon !or trnas_port by · •.
,. : highway accordirrn to _apphca~le_ rnte(nat1onal and n_ at1onal gox!='rnrnent r_egulahOf!S._ -·. -• .... .-.; ~-::.:~: .-: .-.-,-,. ... : :·._._.,.· • • • :. .· ;· :>: : : .. ,' ~. ···: . ·:'·: .. .-~-.. ,._~·-,:•,.·,7.:-:-::::::.;:,.\."'' .. ·, :_;:;t·:".;•·::·,_,; ·: '-: ; ... ·· ·<· . ' •.· .. · ' .. ; ·-:· ....•.•. '.\ .. _.;•-''. '• • .. ·.•. . . . . .
· It lam a large qu.intity"g"en8rator, I Ceftifv that I h3Ve·a pfOgrani in place to·;educs the Volu_ffie 'and toxicity 'of waste ·a generated to the
, degree I have dete:r.~1ned to be ec_on9mfoall"t prac~icabl8 ar:id th~t I have selected the practi~ble method of tr~atment, storage, or . : ·
. disposal currently available to me which minimizes the present and future threat to human health and the environment: OR, if ram a • small quantity generator, I have made a·good faith effort to mlnlmi_ze_ my waste generation and select the best waste management method that 1s available to·me and that I can afford. · ·• · · · · · ·· '· ·· · ··
~ri~;ed/Typed ~~,;;.;'? ,,'': . Signat~/~ \ . ., Dat~i
,F;~,\,'JK PASS. I c..,.-, / ;.,,_,/ ,/ ./~i~·-:>>;L•' J J / 1}/9,J
.-..
. . ...:./:;;." ii/13i?)
ransporter #2: c now eagemento
Prin_te~/Type~. ~~m-~ <·:_ ··;~.· · ... Si9n_a:ture
CHE,ROKEE RESOURCES CERTlFICATlON OF RECEIPT
Printed/Typed Name ... . . . . • . Signature
·;:-1.~i) .·,.&Cl'\'J~£<:..
:,: ____ ._.
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HORTON IRON B METAL COMPANY HWY. 421, NOR.TH WILMINGTON, NORTH CAROLINA
Ja.nuo_1ty 7, 1991
Andy Simmon•, )Jr.. High Ri•e Setvice Company, Inc. Po•t 066ice Bo~ 730 Leland, NC 28451-0730
Vea.Jr. Andy Simmon•:
Pu1t•ua.nt to ouJr. telephone conve1t•a.tion today in 1te6e1tence to the 6c1ta.p ma.teJr.ia.t~ picked up 61tom you11. 6acility 6Jr.om the En6ite p1toject in Wilmington, Nokth Ca1tolina, thi• mateJr.ial ca.me 610m the ta.nk• Jr.emoved ~II.om tha.t pJr.oject a.nd weJr.e cut up by youk ptk40nnet a.nd loa.dtd on ou1t t1tuck to be di6po•ed 06 a.6 6c1ta.p metal. Thi• ma.teJr.ial wa.6 picked up 61tom youJr. 6ffcility on 11/15/90 a.nd 11 /26/90.
Tn addition to the avove, you u6ed youJr. low boy and tJr.a.cto1t to deliveJr. •cJr.a.p 2" piping ond othtk mi•cetlancoua 6Cka.p ma.teJr.ia.l• to OU"-6a.cility on 011. a.bout 11/28/90 a.nd 11/29/90. Thi• additional 6cJr.a.p ma.teJr.ia.l waa 6kom the En6ite pkoject a.l,o.
76 I can be 06 a.ny 6uJr.the11. a••i•tance in thi• ma.tteJr., plea.6e do not he6ita.te to contact oult o66ice.
S-ince1tely,
HORTON IRON 6 METAL COMPANY
!J~~~-
Te1tJr.y Ho11.ton
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,. n South Carolina Department of Health
and Environmental Control
Bureau of Solld & tia=dou, Wa,to Mgt
2&l0 Bull Stroot, Columbia. SC 29201
Phcna: (BOO) T.l4-5200
~ency & Hollday,: (803)T.l4-5-124 B PLEASE PRINT"' TYPE (Fann desicned f0f" U5e on e!lte '12-oitchl tvt>ewrftert Fenn Aooroved. 0MB No. 2050-0039 E,olra, 9.JO-U
II I M&nll-t I 2. Page 1 · · 11nfonnaUon ln U,e shaded &c8.8:, l:s not UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Genora!D(s U.S. EPA 10 No.
I I I I I I t I
'' New Hanover.County/ City of Wilmington·
' ' ' m I 1 Generato<'3 Name and Mailing Address
414 Chestnut St. , Suite 101 Wilming.ton,NC.
,~;r-:'~ 1· of requlredbyFoderallaw,butbbyState!aw.
28401
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4. Ge.nerator':s P.hone ( 919 l 341-7139
S. Transporter 1 Company Name
7. Transporter 2 C:,mpany Name
9. Oesigna~ Faclit'f Name and Sita Address · SRC . .
Box 2005
Columbia,SC29202
6. Uj EPA ID Number
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a. U.S. EPA ID Nwnbor
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10. U.S. EPA ID Number
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11. U.S. DOT Oe.scription (including Proper Shipping Name. Hazard Oas,. ind JD Numbet/
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15. Special P2ndling Instructions and AdditicnaJ lnlonnation ,
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t:.~•siaia T ~ ... ._-~~•.-.:.: a"lO~~~:W-tJ,;.?i.i~h-;..,:;;;•:s:~
o:tAt~:»it<f PhoM:;;~.;.;,±~18-~Str:~1:~~-~•::::;.
·t~~f ... -.._._, .. ~,-~.,O~t.{)l~i"~id~n..5-J::?:.~'iift3
·F::~~~,;c;;'q~r~-5-r~i:~
12. C:,ntainero
No. Type
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rl e. C EN ERA TO R"S C.ERTIFICA TION: I hor•by dee.Lan that tho contonb or this cot'la.l,gn~ 11n1 tufty a.nd a.ccura111lideacrlbed a.bcrn by pro pet 1-hlpp~ name and •re c!u.ail'io,d,
packed., m.arlted, and label ad. and ar• In all r-poctll, In propor ccndlt:cn ~r tr&napor1. t,,; tugnwayaccordlng to appll.cabl• im.m.t1on.al and national 90'l91'T\ffl.Onlro,tjjvlatlona and
V'le ta.-. ol tne State of Sova, Can:>lln&.
y
HI •m • l.arg e quantJty gonen11ot. I certlty lhal 1 haY1t • program In pl&c. t0 redu09 the 't'Olum.andtc:aJc:ty of wa.augflMBtad io the de,gr-1 ha-dotannln.d to be oconomlc:.aJty
p..-.c:iC2.ble and in.at I ha--'-clod th• pr,,c:lc:.abl• mocno:1 ol tro.tment, sto1"119&, Of dkspo:MJ CUl'ftfltty a-ralt.ble ta mo •hie."!. mlnlmtu,a C'lo p.--nl and fl.ltlHO lhre.o.t 10 hum.an
hGaltn and C"lo ■nvlronm■n~OR. HI am• amall quan!lr, genonLlor, I ti..vo made a good tail:n .notttominlmlz.a my•&.-g....,.Uon and a.(ect11'1o b.alwa.at.o man..agamanl rneU'lod
lh&t ia a..-a..ii..tilo to me and 1na1: I can afford.
P~/Typed Name
'K 4 ,/ ,l't\1,n-1 D L. ,-/ I ISignaoure (;)_ •. c...,,-,_ r .,,,(_ _::r ;Z_ 1/.
~ 17. Tra.mpcrtef 1 Acknowledgement cf Receipt cf Material:s I'
17
~ PrintedlTyped ""M ) . r ~ f-1 l::n 14cr.._ -~Pl I Signaoure {"J_?.,....._ '), vb,,.., ,..-v;,
Month Day Year
1 /,/I /,°/19,C
Month Day Year
·11, I,\, Ci!''i,r,
o 18. Tran.spcr"..er 2 Adnowlecigement of Re--...ei~ of Material:s ~ r--::-:-':-:,:=-Ti:ped-,-,,.-----':.c....=.:c..:==.:c..:==c.c...---,-------------------------..,,---:-:--~ ~k' GA; ~ ~ ER f< y ls.coo h k:in hO< '--f ~ O J-, ;-, . 1
Month Day Year
F
A
C I L
19. Oi.sc:er-ar,C)' lndlc.:1ticn Spac.a ) 1
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I I, 1 I /,Cjlq,~
pi,,. < I I I I I I !Ibo.
,,,,_ d I I I I I I !lb:..
•i-:-::-:::-:::---::----,------------------------------------------------~ 20. Facility Ow-ner or Operator, Certification cl receipl of hazardOU3 materb13 CO'>leced by thh rnana.e5t ez.cept u nottJd ln Item 19.
Printed/Typed Name I Sign.ab.ire Month Oay Yea:
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South Carolina Department of Health
arid e·nvironmental Control -
Bureau al Solld & Hazardcu> W"'8 Mi;t
2SlO Bull Slroet, Columbia, SC 29201
Ptocn« (800]7:14-5200
PL.EASE PRINT OIi TYPE (Form de$ ned for~ on eOte 12-oih::hl tvpew,itao
UNIFORM HAZARDOUS 1. Generatot'1U.S.EPAIDNo.
WASTE MANIFEST
3. Generator', Name and Mailing Addres, New Hanover County/ City
414 Chestnut St. , Suite
4. Generator', Ph~ne 919 ) 3 41-713 9
5. Transporu,, 1 Co!_npany Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address -SRC
Box 2005
Columbia,SC29202
of Wi lrni ngton ·
101 Wilrnington,NC. 28401
6.N Uj EPA ID N-umber
8. U.S. EPA 10 Number
'.
10. U.S. EPA ID Number
NA
11. U.S. DOT Oe3cripticn (including Proper Shipping Name, Ha=d Clas,, and JI) Numbetj
Emorgonq & Holiday,: (803jl':14-S.C24
Form Aocroved. 0MB Ne. 2050-0039 Excln,o 9-30-U
2. ~• 1 lnformaUon In the shaded ace.es b net
~od by Fodera! law, but~ by State law.
Oitrai:W::&?~r~~l:t~'2.~5ttSJf1;~~~.;~:J
·e~Ti~i~ic-~~~~.~:Bllit..:~y.~~:~~~
-F:~~~~~~!:'.!$r~i'.i~l~:ri!l 1
12. Conlainffl
No. -Type
G a. Petroleum Contaminated Soil (NON-Hazardous) fl.;'',"6 ,X::'j"'!~\
~ f;:-----------------------'----+□.l0-l.l+D.lT-t....L.L1.2....LO+Y-D-f:;~1_rt7:;:1::7:;1 7;li1::;7~1-:£~j
R b. i;,; f· ··,·toe,·~,~,i~i
A 1'1 ,,,: ~ rc.:-___________________________ .:..._ ____ -l_LLt..L-t....1....JLLLt--t\;~!~:!·g-=..It.~'=·· ~~•~:st
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iA Li -'-'-.L.....JJ ~.
,4 ~~
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15. Spec:aJ !-1.andling lnstruc:ions and Additional Information , \ M~ (ek {)l-1,1-010 I
Ii. C EH ERA TO A-:5 CERTIFICA TIOH: I hor■by doci.r■ that tne contanb ol thl.a cana.J,g~t a:11 tuty and accu~•l'f d•~ a.bow-a by proper I.hipping n&me and an, c!a.u.iTied.
packod. rn.an:ed., and t.beled, and ar• In all , .. pecta in pr ope,-candltlon far tr-anapor1 by h.lghwayac:corulr,g to &ppkabi■ lntemadona! ~ naiione.l g~nt r.;vlatloru and
aia 1.a..., cf Ula Stai. ol Sou1h Can;1Una. · · · · ·
111 ■ma l&r,;,e quantity ganen.to<, I certify that I heYII • program tn place to reduoe u,.. 'IQlum. andlO:ddtyotwast. g~ted to ai. d.,_,,_ I h.aYII dac.nnln..::t to be economic.ally
pnic::ii;..;abla and tl'lat I hevo -locted tha practlc.abla mocnod ol tr-O&t.mant. stc~e. Of~ Qanntly available tom. •hich mlnUnlz.H U"\a p,-ntand tuCIJra thrlMll to human
h6a!t:i &l'l.d tha envlronmen,:QR, HI am a am.all quantity genoni.tor, I h.a't■ mad a a good ta.il:ti .-f!crl toml.nlmlz:a my•-• g...,.aon and ...ctU'\a be4.t•u:ta ~,;11m11nt ~
1:ha.t 1-■'f'a.il.ablo to me and in.t I can a.Noni.
Signature
~ 17 ledgement of Receipt of Materials
A
N
~ f--'::-t....!::l--U.J..£.!....J,L--!wlL..J..---,~!LL..LJ...i..:. _ ___J-c.J::.:J.6.i!.1.!L~;......LJ?.~..::i..c,;~"1.a,.c._ ____ ..LLL.1~~J.LJ£
o 18. Trans;>cr".er 2 Adnowfedgement of Receip.t of Material, R!--'-='-:c':'=:-=:============:_---,-----',;L.--------------:-,-,--,~--;-:-
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19. Oi.scre~q \ndic.:.~cn Sp.ace
.d u
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b ,._l -L.1...L..J....1
Month
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if-~----,,,-:---:----------------------------------------:;: 20. Facility Ow-ner or Operator; Certification of receipt or ha.urdo(;s malsrlab covered by thu rr.a.rmst: cx.cept as noted In Item 19.
Printed/Typed Name Signah.lre Month
Yea:
.'.'.
\Ibo.
\Ibo.
Day Yea
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South Carolina Department of Health
· ·• _ and Environmental Control
·-a1 s,;,;d & Hawdou, Wa.o, Mgt
2!iOO Bua Sir"'"-c.,/umbia, SC 29201 ·
Phone (SO:!) ™-5.--00
': ·,-•
UNIFORM HAZARDOUS 1. Genen,!0t1U.S.EPAIOHo.
WASTE MANIFEST
3. Generator'~ Name and Mailing Addr=s _ .. -· • .. - • ·· -• · . _ _ _. _ ~-;:. ... New Hanover.County/ City of W1lm1ngton·., -·' .
-~~_·· 414 Chestnut St. , Suite 101 .. Wilmington,NC. 28401
,:~.;;.,;,~,Ph~~~ 919 -· 341-7139
5. Transporter 1. C<>mpany Name ,
Emo,,,ioncy & Holiday.: {B03JT34-S'2~
Form Ao"""""101.18 No. 2050-0039 &cl,.. s-;io-,
2. ~•oe 1 lnfannaUon In the shad&d area:s Is no
n,quirod by Fodor>! law, bulb by St.to law
'c1~1'-----"·'•"--~io.71'\i.;:t¼,~~;.;,fil~_;,,,~
o;t~t.'IPHoo.'Wi~~~'.f:..su-&~t~w-:r.;
7. Transporter 2 Company Name.-.::_: · · -·· ··:·.-: =~,--·:.::-8. U.S. E?AID Number·,·.:-.-_,., ·, · ··•·" · E.~i:"1.---.,,.,,,i'io~~~~F.il...'fi:.ii~if~:'
·· ~. -:,·•.:..· -~--,. :··:··· · . ··:.:.:~-~-,~ : :-. ~-~--•.r:-:.-:1:•=:-.;•: :::.~·":_1::.-. '..::.::.:-.;._'..!..,. ::.:...::· · .. __ ..... ,-·: · • ·-~, ·• · -----· -F~~•~~:'.Z..~4-:--~?'~!!'.ta~~i!i
11. US. DOT De=ip<ion (111c/uding Proper _Shipping Name, Hazird CJ=, irtd ID Numberj . •, ,.·. •·=·
G a. Petroleum Contaminated Soil· (N0N-Hazardo~s) · · ,. ~fr'1"7··;,00
~ 1---' ___________ _:__···_·-_· _· _·· ·_·_-·_·· _· ..:___;.;.__·_· -_.-_.,_;, --l-o.l....L.Ol-l-D.l-l-T-L.L.L2LO-I-Y-D-+l;!~--=l 7;:'=7=' =7=' 7:::.:1~
,i~~-;_•_·_-_.-_,_· ___ -'----------·:_:._·~--~-·:_''_:_~_:~_:_'_~_=_:_\_:-_::_•·_.c_·.,_~_,._:,_;_:_:_"_·_,_,c_•_"-+....L....L-J-'-7r'-::L,_;"L'._~i-~_··~·"~·t--c--f[E1i•~="=:=··=:=-·=·:=·~=,j~]
R c. ?~i 11
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15. S~ ':{andling lnstruc~ons and .,f,dditional !nlormation
·fi\~~J_ (ok, ~6\-15}:-°.lo I_-.. :: · .
',·-;,, .... ~,,, ><---·····.··,,-... , :.~ .; lu 6. 31/fob ·
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6. C EN ERA TOR-S CERTIFICATION: I t..r•by dodar• that the conlent:I of th.LI ccnUQ~ani Wyand ac;Q,1ra•liducribeid a.boYe by proper ahlp~I~ name and are d.u.ai!'i•
pacl,;ed_ marked., and la~.and as■ ln all ,.-.pee:. 1n ptepot condll:1on tor tnnaportb)' hlghwayac::onilng to appllcableintamadonal and nanon.J gavwmm.nt ~utadcn.a a,, 01• la1W11 o! aie State of Soul:h Catolln&. · ·· · · · · · · ·
.• tt I am a t./ga quantity g■,......tl:M', I certify tt\al I ha-• program In pl.ace ta r•o:foc. lhe •,oh,un. andm!dtyof...._.g__..tadtothe d.g,_ I haw dalermln~ lQ be economlc.&J
prac::iC2bta arid tn.at I hay,e -locted ttia p~dc.abla m.tnod ol ~tm•nt, stc~, Of d~ cun.nay a....Jlable to me •hld'I m.lnlrnlua the proaont and tutur• threat r.o hum.a
he.a.Ith and 11'1• envlronmon~OR. tt I am• am.all quantity g~tor, I t-L.v• made a good tai1n et'lortlDm.lnlm.lz:a my wua gwieradan and ..«ectth• b.at w...i. ma.na,;ion-..nt n'Nl'thc ~c ta ava.la.blo 10 mo and U\al I can allon1. · ·
Month Day
I,/ r' ~ 17. Transporter 1 Acknowledgement of Receipt of Ma.teri.al.s
;'.: Print,<l/Typed Name
s p
0
Ye
~t-=:::::;=-:"-:~====r=====--r~f-=:------------,,£:---------,-=-:::---e
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Jll:o. CI Jib.
!Ibo. d I Jll:o. i r.2::0:-.-;F:-a:-ci;,!ity:::-;Ow;:-n::e-,-or-0;;:pe::-r.,:-lo::-c,r,-;C.:-rt>::.fi-ca-,:-.o-n-o7/-rec--,,;,-p:-lo"'l7hazartlou,--,--ma-,terlal,-,-,-cr,,-.,-od.,.by-llti>-:.-mana.,,-:.--except--.,-no-led..,.,ln-lle-m-1"9.--------------
Print,<l/Typed Name · ~nallJro Month Day '(e
,;•;:; ;:,:" • > .-,--•: • 1 ,:· _. •.'·:•, 0: ·,·,·:: . .-i_;_-_ 0._, 2.c ~';;.-.:. :.-,~ -: ~; _-.·_.-';:.'.-\ ,,'_c,:,c,;,.;:;.;_ -,i:,=:s;: ,: ." .', ~---,~ ;:;C· ,Cf _,;,_.o,.:.;,;. c. ;,: ; ;· ;:_; ,;.-,.:;~'.)i;,.,;'-;_-,:,;·, ~;~,~~':;,:;c·.:; ~--•::.:; _. ,;-.-,' c.:·:. :; :·.': ~.-::: < ~, '. «~ SoUth Carolina Department of Health
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· · ·~ . and Environmental Control
·. -. '" .,. · .. --•· . --: .: .
Bureau al Solld & Hazard~u> w..,_ 1,1\11.
2!i00 Bull Stroe!. Cclumllia, SC 23201
Phono: (BO:lJ 7:l-1-5200
. Enwgency & Holidays: (B03J734-5"24 .
PI.D.SE PRIKT o,lYPE (Fonn d . . .. "'.. . 112:oiti:!i ivi>iiw,a..l ·' · Fonn Aoorn;,,.i: 0MB No. 2050-0039 E<oln,, 9~
UNIFORM HAZARDOUS 1. Genaralet'sU.S.EPAIONo.. Do=~-Ill-2. Psge_1_,'. lnforynation In tile shaded., .. , 1, not WASTE MANIFEST t... al . ·. ~uuodbyFodera!law,butbbyStatelaw.
1 Goneralo<'• Name and Mailing Addr... . .. · . . ; .
-_0 ,~. New Ha_no_ver. County/. c, ty of. W1 lmrngton: ..
· · 414 Chestnut St. , Suite 101 .. Wilmington,NC. 28401
4. =erator'•Ph~ne 919 · I 341-7139 ··
5. Transporte< 1 Comoanv Name -\
I
7. Transporter2 Company Name ., ..... -~ : . ,,,., · ·····•··· .. •.),;._ ··--.--:-a. U.S. EPAlO Numbw ·; --
DJf,i""'tioo.Wf~~'.f.t-l1~)[G..S~~;r,:!;::
... t;~Trm'°@'tM'ii5~~fi¥..mf.:.,.5J4.:?ffi:Zi1:~i
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,-r ·--:· ···::"': ::~.;~_;::-::.·.!"?!...-2".:' .-..::-. ~.:..~-~=~~_::.:.-; :..~-:::.:: . .-::~--=---· ::--: --: ··--:: -: --.-
d.
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C. C ENE.RA TOR'S CERTIFICATION: 1 Mr•by doclar• that tho cantanb o! ttua conalgn~.,. blllyand a.ccuraaJ'f d .. crlbedabow by proper .t,Jpplng name and are ciu..ifieod.
pac.lr.ed.. m.arltod. and labolod,and are In &11, ... p,oc-.. In p<Opo4' condition 9ortnnaportby hJ¢--rlll:COf'dlng m ~p.ll,c;able lnteme.lSonaJ and nadon&J 90V'e1'tVnent ,...,_ulatlora and th• la~ cl ltl4 Slate ol ~ CM-ofln&. . . ·. • . . . : ·~: • .. . . • . . ... ., -. . . .
: .• 111 am a t..rg• quantlry g•~tot, I cartlfytrlat I ha Ye ■ program In place tor.due. uw 'l'Qlu.ma andbdc!tycf wa,steg~tadto aw de,gr-1 hav. deu.nn.lneod to ti. ..:.onomlc.ally
pr.C':ic..abl• a.r.d trial I have Miocted 11'1• p,...c:icabl• m.0"1od ol tn,alm•nt. co,-..g-.or db9'QUJ ~ ■Y&JL..bl• tom.whicn mlnlrniula th• pr...nt and tut!Jra lhr-t to human
h6.Blttl a.Qd t:'la oovlronmOf'l~OA. n I am• IUn&II quantity geoen1tor,J hava mad■ a good ta.1th ■ffortio dnbniu myw...-~ and M(edth■ ba:atw...i. man.goment method
C"l.at la ava.l&ote to me a.nd that I c:..n don:!.
L.
Prinled/Typed Name
-VO · AJ ;?.,E/vTo rJ ·
18. Transpc~.er 2 ACXl\owl~emenl ol Rec.ei:;:.t al Materiab
:e<liTyped Name Ar( 31tK..ft f
19. Ois.::epar.':f lndic.Jtion Spa.ca
)fl_
1 LI .1.-1...L..J...l
b ._t ....,_ ...... _,_
20. Facility Owner or Operator; Certification of receipt ol h.autdous materiab covered by~ marimt w:.ept aa noted In hem 19.
Printed/Typed Name Signatl.Jre
Month
II
Month
/J
Month
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lib,. C I
lib,. d I
Month
Day Year
·'> ,G
Day Yea,
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Day Year
,(;
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Day y..,
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Bunoau of Solld & HazardoLU w.,,,, M,t
2ti00 Bull Slroel, C.ilumbia, SC 29201 · :
. _ South Carolirtci Departnient_ of Health·-·
.. _ ._ _ ... and Environmental Control _ ,. .............. ---· ···-. .... . ... _____ .,, ---·· .---· ·--··-····-------·-·· ·-··-. ....... Phone:: (8(XJ} 734-5200 ........ .,, .•..•. _ ... , .•
UNIFORM HAZARDOUS .. :_ 1. Generator• US.EP.t.lD No,:,;_, ;:.J ___ ~.,,!!,,~~ . WASTE MANIFEST --, .... ,. -. , ,"I
3. Generate(~ Name and Mailing Addt8$5 . .
... : New Hanover County/ City ·of Wilmington·
. --~ 4lfChestnut St. , Suite 101. Wilmington.NC. 28401
~-Generatcr',Ph~ne 919 341-7139
5. Transpo\.er 1 ~pany Name
7, Transporter 2 Company Name
. -·· -·---------------·-·· -----~
9. Designated Faclity Name and Site Addtes, ~~~. 2005 -~ ,,,
10. U.S. EPA ID Nwnbs
Columbia,SC29202 .,. NA
11_. _U.S. DOT_ ~p~~~_(111cluding Proper Shipping Name, Hazird ClaSl, llld iJ II~
-·.· .. -.....
d.
. · ... _-_ ...... . : ,• -·. ' ___ .... _-.
1~ Special Handling Instruction., and Additional Information . .., ~
~".; 0±i~ttif •~.1.-i3~:;io:i:Gt;1:;
--· ·· Emergency & Hollday,: laooim-~2, ~--
· Fom, Aoorovecl 0118 Pia: 2050-0'.J39 Exci~ ~~
2. P•~.!.:=.: lnformaUon In the st\aded a<eas Is not
of · · · required by Federal law, but Is by St.Ila law.
DitAE@"8·~..;;f,e::~.;:.:..;.;:~;~~~¥-•:r.1
... ;~f·----•·ac~&~..t~,f.:.½
-F~~l'hoi~~.B::;";..~!~:::-::.:2:J·!i.i
-·-.... ..:
e.. GENERA TOR'S C£RTIACA TIOH: I her•by doc;iar■ the.I th• contanb of lnla conalg~ .,..t:iar' and a.ca,rw.•IY dHcribed aboYe by prop« ahJppln-. name and are du.a.ltiao;:!
packed., rn.aOl:ad. and Label.ct.and at■ ln all , .. pect:1 In proper condition fartranaportb-f Nslhwapc:ccn1lng to applc;:able lntematlonaJ and natlon&l 90\"erl\mentr.-;iula!lon.a ant
-·: l:tl• 1a_.. of th• Stata, of Sou1h CaroUna. .. ': --=-;: .---:. :.:: .. --; ... -··-,: . : .--:,.: .. 7 :; •• .--:,: : ;•:,-:.: .; •• ;. ;. .-: •••• , •.• ·· •• ,,. ••• .:::.:.-. ::,::-:-::..:. •.
.,. HI am a 1.arSle quantity g~tof', I certify that I have a program In place tor.duce ttt.e"t'Olume and'ICcdc!ty cfwaJ!tll g~lad ta O'\e degr-1 h8ve datem\lned to be economic.al!~ p~dc.UII■ and Ch&! I hay,o Miected U'le p~cttc.a~• method of tl'-.t.ment,, ~ .. o,dbpo:ul asrent:y avaJLabla to~ .,,,h.lch minlm.12.D■ ttie p,-nt and tutura lhrMI to humar
he.al th and 11ta envfronmoni:OA. HI am a .n\all quantity o-nator, I have made a good f&la'!. eifortl1ininl~ mywaall g.,..,._,Oon and M4ectlhe bi.al w&aie man.agan-..nt ~
Chai I.a a:r&il&blo ta mo and th&! I can afton1. · ·
P;illleq/Typed Name
'1<4 }n;,,i p
~ 17 porter 1 Aclcnowl ement of ipt of Ma.Leri.ab
A ype<I Name i ~ "' .. -. Vv'I -e. l L-Month Day
o 18. Trans r'..er 2 Acxtlowl ;!f---::-,-7:::,---:-:-,----"'=========--~----------------------,---::-Oay E R
F
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\it>,. d I ? bLl1..1...u..J...1 L 11-::-,--::---:::--=----------------------------------------~ 20. Facilily Owner or Operator, C<!rtification ol receipt ol r.azardou3 matartal, covered by thi.s marimt e.x.cept &3 nol.ed 1n Item 19.
Printed/Typed Name SignabJre · -, I -✓ Mon:h Day
Yea: c,z
. Yea.
C
Yea 'tt_ ,~
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PLE.lSE PRINT or TYPE (Form d~ ned fcC' U3.e on eltta 12-oitch
I
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UNIFORM HAZARDOUS 1. Generalor'a U.S.EPAID No.
WASTE MANIFEST
3. Generalo<'s Name and t.Cailing Addnm • • .. :. New Hanover County/ City of W1lrn1ngton·
"''414 Chestnut St.-·, Suite 101 .:.Wilmingto·n,NC:-2840.1
2. :,a;-e 1 lnlonnaUon ln th1 shaded iwe.a, l:s net
. requited by Fodera! law, butb by Sble law.
m I D?i'A1Jewi.1M',r~~~~~i;\,"\r/::;-2
7. Trans~rt.er 2 Company Name .,• :---·-: ... -.' ___ :_.::·, ___ _____ : .. 8. U.S. EP>.IDNumber.: :,.._,..-__ ~T~a"il~S.~"'¥!
~-~er:rWsPh~ne 919 341-7139 · · ·
5. Transporter 1 ~pany Name ~ •· 8.N Uj; EPA ID Number
1 ·-·-··. --~~~..b!~~~i'.f n 9. D;5igna~R'ec,lity Name and Sile Add,.,_, 10. U.S. EPAID Nwnb« ~-,~~~~j
I ·-~~~u~~~~,SC2.9202 -,-,'·••,c:; '~;••-, ----. :~:~f~~~~{l;.
I . 11. U.S. DOT De,criptlon (u,o/uding Prope, Shipping Name, Hazim O.S,. and 1D Humbel/ 12. Con~ ;3. ;.-:~.~ ==.·.~~;
II . . . -· Na. Type ' . . 'MMi ·. ~~.§
D .GNE a. 'Petroleum Contaminated Soil (NON-Hazardous) . ·:: :·.:-:: ~r·..-,-·:v;;
.. • 0 0.1 D T 2 0 YD .. ~171717171~
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15. Special Handling lrutnJcloru and Addiconal Information. ,
e.. C DIER.a. TOR"S CERTIFICATION: I h•r•bydedar• that th• contont2 of !Na ccnaJQ:ntMnl ar,i "4'f and aca,ra•/ydellCribed abow-9 by prop« ah!J)plng name and ar-. ciua.lfte-d,
P•Ckec::1. marlced. and tabel.d, and at• In all, .. ~ In p,cp,e,r condJtlon kx tranap,ortbJ' tv;h...,ac::con11n; to 114)p,b..b'e intemaUonaJ and natlon&J gov.mrnent ,...ul■llon.a and
.Ch• taws ofO'le St.ai. ol Sou1h C,uollna. ·:-·:·-~--.. ,;:i·.:;;.~::---:,·::-.:~-,:;. -. ~ -:,-~,~ ,·. ·-" -·. . ... : -.~,-·,:,:. ·.:.:,.~·,::_-.,. .. _ ~-···· .. -. - . - . . -:·.
HI am• lug• quantity genera\04', I certity ai.at I haw a ptogram ln pl&c:e to r.duc. 01,e\lOlwN andcddty of wutil g._..r.d to 01a d~r-1 N.¥11 dai.rmlned \ob. -.;.onomlc.ally
p~dia.bla and ~t I ha.,. Mlocted th• pra~cabla nMlhod of troatm.nt,, stora,ga,, or~ a."T9f\Dy a.....u...bla to 11M _.hld'l mlnltnlua lhe p,-n1 and tutu,. OVMl 10 hum.an
hu.lth and tha ef'IYl'ronm..,t:-OR. HI am a .mall quantity gen.rater, I ha'W■ m&da a good tallrl .sort-,minlmiu my,..... ;--adon and Ml-=t1ha beat._.._ tnanagern.nt rn,ett'lod
Vlatlaavailablotomoandl:hailc.an&lforcL __ ·.,·---··-· '
P~/Typed Name -~ / . ~ ;q m <T>1 o L. '-~ c--A-. 01?_
19. Discrepancy Indication.Sp.ace
t l':2;;0:-. ~F::ao::.:::liry:'.'";:Own;:-::-•:-r o-,-:0::-pe-ra-:to-r.-, =ee-rt-::.~fic.-:-tic-o-n-c'"r =-"'ip_t_o7r "tiaza--rdoo:,.,--ma-,-torials-,--,-ro;-or-ed-:-:-by-tt,i,"·,----:,-,-"'=--u-nc-,-led..,.,-ln-:IIMl:--:1"9.,----------~----j
Prinlednyp,,d Name · Sign,itur,, Month Day · Yw
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South Carolina Department of Heal,h
and Environmental Control
8uniau of Solld & Hazardou, Wa.,ta Mgt.
2ml Bull She!, CQlumbia, SC 29201
Phone: (BOJ) T.l-1-~
Emorgonc;y & Holiday,: (80JjT.l4-5"24 ·
Pl.EASE PRINT or TYPE (Form de,.iQned for u:se on eDte r12-oitch1 tvoewriterl Form Aoon>ved. 0MB No 2050-0039 &ol"" 9--30--a: UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Generator's U.S. EPA 10 No.
I I ' I I f t I I
M.nlle.t 12. P1991 Doc:um-,1 NO. of
t I t I I I I llnfonnaUon In the shaded &1oa3 13 not required by Fodera! law, but Is by State law.
3. Generator', Name and Mailing Addre:s.3 • • • ' New Hanover County/ C1 ty of W1 lmingto_n · 414 Chestnut St. , Suite 101 Wilmihgton;Nc. 28401
4. Generaior',Phcne( 919 \ 341-7139
5. Transporter 1 ~pany Na~e \\J:\,..,, Tw,11:.A .. 6. llj EPA ID tiumb..
,N I I I I I I I I I
7. Transpcrt,r2 Company Name .,I 8. U.S. EPA 10 Number ···,,,,,·,.,, I I
9. Designated Facility Name and Sita Addres.s 10. U.S. EPA ID Number SRC . . . Box 2005 . Columbia,SC29202 I I ,N~ I I I I I
11. U.S. DOT Description (,ncluding Proper Shipping 11.une, Hazard Clas,, and JD Numboij
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15. Special Hanc!!ing lnstnsc!ion3 and Additional Information ,
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16. C.ENEJU. TOR"S CERTIFICATION: I herobydodar■ th41th• contonb oftnls COtl~n~ueliay and accu,..mlYd•~ ■..bovebypropet ahJpp[ng n11me and•'• cJusifiec p•ckod,.ma,xod., al'ld Lab.,18'd.and are In all 1.-.p..:t. In p<opet condltlOl'I Jor tn.naport't:ty ~m--,accon:1lng to app,l&cable im.m.t1onaf and national gOV9JTVT\.9nl r-..gulallon■ an,
y
aie laws ol tt.• St.ala ol Souu, Caro.Una. · ff I am• b.t,;i o qu..,,tlty genoratot,l c.r11 ty ai..c I have a program In place to r«:luc■ the•,ohunu:nd mldty ol Wastll g..--.t■dto ~ da,grN I ha-determined to be economlc.aJI prac:i~ble and that I ha~ .. lected ~• pra~c.able m•tt.od ol tro.tment, sto~a, 01 d~aannay avall.ablo t.om■wh.lc."I mlnlmtu• !he p.-...nt and h.Jtut• lhri~at ta hum.a.. hGAltn and tti• envlronmont:OR. If I am a amall ciua.ntlry general.er, I have mad■ a good t.Jtn .-f!ortto mWmli.■ my•u-;-wrackm and ..Ced uie ~l•uta man.1gement m■U"lo­that la available t0 mo And tn.l J can aJ'lord..
ntedtTyped Name
'l<..A-d""-Or\l) l. Month Cay Yea
, /,I, 1,5",9.t ~ 17. Tran.sporter 1 Acknowledgement ol Receipt of Materials V •
~ J~~~Name s ,_,.:,i'k ~:~, ·,4, ~~A" ~0~1 ,r~l 19~ ~ r:,-:a-. -:;T:-ran-,;,c-r:,-~--t:-2-:A-clcn,--o-w-:lec-,-g_e_m_e_nt-o"'l-::R-ec,'-:i-~-c-:1-:-Ma:-te-crial:-:-,---...1../r':-'-='-.,ff-,._'--===--"'--"-..:...------------_..'-'---'-'--'-'-_,__~
k Printed/Typed Name I\B!inawra
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lh d! l I I l I \h 'r-::--=--:::--:---:---:------,---,----,--------------------------------~ 20. Facility Owner or Operator; Certification of receipt ol h.uardow mal.eriab CO'iered by thu ~ except as notsd In Item 19.
Printed/Typed Name I Sign.all.Jre Mcnth Day Ye.i
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South Carolina Department of Health
· and Environmental Control .. ·8•-A_~ I
PLE.lSE PRurr or TY"Pe" .::. ·(F~ desl ned b" 1,13,9 on eOta 12· itch
Bureau of Solld & Hawdou, Wuo, M.t-
2500 Bull ~oet, Columbia, SC 29201 .
Phooo: (80:l) T.14-5200
Eme,gency & Holiday:,: (Bo:JJT.14-5'424
UNIFORM HAZARDOUS 1. Genen,!e(aU.S.EPAIDNo.
WASTE MANIFEST
roved. 01.18 No. 2050-0039 Exol,es 9~gg
lnf0rmaUon ln the ahaded a<u:s l:s not n,qulrod by Feder111 law, butl:s by Stai. law.
3. Gen=tc<'s Name and IAailing Addn= . · · •
.->, New Hanover County/ City of Wilmington·
28401 414 Chestnut St.·, Suite)0l' _Wjlmington,NC.
4. ~~~sPh~ne 919 .. 341-7139 .
s. Tran,po,,.,.~~~ Nam":;, W~\l"'~ 'frucJt.i o;;;:~----.1-... ·,t•~~s~~~~~~-'.!f-:(,:t
~~-r,"•-... i'C§!!.~Si~l!§i.~'i! 7. Transporter2CompanyName · ·. 8. U.S. EPA ID Nwnber ,;:· :: .. : -·:. ::. .. . .. ··-:· . --~Ph&~~;.'%,..~_t::~?"~i!.~
9. Oesignaled Facility Name and Silo Addreso · · ·-c-.'·:c ., .. , -10. U.S. EPA ID Nwnber . ·. SRC . · .• .Cc.,.,;, C-, · , ....
Box 2005 ·
Columbia,SC29202 NA
11,_U.S. DOT o.=iption (including Proper Shipping Name, HazNd Cl=, and D Numbotj 12. Conlainln 13. To_ta!Ouantily 1llJM :_i•~---, .. ,~_'"i&.
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15. Special Handling lnstruc~003 and Additional Information ,
,-.·M~~u{;J CMi_-o·r -~l~l:~ z,_i?-·! :.~--·. -
-· --, ·_ -----· ·. ·-G ·c;W9"L---
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e.. C eiEJV,, TOR"'S CERTIFICA TICN: I her•by dK!ate 1hal the aJntanb of IN.a conp;n~ IN W,-and a.ccw-a■IY dncrlbed &bowl by proper ahlppl"',;I name and are el-.all'iad, 1
packa,d. m&J11:_-S, and \Ab41ed,and ar• ln ail rnp«:ta 1n ptop,ef' condition lot ir&naponb:(higtlwayaccot'dlng to ~p,icablaimematlona! and natkln&I 9ov.mmen1 rw-.iulatlona llt\d
lh• lawa of tne ~1.ata of Sou1li Cuciln&. ·. · . . · . .. . . . . . . . , _ .. . ·· . . · ~-. (
NI am• luge quantity genen;tof', J ee,tjfy OWi I haY9 • program 1n placa to Nduea aw wh.m~andlctddty of waste g~to ~ degrM I haw d•tannln.ed to b,e ..eonornlc.aJ!y
p~dca.l)le 11.nd ~t I ha-~ th• pracUc.able mecn.od ot tr'Oatment., atora;e. or diapoM.I c:wftntly a-.Jlable to me '#hich mlnlmlua the P"-nl and tu CJ re th1MI to human he.&Jttl~tti•envlronment:OA,,lflam ■am.allqua.ntltygon.rato,-,lhavem&deaQoodtaltt'lsftor1~minlmlumy.,....~and--ed1he~l•utetn&NQ■mentmethod ai.at la an.ilabl• ta ma and that I can affOtd.
~/T Name
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lu,,. ! ~2;:o;-_--;f:-:a-:-o:;:.,i:-ty:-;Own:::-::-.-:-,-or-O::--pe-ra-lo:-r,-:C,:-:rti::.,-c:a-,'"·0-n-0-:-l-rece--,;'"p'"1 o-:l-:-haza--rdou,-,---ma-,18rial:s-:--:---cm«--ed-,-:--by-lhis,-.,-IIW'Olo>!--::--:-exc.ept---u-no-,18d'7.ln-::-bm-1-:9.:---------
Prinlad/T)'?Cd Name ' Signal!Jre Month Day ··vear
-------·-----------
South Carolina Department of Health
and Environmental Control
llur8llJ cl Solid & Hazard~u, Wa.u,, Mgt.
2&lC 8ull S1reet. Columbia, SC 29201
Phone (Bo:J) 734-5200
Em«-genc;y & Hollday,: (8/)3l734-5-(24 . . . :o
_ .-EA.SE PRINT at TYPE ed for use on eDta 12·Ditch . · • Fenn Aoon,ved. 0MB No. 2050-0009 Exolre, 9-30-88
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UNIFORM HAZARDOUS 1. Genera!Dt'1USEPAJONc. WASTE MANIFEST ; .. s.,c .•· '"·
3. Gener.ators Name and Mailing Addre,s · --. New Hanover County/ City
.c,·414 Chestnut St;·, Suite
4. 6<1,er.itc;., Ph~ne 919 341-7139
of Wilmington·
lOL .Wilmington,NC. 28401.:.
\ I s. Tra,upcner 1 Comoanv !lame I ' 7. Transporter 2 Company Name
i \11115 T<vt-Ki ~ Uj EPA JO Number
8. U.S. EPA JO Number .
11 ' 9. :;~~' ;:cill'f Name and$~~~;~ · .. SRC. --· -· . ·. :·, .. : .. -::~ Box 2005 ~---~-
10. U.S. EPA JO Number
11 11. U.S. ~To =~:0: 'c!~1~:n!
0p~;., Shlppmg Nam~ Hazard-~ ind l) Numbet)
IG a. Petroleum Contaminated Soil (NON-Hazardous) , -fri"'r"T','*'~
•~~~~~~--~~~~~~~----~---~-OLOJ __ l+D~T~Lii2~0+Y~D➔t~~1~7~1 ~71~7~1~7~~~;
In b. ·,.::--:·. __ c ··-'• r, ,-.. -~ ·;·~·;i~-1 1 r,c.:-----'--_;, ____ ;_ ___ ' ·_,_' ·_>_' "'"• _· ---:------._,._:_c_· _____ j-l-l-t'-'---t"-'--'--'-'.'.:-'7-77:~;:J:::•=:j::. =1=·=: 1=:=1-:;·~:j-, -~, , ,. ,·· "~ I] ~ . ~ ~I ! I I . lf.~~-,t-•--------...,
15. Special Handling lnslruclons and Additional information
\
e.. CENER.A TOR'S CERTIFICA TIOH!. I hereby doclar• that the contant::I of lhia con!UQn~ an tutyand aa:un111aly deacribed a.bow by proptt ahlpplng name and ar• cl~rled, packed. /'1'1-&rked. and labeled, and at• ln all tnp,ecta In ptopa1' candltton Sot 11'&1\a.port~ hfgl'lwayac:con:ilng to a;iplcabl,e lrJtamalfonaj and natSonaJ gO'A'ffllTl,eftt r.guladon.a a.nd aieta-.oft"leStataolSouthCAl'Ollna. -

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·· · NI am a 1-lg• qua.nttty gener.tof", I certify OU.I I t\&'19 a program In plaai to reduca ttMt-.oiwne and 11:mdty ofwast■,gfflefaad to oi. deorN I ha-ni d•tanni.n..d to be .conomlc.ally pn.c:i=bt• and tr1.&t I ha-~ th• pn.CUcabl• mett\od or tr-..tment, ~--o, ~ cunanCy a~I• l0 me wh!ch mlnlmlua lhe p,..._nt and tub.ire ctu-.. t tc human he...lth and tr!• envlronment:OR. tfl am a a,nall quantity g-raLor, 1 have made• good tallf1 .nor1mminirnlu myw_. ~Uon and .eledU'\41 ba-1:wut. man.agernent nM'U'lod lh&t la a-a&ble tD mo and O\al I can afford.
Ii Prinlf<l/Typed Name c) r () V I ~~1~8-. T=ran-,-pc-rJU--:2~A~cl<n,--o-w~l.::.,.se~mwe~n~lo',-~ece-=,,~"'-'-o",',~~-riaJ~.~,='---'----.....;1....,p.;~~'-'-''-":::;;."'-"""-="'---------J'-'-.i...:..=:.,_..,_c..i..:=,
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Prinlf<l/T)'?<d Name · $\lnahrru ~onth Day · Yoor
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South Carolina Department of Health
: and Environmental Contrdl ·
Buroau o! Solid & Hazardqu, Wa.s!O M.t
2!lJO BuD Street. Columbia, SC ~2'l1
Phone: (80:lJ T.l4-5..."00
-.-... Emergency & Ho/ldays: (BOOlT.l-1-:1-m
PLEASE PRINT or rtPE '•-(Form de,.iqned for LCe on elite 12-oitchl Fonn At>Droved. 0MB No. 2050-0039 E.xolre3 9~
UNIFORM HAZARDOUS 1. Goneratol'sU.S.EPAIONo.
WASTE MANIFEST
_2. ~•;e 1 lnformaUon In lhe shaded Meal '3
roquired by Fedor.il law, but~ by State l
3. Generato<'s Name and Ma.Ting Addnm . . , . . . • • . . . · : . New Hanover. County/ C 1 ty of W, lm1 ngton · .
· · · 414 Chestnut St. , Suite 101 Wilmington,NC. 28401
4. -.rater's Ph~ne 919 3 41-713 9
5. Transporter 1 C<lmpanv Name
7. Tran.sporter 2 Company Name 8. U.S. EPA IC -· V .... -· . ···-·· ·--. --' .... -. -.. __
9. Designated Facility Name and Site Addre:sl
· SRC •... ·., _. -::·.:c.c, Box 2005 · ···
10. U.S. EPA IC Numblr
__ Columbia,SC29202. NA
11. U.S. DOT De=iption (111c!uding Proper Shipping Name, H=rrJ_ Clas,, ind Ill N""""1j
Ga. Petroleum Contaminated Soil (NON-Hazardous) ·· -··· .. ;q~cl°'",""';·,
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15. s~. ~~~i_ng ln:stnJctloru an~ Addition.al Information
\
e. GE>lERATOR"'S CERTIFICATION: lherebydoclar• that1hoccntenb cfltllacon~n~an 11.-yand accuralDJYd•~ a.bc:rYw by prope< al'llpSllng nam• and aro ciu.a.
packed. m&rked. and l.abeled.&nd aro Jn aJI ta~ In PfOpcH' condition for1nnaportUf N;bw11fa.cc:on1lng to appl&ca.ble lntamadonal and natson.J govef'l"lffient J"99UlallcN
t:1• ta-, c1 t:l• Stata or South Catollna. · ' · · · · · · · · · · · · ·· ·
HI am • La/go quantity i.r~ralof", I cortlty U\.al I ha\111 • program ln pl&ce to re<luc:a !tie wojuma andb:dctyol ....aiag•~ to the da,or" I ha,... determined to be econcml
pr_ac::ia.bl• and c,.et I hev,a -lected th• praCUc.abl• rnett\Od ol ~lm•nt.. ~., or ~c:..ntnoy •va.llabl• lo me ._hich mlnlmlul• lh• praaent and tub.Jr• auo.a.t to hl
hn.a!ltlandtiioonvlronment:OR,lflamaam&Jlquanttr-,gonerator,lhaYem..d••goodtan:tle:ISloct=:JmlnJm!z.amywaa1111~0n&nclaelec!lheb<N.twutemanagementmc
U\.at I.a a...-an...ole to mo and tt..t I c.an all'Old.
L. C
Monlh Day
1/
;; 17. 1 Acknowledgement ol Receipt ol Materials
j k-,?S.$dLLL:::::.e,!Z/-J,L.!. ~~~_:_j_-~~~:::.__:::~::::::::::::::::::_...l.,Ll.L'..!LiLl ~ ~1::B::.::':r.n=s7po=rter:::::..:.2:.._A::cxn=:;o:;w::led<J:.::,~•::m::•::"':.:c::f::R==::.::..::.::=.::::=: ___ .,..,,_ ______________ _,~--------.,.,,-.,--;:--
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Month
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'b-::--::::-::---::---:-~-=-:---,--:---:--:------,,--:--------,.,.----------~ 20. Facility O,,mer or Operator. ~rtification of receipt ol haz.ard003 materlab covered by lt-43 m.a..~ iucept as notsd In ttem 19.
Prinled/T)'?ed Name · Sign.ah.ire Month
Cay
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South Carolina Department of Health
and Environmental Control
Bwuu al Sofid & Hazardou, W""" Mgt
2600 6"JI Sir..,_ Columbia, SC 29201
Pt>on«: (00:l) 7'3<-5200.
Emeriienc;y & Holiday,: (1!0:J)T:l<-5424
PL.£.ASE PRINT o, TYPE (Fonn desioned for t.=,e on e!Jte r,2-oitc:h1 Fonn Acoroved. 0MB No. 20SO--OOl9 &cir~ 9,10-88
UNIFORM HAZARDOUS 11. Genera10(1U.S.EPAIDNo.
WASTE MANIFEST ' . . . . . I I I I I
~~~0.12. ~•g,e 1 llnfoi:naUon In the shaded a,ce.e,3 b, not I
, , , 1 1 . required by Federal law, but ls by St:J.tei law. j
3. Generator', Name and MaJUng Addres.1 of. Wilmington· New Hanover County/ City
414 Chestnut St. , Suite
4. Genera\o;,,Ph~nel 919 \ 341-7139
101 Wilmington,NC. 28401
5. Transporte~ 1 Comc:my Name
7. Transpcrter 2 Company Name
9. ~ignated Facilit'j Name and Sile Addres-3 · SRC
Box 2005
Columbia,SC29202
'
6. UjEPAIDN.umbor
,N I ' ' I ' I '
8. U.S. EPA ID Number
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10. U.S. EPA ID Number
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11. U.S. DOT Description (1/Jcluding Prop« Shipping /lame, Haz.ard C!as,, and ID Numbelj
d.
15. Specal Handling lnstruclion3 and Addition.al lnlormation
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o;;:;:;.::;:.:i;:,.·Phooi:~1:~-!:1.~:..:~::t;t:~t~ttt4~~::-~::_. j
·E::~xm ~a 1:1 ·:~ ,:::;,: ':~ °½'!t: ·' ·~.:~f.~/::1,:.-:~~~;~'.:
-F.~~-P'ho(-:&~.R'0!::b~~L~.;:~3;~~•::-
12. Contline<>
No. Type
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1 d. C ~ ERA TOR"S C.ERTIFICA TlON: I hor•by doc.Iv• th.al tho contents 0! 1t1la co,uiJgn~ are lilly and -.ccura•IY do&erlti.d abow by proper ahlppln9 name and ar• cia.ulfilod
p•ck..-d: mafXDd. and Labeled, and are In &ll ,_po,cta In ~Opet' c.ondltlon tQr ir.nS90rt. by hlwh■aJ dJ,,g ta appk;a.ble lni.m.Uonal and n.a~ g~nt~u·lat1o~ anc
y
aio law, of ttl■ State of Sou1h CaroU.n...
rt I am• 1-.rgo quanUty g■~lOf". I c.rt.lty th.all have• program In plac.e ta r.du09 'Iha volume aNfta::Llc:tyol~g-.tad ta a,._ da,gr-1 have d•tannlnad to be ■c.cnomlc.aJI)
praC:c:.abl• and tn.at I havo -1oc1oc1 tho prac:lc.ablo moinod of ini..tment. sto~e. o, dbcxn,al o.wnntiy avail&bla ta mo which mlnlmlzna ttle p,-n1 .and tun.it■ airo.al t0 hum.6r
he.&101 and 010 onvlronm&nt:OR. Jf I am a amall G1.1anUty gel'\erator, I ha"• mad■ a gOOd t&ttn •f'lort~mlnlmiz.11 myw_. g.wr-atkJn and .aled tl'la beal ...,■.s:..& man..,;amont rmrtrl,o,:
tn.&I La aV&iLLbl■ to mo &l'\d tr".at I can anon1.
Pjll,te<llTyped Name
'K A 1/ /Y\ /rV'\ t) L, c,. L._ ~ u/.._ Tr, . .1
J.lcnlh Day Yea.
1 / , / 1 /, b, '1,l
19. Disc:ep.ancy Indication Space (
F
A
t /JA-R.! ' t::;:-'-;:---:;::-:::-:-=-'--:::----:--::---,c:--.---,---:-,--.,,----,------,-,------,---------,-,----------------~ 20. Facili~ Owner or Operator; ~rtilication of receipt ol h.alatdow malerlab CO't'ered by tru, ma,mt u:cept a..s noted In Item 19.
Printe,J/Typed Name J Sign.,lun, Month Day. Ye!'
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S.outh Carolina Department of Health
and Environmental Control
Buruu en Soild & Hawdcuo w.,_,,, 1,4_-,
2600 Bull Stroot. Columbia, SC 29201
Phone: (80:l) T.34-5200
~ency & Holidays: (BOJ}T.14-:;.<24
PL.ElSE PRINT or TYPE (Foml d~ned for~ on eilte 12•oitch ~ Form Aooroved. 0MB No. 205Q..0039 E.tolre:, g~
UNIFORM HAZARDOUS 1. Generatc(aUS.EPAIDNo.
WASTE MANIFEST ~!!,,8f Ce .2. ~•ga 1 lnfonnaUon In the shaded Mea3 1:s not
1 1 ::, roquiredbyFederallaw,but~bySlatolaw.
3. Generatof'3 Name and Mailing Addnm New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington,NC. 28401
4, Gei,eratc~, Ph~ne( 919 341-7139
5. Transporter 1 Company Name 6.N Uj EPA ID Numbs
8. U.S. EPA ID Number 7. Transporter 2 Company Name
o;,r.a.-=~~~~~::'t.;:'.6;..~n-i:~"J;.:~~-r:•:r.":]
i~~T:-iZmi,-b·ri~;'i~Yfr:;?2f.!.....~,.,':?i~b;t~
·Fi~Phol;.~;~~lf~!~~t-s.--ce~~~
9. Designated Faolit)' Name and Sile Address SRC · 10. U.S. EPA ID Nwubor
Box 2005
Columbia,SC29202 NA
11. U.S. DOT De,cripticn (including Proper Shipping Namo, Haurd Clas', ind Jll Numbetj 12. Contlinen
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N s p
0 R T E R
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No. Type
d.
15. Special Handling lnstructions and Addition.al lnlormation \
6. GENERATOR'S CERTIFICATION: lher•bydeclar■ th.at the eont.ar,t:11 oftlib c:on~n~lar.fulfand a.ccurai.ljducrlbed U>O"l9 by proper a.hipping nam• and ar•da.ull'iad
packed, n...11ced, al\d Labeled.and are In all r.-.p.ctia In prep« cond!tl0"1 lot' tran-.port tiy hSghway~ng to appk:ab!• lntamaUanal &nd natlona.l gOVWffllTMlnt,-gulalfon.a an,
01• laws al tna State er Sou1t, Catollna. ·
17
HI am• La.rgo quantity gen01'lltor, I certify that I have ■ prCQram In place tc r.duca th■ voh,u1~andta:dc!ty of--..ta g~La<I to th■ da,or■-I h■v. d•t■rmlneod to be economlc:s.J~
pradc.ztil• and C\.at I ha--lectad th• practic.able m•tr-.o::I ol ~tm•nt, stantQo. or d~ cur'91itly avail&~• to mewhlc."'!, mJnlmtua th• pn,.aent &nd rutura ltlraat 1.0 hurr.ar
he.ate, ...nd C'le envlranmer,tOR. If I am a -.n1&.II c_uantlty generator, I ha't• mad• a good bJth al'!ort:O.cnlnJmlz.a myw--g_._.ljan and a.eladU'!.a ~ w...i. manag6mtllnt met:l"IO<
th.at i. av-&i\.al:lle I.Cl me -.nd that I can atfon1.
(., cL,.._,1._ Tu Month °'4 Yea
I /,I ,c
i~t of Materials
Mon!h Yea
I
edgement of Receipl of Materials
t.'Ft~~rzA -~ Montt'l Cay Yea R..R ,; I , I q,, ,,q
19. Dis.c:ep.ar,c1 IOCiQtion Sp.aca ·u
I I JU,,. C I ii"'-
b I Ju,,. d I )U,,.
'r.:--=--::,c-::------------,---------------------------------~ 20. Facility Owner or Operator; Certilic::ation ol receipt ol hatan:iou:, mate.rlah CO'o'eted by thl-3 ~ e.xcept as noted In Item 1S.
Printed/Typed Name ' SiaMtm ..
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South Carolina· Department of Health
and Environmental Control
Bur.au al Sood & Hazardou, W""' M,-t.
2600 Bull Sir""'-Columbia, SC 29201
Phooc: (1!03) 7:>1-5200
Emo,genc;y & Hollday,: (l!OOlT.l4-!>4,4
PLE.ASE PRINT or TYPE (Form d~ned for use on eOte f12-crt:ch1 tv?e•.itar, F0m1 Accroved. OMS No. 2050-oo:?9 EJ:clre, 9~
UNIFORM HAZARDOUS 11-Geoorato(aU.S.EPAIDNo. WASTE MANIFEST , , , , , , , , , ' '
~rn!,-:'No.12. ~•oe 1 · 11nfonnaUon In the shaded aceu i,, not , 1 , 1 1 requlrodbyFoderailaw,butbbyStau,law.
l. Generator's Name and Mailing Addr8S3 • , • ' New Hanover County/ City of W1lm1ngton·
414 Chestnut St. , Suite 101 Wilmington,NC.
4. Ge,,erato;,,Ph~ne( 919 I 341-7139
28401
5. Transporter 1 Company Name 6. U.$. EPA to Number
,N ,A I ' ' ' ' ' ' ' ' ' 7. Transporter 2 Comeany Name 8. U.S.E?AtoNumber
"rff.T~t.?a-·Phoo.:~1'::~1.9:€~::r':::t.;f~~~':;·7::,-
tP~Tl&~i-0·;:,'!£~~,~~;~3!~,::i~::.~~
9. Designated Facility Name and Sita Addres.3 · SRC
Box 2005
Columbia,SC29202 ' ' ,N~ I ' I ' ' ' ' 11. U.S. DOT De=iption (incluamg Proper-Shipping Name, Ha=d Class, and D Numberj 12. Container, No. .. Type
Petroleum Contaml·nated Soil (NON-Hazardous) :··-;·;v,c, ·-., G a. t~I I I J It' e o, o, 1 o ,r , , , 2, o vo m, 1, 1, 111,~ i r,b.;----------------:---------------'-----7rL.Lt...l.i......lLL.L...l..i--'r,,i,~"": .. :1~-z-:i:,:,;:.~,~-,2-:
~I 1 I J ·H,; ~ , , , , , , 1 tl, J 1 . ,~ ~ ~c.:------------------------------------l-L.Lt...L-f......1-L.L...l..-t--l~{;j:)~i :_:_:_::_= ... ~_=-'~,-~~
I 0 I I I I I S~~L._ _ __ .... _).S
d.
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15. ·speciaJ Handling lnstruc:ioru and Additional lnformation
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e. GEN ERA TOR-S Cat TI FICA TION: I Mr•by ded.ar• thal the contanb ol IN.a conMQ~&t9 fl.lOy &/'Id accuralillYd•acrib<ld &boYti by prcpo, &hipping nam• and are c!aul!'i ... p•clted.rnal1i:Dd.,anclla~l..cf.andar•lnallt.-.pec:alnp.-Ope1'condltlontortranaportb)'h/.;hwayaccort11no;toapp.ll,cabl•int.m.tlona.1.ndnaDOn&lgav.mm.n1~ulall0Nan
U'I• I.a~ of tn• Slata ot Sou1h Catollna.
HI am■ }arg■ quantity g■neratM. I c.rtify tt,.at I haw a program In plaea to raduc. U'i.e'l'Olume and tcxldty ofWa.ste g....._tad to the d..,;it-1 ha.,. d■tannlne,d to be oconomlc.&Jl practic...lb!■ and tnat I have -locted the pracl:lc.abl■ ~tnod of traatm■nt. su:i~-. O¥cf~airq,ney ■-U...bl• tom. whlc.., mlnlmlia1 th• p.--nt and h.Jtur■ ttlroat m hum.a health and th• e,,...,lronrnont:-OA.. tr I am ■ small quantity g~. I hav• ma.de• goodtailh l'florttQ minlrniza my•-• g~don and M{octth■ t:i..t w...i. management~ that i. ava.il&bla to me and 1:hat I can an'on1.
fJilltediTyped Name
'Kll,;,,.,on-,... L. Month Day Ye,
l / I,.' f .S, 'l,l ~ n. Transporter 1 Acknowledgement of Receipt of Materials V ,
~ P/ht;3,'1Nam, rt4v'/~ 1Signa,(1pi,,d ~lU--7)'" :;:~,~2,}~ P f-:-:-!::-..!..!...=~~_,u:..:....=:~=,---,--,-,----,----L--l-,2,L:)~~a:::!....-....t.:;==-~--------1..L.J!._L;'....t!:c.1..1..l: ~ t-1_B.-;;-T
7ran::'."",pcc:::c_:er--c2c:A-;-d<n-o_w_led_,g_em_en_t_o_f_R_ec,_i.,.i'--c-l_Ma_te_riaJ_, ___ -,-c,--__ -__ fl ____________________ --:c::::::--;;---;;~
E Printed/Typed Name ISisnawre Mcnth Day Ye:
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19. Di.sacpancf lndic.:1tion Sp.ace
• ._I .,_,__,_,__._.lib,. C ... I ~~~\lb.
bl lib,. di 1~ •l--:c-c,------------------------------------------------· ~ 20. Facility Owner or Operator; Certification or receipt ol hazardow malerlab covered by tt.il manim:t e..xcept a.s noted In Item 19. ~ted/Typed Name · 1 c:;,,,.,.i,,,_ V-
I ·-----·--·-:--.... -----· -· -. -·---·. ---------~. -. --_ .. ____ . ···--. ---•-....... ·.·--, .. --.. -
· -~ South Carolina Department of Health I ~ and Environmental Control
Bureau of Solid & Hazatdou, W'-"" Mgt
2!ilXJ BuU Sb-"'"-Columbia, SC 292U1
Pl>ona: (80JJ T.l-4-5200
Emergency & Holiday,: (803l7:l4-S424
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PL.E.lSE PRINT or TYPE (Form dciQnod for use on eOte r12.citchl tvoewrn:arl Fenn Aooroved. 0MB No. 2050-0039 Ei:olre:s 9~-B.a
UNIFORM HAZARDOUS 11. Geoerato~a US.EPA IO No.
WASTE MANIFEST . I • • • • • I I I 1
· ~!!.,~No.12. Page 1 llnfonnatlon In the 3haded Mea:s f:s no!
1 1 , 1 1 of requirod by Fodor>! Jaw, bu1 b by StaJa Jaw.
3. Generato(:s Name and Mailing Addre:s:, of Wilmington· New Hanover County/ City
414 Chestnut St. , Suite
4. Generato;,sPh~ne( 919 l 341-7139
101 Wilmington,NC. 28401
S. Transpcrter 1 Comoarrv Name
7. Transpar.er 2 Company Name
9. Designated Facility Name and Sile Addres., SRC
Box 2005
Columbia,SC29202
. -.. ' "
6. Uj E? A IO Nwnbor
,N I I 1 I I I I
8. U.S. EPA JO Numbo<
I t 1 I . t t · I
10. U.S. EPA IO Nwnber
·11. U.S. DOT Description (111cluding Proper Shipping Name, H;JzarrJ C/&3.. and Ill Numbetj
d.
b.LLJ-1 1-1 )-1
15. Special Handling Instructions and AdditionaJ lnfcrmation
1 I
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··c.35:t1taf· .. --~---~ ... , ... ID.:.r~~;t~J~~f:!-:ff~.=rrf.;:;~1;,~;,_
Oitffllu£ri-"ir~~r::•gr.G:;~stt!~11H~--:;-;,~:;;
·t~~t~~a·o7:1~a.i;"'bdi~~-£!:~i;d·E~:~.:f.i
-F:~~-Phii-~~~-~~h-~Tb!:i~,=i-:_~J!tl
12. Conlaineo
No. Type
' 1 I 1 I I 1
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1C. GENE.RA TOR'S CERTIFICATION: I her•bydoci.ar• l:hatthacont.anbol!nla con~n~laniW)'and u:curat.lYd•IC'ibed above bypropo, ahlpplng name &nd are clu.&.il'ie-d. \
P•ckod. man:ed, and labelod, and ara In all , .. poc:a ln p<opot eandltlon kn" tf1naponby hlgttway accorc.Jno to ap~W'ltam.atlonal and nal1oonal 9avemm..nt r...;iulatlona anC
tr'I• lows cl 11'1• Stai. ol ~ Carolina. · · l
NI am• l&rgo quantity generator, I certify thal I have• program In pl.ace to r.duee ~ ....olume and~c:ty ol waa1a gOl'Wal.9d t0 1h41 davr-1 ha..,. d■i.rmlned to be eeonomlc.aJly ;
pnic:i=b~• and En.al I h.a,.,.. -lectod th• pradc..at>l• metnod ol U'-tm■nt, 1:10.....,.._ o, dkspo-.1 curnnCy ava.lt.bla to GM "Which mlnlmiz.aa the p~nt and tun.ire ttlrN.t to hum&.r1
h-.llTI and aia envlronme-nt:OR.11' I am a a.mall qull/\tlty ;onenator, I ho.Ya made a good t&Jth e-tlortra mln.!mJ.z. myw--g«Ml'adon and a.lactU'\■ beatwa..ta ~gornGnt m.rthod
ai.at t.. a..-..i1.&J:ilo to ma and tha.l I can al'lotd..
r
~ted/Typed Name
'~AV""-"" i) L. • _(j L Mon~ Day ,ear
1 /, l,t,5,q,o
T 17. Transpcr"..er 1 Acknow!edgemenl er Receipt of Material, . / / Rj-=:;::;-;:;:::===-=---'---'-----'--__;__----==----:;,;-;------;:------------;-=:--=-;;::::;-
A ~/Typed NamJ_" I 1Signa"'9'} /2,,,,,,, / ,/,7 ,J A • ,_ , Monlh Day Year ~ ( 1./}Pdcs C.::/7//owP/ { -lf1r1 (fa ( cr..JIJ'l/1..fi,., -, I, I 1/ ./_, 9 ,O Pf-:-:--'="=-=-==:::,..,..:=:--';""-'-'-,--,½-----:---:-:-,--,-:---L...~_:_=~~;__.!..,.!=s,:!_..=~;£_-------L.I....Wc.J.!..:..Zl..!.-L:;:.. o 18. Transpcr4.er 2 Acknowledgement Of R.ec.ei;:t cl Materia.13 / RR~l--::P--:rin-1-ed71=,:--yped-:-Nam-,--•'-~"-..;__;.:..c;_;_c..:..:..:::..:c..;.="--='-'----..-,1Si_g_na_w_r_• __________ ......,,,,,_ __________ M:-o-n~--=o-,y---:Y-:-.,,-
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19. Cisc:e~cy lndiCJtion Space
~r.2~0:--_-;:F:--a7c"lityc-::Ow:-n-,-,o-,--:0:-pe-ra--:to-c-,::C.-rti7·-;-fi-ca--:,:--.o-n-o7f-rec-,oi"p:-to=1-;-haza,--:dou,--ma-:to-rials77-cov--.,-od-:-:-by-,lhu7·---:-:--oxcept---.,-no-lod-:-ln:--c:a.-m-,19.:---------------
~~'/4) v, .,, ,...-, -::, , ~n ~ ' / I SignallJn, Mer.th Oay Year
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PLE.l.SE PRINT ot TYPE (Form de,iqned fer U$1!1 on eiJte r12-prtch 1'ipaw1it811
UNIFORM HAZARDOUS 1. GeneralD(aU.S.E?AIONo.
WASTE MANIFEST ' ' 3. Gener.a.tor's Name and Mailing Address New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 .Wilmington ,NC. 28401
4. Generato~,Ph~no( 919 ) 341-7139
5. Transpor:t,er 1 Company Name 6.N Uf E?A IO Numlx<
7. Transporter 2 Company Name 8. U.S. E?A IO Number
9. Designated Facmty Name and Site Addres.l SRC 10. U.S. E?A IO Nun:b<r
Box 2005 ·
Columbia,SC29202 NA
11. U.S. DOT Description (u,cfuding Proper Shipping Name, Hazan! C!as,, ind JD Numbetj
d.
15. Special Handling lnstruc~om and Additional Information
Buruu of Soild & Ha=dqu. w..,. Mgt.
2500 BuD S,,oet_ Columbia. SC 29201
Phone (80J] l'U-S:00
~oncy & Hollday:c (803ll'U-5-<24
Form Aooroved. 0MB No. 2050-0039 E,01,.. 9-30-M
2. Potage 1 lnfonnaUon In the shaded Meas Is net 1
required by FodaraJ law, but b by State law. !
·t::sii'ie~T~,---•.,.,._ "s'IO~<PW·~-.1-i;.f:£::t¼~Jff..;~\¼:,~1
tr.7.t Altioo' li.1{~;~..,..E!~~:;.z~~~S~t:e.1.%,~;:;:; i
'E.~~i,'.ii~a·io;~~~'-t?~~:.t!'.§~=~::::.~ l
-B~-Phi•~~~~~~i~i.S.=i-~~~~:
={~tirtmif.li%iii.-
~~l1~~~~~~~t~1~
12. Contain""
No. Typo
\
e. Ci ENEAA TOR"'S CERTIFICATION: I hereby dociat■ thal th• contants ol ttua cona.lq~ antily and aa;uraalY dea.c:tti.d a.bcr,re byprope,r -.hipping name and are c!~fied
pac.ked,, marltod, and Lab<ll-.:i. and are ln a11,-poc::a 1n prcpef' ccndlt1on to, tra.naportbyhi\,11■-1 : : rdlng to ~pUcabl•lnt.m.etlcnal and n-.uon..I 9ov.mment r.g1.1laC:1;1na anc 1:tl• la~ o1 th• St.al.II ol South Caralll'\&. · · . . .
l'
If I am• 1.ar;o quantity gen-era tot". I e■rtify U\at I ha-a program In pl&e:a tD r■duoe 1he 'l'Olurneandlnh::ltyol wast.genentad tD a,. d~,-I hav. detarmlo-.d ta be econcmlc.aJl)
P"dCUl!e M'ld tnal I have -1ectad U,e pr.die.able m.~ ot treatment, sto~e., °' di:spo:MJ CUZltftCy avalJ.abl■ tam. wh!ch mlnlm~a the pr-ntand h.alUre ttu .. t to hum.ar
health a.nd the environment; OR.111 am a ame.11 q1.1ant!ry goner.tor, I have me.de a good taittl sffcrtt:,mlnlmiz.a mywaaa g_,..don and -4ed !:tie beatwu1'1 mana;ement rnet:twx
in.I: la avail&tile to me and thal: I can alfCld.
~
;;: 1 rter ledgement cl Receipt cl Materiab
A
i 'n... Monln
0 ~r~=~=;';;:==========:_---,=~-----r<;L---------------;==-E SignabJra Monltl
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19. Oise:e~c-, Indication Spac.s
•IL.L..l....L..L...1.
b,__j .l....L..L...1...J.
lit,,. CI
lit,,. d I
Month
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l
Day y..,
itt:..
ltt:..
Dav y.,
1· .,:;.,..,.:c ... ;c:,;.c ,',•;;,.;,;-.,'c,c •• ,~c:-.·,;:,, ,;,~·-. -~ ., ..
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South Carolina Department of Health
and Environmental Control
Buruu of Solid & Hawdqu. \'!a"8 ~'..t,
2500 Bull Slree<, Columbia, SC 29201
Phone: (BOJJ 734-5."00
PLEASE PRINT or TYPE (Form de:sioned foru:se on elJta 12-oitchl tvpew1itan
. UNIFORM HAZARDOUS 1. Genera1oraus.EP>.10Ho.
WASTE MANIFEST
M&nlreat Doc:um_,,, No.
I
3. Generator': Name and Maiiing Addre:53 · of Wilmington· New Hanover County/ City
414 Chestnut St. , Suite
4. Geoeratcr',Ph~ne 919 l 341-7139
101 Wilmington,NC. 28401
5. Transpc,:-~ ~ .~mpany Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Addres.3 · SRC
Box 2005
Columbia,SC29202
\ Uj E?>. ID Number
8. U.S. EPAID Number
10. U.S. EPA ID Number
NA
11_. U.~ DOTOe5cription (inc!uding Proper Shipping Name, Hazird Clas,, and ID_Numbetj
d.
15. Special Handling lnstrucUoru and Additional Information , _
. ~onc;y & Hollday,: (BOJJ734-S424
Fonn Aocrcved. 0MB No. 2050--oo:?9 Exel~ 9-30--8.f
2. o!Page 1 lnfonnaUon tn the ahaded Mea:i ls not
requiro<I by Fo<loral law, but Is by Sta to law.
01t~ea&.~~~~:{t~t;..S~~E.~~~,~;.r;,'
t.~Y;&@ili'i'IF~~~~~SEiz.:fri-JE~±~:r.~~
·~~~~~~!-~~~:-f~~t~
e.. C ENE.R.l. TOR'S CERTIFICA TIOH: I h•r•by dOC.r■ 11'\at th• CQntent:1 ol th.I.I conalgn~.,. 6;llf ■nd a.ceunat11lj do.crlbed a.bow by prop« ahlppln<., nam• and ar• O~fiK
packed. ma.rlcod. 6l'ld lab-91..:f.and are tn -11 r.-.p.,;:a In P,Opet' candl:101"1 br tranaportbyh!;ll....,-=con:1lng to appilcable lntarnatlon-.1 and n&tionaJ goY9TT\ment ~ulallona an,
tho law, ol t:i• St.ate ol ~ Carolina. --.
r
• t1 I am a l.&t'il• quantity Oenotaloc', I cortlty that I ha-• program In pi.ca to ..-.due. ih.-\l'Olum■ andl:mdtyct w...i.g•n.a~ to ttlo■ degr-I~ .... deLem\lned l0 be ec.onoml~t:
practi~I• and U..11 ha~ -w,etod u,a pra~c.able method ol traalment. stora<;ie.Ol db;>cnai curnntty avall.abla tarn. whJc."I mlnlmlz.as lhe p~nt and tutl.lra lhrN.I l0 hul"T\.41
ho.lo, and i:ia environment OR. If I am• amall quanllty gooerator, I ~v• m&da a goocUaltt\ al'lorta:,mlnlmlz.a my•-• g.--..aon .net Ml1K1~• beat w&ata manago.ment mett"IOo
Chat la av-ail&Dlo l0 mo and that I c.:u, aNOt"d..
L, Day Yea
1,S'i"'J,Z i 17. Trans rtar 1 Acknowledgement ol Receipt of Material,
~ Print.ed/Typed Name Signab.Jra Month Day Yea
s ~ ~,:-a:-_-::T:-ran-,-pc-c-:-:er-:2-:A-:-cxn-:--o-w-=l-ed7g_e_m_e_n,-t o'"'f"R'".ec,__,;,..pt-o-:1-:-Ma-:--te-riaJ:-:-,---..l.-------------------------'_;LJ.
~ PrintedfTyYe<l Name
R
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A
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19. Oisere-;.ar,c1 lndic:ltion Sp.ace
I I
b I
Month Day y.,
lib,. C I \lb.
!lb1 d I \!b,.
•1-:-:-~--::-:-----.,,.----~--,-------,---------------------------~ 20. Facility Owner or Operator; Certification ol receipt ol haurdou:s m.atanab cc.-en,:f by ttul rnanict ax.cept as noted In Item 19.
P · /~ Name · s;gnal!Jr-e
i,-. , ./J .. ·--v --,,,.., Month Oay Ye.
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South Carolina Department of Health_
. . __ and Environmental Control
Buroau at Solid & Hazardou, w..., M!,l
2600 BIJU ~oet. Columbia, SC 29201
Pt>on« (BOJ) TJ4-5200 . .
.. ~ency & Hollday,: (W:l)TJ4-S424
Pl.E.A.5E PRINT or TYPE · (Form de:!ioned fof' u,.e on eOta 12•0itch ~ · · Form Aooroved-0MB No-2050-0009 E,cf,., 9-30-a,
UNIFORM HAZARDOUS 1. Genorato(aUS.EPAIONo.
WASTE MANIFEST
Manlf..t 2. Page~ . · Information In the shaded &<e..a.s b not
"7"'m~;r,, of required by Federal law, bulb by Stile law_
3. Generato<': Name and Mailing Addres, New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington,NC. 28401
4_ Genera!c~•Ph~nof 919 341-7139
5. Transpcr.er, Company=· 6-N ui EPA ID Number
DJ:fti'@i.'B~~,,i=i~;:~~-;:~5~-.t:1:~9k~~'.~-;-;::-;,
ts~T~~a'-i:iT~~g-~-ri'f~?ZC~ZJ:iff&.i:?~;-~,
'fifrn'·rfar.•·•?i~Si-0'!~~~~:.~~~r.,i
7_ Trans per.er 2 Company lwne 8. US. EPA IO Number
9. Designated Facility Name and Sile Addre:s.3 10. U.S. EPA ID Nwnber · SRC
Box 2005
Columbia,SC29202 NA
11. US. DOT De,cripticn (u,c/uding Proper Shipping Name, Hawd Oas,, and JD 1/umbo,j 12. Ccntlinffl
No. Type
'{
T R
A N s p
0 R T E
R
F
A
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d.
15. Special Handling ln:stn.Jctioru and Additional lnlormation \
e. GENERA TOR'S CUTI FICA TION: I hereby dee.tar■ that \ho cc,ntanb ol tl'lll contJgn~.,. twtyand &CCUna•IY d.-crib«I a..bov9 by pro pew ahlpplnQ name and are c!Ll-5iliec
packod, man:od., and tabel-.d,and ar• ln all ,_pecm, In pt aper condition tor tnnapcrtbytugtr.ay-=oo11nQ to a;>pllcabla lntamat10nal and na.DOna.l gavernm4nl re,,;u!atloru. an
12'1• la~ of oie Stai. ol Sou1h CVol:tna.
n I am a large quantity genonator, I certify that I ha.YO a progr.m ln placa to radur::11 the wolwneandti::cdctyolwa.at. gen.ai.d to the degr-1 ha.,. data.nnlned t.c be e,c.onomlC211
pnac::ic;.;ab!e llnd tti..l I t'UI,,. -loc1ed tzi• pnadc.a01• melhod ol tro&tm•nt, 110rago..01d~CWT11nlty avtllabla l0 m. ,.h.lc."'1 mlnlml.1.o• the PnlMlnl and tl.lt\Jra ttm,.e.t IO hum.a
h-11:l &rid 11\e envlronmen~OR. If I am• Sl'TWI c;,uantlty gonen.t.cr, I hava mad a a good tail1I af!orui::unlnlmha my w&a• g--.tlan and M(ect tt'\a baatwa.ste man,agemont mot."\o
u,.ac la avallU>Je tc fT1Q ~ that I c.an attOf"d.. • . • • -•
c4,_J-s-Sigr.atuni Month Day Ye. t:__, / ,I
17. Traruporter 1 Acknowledgement of Receipt ol Materiab
Printed/Typed tr Month Ye;
/..._. ,4
18. Transpcr'.e.r 2 Acknowledgement ol Recei~ of Materia.J.s
. ediTyped Name ~~ R bn R ~/)
Mon:n Yee rz ,<i 'p, r~i~ 'I 9,,
l-:-----
I I lib,. C I l'"-
b I Jib,. d I l'°'-
I t:::c-::-::::--,::---,::---,::--::;-----,---,--,---,-----,---------,---.,,-------,----------------~ 20. Facility Owner or Operator. Certifiwtion of ~ipt ol haz.ard003 mat.eriau o::Neted try thi3 mani!est except a..s not.ad !n Item 19.
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South Carolina Department of Health
and Environmental Control
Bureau o1 Solid & Haurdou., Wela !.!gt
2500 Bull Stroet, Columbia, SC 292'J1
Phone (B0JJ 734-5200
PLEJ.SE PRINT or TYPE (Form de,i ned fcf' t.1$9 on·eate r12.0rtch M)eWl'ftet1
UNIFORM HAZARDOUS 1. Genera.,~sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator'-, Name and Mailing Ad.dres,
New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 .Wilmington.NC. 28401
•· G<!lerato;,,Ph~ne( 919 341-7139
S. Transporter,1 Cq_mpany Name
·,
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address SRC
Box 2005
Columbia,SC29202
"N UJ: EPA ID Numbor
8. U.S. EPA ID Number
10. U.S. EPA ID Number
NA
11. U.S. DOT De>cription (UJc/uding Proper Shipping Name, H.wud C!ass, and ID Numbetj
d.
15. Special Handling \nstruc!ion., and Additional lnlormal:ion '·
· ·. Emo,gency & Holldsys: (803)734-5,124
FOITR Aooroved. 0MB No. 2050-0039 ex,,;,.,. 9-:lO-Sa
2. Potage 1 lnformatJon In the shaded are.a, I, net
requ~od by Federal law, but is by State law.
o;;;-~.;;.-~ .. ~.t~~~:t&::1~'ii~::t:~:1
t~~f--... --.,N•ai5~t'.Y..fl~ffhc~~1:£ti:E~t
--ff.~Ph&;.~pJF,.;:,*i$~~i-f~=!::>i'!-~l
12. Container>
No. Type
\
8. Ci ENE.RA TO R"S C£RT1FICA TION: I hereby doc!are thal the content, ol ltu.a cona.lgn~arw tuay and accura11ilYde.atbedabo¥e by proper ahlpplng name and ar• d--.lfi!KI.
pa cited,, m.ar1ca,d., and l.atMiled.and at• In all, .. ~ In p,op,« condlt1oc, to, trans.port by tu;n..., accord.ln,g to appll,cabl• lntaorn.at1onal and natSon&J gav.rnm.ent rwgulallona and
Di• laws ol 111• Sta:. ol South Cuollna. · · ·
HI am• luge qu.nt1ty g•nenitor, I certlty ai.ac I haw• progr.m In place to r.du011 iha'fOIUfflll andtl:mdtyot wast. gen«atadto ih-9 da,gr .. I hav. d•ta;rmfn~ io be e,c.onomlc.all)
pnic:iQbl• and cu.t I h.a-~ U,a prac:1c.abl• mairiod ol ~tmant, 111:l~e. Ol"d!:spo:Mi ~lly a....Jlable tome which mlnhnl.u,a th• p,._nt and rucu,.111r .. t to humar-.
he.al th and 1110 eovlronment:-OR..111 am a am&ll quanllty g~tor, I hav• mad• a good tal1h oilort!D mlnJmt.z. my waaaa g---.150n and .. lactttla ~ w~ managomant rnetnoc U"\a.t 1-av&.11.a.Ola to ma and that I c.a.n al1ord..
Month
I I ;l; 17. Tr~ rt.er 1 Acknowledgement of Receipt ol Material,;
;'.'.. Printed/Typed Name Month
s Ec_fw{"'c! · // ivr,-·I
p f-:-:'~==~:-:-='":-'.L.:..=::,:..--,---,------_J..::.S.,Za!:'.w.Ll:J:~::...Jc.::l..CL..~:..::::=:::....-------..l.!c.l...l · ~ 18. Transpcr.e.t 2 Acknowledgement of Receipt of Material,
~ . te<l/Typed Name
R R y
F
A C
I
L
Month
("
lib,. C I
lib,. d I
I f-::-c:--:::-:c----,:----:,--:,:---:-----:----,---,-----------------------~ 20. Facility Ow-ner or Operator; Certification of receipt ol ha.tardoU3 malerlab: ro-.-end by 1h11 ~ except a.s noted In Item 19.
Printed/Typed Name · Signature Month
Day Yeai
(,9 '7,C
Yeai
Day Yea:
I , {:,
i'b.
\lb,.
Day Yea
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PLE.lSE PRINT or TYPE (Fann desi ed for u:,e on eOte 12-git:ch t.p,ew1iuai
UNIFORM HAZARDOUS 1. Generatcta US.EPAIDNo.
WASTE MANIFEST
3. Generaloc'3 Name and Mailing Addres:3 New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington ,NC. 28401
A. Generato~•Ph~ne( 919 341-7139
5. Trans.po~..er 1 Company Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address SRC
Box 2005
Columbia,SC29202
6.N Uj EPA ID Number
8. U.S. EPA ID Number
10. U.S. EPA ID Nwnbor
NA
11. U.S. DOT Oe3crip_tion (lllciuding Prope, Shipping Name, Hazard Clas,, and ID Numbdtj
Form~ 0MB No. 2050-roJ9 Eiol"" 9~
01f~~l>M8:t:i~±i~!"t;Jx;.:~~;;~::;:;~
~~'t"' __ .._. __ i'Dif~Q.fl~S;';flc.,,'"z;;qi~tt~.
-#..~Pboi~S--~~o/:?t:ts:r~t'f3:T~i!1l i
12. Container,
No. Typo
G a. Petroleum Contaminated Soil (NON-Hazardous) :~t';-r,""'"';'"~;!y
E O O 1 D T 2 0 YD ~17,7,7,7,~1 ! ~b;;-_----------------------------'-------t.l.....1.---t.....l-'rL.L.L...l.i--rf-mj~:~_ ~-=:~-~-~-;~-;i.,:~_~H·,
~ 1-c. _______ __; ___________________ __; _____ +...1.....1-1rLt-.L.1-.1.....1.--1--f
1
~_]!±,.i=~~~~.s~-s~;
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F
A
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;El' ·---·----}11
d.
15. Special t-'.andling lmtnJcfons and Additional lnlormation , . \
6.. C EN ERA TOR"S CERTIFICA TIOH: I her•by dec:.!ar• that the ccnteints ol thla conalo;Jn~t .,..~ and a.ccun.•ty dHcribed abov9 by prcpetshlpptnQ nam• and are da.sa.ifi..:I, :
P•Ckod. m.ariced. and \.abeled, &nd are In a.11,-pecu In Pf Opet condltlon lot-tranaportb>f hJ;hwayac:c:on1lng to &'3pllc;;ab6elrd:emallonat and natlon&l 9QV9f1Vn.ent r--,;uladona and .
U'l• 14""11 cf me Stai. of So,v,;h Carolina. ·
NI am • Wge quantity genon.tor, I carUty thaC I have a program 1n place to reduce ~vohun• andlD1.lc:tyofwastag~ta thede,grN I haw datennJned to be ..:.onctnlcs.lly
prae:ic.atil• &rid ai.a11 ha¥& aeloc'led the practicable mamod of tro.tment,. atc~e. o, dbpol-&I CUTWntty aY&!i..bla lo tnawNch mln1mi2.ea the pra.Mnl a.nd future ttiroat lo human
he&Jt:i and aia anvlrcnment;-OR. ti I am• small quantity ganeralor, I have mad• a ;cod taittl anottto mt.nJmlui my wu1111 g--UOn and aeladU'le bel.t wuu. man.gafl'W!nl mettlod U\&t i. av-1.il.&bla ta ma and th&I J can atfoni
~/Typed Name
19. Discrepancy Indication Sp.ace
oL,J._
l
I Li ..1....1..l...L.L
bL-).L...L....L...L...
Month
I I
Month
I I
Month
' I
)Ibo. C 1
!Jt:o. d I
Day Year
/.Ci l
Day Year
" 9 "
Day Year
,,qq()
!Ibo.
)Ibo.
'b-::-c:-::---,----------------------------------------~ 20. Facility Owner or Operator. C!rtific:ation of receipt cl ha.z.ardow ma~ ~e,e,::f by thb rnanae:st except a.a noted In Item 19.
Printe<l/Typ,ed Name ' Signature Month Day y..,
111 · ~-~~•-. i_ ..... ~-,1,,.~~•-·,. ,,,. ~.>-...:.~~--~-~w--=---=.,. "'~-·~...:..~::;_. .. -. u,'c_,...,_.::___,.:,.,"; .... •. ··-~~,:.;-_· -~:-!.,..=-·--..:c---::r. .. -.
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South Carolina Department of Health
and Environmental Control
Buluu of Solid & Hazardou., Wa:ie t.11,1.
2fDl 8"ll S,,oe1, Columbia, SC 29201
Phone (BOJJ 734-5200
Emergency & Hollday,: (B03}1'34-S42< ·
Pt.ElSE PRINT°" TYPE (Form de:sictned for use on e!1te 12-citch tvpewrita1 Form Acoroved. 0MB No. 2050-0039 E.tolre, 9~-88
UNIFORM HAZARDOUS 1. GeneratcraU.S.EPAIDNo.
WASTE MANIFEST 2. Pao! ge 1 lnformaUon In the shaded Mea:s l:s net
roqulred by Federal law, bulb by Slat, law ·,
3.. Generato<'s Name and Mailing Addre:s:s · New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington,NC. 28401
4. Genera!o(, Ph~ne ( 919 I 341-7139
5. Transpcrter 1 C'J'\IT\tl3l1V Name 'h UA° EPA ID Number c...~St.im.TnJ;Zo. ta?61h~''?,!f.\1~i':,,j-J,1:~,}.}-n_·Zl;t_~;,c,!
DJ;fABUOQW"a -~~!i~;{t;;:·G;.;-jt;f,:1~:-a~~::~-:::~ l
7. Transporter 2 Company Name 8. U.S. EPA 10 Number
. '
t~Y~a·o·;r.;~~~!·@1~f~'±.;:Ei~-::f.:.z~~it
'F:.~~Pholl.'?:f.~~~r;::?~~~9!~?.t.•
9. Designated Facility Name and Sile Adi:ires.s SRC . 10. U.S. EPA ID Number
Box 2005
Columbia,SC29202 NA
11. U.S. DOT De=iption (including Proper Shipping Name, Hazan! Clas,, and ID Numbo,J 12. Container,
No. . Typo
F
A
C
I
L
d.
15. S~ Handling lnstruciion3 and Additional tnlormation \
11. CENERA TO R"S CERTIFICATION: I het•by doci&r• thal U'le contan~ of th1a conalgn~I ani ~and a.CQJra•IYducribed &bow by roper -.hipping name and are cla.uifi.d,
paclir.ed.. mal'Xed, and label.cl.and ar■ In &JI t"poctl In PfOpot candlllon lat tranaportby hJ;~.::cordlng to ~pllcabl•int.m.tlonal and na.DOnal goven"U"nenl r.,..ulaC:on.. and
ltl•la-,,oltrieSt.ateolSoult'IC-0,ina. .· · .. ,: : . : -· · · ·--.,,. ·
HI am• Large quantity gon_.tor, I c.rtlf')' tt\al I ha-a progr.m ln pl&CII to r.duc. ttia'ldu~ancltctx!c:t)"ofwasta ge,-,.tad:to O"Md--.r-1 ha..,. det.emlin.d to b,o .c.onomlc.11\y
prac:-:io.ble and O'lal I ha--loctod tn• pracdc..able meehod ol troatment, at.o~e.Of"dbpoM.I cunwnoy avail.able to mo. whlc.~ minlrn.12.oa th• pr.-nl a.nd tuture inrMI to human
hoa.Jttl and trie envln:inment:OR.111 am• a.mall quantity gen-erator, I ha-we ma.de a good taM eflol1tomlnJm!ui my w...-~don and M(edU'la b-.1 w...i. man..gament mwt:hod
ai.at la &Yai1-.t,le tc me and tn.a.11 can &tton1. . . . . . ·
19. Cisc:ep.ancy Indication Spaca (J I IL-l....L..LJ..J...Jllb,, C I jlt,,.
bl lib,, d I lib,,
•r.:::-~=--:::--=-:-:::---:--:--:::--::---c---,-..,,....-.,----,-.,-------=------,,---------------~ 20. Facility Owner or Operator. Certification of receipt of haz.ardou3 maleriab CO\lered by tt-13 IMJ)ile:st except u noted In Item 19.
Print.d/Typed Namey /7 , Signature , /./ .-4 ,-. /7 1 / • _ ,-,Month Day_ Yea
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PLE.lSE PRIHT ct TYPE (Form d~ nod for u:se on ellte 12·Ditch tvpewrnBt1
UNIFORM HAZARDOUS 1. Generamfa U.S.EPAID t1o.
WASTE MANIFEST
3. Generate<', Name and Mailing Addres3 New Hanover County/ City of Wilmington·
Manlf-1
D,oa.i,n-,tNo.
414 Chest~ut St. , Suite 101 Wilmington,NC. 28401
4. ==to~>Ph~ne( 919 341-7139
7. Transporter 2 Company Name
9. Designated Faci!it'j Name and Site Addres3 SRC
Box 2005
Columbia,SC29202
8. U.S. EPA ID Number
10. U.S. EPA ID Number
NA
11. U.S. DOT De>crlption (,nc/uding Proper Shipping Name, Haza/Ii Clas,, and V Numbet/
Bumw c,f Solid & Hazardou:i w..,. t.lgt
2500 Bull Slroet. Columbia, SC 29201
Phan« (110:l) T.14-5200
Emergency & Holiday:,: (B03)T.14-S424
Form ADorovod. 0MB No. 2050..()039 Excites 9..J0..88
2. ~aoe 1 Information In the shaded ace.as l:s not
roquirod by Fodera! law, but Is by Stu, law.
a. Petroleum Contaminated Soil (NON-Hazardous) 7,··c••nr'--'··•·•7,, G fl1 f I t J~ ··; '"' E O O 1 D T 2 0 YD ~,7,7,7,7,~ ; ~b;:-_-----:----------------------'-----1--LLl-Ll-LLLLl--ff~.~~i''~'~, ::::, ~ .. ::,;:;.~,,[;¾]~
T rtl.)JJI_~ ~ f:<-----;---------------...:._ _________ ...:._ _____ t.J.....1.7_J...:._I-L-1...J.....1.7--~f:~i±j~:~~~,~f~8,
d.
15. Special Handling ln.struciions and Additional lnlormation \
~4 t:, ~u.1VM--•-n.--•-•'•~
6.. C EH ERA TO R-S CE.RTIFICA TION: I her•by doc1..ta lhal the c0ntonb of IN.a conp;inm«U.,.. hlly and 11.CClJra•lyd..,crlb.d a.bow byprap,tt shipping nama and ar111 c.!-...lfied,
paclcod., m.anco.:1. and labeled, and Ill• In all , .. pocta In PfOper condition fcf'tr.n&portbyhtghway~ to a.ppllcable lntamatlonal and nadonal 9ovwmm.entrw<jjt.1!atlona &r1d rt'la la'IO ol ll'l• Slate of Souu, Carollna.
HI am • l&ti;ie q1,1-.ntity genoq,tar, I certify lh.al I h.ava • progr.m In pl&ec1 to reduce tha-.olume andbllicftyo1 w■..iaQon«a'-d to a,,. d-OtN I Nve d•'-nnJn.cl to be l9COf'ICJmlc.ally
pn.c:ic..a.hle and tn.al I ha,... -1.oaed the pradcsbl• m•tnod cl tro.tment. S10f'l>'il-. or dbpou.l a.nnay ■Yaltable to me whlc.'i mlnlmi1aa the pro.enl and future ltlroat to human
hWtn and t:"IO envlrgnment: OR. II I am a am.aJI quantity gl!tntlrator, I have mad• a ;oodta:'11'\ •ffort~mlnJrniz9 my•-• g......,_oon and •ec:tthe bMtw-.te management m.ttlod
ltl.&t ta av-.11.a..t:ile tc me and that I can a.tton1.
Month Cay Year
f-1.... I I l ..Sfl.O
~ 17. Transpcrtef 1 Acknowledgement of Recei~t ol M.atariab
~ PrintedfTyped Name
~ f-:::.J;faA'i.!o_K!::U'~:-;--,._:J~l1c_C::.:_:l(:_:J'_co~_,J:_,-,-=--:-:---...L...=2.:;i::!..f:!~~-~..j,.c~l::J=:!:::::_ _____ _j.ll_!.J___l..::.l.:J
Month Day Year
I f ,r 'I p
I
~ ~1_B_.::T-:r.n_s':-pc::c:-:e_r_2:-Ac-cxn_o_w_led_cg-"-'e-'m'-'e"n'-t o:.:l.:.Ac:ece.:..:.i::..p_o:_f_Ma..;:.cte::.rial=.::'----,---------~'-------------------::---:,-
E Printed/T~ Name Signatim,
R
Mont:, Cay y:u I
F
A
C I
19. Ci.sc:ep.anq Indication Space
I I
bJ
!lbs. C I l'b.
!lbs. d I libs.
L / f ~2:;;0:-. -;:F:-a-,ci"lity-::Ow:-n-e""'r ci-,-:0::-pe-ra-,to_r_, 7C.-rt""'·7fica-cti:-o-n-07f rec-e-:i-pt:-o-:f:-ha.ra--,d-,-O\l3--ma--:te-r1al>,-,--=-er_od_by_thi>-:.-m&nilosl--c--=apt--..,-no-tod-:-:-ln-,lte_m_1_9_---------------
---P,l'inted/T~ Name SiaMb.rrP
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J. Generato<'> Name and Mailing Addnm -. -,--.-New Hanover County/ City · ·· · 414 Chestnut St. , Suite
4. Generato;,, Ph~ne( 919 341-7139
5. Transpot1"! 1 C<lcnpany Name
7. Transporter 2 Company Name
9. Designated Faolity Name and Site Addres.3 SRC
Box 2005
-Columbia,SC29202
of. Wilmington.-·_
101 Wi lmi ngt6n ,NC. 28401
, 8. U.S. EPA ID Number
10. U.S. EPA ID Nwuber
NA
11. U.S. DOT De,aipticn (inclucfmg Proper Shipping Name, H=w Clas,,_ ind rJ Numbet)
d.
01f___.-#_ .. ,~~;f!f_::._;._:;tl1Sl~I~::~~
~t---N'i'jj~~~~~~~~,:.;~~t~
"F.~!iim~-~~!"~~1::£~~~~
e.. C EN ERA TOR"S CERTlFICA TION: I MA by dociar• that th• content:, o! lh1a conalgrwenlanf&llr&nd accura•tY dHcribecl &boYe by proper ah!pplng nam■ and •re c:Ja.saifi..:I. p•cited. tna.rkad. and tabeled,and .,..1n &11,_pec;m. In ?1"0porCOndlUon br tr&napol1by hJ,ghw.y-=con:11ng to &ppllcabl■ lntemallon&I and nation&I 9~nl ~ul■CoN and 1:t1•la-oftT1eSlat11olSou1hC&roilna. :-·,_.·: .. ·.•:.:· .. :: .... ·:~··,:.;:_:_·,_;·:. ·· .. :.: ... :·;:_ , -·. ~ .... ::,_;.:::..,,. ,._.·:.;. · -··.-.· ,;_,· ... ·.· ,,'.•·-···
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HI am ■ larg■ qu.ntlty g■Reffl\of', I cartltyui.i I haw• program In pl&ee to reduoa a,a'IC)Wml andmldtyofW&Sl.e g.,_..tlldic, ~ d~t-1 ha-d■iarm.lried ta be .c.onomlc.a.Jly prac:::ic:abl■ and tn.at I hav,a -1.octed th■ prac;'jc.abl• metrK>d of tr-e.tm•ot.. SlOra,ga, ord~ cwr.ntty •Yailabl• tom. wh.td\ mlnlmlui• th. pr.aeot and rutur• G"lraat le h1,1mao he&lth and th• -,wlrcomoot:-OR. tt I am• amall q1,1■1\C'r'f goner.tor, I hav• mad• a oood tattt1 eNon.11111W'Umlz:. my ---g~n and Mf.cttri• bMl wa.at. ~gemoo1 me1T'ood that la ava.,1.ablo to mo and tt\&i: 1-~ afford: · · · ·
17. Transpcr1e< 1 Acknowledgement of Ree<ipt cl MateriaJ, · ,. --·
frinled/Typed Name .. '<" . LJ, l ,·,,._,.;..s Mcnlh Day Yw
9.c
Month Year
,C
J J 1 t lib,. C I \lb.
r ! I I \lln. d I \lln. •f-cc--::--:::-:-::------------,----------------------'--------------~ 20. Facility Owner or Operator, Certification ol receipt ol haiardOU3 materlab CCNered by thi3 rrwile:st eJ:C.ept u notad In It.em 19. Printed/Tvoed Name e;,..~,..,,_
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South Carolina Department of Health
and Environmental Control
Buteau a1 Solid & Hazardou, Wa"8 Mi;t
2SXJ Bull StrOIII, Columbia, SC 29201
Phcoe: (B0,3) T.)4..5200
~onq & Holiday,: (80:l)i'J.1-5,12◄
PLEASE PRINT ot TYPE (Form desioned for use on elite f12-ortchl tvoewritarl Fonn Azlcruved. OMS No. 2().50.-003.9 Exoir~ 9-30--8. UNIFORM HAZARDOUS 1. Generatc(sU.S.EPAIDNo. Manlfeat 2. Page 1
~men ~o of '
Information In the shaded are.as b not required by Fedora! law. but ls by Siala law. WASTE MANIFEST
3. Generator's Name and Maifing Address New Hanover County/ City of Wilnington 414 Chestnut St., Suite 101 Wilmington
4. Generatcf, Ph~no ( 919 341-7139
N.C. 28401
5. Transporter 1 Company Name Willms Trucking
7. Transporter 2 Company Name
9. ~ignated Fac:lity Name and Sile Address SRC Inc.
Box 2005
Columbia SC 29202
6. U.S. EPA Ill Number
A
8. U.S. EPA 10 Number
10. U.S. EPA 10 Number
11. U.S. DOT Description (111cluding Proper Shipping Name, H:wud aas,, 1nd ID Numbet/
d.
15. Special Handling lr\StrucUon.s and Additional Information
Mat~~{al Code# 01-137-0101
' '
\
C: 'Stitt inU LicOtia1i~iti~,;p·:.!,~,i>i;.~iit7~1,;~~~!f~;-
D7-TAH tiiiiln'~,S.~~!f~~#7-;1~~*~-::,-:;
'E.~TBl@iati0~.!.2E:&:17~~~i::~::-:t:
-i=:~P!loi-·~~:~};..~!~:-t~;i!:f;f~::=~~~
,-::;•,,_, .. _ .. ,.,, .. ~------.. ,. .. ,,
~: : : l :i
e. GENER.A.TOR'S CERTIFlCATION: I hereby dociaretti.al U'\11 contenb ofttil• c::onal,g~l.t9fu0y&nd &CQ.Jra•/ydea.crlb.dabov. bypropetshlpplng nam• and 1r11 cia.ulfiec packed, ma.rkDd. &nod l.a~led.and .u• In aJI , .. pec:s In propor ccndltl.on f0f'11vlaporttry~l'IWay ~ng to &9pllcablelnwm.tlonaJ and naoon..l g~nl r9Q1.ilatlona an, O'le 14""3 of tr\e St.le al Sou1h Canltln&.
111 am a l.ug11 qu.nUty generator, I cortlty that I have a program In plaea to reduc:eui.e-.olumiaand IIDlc:rty of waste;~ to GM deg,... I ha-datarm.lned to be e,c.onomlca.ll-prac-:ic..abla &11d au.11 t'Ulw -loctocl tria pracdc.abla matnod of ir-tm•nt. stcrag,ordb,pcaal, Q.lff9n0Y avail.able tom. wh.tc."\ mlnJrnlz.aa aia p,....nl and tutura aira.at lO hum., haa.Jtl'\ and tho onvlronmont:OR. ll 1 am• small quantity grtnorw.tcr, I hava mad a a good tall2\aflofttQmJ.nlmtza mywu• g_.._.tlon and aeled a,a beat 'W..U. management met:J'\O< in..t la --.ilatlla to mo and thal I can anont.
Prin
~ 17. Transporter 1 Ack:nowlodgement of Receipt ol Materiab.
A Prin ~ ·I p
~ 1a Trans r.er Ack:ncwledgement of Receipt of Materia.13
T E
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Montt'I Day y..,
Moneh Day y.,
In,,. .. • I \lb.
Jib,. d I \Ibo. 11-:,,--:c-,--,-----,-------,------------------------------------------~ 20. Facility Owner or Operator, Certification of receipt of hazardou:3 materi:ab: coveroo by mis manifest~ as noted In llem 19.
Printed/Typed Name. r-I Sign.ab.ire ,--.. . F i (' /!/ . I I u:, --, Jc,,;.,__ Q.-:,'-,;r..-,c
Month Day Yee
,1./,d.7,9'.,
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South Carolina Department of Health
and Environmental Control
Bureau ol Solid & Haurdous Waste M;t
2ml E!uJJ Slroat. Columbia. SC :mo1
Pilon« (BO:!) 7:l-1-5200
Emergency & Holiday,c (B03)7J4..S'24
PLE.lSE PRIH'T « TYPE rForm de:3ioned forusa on elJte r12-ortch tvoewritBo Fonn Accrcved. 0MB No. 2050-0039 E.xo!r~ 9~
UNIFORM HAZARDOUS 1. Generato(sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Mailing Addre:53
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generato~, Ph~ne f 919 341-7.13 9
S. Tr.iMpOrter, Company Name
Willms Trucking
7. Transporter 2 C<lmpany Name
9. Designated Facility Name and Slta A.ddres.s SRC Inc.
Box 2005
.Columbia.SC 29202
6. U.S. E? A IO N.umller
A
8. U.S. E?A IO Numller
10. U.S. EPA ID Number
11. U.S. DOT Dewiption (including Proper Shipping Name. Hazard C!as3. and ID Numbetj
2. Paoo 1 lnfonnation In the shaded weu f3 nol
of I required by Federal law, but~ by Stai. law.
'C:•~tm.ioo.·tn,iai::??~•;f.":'4.;:'.1'!;.J''.t:b-:-S,;:F.:E:i.:i,,_
OJT~l«'a~~~~S.1~7h~~t'.t!!~~\¾.;:~;l
E.~T~~ri:f:i;r'r.!.2~~3Ei~'4;;t¥t£.-3.~3:~I
"Fi.~~._:·1,t~;;:::;;::~::~~~~:fa.:J
12. Container.,
No. Typo
~ a. Petroleum Contaminated Soil (NON-Hazardous) t!.;··-rz";t'-~l
~ r.b.:----'---~----'-----_:~---------------fO:..tO:'....tl:.fD:'....tT4-1-1-...1:2:....107.!_Y~D-1~r~~~73;::~7~:~7t.'~:~,:#if~
~ ~c.=--_______ _: __ ~~----------=--_: _______ _!t-L.L+...l-1..JLL.1.....1.-t-~~t~~f, :2:l::!Et~,s~
-~~t, ____ v,•••-•-~-r~
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15. Special Handling lnstructioM and Additional lnfonnation , \
Material Code# 01-137-0101
~ GENERA TOR'S CUTIFJC.A. TION: I h•r•by doc;Jar11 U'\at 1h11 contenb ol ail a conal;nffi«l1 an fufJ,y and accuraalY deacrlbed aboY-a by ptcpe, ahlpplng name and aro c:lu.ail'iad.
_ . pecked., mvked.. and l.t.t>.lod, and at• In aJI ,ea~ In ptoper condition loc-ir.naponby hJgri--,accon:11ng to applLcabl11 lntarn.aDonaJ and nationa.l 9CN'effllnent r.-gulatlona &11d aie la.W11 of ?ha Stata o! s.o..m, C.aro'1na.
HI am a la.rge quantity o•nOl'atoc', I certify that Ir,,.,~■-program ln p~ to f'aduce 'Iha 'fOlurr-.. andlcxJ.city0f waatagenetal.-dto U'MI d-oree t ha~ det.ennln.d 1,0 be economlc:.a.lly
pr.111c-::iC-Ull11 ~ aw.t I h.av-e -lectod the pradc.abla m.Olod ol treatment, su:11·•-.a. or dl:apo:a&! CU1TanCy rn.llabl■ l,O mo. which mlnlfflWa Iha pru,ent and future throat to hum.an
hoalth and a-ia envln:inmont:-OR. HI am■ ama.11 quantity g.,,......tor, l have rnada a good tam, .norticimlnJmlra my wuta gWten.Uonand aelocttha beat wa.at. m..n..gomant med'\oCI in-1 la availaole tc mo &nd tf\&t: I can affOt'd.. . . ·-. . . .
Signature Month
A._
• .. 1 J...J...L...J....L.Jlll,,. c I
bl Ill,,. di
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t ~2;;;0;-_ -;F:::a~c;:;:1;:-1y-;Own;--e-, -o,:-0:;-pe-ra-;to-c-. ::Ce-rt<c,.:::fi-ca-;ti;-o_n_o-;-f =--:;,-p1'"0-:f-:-hazar--d=-,--ma-,lerials-:-. -:--C<N--..-.d--t,y-1""-. __ _,_,----t-as_no_tod--:-ln:--lle-m_1_9. _____________ _
Printed/Typed Name · /") j Signature ,---
-f;:_i;/1 /-{d, . ._r--, 11.::,..,,;1, Month Day Yes -~ ,_,.., -,_o;,.
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South Carolina Department of Health
and Environmental Control
8wuu al Solid & Ha=dou. Wa3!8 Mgt
2500 8"ll Stroot. C-Olumbia. SC 29201
Phone: (80J] T.l-4-5200
Emergency & Holiday,: (BO:J)7J.l-5"24
. l.E.lSE PRINT or TYPE (Form desianl!ld for U38 on eilte f12•ortch tvpaw,ite.i form Ao0roved. 0MB No. 2050-0039 El:oirM 9-30-&
Manlfeat UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generatc(s U.S. EPA ID No. ~~t~ 2. Pago 1 lnformaUon In the shaded a,eas Is not
ol I required by Federal law. but~ by Stile law.
3. Generator's Name and Mailing Address
New Hanover County/ City of
414 Chestnut St., Suite 101
~-Geoerato(, Ph~no I 919 341-713 9
s. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Oe!iignated Facility Name and Sita Addres.3 SRC Inc.
Box 2005
Columbia SC. 29202 --
Wi 1 ni ngtori
Wilmington N.C. 28401
6. U.S. EPA ID Number
A
8. U.S. EPA ID Numbof
10. U.S. EPA ID Number.
11. U.S. OCT De,cription (including Pnoper Sllipping Name. Haziud Clas,, ,nd JD Numbe,j·
'tf'.:tfll.iw.~~Phoo.";~:z'-t"!:-=ir~~t;;;~~~;..12_~~r.;:
E.:.:~X'risico,:t6(io:'!~:Y.i~d!.-~:1~C...:~~·~~:":.::~~;i_
"F:~~~.-~~~:fr!~;:4~~~;:F-~jit
12. Containers
No. Typo
I~ a. Petroleum Contaminated Soil (NON-Hazardous) (f;,·-~"'f=T"~ ~ ~b.;;-----::---------:--:----,-,--:------:---foEo.11~0c..l!.T+.1-.1-.1:2:...t:DTY~o7~i;~~.'.7~ ..• ~'1=·'~-?:t,',~::ii.~$:1! I~ -~, , , '~
~~.J ... ' I. '. J:,';, ~ ~c.=---_____ .:._ __ :_.:._ ____ _: ___ ...;_....:_.:_..:...:..... _ _:_ _____ ...;.._r.....;..!-.L.Lf..J.--,....JJ__L.L.l.➔.:.....-1;l~gt:~,==±'=~~:~f8:i
"·•·~·-----·~-,-" d.
15. Special Handling lnstruc~oru and Additional Information , \
Material Code# 01-137-0101
6.. GEN ER.A TO R"S CERTlFlC.1. TlON: I h■r•by declare d'\at the contarlb of !Na ccnalg~t.,.. Wyand ac::r:u~•l't d•.crlt.d •~ by prope, ahlpp!ng nama a.nd aro da;uifiad,
packed. m.&!'W-.d,. &l\d lab-91eci, and.,. tn aJI rnp,ec:a In proper condltl.on fof"tranaponby hJghwey~ to applk::able lntamatsonal and naliof"lal 9avemm.nt r~ulatlona a.nd
U'I• la~ o1 the State of Sou1h Carolin&.
HI am • I~• quantity generator.I c.rtlfytt'l.al I haw D prograzn In placa to r.duQU,e ~ume andlQ:dc::ty of '#&SWg~ to aw d99r-1 haYa d■tamun.ci to be eeonom!~ry
pnsc-:ic..;1.bte and IT\&t I have-~ th• pradc.able m.tnod ol troa.tment,, st.craQe. °' diapo&IJ c:i.in.nay r,a!J.able tc nM •l\lc:, mlnlmluia U'\e pr..Mnt and tun.ire tnroat IQ hu~n
he&Jltl and trla envln::inment:OR. n I am a am&JI quanury got'\el"ator, J have mad a a goocl taJai eflorttD~ rny•-•g~don and Mlectltla ~ wasi. management m-sU\od
~, 1a •~"-10 mi, and trw I can anon1.
;; 1 Acknowledgement of Recei~t of Materiah
A ~rjntedfTyped Name i ~ 1/K.Ul.,/. "JiJ Cl er,,,..,/
~ spcrter 2 Ackno ent of Receict er Materials
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b.._i ......_.......__.
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' ~--=--:::-::-----::----,--,---,--,---,-,-,-----------------------------~ 20. Facility Owner or Operalor, Certification ol rece.ipl of haz.ardoo3 materials covered by thi3 manaest except a.s noted In lt!im 19.
. Printed/Typed Name · Signature Mcnth.
Cay Yw
11tn.
lib,.
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South Carolina Department of Health
and Environmental Control
Burau o1 Solld & Haurdou, Wa30! M!jt.
2600 Bull Sl:oei, Columbia, SC 29201
Phontc (80:l) J':l.l-!.200
~ & Holiday:,: (BOJ)l'J.l-5•424
PL.E..lSE PRINT« TYPE tForm desianad f0f' U38 on elite r12•oitchl tvoewriterl Form Accroved. OMS No. 2050-0039· Exoirm 9-:30--8.8
I
II
II
II
11
UNIFORM HAZARDOUS 1. Genorato(sU.S.EPAIDNo. Manlf••t
Doc:utn.olNO. 2. Page 1 lnformatfon 1n the shaded we.as I:, not
ol / requin,d by Federal law, bl/I Is by Stats law. WASTE MANIFEST I 0
3. Generator's Name and Mailing Address
New Hanover County/ City of
414 Chestnut St., Suite 101
~-G<neralo(sPh~nel 919 341-7139
S. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Fad1ity Name and Sita Address SRC Inc.
Box 2005
Columbia SC 29202
Wilningtori
Wilmington N. C. 28401
6. U.S. EPA ID N.wnbor
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT De,cription (including Proper Shipping Name. Hazard Clas', ind JD Numbetj
't.:~_$:ta1a1'~&IO.?.~;f,;,;i..;=;tf:tW:3.,r~~l5:~·-
0Ytm!ti1»'-WIPtioot\~~2.~~~~";t~;."!l~tm-'.~"-'f;';,~;!
'E.~~T~.iiooiiiit.rD~~,~s!~E::l~~f~~'f.~_
'F i-iiar?iOOfi.w:;iCP't;..,ii.•?.;?.~,;.;f,~~~~~~::!:Ji~i
12. Container,
No. Type
I laNE a. Petroleum Contaminated Soil (NON-Hazardous) :r-:-·,-.,,,~
E b-.:_-~----------------------irD_J1!;'._D.1l~D:.l!T+..L..L..t2:..J:o:.pY-=D7i:J:,;;~17~. t:12::;:17~-'~::;;,~~~-~-
I 1i ~b. _________ _::_ ___________ __:_ ______ -t.J-'-t-1-J-1UUL..:L..:!---:-P!::
0
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15. Special Handling lnstruc:ion, and Additional Information ,
\
Material Code# 01-137-0101
d. GEN ERA TO R'3 CUTIFlCA TION: I h•r•by doc.!&r• that the contenb ofttua a:inaJgnmenl.,.. f'ulty&l'ICI a.ccura111tY ducrlt.j &bov9 by proper ah!pplnQ nam• and ara clua.Jfi.-d, '
pack.lld_ mat'llod., and l.abeled., and ara In aJI r-pec:3 In P,-Opo,'C0ndll10n fo,tn.naportby tughway according to app.llc2bl• lrti.mat10nal and l\lltklne.l 9cvemm.nt r~ulatloru. and
th• la-ot 111.-St.ata ol Souih C&rollna.. .
If I am a iarg• quantity g•nen.tcM'. I c.nlly ai.at I ha,... a program In pl&ca to r.duc. 1ha....o4uma and ta:dc:lyof waate g111n.t11.tacl to 0... de,gr-1 ha-d•tamllne,d to ba oconomlc..-Jly
pniC'tic.atll• and thal I ha._.. -lectmd th• prac:tc.&DI• mett"lod ol tT-tm•n"t. t:10~-. Of'dl:apol.&I c1.1rrwu1y avaiLabl• tom. •hlch mlnlml.u,a 0\111 p.-...,nt and tutura throat 1ll human
hoaJth and tr1111 lllf'lvlronmontOR. If I am a amaJI quantity '.IIN'lef'atcr, I hav• mad a a good l:aitn snorttDcntnlmiz:a my•-• genen.tlcn and M(aci:1h• t>.atwa.si. man..gamont rnothod
that la a..-.i.l&bla to mo and l:h&I I can anon:,..
U--,Lj,1-.. Monlh Day Yw
I -:? "/,0'
~ 17. Transpo~.er 1 Acknowledgement of R.ec.eipt of Materials i Printed/Typed Nam O Cl // 1
~ 1 ow!edgemen · ·
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Month
(
Month
)!to. C I •I .. -'--'....L.~-
b I .............. ~ )it.. d I
I 1-::--=-:c--::,-:---::---"7"----:--:----:--:-:-------,-----------------------~ 20. Facility Owner or Operator; Certification of receipt of ha.zardou, malaria!, covered by thi3 rr.aM~ ted ln tlflm 19.
Month
I I _/ I
/ ,'., , / Signatun, ,,..--/ A, ({,
.A/,1/"-t cf-t-L
Printed/Typed Name
Day Year
Yw
,('
)Ito.
)Ito.
Day Year
'J. --,, '9t:'j
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South Carolina Department of Health
and Environmental Control
8wuu of Solld & Haurdqus w.,., M,t.
2500 Bull Slroo1. Columbia, SC :mo1
Phone: (80:l}T.l-1-5200
Emergency & Ho!ida~ (BOJ)l'34-Sol24
.PLE.lSE PRUIT or TYPE (Form de:s.ic:med for use on eUta f12-oit:chl tvoewrimrl Form Atlcroved. 0MB No. 2050-0039 Exoire:, 9-30-88
UNIFORM HAZARDOUS 1, Genoratc(sU.S.EPAIONo.
WASTE MANIFEST ' '
2. Page 1 Information In the shaded .,e.as b not
of J roqu!n,d by Fedaral law, but ls by St.lie law.
3. Generator':s Name and Mailing Ad~
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generato(sPh~nel 919 341-7139
5. Transporter 1 Company Name Willms Trucking 6. U.S. EPA ID Number
A 1 1
'ci~i~a'D~:tfi;<,i'!ti:':~,.;~3;.:~5-;;._
tf.ZtR!i~&nPhooi-$":t;f~1'.~~~~t~:4(4~-~~l
7. Transporter 2 Company Name 8. U.S. EPA ID Numbec 'E.\siibi7t, .. ·"'·--"'-i"ti~i:r~J.~d:11:E:?.rijt;tfi
"f£~J'hoi-¥f;'.~~~J±;~~~~J!;;~
9. Designated Facilit'f Name and Sila Addre:s.s SRC Inc. 10. U.S. EPA ID Number
Box 2005
_ Columbia SC .. 29202
11. U.S. DOT De,cription (including Proper Shipping Name, H=ud C!a.s3, and ID Numberj 12. C<>nlain.,.
l'
T R A N s p
0 R T E
R
F A C
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No. Type
d.
15. Special Handling lnstruc~oll3 and AdditionaJ Information , \
Material Code# 01-137-0101
( ~-
8. GENERA TOR"'S CSITIFlCA TION: I horaby dociar• that the cont.ants of !nla conaigt\lMl\tar. euOyand ■ccul'lltnlY dollCribed abovtl by proper ahlpi::,lng nam• and are c.ta.u.ified,
packod., mafXed. and l&beled.and ar• In all,-~ In ptopot' ccndltlon f01 tr.napon byhlgtlwtJ'ac::ot'dlng t0 agp1k:at)l• lmamadan&J and naDOn&I govemmant r.;iu!all0N and
ll'l• la~ at the Slat., 01 Sou1h C.aroUna.
HI am a luge quantity g11n0f8.tor, I cartlty that I haw a program ln placa to r•c:h.1c. tti11'1'01ume and lmlcty at wast. garwnt.tad to a,.., dag,-I ha,.. datannln.d ta be oecn0mlcaJly
Pl'llr:tic.abl• .and tr'l&t I ha..-. Miectod U'I• pl'llcl:lc.■Ole metncxi al tfoatm•nt, 1:10~-. 0¥dlDpc,:;lu!C1.1RW1ay av&llabl• ta me whlc.h rnJnlmluia 17\a g,.._nt and h.ltur• ltlr-t ta hum..n
health and tno oovlr0nmont:OR. If I am a am.all quandty genenatcr, I hav• mad ■ a good t&/tt\ a11ortt0 -.niml.z:e my•-• g.n.radan and .-acil:ha ~ •aa:t. maN;arnont m-aU'IOd
Ul&l I.a available to me and that t can afford.
Prin
Monttl
l J
Jib" C I • ... I ....... ~__,_
b._J ......_.....,_...., Jibo. d I
20. Facility Owner or Operator; Certific:ation of receipt ol hazardOU3 maleriah covet'ed by~ manifesle.x.cept a.s noted In lttim 19.
Prinlod/Typed Name ,......... A / Signaturs ~ ,(' , #
/0);1 ,,4, e-, re}"''-,£:k,.::.,,r,,_, Month
Day Year
1..7 '1,C
[)
\Ito.
\Ibo.
Day Year
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
South Carolina Department of Health
and Environmental Cori'trol
-al Solld & Ka=d0U3 WIU!a 1.4gt
2600 Bull S11oe1, Columbia, SC :mo1
Pl10ne: {SO:l) 7:lH200
Pl.£.lSE PRINT ot TYPE (Fann desJQned fer u:58 on ente f12•oitd'll h'D8writ:erl
UNIFORM HAZARDOUS 1. Generatc(sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Mailing Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
,. Gener.ilC~, Ph~ne ( 919 341-7139
S. Transporter 1 Company Name
Willms Trucking
7. Transportor 2 C<lmpany Name
9. Designated Facility Name and Sita Addres.s SRC Inc. ·
Box 2005
... Columbia SC .29202 -
6. U.S. EPA ID Number
A
8. U.S. EPA ID Number
10. U.S. EPA IC Number
11. U.S. DOT De=iption (including Proper Shipping Name. Hazard C!ass, u,d ID Numbetj
Em«goncy & Hollda~ {a03}73+S42'
Form ADon:Mid.. 0MB No. 2050-0039 Exolr~ 9--30--8.'
2. Page 1 Information In the ahaded Meas 1., not
cl / required by Fedora! law, but!, by Stala law.
i~~ifi\~!t~~l~illi~
·a2~•~~'lf~~~~~?i:i-Yi:~+:~;;5p;...~~-.i:, ~~~~~~~'1;M~~4
·c:•stfi-~'<,... ___ ,_.,;, -.-Eil.?~:/.-t~i.;: .. ~,f:.;tffi~.$.i£•i;½;;
~01TU..Z._:;.f"J>hooe:\t:.i1:i!;~f~it:tr;tr;~~~~,~~
E?~T'fi~l'ii~~½~\£!~~"rZ-:cv:.i~~55~$~
"Ff~Phoi•~~~~~iz:::~~~J!;~
12. C<intliner,
No. Typo
Ga. Petroleum Contaminated Soil (NON-Hazardous) ~t'Ti''t''j;)
;r.b.;--------------------------~--1~0Eo..1.:.1fo~T!.f....1.....1....1:2:..l!:OfY-=o!.....!~;~::~:~.'=z~,~z~.:z~;-.~;~
T !1.J. 1. I~ ~ rc.=----------------------'------------,---l-L.L+..J.-l.....;LL.L-1.--t--fc~]~,~~i::~~,~t
F
A
C I
L
-~~•'Y-•-'-••Ym•~~
d.
15. SpecaJ Handling lnstructio~ and Additional Information \
1 Material Code# 01-137-0101
e., GENER.A TOR":! CERTIFlCA TIOH: I her•by dec!ar• that the contenb of tni• conalgnlMfllan h.i!ty and a.ccuratalY d•&eribed aboY-a by proper &hipping nam• and •r• c.la.ulfi,..
pac;.kod., mukad. and Ll.bal.0..&nd &1• In a.II,-~ In Pfopot' condition for tranapor1r,ytu;:h .. y ac:cord.lno;i to applicablelm.mattona.1 and n.adonal 9ov.mmentr.;1.1!ad01Uo ar.
tl"le I.a~ 0111\41 Stai. ot South C&rot!na.
If I am• Ja,ga quantity ganonr.t04",I certfty tt\al I l\aYlt a program ln plac. to reduce O"l.a'WCWwn. and l:Qdc;ty ofwast.ganer.wci to a,,. d~...,.1 ha...-dai..rm.lned ta be economic.al
prac::iCU>la and tnal I ha--1.ee:uiid tna pradc.a.Ola meOlod ol tr-tm•nt, a10ra,_a. or dl:t,pc:r:wJ cun.nay avall.bla to nM which mJnimlua th• p,....nl and futlJra lhraat ta nurrJ
h-!tti~_tl"laoovlranmencOR,lflamaamallquantlrygenorator,lhavamadaagoocltam,etScrttDfflU"llml.umyw .... ga"l9radonand_...:t1ha~w...i..managemonltmrmc
ui..1 la avail&l)Le 10 me and tnat I can ■non1.
Prin~yped Name
,,-/( 4-. /)\.v>/\ .D L . 2. ~ Month
/,/
Day Yee
4,
•! L ..L..JW....L..J..Jlibs. C I I i \lb.
b I libs. d 1...I .W..~..J...J'lb,.
' f-:-::--::--::::--::---::---:--c:-,-:--:---:------:---,-----,-,--------------------------~ 20. Facility Owner or Operator; ~rtificaDon of recaipt ol hazardou:s mat.eriab covered by this rr.anitest. e.xcept u noted In ttem 19..
Printed/Typed Name Sign.ab.ire Month Day Y<
• I • I
I
I
I
I
I
I
I
I
I
I
I
I
I
G South Carolina Department of Health
and Environmental Control
&nau ol Soild & Haurdo_u, WlUIB M,t.
2SXl BuU Slroet, C<>lumbia. SC 29201
Pllcna: (BOO) T.l-1-5200
Emorgonc:y & Holidays: (SOJ)~s,2,
PLE.l.SE PRINT or TYPE (Form deslaned for use on eOte r12-0itchl tvoew,iter\
UNIFORM HAZARDOUS 1. GenoraJctsU.S.EPAIONo.
WASTE MANIFEST
3. Generator', Name and Mailing Address
New Hanover County/ City of
414 Chestnut St., Suite 101
4. Generato;,sPh~ne( 919 341-7139
s. Transporter 1 C.:impany Name
Wi 11 ms Trucking
7. Transporter 2 Company Name
9. Designated Facility Name and Sita Addres., . SRC Inc.
Box 2005
.... Columbia SC .29202
Wil ni ngtoti
Wilmington N.C. 28401
6. U.S. EPA ID Number
A
8. U.S. EPA ID Number
10. U.S. EPAIO Number
11. U.S. DOT De>aiption (including Proper Shipping Name, HazNd Clas,, ,nd ID NUlllb,t/
Fonn .lDDl'D\'8d. OMS No. 2050--0039· Ex.cire:3 9--30--S.S
2. Page 1 lnfannatJon ln the shaded Meas b: not
of / requited by Federal law, bl/Ii. by Sia to law.
·c}Stiia:i~.itai~i;;-;~.;;"j~:iit-:¾zv,~.s;t.~>-
~07TA!ltim"1dfhoo{~:1!t~{!.;r~ir~:r~tJJ¼_,~~r.:J
12. Containffl
Na. Typo
~ a. Petro 1 eum Contaminated Soil (NON-Hazardous) ~tTTfb~
NRe f;b.;--_:____:_ ____ ...:._ __________________ 10::....co:..1:1To~T+-.1-L!!:2c..e:of-Yo!:-f;~~~';E;.'=.7='.=?-~'.~:~.!;~:..-~
~I J I';'_
A i ~ ~ f----------------------'-----..:_ _______ +..1..J---!I-Lt..l...l..J..:...Lt----fr~::.a_±l:: ... t.l=:l± __ ~J::· ~1~.tfd'·'
R c. jfr I~~-
l'
F
A
C
I
L
-,# t-~ ;;31 r':; ,., ....... _ --·---~ ~
d.
15. Special Handling lnstructio~ and Additional lnfonnation \
-Material Code# Dl-137-0101
e.. C EN ERA TOR-S CERTIFlCA TION: I h•roby doc.la re that tho cont.en~ of thla cons.Jg~ 1.t11 h.dlyand a=ra•i'f d•acribed 1t>ov'9 by prop« shipping nem• and are cJu..lfie-d,
packed. manced, .and labeled, and ar• In all rnpect;a In prep« condition for tnn~rt:,Y hlghway -=c:0C"dlng ta a;,pllcabl• lntamallonaJ and n..~ 9cvemm.ntragul•tl0n.a and
tho law,i of O\e. Stai. of Soud\ Carcl:lna.
tf I am a large quantity genon.lof', I certlty that I ha~ a prog~ In plaea tc 1'91duOI a,•-..olume andtmic:ty otwastaoon.ratadto tt"4 ~rM I haw d•1-rmlna,d to be ec.onomlcaJly
p111~c.abl• and ~t I l'ulv-e -lected th• p111ctlc.abl• m.tn-od cl tr-tm•rrt. cc~-.« ~!apou.l ~ .--ll.at>t• to me .,.nlch mJnlmtuoa th• p,--nt and hJn.Jre ttlre.&t \0 human
hoa!tn &l'I~ tne onvlronmont:OR. If I am a .am.JI qu&l'ltlty generator, I have m.d• a good tata, e1\ort tc minJ~ my•-• ;_,.,.Uon and a.iacttna b9:a.l w~ man.agemont nw,11'IOd
that la avall.&DLo to mo and that I can al1QfU.
P~/Typed Name
\c_,o,, ~b
19. Discrepancy lndic.ation Sp.ace
Signahlre Day Yeu
2.7 '7,C
......................... lib,. C I i'"'-
b ... , J....L..._,...l...llibo. d I lib.
I tc-:----::----:::--::-----::---7'"-:--:---,--:--:-:-:-------,---------------------------~ 20. Facility Owner or Operator. Certification of receipt of hazaTd003 materi.a.b covered by tt.u manacslucept u noted In Item 19.
Printed/Typed Name Signature Month Cay Ye.a:
I
I
I
I
I
I
I
I
I
I
I
I
I
_ Sou~h Carolina Department of Health
· · and Environmental Control
.. ··..: .. ·
Bureau al Solid & Ha=dqu, w..., 1.1.t
2GXl BuD S11oet, Columbia, SC 29201
Phooa: (80:J) 73H200
Emer!ienc;y & Holiday,: (803)734-5"2•
PLEASE PRINi ot TYPE (Form desianed for use on elite r12-c,ih::hl tvpewriter1 Form Aocroved. 0MB No. 20S0--0039 E.xoire:, 9-30..,aa
UNIFORM HAZARDOUS 1. Genorator'aU.S.EPAIONo.
WASTE MANIFEST
Manlfe■t
~mentNt 2. Page 1 Information In the shaded &<eas b net
of required by Federal law, bvt Is by Stai. law.
3. Generator's Name and Mailing Address !~~~~;~?t1f?li
-~~~~~@1~:~f}fj~~:
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
•· ~erator,Phone( 919 341-7139 ,.,,,.:e,r.r.-~tJ~i~-'!).._.., ___ ~.i!!,~ •. ~;.,-:e,, .• S.~~~
5. Transporter 1 Ccmpany Name
Willms Trucking 6. U.S. EPA ID Number
A
·c·"'siiii,i'··•~--·-··-· ·a·D?~:;;=:a~,-;.iid1i.~~r~~!s-;,~
0:7:'tmlti'.cx.li<t~~~{tJ)~f~7-~~~~~~~~
·t~Tm~i"i:f::i'l'i~~::t:!!£'.:.f.i?~::;~ti'f
"FE~Phiiw~tt~~'?f,;;I1';_~$~~t-fi:·(~:iii.
7. Transporter2 Company Name 8. U.S. EPA ID Numbet
9. Designated Facilit:t Name and Sita Addre:53 SRC Inc. 10. U.S. EPA ID Number
Box 2005
Columbia SC 29202
11. U.S. DOT De=iption (,ncJuding Propet Shipping liamB. HazJJtd CJas,, 1nd ID Huml:etj 12. Container,
· No. Type
F ,._
C
I
L
d.
~~~~~~~~~i~I~~~~~~~~"-,~~~~~ f~~·,~1,~,~~~~~~I
b. LLJ-1 1-1 _,_ !.Jl~illb_Lµ-1 I~ I I I~ t~:, "''""~• '"·''"''"""''':~~)~~ti~~!
15. Special Handling ln.stru~oru and Additional ln1crmation
\
Material Code# 01-137-0101
e.. GENER.A TO R"3 CDITlFlCA TION! I her■by doclar• that U'le c0ntanb of thla ccn&ig~an futy and &CCUraaJ.; doacrlt.ed &bov■ by pro pet shipping nomo lll\d aro c:!&.Ml!'i..:1. '
pack.ed., rnat1o:ed,.and i.beled.and aro ln all rnp«:ta ln ptoper condll:1on fOJ'a"an1.p0rt t,yhlgtrwwra=f'dlnQ to a;,pUcable lm.■matlon■.I .nd na~ 9ovemm■ntr~vlac'ona a.nd ai■ laws of th• Stai. ot Saudi Can:iUna. -· · j
HI am• lat go qu&rnay goneratof', I e■rtity ttwl I haw a program ln plac.■ ta 1-duo. tho'IO!utro■ and m:Jcityof....-. gen■ta.t.ed t0 CM dllQ.-..1 ha,... d■L■nnln..:1 to be economlea.Jly . practic..ibl■ and ai.at I hav-■ ael.ec:1ad tne praCUcaDI• m.1n0d of troatm.nt, s:10~., °' dla:i.poa&I CIJR:Witly avallab4■ to me which mlnlmiiaa th■ p,-.en1 and h.lt\Jro ltlraat to hum.n
health and nio er,vtronment:OR, If I am■ am.-.11 quantity generator. I havo macl■ a good taaneftonm mlnlmt.z. mywu• g_._.tlon and Mlect tho be.t wast■ m■nagomont me-UIOd
lh&t La ■-.il..abl4 to mo and ttw.l I can anon=.
• 1..I ..L...1....1...,__,_
b '-J .,__,._..1...1._,_
Month
1 //
Month
l.lonth
Ill:,. CI
Ill:,. d I
Day y..,,: °i -o• I I
I
Year:
' C
Year
()
\lb.
Ill:,.
I r.::;:---;:-=-;;----;;--,--"=--,-:---C---;--:-:-~--,-----:--,---------------------❖ 20. Facility Owner or Operator, Certification ol recaipl ol hazardOll:3 mal6tiai.s Cffi~ by lhi3 m.a.Mcst except 1.3 noted 1n hllm 19.
Printe<l/Typed Name · Signatun, Month Day Yw
u
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
. ·--·
South Carolina Department of Health
and Environmental Control
8uruu a1 Solid & Hazatdou, WMbl M.t
2IDl eun Street. c.,iumbia, sc 29201
Phono: (803) T.14-5200
PLEASEPRiHT«:YYPE (Fonnd~ nedforu:seoneOta 12-itch1tvoewril:arl
UNIFORM HAZARDOUS 1. Genorator'alJS.EPAIONo.
WASTE MANIFEST
3. Gener.itor'3 Name and Mailing Addre.s3 · New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 .Wilmington,NC. 28401
4. G<nerato;,,Ph~ne( 919 l 341-7139
S. Transporter 1 Company Name 'h Uj_-EPA ID Nwnber
7. Transporter 2 C<lmpany Name 8. U.S. EPA ID Number
9. Designated Facility Name and Site Addres, 10. U.S. EPAID Number · SRC
Box 2005
Columbia,SC29202 NA
11. U.S. DOT Deocription (inr:luding Proper Shipping /lame, H=ird Clas,,· and IZJ Numbelj
Emergency & Holidays: (803)7:l-l-5"2'
Form AoDnl'V'ed. 0MB No. 2050--0039 Exclre, 9-30-f
2. ~•oe 1 lnformatlon ln the shaded Me.a, b nc ~ roqulted by Federal law, bl/!~ by State la•
DXfQj~t.1s·~';ti~l~'.ft;;.St-zi:~~'!J.~r.
,--~~Trii~a--cm~~~eg~r~,..:;:.tt~::-:r:.
'f:"-f.-~-Phai.~R~§:Z:~~~~~~~,
12. C<lntainer,
Na. . Type
G a. Petroleum Contaminated Soil (NON-Hazardous) ~"T'";"'""'j''j;
~ f:----.:__ _______ _;_ _____ :.._ _ ___: __ .:...__+o.10.....1...1+0.1T+..1-.1-1.2.....1...o+v_o-f,R"~·•,~7:t'::7~, a:71~7:!i,f
~ b. a:' •, :·1o· ,,,~
OR l-c. _________________ ..:,_ __ _:_ ______ _:_ _____ +....1.....1-1--'Lt-L..L....l.....l-jf--1~t:;~¼-:~!5· =· l:~·=·· ~E.
r
F
A C I L
d.
\1 '-' ~_. ...... _,!'
~-1 \'jl
15. Special Handling lrutn.zction.s and Additional Information \
6. .C DI ERA TO R"'S CERTIFICA TIOH: I her•by dedar• that U'l• cantenb or ttila conalgn~are tun, and a.ccur.alf ducrlbed abOY9 by proper ahlpi,lng namo and ar ■ df..l.ail'i,
P•ciuloci. rna/'Xed. al'\d Lt.b■led,ancl ue ln all ,.,.pocta ln PfOp« candltlon kl't'tranaportbyhlgh .. yu:cordlng to appllc;abl• lmemallonal and ,,,_don.a! 9QYOfTUTl,,■nt r...;ul•tloru •
U'le 1a._ of~ St.ate of~ Cuoflna.
It I am• large quantlly geneq,tor, I certHy that I f\avo ■ program in place to r.d1.1ea ~ volu:m■ and mJctycl W.-ta ~t.dtoO'\e deg,-I haV'tl detannlned l0 be economic.a
pniC::::c.ble and 17'lat I ha--loected.uie pr.ctSuble mettlod ol tre.atment,, a:tat"aQ-.oc dlapou.l CWTef'\0y ■Ya.!Lt.ble t.o me whlch mtn!miu• th• pr-nt and future threat tc hum
he&lt:'1 -.nd ttle en..-lronm"'1t:-0R. 111 am a amaJI qu■nllty g..-.....tor, I h.■..-e mad■• good t■JateflcrtiD mlnl.miz■ myw■-• gen.radcn and Ml.ct the bat wut. m&.l"I.Agoment moU'I V\&J: t. avajl&b!e to me and th.al I can all'Otd.. ~
Month Day y, q.
-.~L...L...L; I'°'-C I jlt:,.
b '-! '-'-..L.1.--'-lib,. d I \lln
•b.--::--c:::--:---,:-----,-,.,---,---,-,.,------,-;--,---------------------~ 20. Facility Owner or Operator, Certification ol receipt ol haz.ardoo:3 mat.erla!3 covered by thu m.anllct except a.a noted In ttiim 19.
Printed/Typed Name · Signature Month Day y
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
South Carolina Department of Health
and Environmental Control
Bureau of Solld & Hazatdqu, w._,., Mgt.
2600 Bull Slroe!. Columbia, SC 29201
Fllon« (BOO) T.l-1-5200
PLEASE PRIH: ot TYPE (Fann desicried for u,.e on eUta 12·oitch tvw,rnite,l
UNIFORM HAZARDOUS 1. GeneratctaU.S.EPAIONo.
WASTE MANIFEST
3. Generator'~ Name and Malling Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generatn;,,Ph~nef 919 I 341-7139
5. Transporte< 1 Company Name ·Willms Trucking
7. Transporter 2 Company Name
9. De:iignated Facility Name and Sile Addres3 SRC Inc.
Box 2005
_ Columbia SC 29202 ·---..... -· ---·---
6. U.S. E? A 10 Number
A
8. U.S. EPA 10 Number
10. U.S. E?AlO Numller
1 L U.S. DOT De,cription (inc/ua,ng Prop« Shipping Name, H.uird Clas,, and Ill Numbe,j
d.
15. Special Handling \n5tructions and Additional Information ,
Material Code# 01-137-0101
~onq & Holiday,: (BOO)~S<2◄
Fonn Aocroved. OMS No. 2050-0)39 Exoirm 9--30..U
2. Ploe 1 lnfonnatlan In the shaded Meas b not
of / =ired by Federal law, butts by St.le law.
·cl·~ :r~.it"ii~A·;f.'f&-.W4fiE~.$!£!(:½;,_
ortf&ti»"a ~;~~~t!..~,,.~~~~#~~;:
.t~~rr:~a·1f~~-r~-rtBE~~~~~~i
·,::;~~'?if~__;i.~~:::z~~~~;ft~i
12. Containeio 13. Total Quantity lt Unit 1i:':<••aiii/·~;;,; ~~~~--,•;:, No. Type · · WJVd. rt>,~ ........ ~;
\
a. GENERA TOR'!S CD\TIFlCA. TlOH: I h•r•by dociu• th.al U,o contanb ol 11\11 conaJg~aratuay a/'ld &CQ,j,...1y described abOYe by prop« ahlpglng name and are c.!a.uifi..: p■ckod.. m&n:ad. and L■b41ed.and at■ tn ■.111-poct:1, In Pf"cper condlllon lot tranapartbyfll;h-.y■cccrdln,g tc a.pp.Uc:■.ble lntamallcn■.I andn■.tiona.l gowmrn.■ nt r~ul■dona as, a,e law:, ot tt... 5L■te cf SouU'I Ca,·oUna.
y
n I ■m • l&rQo quandty goneratM. I certlfyui.■l I Novo a proQram In pla.ca to recluca ~wlutne and ID:dcity ct w..-te gan.rated to the d~r-1 ~-detarmlned to be oconcmlca.Jl
p,..cti~l• ■l\d tti.■I I h.av-. Mlected tn• p~dc.abl• me mod 01 tro.tmom. au,rago. Of" dt.poui ~tly avall&blo tom. which minim.Lui■ lh• p,....,nt and tutu re ltlroat to hum.a
h-lll"I ~ tl'\o onvlninment:-OR. HI am• am.all quantity ge~tor, I h..ve made a goocl1aJD1 effcwttolftin.lmlza my .... a genen.don and ... ectl:he t.at ...,a.io management ff'l'O'trlO
ai.at la availaole to me and 1haZ I c.an aNon:1.
~ 17. Transpo
A N s p
0
Month
!,/
Day y.,
2-,7 '1,i
C
~ r'-=::=:-:';-;,;-ttiJj;,;====.:..:..=,;z::c=====---r'-r.::--,----,----:::----,-,F---------;-;,=----;=-
E
R
Month Oay Ye.
F
A
C
I
L
• J
b._J .J...J...L.L-'
lib,. • I
Jib,. d I
,, l-:::--::--:::-c-=---:c---=-.:-,::----,---,--,-,--:----.-,-!.-_:_----,,----------------~ 20. Facility Owner or Operator, Certification ol receipt ol hazatdou:, materiab; covered by ttUl maniJe:st axcept Ill noted In Item 19.
Printed/Typed Name Signab.Jru Mench
pi:,.
Jib,.
Cay Y•
I
u
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
• South· Carolina Department of Health
and Environmental Control
Sul8au af Solld & Hazardqu, Wu:. !.!gt
2ml Bun Slroet. ~umbia. SC 29201
Pilon« {BOJ) 734-5200
Emerilency & Hof>day,: {BOJ)734-~24
PL.EASE PRINT:~ TYPE (Fonn de:si ned for use on eilte 12•oitch1 ~ fonn ADcrnved.. 0MB No. 2050--0039 E.icire:s 9-JO.-ag
UNIFORM HAZARDOUS 1. Genen,IO(!U.S.EPAIDNo.
WASTE MANIFEST
Manll-t Doo.,ment No. 2. P1991 lnfonnaUon In the shaded are.as b not
of / required by Fedet>l law, bulb by St.w, Law.
1 Generatcr's Name and Mailir\ljl Address New Hanover County/ City of
414 Chestnut St., Suite 101
4. Generato(sPh~ne( 919 341~7139
5. Transporter 1 Campany Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facility Name and Site Addr~ SRC Inc.
Box 2005
Columbia .SC _29202
• •
Wi l ni ngtoii
Wilmington N.C. 28401
6. U.S. EPA ID Number
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT De=iption (including-Proper Shipping Name. HamrdClas,. 111d JD Number/
l I
'C:~Stdit ''·"--~~-·-fiij~;;:r$.t~i,iit.~l$.j~\~;;._ _
o;tmt&O:Ai.1al%oo.~"¥1:r~r~f~;~z:12~~~;;'~
-E.~-§it;.T"'"'-'"-~~--;-1f1·triY.::!!Er--B~.£±:t'~fi·
·F;~-s:,wi;.~t~Wi~:;L~;~~,:~~7'•"' .... i:\::
12. Container,
No. Type
~ a. Petroleum Contaminated Soil (NON-Hazardous) ~,"T_T\'"(~
Nl--_:.__~--------------------➔0~0!...1.:l~D~T!....!-...L.L..~2::...l!::O~YD!:'._~fu~·-'~7=17==='7='~7='-£~ ~ b. 1·; _____ ·,_ '_. ·_ J. 1 ,_t_}
T J .'. I I 1-.~. ~ ~c.-:-----------------------------4"-'--'-4"-'-4"-'--'--'--'-7-7~;~;±•· ... ,=_= ... ='--=='-=.., =,__ =..,,:::(,;
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,., r-:a.L_ ,rtg
d.
15. Special Handling lmtruc:Ucn., and AdditionaJ lnformation
\
Material Code# 01-137-0101
e. GEJ,i1ERA TO R"S CERTlFlCA TION: I her•by decJ.ar■ !ti.at the contena ofthla ccnalgn-.,. ..,and a.c:cu111•1Y dea.crfbed aboY-e by prcpot" ahlpp!ng nom■ and are c.!u.aif'iK
packed, m.al'Xod. and labal.c!.and at• In all rnpocm In ptopet' condlt1on fortran-.portbf l\lghwaym:cord..lnQ tD appllcabla lnwrnailon&I and national 90-.-.mm.nt r--;u!atlon.a anc . th• la~ 01 the si..te 01 Sou#1 Catollna.
HI ■m ■ lat go qu.ntny g■notatof', I c.ar11tyU'\al I have• program In plac. tor.du~ tti■ volwn.endladc:ty of ----g~ted tD a.. d--.ir-1 ha,.. d■t.rmlned to be oc:cnomlcaJI:
p111ctic.abl• and that I haY-9 Mloc:tad th• praC"dc.able m.lhod cl traetm■nt. atc1nw;;e. ordbpoAJ a.,-,ay n-&ll.a.bl■ to me which mkuml.%.oa th■ pr-..enl and turur■ ttiraat to hum.ar
h-lth and. the onvlronmont-OR.11 I am■ sm&II quantltygenwa.LOr, I haw■ m&da a good tam, effort:1DmtnJmlu my•--• g...,_,.llon and a.I.ct th■ ~wasta management~
U\.&t la av&1i&0le tc mo and O\a1 I can afford. _ . -.. •
L M9ntn Dax_ Yea
I,{ ..2., I '7,1
~ 17. Transporter 1 Acknowledgement of Receipt of Materiai3
A
N ~ fl,:_//-S
~ 18. Trans r ow ement o ~ipt cl Material,
T E
A
F
A
C I L
I LI --'-''--'--'--'-'\!lo. CI )lb.
b .... I ......._.._.~\lb. d I )lb.
•I--=--=--=--------,--~----------------------------------~ 20. Facility Owner or Operalor, ~rtification of receipt ol hazardOU3 malariab; covered by this m.&rastexcept as noted In hem 19.
Printed/Typed Name · Signature Month Day 'to.:
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South Carolina Department of Health
and Environmental Control
Boteau of Solid & Hazardous w..., M;t
2Sl0 Bull Slroe!. Columbia. SC 2'3201
Pliono: (ll03] r.i,.5200
PLEASE PROlT or'TYPE (Fann desioned for U38 on eUte 12-oitchl tvoewriter\
UNIFORM HAZARDOUS 1. Ger111r.uo(sU.S.EPAIOHo.
WASTE MANIFEST
l. Generator':s Name and Mailing Add.res,
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generalo~sPh~ne( 919 341-7139
S. T rans.pcl rter 1 Cvmpany Name Willms Trucking
7. Transporter 2 Company Name
9. Oe.signated Facmty Name and Slte Addre:s., SRC Inc.
Box 2005
Columbia SC 29202
6. U.S. EPA ID Numb«
A
. 8. U.S. EPA ID Humber
' 10. U.S. EPA ID Humber
11. U.S. DOT Oe=iption (,nc/uding Proper Shipping /lame, Hazard O.S., and ID Numbetj
d.
15. SpeciaJ Handling lnstruc~on., and Additional Information
Materi~l Code# 01-137-0101
\
Emergency & Holiday,: (80c)~5'24
Form Anoroved. 0MB No. 2050-0039 E..tcire:s 9~
2. Page 1 ln(ormaUon In the ahaded ace.as b net
ol I required by Foder>! law. but~ by Stai. Jn.
·c..~siiisl'~i~iri~;P.'.~.,i~,i~'.f.:i::.:~"?,;~22~~~
0~;1iaJ-~w"w~~!~~3§·~;;.:;!~~~"f,Cr.:;
t~T~s1~-[);±o:~-:¥.'.Fi~~..:Efr.'-£3£~
·F;~~;;.::;,,~~:;;.½:z,-~s~~~
12. Containm
No. Type
I!. GENERA TOR"3 C.ERTIF1CA TIOH: I hereby doc;Jar• that the cont.enb ol tl'lla can~~ ~tufty and accu,-.•JY dea.crlbed a.bowl by prep« a.hipping name and are c.l.u.iri.C
packed. marked. and laboeled. and ase In all ,.,.p,ec:. In proper c.ondlllcn lor tranepcrtt,yhJ.;itiwey ac:co,ulng tc app.lLc:abl• lrti.mallonaJ and naoona.l govemm.nt r~ulallcna an, Che laW3 cf the Sl.ata ct Scxnh C.an:,Una.
l'
HI am• i.rgo quantity O•net"atcc-. J corUfy that I ha,... a prog~ ln pta.c. tc r.duca 1:tle ~ and tcwcity cfwastaganeratac:1 t0 U'\aa degrN I h,a,... detem,Jned io be occnomlc.&JI:
pni.cticabl• .-nd tnal I hav. -'8c:ted th• pnactlc.able metnod ol tr-tm•rrt., 110~-. 0< dlspoMJ ~nay ...-all&ble to me which mlnlmlus lh• ~,.._nl and h.itLJr• lhro.at to huma1
healttia.nd1:t1111onvlronmont;OR.ltlamastnallquanliryg111,.,.,....tor,lh.av•mad••goodt&iltl.-florttcmlrumlzemyw .. 1111g.,.,.donandselect1:t1•beatwa.st.emanag111montm.rtl"IQ( that La -=.vailabl• le mo .rld ~ I can attoni.
T owledgement ol Reaipt ol Matariah
'.:: t---;;:::::;-;:;::::::~Nam:;:::-•:--','---'---.::-.:....:. ______ r;cc--c::----,r--'-'----;;;,r-------,-----;-;:-:-::--;:::::--~~..,
~ b,~2..2..:,.,Jw',~~,!:,L:..f:.-.i...1.~2=S[...:--:-:-----,-,--...J.-_J_---"~:?;,-;~~~~~~:_ _____ .l..L~l6:2:l.;l'.'..J:,l ~ 18. Transpar-..er 2 Acknowledgement of Receipt of MateriaJ3
~ edlTyped Name
R
F ...
C I L
Mont"!
I
Oay Ye!
a9
t ~2::0:-. -::F:-a-:ci::-lity:--:0:-w-n_e_r_o_r o=-pe_ra_to:-r,-:Certi:--:-:.fi:-ca-,7.o_n_o""'r_reco_'°ip71 o-:1:-:haza--,-:d-ous_ma_,i.-riab-:-. -,--coven,d---,--by-l!li,,-,-_ ---:;i..,:--e.teop1---.,-no-ted--:-:ln-c-n.-m--=-1s.=----------------
Printed/Typed Name Sign.ahJre Month Day YBl
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South Carolina D~partment of Health
and Environmental Control
&n,au ol SoUd & Hawd~u:, W""'8 M,t.
2!iOO Bun Slroo!. Columbia, SC 292!l1
Phone: (80:l) 734-5200
PLEASE PRINT t:11t TYPE (Form deoi ed foru:se on eUta f12-oitc:h tvoewriterl
UNIFORM HAZARDOUS 1. Goneratc(sU.S.EPAIDNo.
WASTE MANIFEST
1 Gen=to<'s Name and Mailing Add= New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington ◄. G<,,i,rata;,, Ph~ne ( 919 341-713 9
N. C. 28401
5. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facilil'[ Name and Sils Addres, SRC Inc.
Box 2005
Columbia .SC .29202
6. U.S. EPA ID ti.-
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT_ Deocription (including Proper Shipping Nam._ HazNd C!sss, and ID Numbe,j
d.
15. Special Handling lnstruction.s and AddiConal lnformab'on ,
Material Code# 01-137-0101
Emetiioncy & Hollday,: (ll03)734-5'2◄
Fonn Accroved. 0MB No. 2050-0039· E.t:cirm ~
2. PaQe 1 lnlonnatlon In the ah.aded arau ls nor
of I required by Fedsral law, but ls by Staut law.
'C.t&iiaT~----"·,-··a~tO~~~.J$.i:2~:.7/
07t~~W<a"J>hooe.~~~~~~i~rtf1t~~':r.t
t~Y~~;;-i:,:_:1r-~:;:~,,Effifil£~
·F:.;~·Phol·.-~~1=-~t~~~j'i~
12. Conlainer,
No. Type
\
a. GENERA TOR~ CERTIFlCA TION! I h•r111by dociar• 11'1.at the contentl. of tnla con»;nfMn1.,.. UIJ' and a.ccura•if dHcribed a.t:iov. by prcP« ahlpglng nama and ara elu.aifi..:l. '
packod., marii:ad, and t..beled.and ue 1n all ,_pee'.-. in P,-Opet" condition te<u-.napcrtbyhlghway-=conilng ta appUc:able lntemat1onal and n.t:lonal gowwrnmantr.gu!•tloN at1d aie la~ Q1 ~ State al Sou1h Carullna.
ff I am■ large qu■ntny generatcM', I CMCity th■tl haw a program In placa ta r.duca the'l'Clurne and~ofwaszag.,_..ted tattle deQtM I haw det.ermJned to be oconomlc.ally
pt111.c:i~I• and ai..t I haw ~ th• pt111.C"llc.abl• m.lhod or treatment. sto~-. or d~ curnncy available ta mt1 which mlnlmtz.a• lh• pr.Mnl and turure ttlreat to hum.n
hoalth ~. the envlronmont:-OR, HI am• ama.11 quentltygenoratcr, I have mad■■ good taffh■'ffortrolnlNm~ my .... ie g.,_..dan and _.act the ~w■.me man.ag■m■nl ~
ai.at I.■ ■-..ii.able to me and tn■.I: I can &llon1.
Signa~ Month Oay Year
/, I z,% ,o
~ 17. Transpcrter 1 Acknowledgement of Receict of Matariab
A PrinledfTyped Name ~ ,) r
p
Month Oay Year c
0 ~t-=:::-:;===::-========.:..:....--.-:::--,---"='-':--1.....<.:c.!.=Cl.l..---;,------------;=~=-;: Month Day Yw E A
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lit.. d I
'1-:-c-=--:c-:,----:c-------:--c--------------------------------~ 20. Facility Owner or Operator, Certification of receipt ol hazardous materiab covered by ttli3 menaast ex.capt as noted ln l'tem 19.
Printed/Typed Name SigMture Month
,0
\lb.
Jit..
Day Year
I I
. . -. . m ~."-:i~-,r'""~;; .. : ~" .· .. "'-' i..:c:.::::·~~.:::.:::c=C:C~;, •-~,.,-i.c:cS•···:·• ·s·..!,,.;,,·,. ,c,:.i==_~:::~.-c:~.:!-.;,; ""',,..:::.,.,,,._...:; ~~=,.;. . .,:~•i:..s ,-·-. . , f'? ·,':--,,-,.· ,<.;..
I B :~~::~~;g'~i~r-~~~:n:~n~~~e:l'.h,:·:,ffi~~:r~; .
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PLEJ.SE PRIHT Of TYPE ; (Form d • ned fof 1.1380\ ente 12-i:,itc:h tvpe...-ritett • ,~-Form .lDDnMd. 0MB No. 2050-0039 Exolf"e:S ~
· UNIFORM HAZARDOUS 1. Genera!ct'aU.S.EPAIDNo.
WASTE MANIFEST
3. Gener.a.tels Name and Mailing Addtes3 New Hanover County/ City
· 414 Chestnut St.·, Suite
4. Generato~sPh~no 919 341-7139
5. Transporter 1_ Comoanv Name
7. Transporter 2 Company Name
9. Designated F acilily Name and Sile Addres.s · SRC · . ·
Box 2005
Columbia,SC29202
of Wilmington·
101 Wi lmington,NC. 28401
6.N Uj EPA 10 Numbor
8. U.S. EPAID Number
10. U.S. EPA ID Number
NA
11. U.S._ DOT Dexription (lllcluding ProperShipping ~._ H,,zird Cl8s,, ,nd JD Numbe,J
d.
15. Special Handling IMtru~on.:,, and Additional lnlormatioo ..
_2. :f~J_: .. ~ lnfannitlon tn the ·ahede"d a<e&i ls not
· requfrad by Federal law, bull, by Stat, law.
·oit•'--v---:-~<;?--~\u@:@.:;~E:f'Et~"!f-::::
E'Siiiai':~-------aii}~~.5%?t.I:%:--~~!i.:i~~
-F:.~~~~~~~~*-~t~~f
'5.. GENERA TOR'S CERTIFICATION: I her•by declar• that tr,e contont:1 ol :ti.la conll-lgnmonl 111'9 61:y a.nd a.c:cun.•IYdoacrlbed at>ova bypropw INpplng nam• and ■ r• dualfi ..
pack~ marked., D.nd labeJ..:1. and are In all t-pecta In ptopo-r condition far tranaportby hJgh-..yKC:1rdlflQ ta ~pilcabl• lnt:emational and n&l:lonaJ 90'Affllnent .-.gul■tlona an
ttl•laW$Olttl•St.at.eol5ouaiC&rolln-.. ... • • .. ' ··r .• ;.• .-... -·-·· ,_ , •...
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tt I am• Large quantity g•n...-atoC", I certify tr,.all have a program In placa to reduc:.ttie~um.andti:a.ldty olWU:Wgen.aladto tha ,ia,g,-1 ha-delam\Jned to be economic.al:
p~c::i~I• and tl"'l..atl have -'octed ttl• pni.ctlc.abl• motf\od ol troatment, st.cr.g-.or~ curnnt1y avallabl• to me which mlnlmtzaa Iha P'-nt and tutur■ thraat to hi.im.a
he&.ltn ·and 'lfl• Oi"lvlronmentOR. It I am• am.all quantity gonet11tor, I hav• mad• a goodtaltn .n01110 auntffiWI my•-• g--.tson .-nd ael.ct:lh■I bN.l waste m..nagament meU"K:
that la availu)l• to me and th&!: I c...J1 atlon1.
~
.... , .l....l...L..J...J
b._l .1-.L.l...L..
Month
I I
Month
Month
lib,. • I
libs. d I
Day y.,
' 'l 'i,
Day Yoc
Yee
'
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if--,,----------------~---------------------------~ 20. Facility Owner or Operator; Certification ol receipt of haz.aroou:, m.at.erlal-3 ro.-eced by this rMJW:;:St e.xc.ept as noted In lttim 19.
Print.ed/Typed Name · Signab.Jre Month Day Ye
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South Carolina Department of Health
and Environmental Control . . . ·''" .
Bureau <1f Solld & Hatasdou, Wa,i,, Mg,.
2!i00 Bull Slroet. C<llumbia, SC 29201
Pl>ono: (BO:lJ 734-5200 -Emefu,nq & Holiday,: (803l734-5"24 .
Pl.ElSE PRINT ct TYPE (Fonn de:si'Qned for tJ:5.8 on eOte 12-om:h tvpewnlerl Form -""on:ivod. 0MB No. 20SO-OXl9 Exo!,.. ~
UNIFORM HAZARDOUS 1. Genoratc(sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Malllng Address
New Hanover County/ City
414 Chestnut St.· , Suite
4. Generato;,,Ph~nef 919 l 341-7139
5. Transporter 1 IAmpanv Nam•
7. Transport., 2 Company Name
9. Designated Facility Name and Sile Addres3 · SRC ·
Box 2005
Columbia,SC29202
of Wilmington·
101 .Wilmington,NC. 28401
8. U.S. EPA ID Numbor
10. U.S. EPA ID Number
NA
11, ,u.s. DOT Oeocription (including Proper Shipping Name, H2.zird Clas', and ID Num!,«j
2. ~go 1 Information In the shaded ace.as b not
•• required by Fedora! law, but lo by Slate law .,
·c::~T ~.~-----.. ·e·o~rl'.~z-E.&~"1;~~-.i
0Xfim@l«'a~~1-l~'!t~~~~~~~~~:J-~
£.!~•f--~-----10:~~!iiE:~~id.6.lli-.~i
"F:~-~'P&)t-~~~~~~'t:~:r~~~'l-
12. Containm
No. Type
a. Petroleum Contaminated Soi 1 (NON-Hazardous) ""'N•niir'">b:~ G ~I t I I I~ if ... -~,
~~----------~---------'-----l-Oi0-1..l-l-DiT-I-..L..LL2..LO-J-Y_D...p~~-1=7=1=71=7~1=7~1fg]
R b. f·•,-7·;•1;1~
A ~ ~
T %_ _I__ __ J_ .. 1... _J. _,_~;; ~rc.-::----------------------..:..------------t-''-'-t-..L..-t....1.-'-''-'-t---t1~j£ .. '",::_=,.=_=.,_=_=}_=.J,~~.!;:;=~
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15. Special Handling \nstruc~on., and Additional lnfcrmatioo ,
e.. CEN ERA TOR'S CERTIFICA TIOH: I hor•by decl.&r• 1:h.al the c0nU1nts ol tnla cona.lgn~1 .,.fl.dlyl.lld a.ccunwlY de.aibed aboYti by prop« a.hipping name and ar. c!a.ulfi..::!
pa cited. mark ad, &rid labeled, and are In a11, .. pecia ln prop« condition tor b'an&por1 byhfghwsyac::ordlng to appll.cable lntam.tlonal and nadonai gOV'91'J\tn.enl ~uladona anc
U"le la-,; 01 trio Stai. ol South Carolina.
If I am• i.sge quantity gen.r.tor, I eertHy thal 1 have• progr.m In pl.ace to reduc. ~~ume and tca:idty ofwast.gen«atadtc the d9'ijlrM I~,,. dalllm,Jned to be economlC111:
prac:ic.a.ble and th.et I ha....,-~ U'\111 praC'llcabl• method of tro.tment, sto.-..Qe. Ot dbpo:MICWT'9"tl.y a't'aJlable to ma which mlnlmlz.iu1 0,e pn..ont and tullJre ltltMI \0 huff'..,,/
h66.1111 and tr'le en-wlronment:-OA. If I am• small quantity ganon.tor, I h.a.ve made a goodtaitn~tc ratnlmli.8 my waa• g~don and M-1-=t tfle bec1w...i. m.an.agefflenll'Tl'9tl"IO<
V'l&I la • .-.. ii.able to me and th.al I can .rlon:1. . . : . .
Day Yea
I b 'll
I IL.LJ..J..J...J..Jllb,. C I 11"'-
bl lib,. d! IUn.
I r.::-"7'==--::----,---:,-:,:-,,---,---:-,-,:-----:-c-..:_----::------,---------------~ 20. Facility Owner or_Qperalor; Certification of receipt of hazardOU3 m.atertab CO'.'eted by thi.3 ~ except as noted In Item 19.
Printed/Typed , , e ;_:;' ,,,.-Signatura '-. ./-Monlti Day Y ei
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South Carolina Department of Health
and Environmental Control . . .
lkJniau of Solld & Hazardquo Wela "4111-
2!ill0 Bull Stroot, Columbia. SC 29201
. Pllonc (aOJJ T.14-5200 · · -~ency, Holiday,: <ao:ii™-542, .
PL.EASE PRINT OfTYPE (Fonn d ned fer use on eD18 12-pitch tv;>ew1itai\ Form ""on,veci 01.48 No. 2050-0039 Exoi.:.. 9-JO-&
UNIFORM HAZARDOUS 1. Generatc~aU.S.EPAIDNo.
WASTE MANIFEST
1 Generator'~ Name and MaiTing Addres, "New Hanover County/ City
414 Chestnut St. , Suite
4. G<neratof, Ph~ne 919 . 3 41-713 9
5. Transporter 1 Comoanv Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Addres.::s · SRC .
Box 2005
Columbia,SC29202
of Wilmington·
101 Wilmington,NC. 28401
~ Uj EPA ID Numb«
8. U.S. EPA ID Number
10. U.S. EPA ID Number
NA
11. U.S. DOT 0..Cription (u,c/uding Proper Shipping Name, Hazird Clas,, and ID Numbe,J
d.
15. Special Handling lnstructioru and Additional Information 1
uJ{j
\
2. Page 1
of lnlonnaUon In the shaded are.as f3 no!
required by Federal law, butb by Stai. law.
i:i~fABUX1Mii(~~"$~1ggg~~~¼W~~
-~~,,---,--i"'if:-.. ~f~tfiz~:".!cZ:'!i~3£i:E-1
-f:.~:Pt.a•~~~s~~'t-f~~J!•1
e.. CDlE.R.A TO R-S CERTIFICATION: I her•by dedar• th.at tho cantanb of ltlta con,Jgn~ are b,lly' and ac:cura•fid•~ &bow by proper .tupplng name and are c!U&ll'iad
paeltod, markod. and 1-beled.and ate In all rnpocta 1n ptopor ccndltlon for tranapc;irtt,y tughwayaccordlng ta a;ipllc:ab69 ln111mai!onaJ and naDOn&J govemm.nt r.-gulatloru. an( · a,• Laws ol 11'1• Stale or SouU'I Cuoflna. · · ·
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n I am• l&tge quantity g•nerator, I certify that I have a program In pla.c::e to raduc. Uia-.olume andllwdty afwastag..--aladto a,. d-.grN I have d•t.nnlnad to be .eonomleall:
pn1c::'c:.uil• and tfat 1 hav-e -'-eted th• prac'Jc.ablo rn.11\od of traatm•nt. sto"9a. Ot dbpaa&I OJffllnl!y avail&bl• lD ffM whlch mtninuuis Ui• p,-nt and futur• ttm1.al to humar
t,-111\ -.nd ltla envlronment:-OR. n 1 am• am.a.!I quantltygo~lor, I Mv• mad a a good taiVI affortto,n~ml.1.-m., .__.g_,.tSon and aelecttho bat wa.ate ma.n..gement mo-11\ot D"\.al 1" aY&ila.bh11 lo fflCI and th&! I can anon:1. · <I.
L. C-1....,_.,.J...
•J ._ J....J....L-.1...J
bJJ..-LJ....J.......,
Month
{ (
Monltl
Month I'
Jib,_ C I
lib,_ d I
Day Yea
/, {,
Yea
Yea
I..
11"'-
\lb.
' r:-::--::-:::,-,:---::-----,---,--------,---------------------------~ 20. Facility Owner or Operator; Certification of receipt of haz.ardOU3 materiah ca.-en,d by~ manmi:st ax.cept a., noted In hl!!m 19.
Printed/) /~e ~ f ,,P pl / /-/7-'w.°".'Jnlh Day Ye,
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· •... .South Carolina Departmenl of Health
· ·~ ·_ and Environmental Control
Bun,au of Solld & Hazardou, Wa,lo !.lgl
2600 8uD Slroei, Columbia, SC 29201
Phone (803) 7:14-5200
Eme,p,cy & Hc!Jday,: (803)7J.I-S424
PLE.lSE PRINT or TYPE (Fom, desi ned for Lt18 on eDte 12·c:irtr:h
UNIFORM HAZARDOUS 1. Generatc(a U.S. EPA ID No.
WASTE MANIFEST
3. Gener:ato(3 Name and Malling AddreM New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 .Wilmington,NC. 28401
A. Generate~, Ph~ne( 919 341-7139
5. Transpo"'!' 1 Company Name
7. Transport.er 2 Company Name
9. Designated Facility Name and Site Address -SRC
Box 2005
Columbia,SC29202
8. U.S. El' A ID Number
10. U.S. EPA ID NWllber
NA
11. U.S. DOT De,cription (lllcfuding Proper Shipping Name, Hazild Clas,, and ID Numbe,j
d.
15. Special Handling ln.stn.ictions and Additional lnformation , \
Fenn Acorova:l 0!.IB No_ 2050-0039 Exolr.., 9~
2. ~•ge 1 lnformaUon In the shaded ate.a:, I:, not
n,quired by Federal law, buti3 by State law.
a&iiaT~--.,._-·a .. 10~:;J"a.t&~~Pifi"6:¥.~2(:~:~~-
01Ttm@i.'l-~~;,l1§~:::r:t~~~-4";f;:<-
t~-r:-----~rc,~~tt~.101~~..YE~!:ia§.
-~~~-q&~~+15!:l.":~*ji~
a. C EN ERA TOR"'S CERTIFICAT10H: I hereby dociara that tho contenb of thla ccnalgn~ are Wyand &CQJraalYdHcrlbed abovw bypropw shipping name and ■ ro du.&ifiad.
packed. rnukod. and lab.led,and ate In all t .. pec:QI In p,op« condltion lor~aport 'l:,f ~h...,.accon11r,g ta appllcablelntamatlonaJ and natSon.J goYe1'T\mo9nt r-.gulatlona and ttl• Law, 0112'\e St.ate of Sou1h CArollna.
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HI am• Large c;uanllty g_,...tDf', I certify trl.al I ha,...• program In pl&c■ to r-du01 the~um. andlDxldtyof~g.,.,....i.d ma,,e d9gr-I ha,... det■nnlned to be economlcsHy pnac:tica~b!■ and th.at I t\a...., ~ U,■ pracilc.abl■ metnod of treatment, .:or.g-. or dbpo-a&I a..qni:ty av.ilabl■ to me which mfnlmlui• 'lhe p,-nt and tutur■ ttir.-.t to humat1
h6&Jttl a.nd th■ envlronment:OR.11 I am ■ Mn&!I c;uant1rygone1"11tor, I haw■ rn&d■ a good talC, eflortlDmlnitnlz.■ my•--g.....,.don and ...ctttl■ ~-ui. man.gernent Tfflrthod 1:h&t 1a &'f'ailabl• to m• and thal I can a.Nord.
P~/Typed Name
'I<.(\ I MO.,,.._ ti
19. Ciscrepanq lndiC3tion Space
-'\...
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Month Day Year
I I I SJ1j)
Month Day y..,
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Month Day Year
libs. C I po..
lit:,. d I lu,,..
,I r,;-;:-;:--:;::-:-;,;---:-:---:;---:---;:--:;,:--:,---,---;77:----,---,-,.,----:-,--,---::--------,,.-,--,:----------------~ 20. Facility Owner or Operator; Certification of receipt ol hazardOU:3 material, covered by thu rr.anamt e.xcapt u noted In llem 1s.
f.ci:lied_/TjJ>ed Name · '--,, Signatun, . I-< /:}.;/? n /1.,/J? ~< J -,......, n ( /" Month Cay 't'w
l:.:.c::-,:;..c.,=·-o"."-So.:!.;:C,;.·, !-=--"--'-~~..:., __ .
• South Carolina Department of Health I . . . ·~ and Environmental Control
&nau of Solid & Hazardqus Wa.sta Mgt.
2li00 8uD Stroot, C<>Jumbia, SC 292!l1 '
P1lono: (!O:l) 7.4--5200
. Emorgoncy & Hollday,: (B03jT.lol-S-424
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PLEASE PRINT or TYPE (Form d ned tot use on elite 12-oitch tvpewma,\ Fonn.lo""""9d.OMB Ne.== Exolreo 9--30-U
UNIFORM HAZARDOUS 1. Generator'1U.S.EPAIDNo.
WASTE MANIFEST
d.
b.L_L.J-1 I
15. SpeciaJ Handling lnstrudions and Additional Information ,
Manu-t Docurn-,tNo.
\
2. o!Paoe 1 lnformatlon In the ahaded a<eas Is no!
,.quired by Fodera! law, bulb by Slate law.
i·;--•·~·~ ···'!"'-,--~,~~!
~I I~~)
6. C EJ,,j£RA TOR-S CERTlFICA TlON: I her•by doclar• th.al tho contanb of ttua c:ot1.,Jgn~ aree.aly and ac:a,ra•l:id•ilcrlb.ct al:MNe byprope, ahlpplng namo and •r• cl-.alfied.
packed. markod. and Labeled.and at• In &11,-pecm 1n pt"Op« condlt100 tortranaport t,yhlghwwyac:con11ng to ~picabt• lntema!Sonal .,,ct national gov.mm.nt~ulatlon.a and lh• La-01 tt1• Stai. ol Sou1h Caronna.
tt I am• la,g• quandty g•~lof', I cenify1:hall haw• program In place to r.duc. it'!• ~WM andm.lcttyol w..:ag.-ai.dto lhed~r" I have daiermlnec:1 ta bd ec.onomlc.aJty
pr.acticib_l• and Ul&t I haV'llll -lec:1-d U'I• prac-:!c..ablo ITl411\0d ol tr.-tmant, st.oraQa. otdb,poMI curnntly avallablo to mewhlci\ mtnlm1Uo• tt'lo9 p,._nl and tuCUr• l:l"lroal le human
he.althandth•.-nvlronmentOA.lfl•m•..-n.allqua.ntlt'fgttnoralor.lhavema.d••Qoodt:a.lthetlortlD~mlulmy•--Q_,.don.nd ... adlhe~w~man.gemontnM1tlod 1ha.t La &Y-.iluilo CCI mo and thsl I can .non:..
A 17. Tra.!15pcrter 1 Adnowl m of Rec.t!ipt of Malerials
::. Pri. ,ted fT yped
s
P f-:-::--::----:-,;_,..~L.1~1::..t;s.l.:,..c,~..:,,_,,,-,----l--....::a~:...r.;.~lU.LS;...:::-44.!l..,,,IWc..l....!...<'+-:S.....,,~-..C...U..U...t:::;J....l.:.t.o: · ~ 18. Trat1s;:x::r.er 2 Acknowledgement ol Receii:,.t ol Material,
~ Printed/Typed Name
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19. Oiscrepar:7" lndiC3tion Sp.ace
Signature Montn Oay Year
I c-;:--:;::--;:----:::----::--=--::--~--:-,--:-,---,---,-,-,----,---,--:,-----,--------------~ 20. Faci11ty Owner or Operator; Ci!rtification of receipt ol haurdou:, mat.eriab COYes-ed tr;' this~ e.x.cept u noted In Item 19.
.Priqted/Typaj__Name · Signature I ~ .£J.P I,.) 11✓.0 .n ..-c/J -,-, ~ 1 / Month Day Year
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South Carolina Department of Health . .
and Environmental Control
Bur.au of Solid & Hazan:lou, w..., 1.1·:t
2500 Bull 5ln>el. Colu,nb;&, SC i,iiJ1 .,
Phone: (BO:!) T.l4--5200
Emergency & Holldays: (BOJ)T.l4--5'2•
PLEJSE PRINT «TYPE (Form desl ned fcf' u:se on elite 12•pitch 0MB No. 2050-0039 E,olreo g~
UNIFORM HAZARDOUS 1. GoneratotaU.S.EPAIDNo.
WASTE MANIFEST lnfonnaUcn ln the shaded are.as Is net
n,quln,d by Fedora! law, butb by Still! law.
5. Transporter 1 Comoany Name
r •..
7. Transporter 2 Company Name
9. Designated Facility Name and Sita Address · SRC . · 10. U.S. EPA ID Numcor
Box 2005
Columbia,SC29202 NA
11. U.S. DOT Description (111cluding Proper Shipping Name, Hazird C!as,, Ind ID NUlllb«/
Ga. Petroleum Contaminated Soil (NON-Hazardous) )' 1 1 1zi;i;i
E OOlDT 20YD ~171717171~ i ~b.;;-________________________ _; ___ -:_+..1...1.-t..t-t...l....l....!LLl---!i .. ~.~~~---~---~-,~,-~~l
~ ~
~-'----~-----....:...:.. __ ~:_:_.c:c_~ __ _:._~_....:.~--~-'r-LLf-Lt-.L.l....L..L-t--4~·1=·· E.I~. ·aE:!::~'.:. .. ~ re. ;a·· >~~
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;i '-' _,__,___,__,t, .. · ,. ~;
~I }:1
d. •'
15. Special Handling lnstruc:ioru and AdditionaJ lnformatio? ,
, .. · .. rv., .L,J_ t,ji 01 -l~i-otli\
·. · '"~ ··· ·• · -w/3 8Yb2'..
C. CDIERA TOR-S CERTIFICA. TIOH: I her•by doclar• that U'\e conteob of tNa conal,;jn~ an ~and ao:urw.•l°f d...att.d abov1i by proper ahlppln,g name and are d.ualfiad
p•ckod. m&n;ed, and Lat>.1-1.and a1e In all , .. pec:ta In pt0p,e1'COndltlon k>tiranapon: by hJgh--,ac:cordlng to appllc:ab.lntel"natlonaJ and na!lon&I gO'ffmment,-.gul•tlona &r1c
th• t..ws ot C"I• Stal.II ol Souch Carolina. . . . . . • · · · · · · · · ·· · '-· · ·· · ·
·: Hlama~g•quantltyg•~tor.lcertttyU'\atlhawap,ogramlnplac.toNodu~the-.olwneandlmidtyol...-o--a,tadto~d.;r-lhawid.iann.lnedtaba.:.onomlc.a.11\
pnac:ic..ibl• &nd t:nat I ha-~ th• pnactlc.abl• maD'IOd ol ~tmant, s1or..;i-. °' dbpo:a&I anwntty aY&Jlabl• to nw ~ mJnlmi2n• h p,-n1 and run.,,.. U'\rMt to humar
h.,..Jtf'1 and ll"I• -lronmont;OR.11 I am a .slT\&11 quantity generator, I ha•• made a ;ooc1 taltn sffor1,-,m1n1nux,a myw_. g--.aon .and ae,ec::1N beatwa.M manag•mantmetho<.
1:tl,al I.a availa.blo to me and that I can atron1. . . . . -. · .
1 LI ..L..JL...L..J-11..Jllhs. c ) f I l'"'-
b I , )lbs. d I , , !lbs.
~ 1-;2;;:0-. F;:a:-o::;:!i:;-tj:-;Own~:-:.:-,0-,"'o"'pe-:-r.i-:-:-lc-r,""C.:-:-rtic:-fica-::,-on-::of,-rec-e7;p7to"'fc-haza--rdoo,-:--ma-tarial,-:--:--cov-..--oo:-:by-lhil.,._-rnanilooi-,:--:-OXC8pl--u-no-lod-:cln-llom-1"'9. ____________ _
Printed/Typed Name · Sigr.ah.rre Month Day 'te.e
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~outh Carolina Department of Health
and Environmental Control
8uroau ol Solid&. Hazardous Wasta Mgt.
2!iC0 Bull Slroet. Columbia, SC 2921l1
Phone: (BOO) T.lH2CO
Pl..E.lSE PRl1'.T or TYPE (Form de:sianed fer uss on eiJtn (12-oitch tvoewritert
UNIFORM HAZARDOUS 1. Generalc(sU.S.EPAIDNa.
WASTE MANIFEST
3. Generator'3 Name and Mailing Addres,,
Manliest l>ocu.....,.N
' b
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
,. Generalc~sPh~ne( 919 341-7139
S. Transporter 1 Company Name
Wi 11 ms Trucking
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Addre:s3 SRC Inc.
Box 2005
Columbia SC 29202
6. U.S. EPA ID N-_
A
8. U.S. EPA ID N.-
10. U.S. EPA ID Number
Eme,gen,:y & Holiday,: (603)7J.l..5<24
Form Accroved. 0MB No. 2050-0039 E.:z:0ire3 9--30--a.:
2. Pag,el 1 lnformaUon In the shaded Meu ls not
cf required by Feder>! Law, but!, by SI.to uiw.
l~~~~i~~iii
~~~~~~~~i!if4~~
C:.~~T~.i{I047~{?1L.::;,'!;,?fS,SiV$..1'5;l.~;,
O.itimciwQl~~:i~~1R:~;;;-;;;tr:~:?J.~,"2,a.;.~~
E~,T7~A1:1:~a~S:;::~_:1!.1~-;:,;;.>~~""-::"!~':i.~t-~
·F;~-~•~~~:;;,v~1:t:-bi!t·Fi·~='iit
11. U.S. DOT {le,cription (,nc/uding Propet Shipping Name, Hazim Clas,, ind Ill Numbe,J 12. Container,
Na. Type
d.
15. Special Handling lnstn.Jction:1 and Additional Information , \
Material Code# 01-137-0101 WB81o
6. GENER>. TOR"S CERTIFlCA TION: I hereby dedare 01.at U'\e contents of tN.1 co~MMWl't.,. euty and a.cc:ura•IYde~ abOYe by pro~ &nipping name 11/'ld aro d&-.ifi..:
packed, rnan:Dd. and lat>.led. Utd are ln all ,_pecm In p,oper c.ondlticn lo, trv,aportbyhJgtrway-=ccn:1lng to appk;a.bl.e imematlona.l .,,d n.aDOn&I gOV9fflfflenl r~ulatlon.a &11 itio 1.aws o1 Q'\e Sta~ ol ~ Caro,Jna.
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tf I am a large qu.o.ntity ;•non.tor, I c.artity uiatl have■ program ln plac. to rocluc. tno..olumeand~of -■--g.,_..'-'d to in. d--.,, .. 1 hav. d•~rmlned lo be economic.all
prac:il:4blo and that I h■..,. -i.ci.ct tho pradc.aDlo m.tt'!Qd of tr-.tmorrt,, S:Ofll'ilO. or cUa;>oaalCUIDtltiy avail.able lo me whlch mlnlml1a• th• 1::1r.aant and future thr-t lo hun-o..
hca.lt:1 and tho emtlranmont:OA.111 am• small quan~r, gttnen1tor. I have made a good tannollorttDm1nlml.D my•-• g.,.,..DOn and aeloctth• ~-&stll rnan..goment m-e1"lo
lt\&t I.a availabi. ta ltWI and that I can ■ttora.. . . • · . . .
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Month y.,
'I
Montt'l Oay y,.
... , ...................... j\bo. C I jib.
b 1...I L..l,..;L..LI j\bo. d I j\bo.
I r:::--::--:::----::---::----::--:--:---,--,--,--,---,---,--,--------------------~ 20. Facility Owner or Operator, Certification of receipt cl ha..zardou:5 materlal, coven,:::l by !hi3 manmsst. except a., noted ln !IJ!m 19.
Printed/Type<j Name s;gna\un, Month Day Yo
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South Carolina Department of Health
and Environmental Control
&noau of Solld & tlazard~u, W83la I.I~
2ml Bull Streot. Columbia, SC 29201
Phcn<c (Bo:lJ 734-5200
Pl.E.lSE PRIYT or TYPE (Form deoianed for U3e on el1te f12•oitch1 tvDewnl:eri
UNIFORM HAZARDOUS ,. Generata(aU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Mailing Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
•· G,nerata~sPh~nel 919 341-7139
5. Transporter 1 (;(lmpany Name .
Willms Trucking
7. Transporter 2 Company Name
9. Oe.5ignated Facilit'f Name and Sita Addres.s SRC Inc. ·· -
Box 2005
___ Columbia SC __ 29202 -·
6. U.S.EPAIONuaow
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT De.,c:iption {including Proper Shipping Nama, H=d C:.,S,, and ID Number/
Emergency & Holiday,: (Bo:l]734-5'2•
Fonn ADoroved. OMS No. 2050--0039 Exclre:s 9.J0-8.
2. Pl;e 1 lnformallon ln the sh!.ded a,eas 13 not
ol I n,quitodbyFede~law,butbbyStalalaw.
o::timiiu~Phoo{-:~i'~;f~ef~~~:4~~:
'tt~T~~i'il~~3u~~fu~~Z'
·1t=.:~Phoi•~~~i=.i~~~~~~:ts:
12. Containe<>
No. Type
~ a. Petroleum Contaminated Soil ( NON-Hazardous) ~;-·Trr~
~ l---'---'-------'---:._ _ _:._ _____________ ~o'...J!::o:.J.:.1..fo~T~-1.....1....1.::.2.xO~Yc!D:'.......!J:::f;~il::;7:::\7::::::IZ::;. !:'7='!±-'i-
R b. ~!ltd A t ~ 1--------------------------....:... ___ .....;._t--,__.,_t--'-t-....L..-'-....I.....L7--f"';;"i:.1.:E .... ='=J.=.='=· ::1S,;
R ~ ~: ·--·-·-···:.i.
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15. Spedal Handling Instructions and Additional Information \
Material Code# 01-137-0101
15. CENERA TO R"S CVITIFIC.A TlON: I her•by dociar• that tho ccnlenb of ttua conaJ.;fUTMWll.,.. fuQy&nd accuratalydoacrlt.d abOw by prep« shipping nam• &nd aro du.a.Iii.-.
packed, m.ni:Dd, and labeled.and a,e ln all ,_pecta Ln proper COndltlon fortn.nspont,yhJghway accon:ilng ta appk;abfe lntamaUonal and n.don&! gOY9n'\t!\enl r.gulaliona an
trio la~ of 1n,a Slate of Soulh Carolin&. . . · ..
111 om• 1..-go quontlty o•nonr,tOf', J c.rtlty that I haY9 • progt1tn Ln pl&ca to teduc:a #l•'f'Oiutneard tClldotyof...-g~ ta tti. deg..-I ha-daa.nnln.-d ta be .conomlca.JI
pn1c-.:ic.abl• and that I ti..ve -lociod tn• prac:lc.ablo m.ClOd of treat:n•nt. sto~._ ~ diapol&I ~tty r•••JL•.ble to me whlch mlnlmi1.e11 tn• p.-...nl and tutur• lhroat to t'\um.a
health and th• envlronmootOR. If 1.-m • small quonUty goner.tor. I hav• mad• a goodtalln .aortm an.lminl my__..g__,,.Uon and aelect tn• ~ waa::a man.gomonl rno1t\c
1:t1,at Ls •~i. to ma and tr\at I can anorcL.
Pne'/tTyped Name Signalll:e Month ~, Ye.
I ,l "};
;l; r1_7_. ;;T:-ra:;n:-s:;-po;;rte,,':-:'-1:':Ac:;::lm:'-o:-w_ledg:..:.,c.•m=•:..nt7o71.:.Recec..:.:..;•:ctc:o::.f;.:Ma.::.terial3:."=: ___ -r::::---,----;_----;------,::=-;----:,-,,-------;-:---:;:--;:,--:-c ~ Printed/Typed Name Signanm, y" s Pf::--=------:-,:-,-..U,=-/-/-L+..c..-,-,L.~J..:;:_:....,_;__J_:._ __ _,.!:::f::::..:::i~~~_,;Z::,U.{;.<:.~-=a=:_ ___ ..J..L..J.!....Jl<'.~JJ o 18. Transpcrter 2 ACXJ'lowledgement of Receip.1 or M.ateriab i i-'--'-:::P-,Mn_t_ed;:.i.:,Tccypedc..::.:.Nam..:...:..;e:...;_=c::..:::..:..::...:..::.::.c::..:::..::.::.::.=::_ ___ ~Si-.-gna_tu_re _________ ....:_ _________________ _
Month Day Yi.
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19. Oisc:epanc-1 Indication Spa.ca
1 LI ..L.l....L.l...J
b1-l '-'-1...LI
lib,. C I
Jim. d I
I 1-:-:--::--:::-:--::---::-----:-,--,---,--,-:-,---,-------,-,--------------------~ 20. Facility Owner or Operator: Certification of receipt of hazardou:, materlab c:ovind by tt'u.l manilestexcept a.s noted In tltim 19..
Printed/Typed Name ' Signature Month
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South Carolina Department of Health
and Environmental Control
Bureau of Solld & Ha=dous W""8 Mgt
2!lllO Bun S1ree1, Columbia, sc :mo,
Phone: (1!0:l) 734-5200
Pl.E.l.SE PRIHT ot TYPE (Fom1 d~aned for use on eOte f12•citc:hl tvoe•riteo
UNIFORM HAZARDOUS 1. Genorato(sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator'l Name and Malling Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
,. Generato(s Ph~ne ( 919 341-713 9
S. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Fac~it:i Name and Site Addresl SRC Inc.
Box 2005
..... Columbia SC .29202
6. U.S. EPA ID Number
A
8. U.S. EPA ID Number
10. U.S. EPAIO Number
11. U.S. COT Dex!iption (inciuding Proper Shipping Name, Hazan! Cass, and JD Numbetj
d.
~f~~~~~~1:~}t:,~v•••
.. LLJ-1 L ...l-..L.J--L..JI-LI ...L...L...L....J
b. LLJ-1 1-1
15. Special Handling ln.structi003 and Additional Information ,
Material Code# 01-137-0101
Emergency & Holiday,: (803)734-5'2,
Ferm Aoorovod. 0MB No. 2050--0039 Exoires 9...JO-a.a
2. ~Qe 1 tntormatlon ln \he shaded a,eas b not ~ / requhod by Fedora! law, but Is by St.Jo law.
·c·;sii1a:tl;Wlm;~.,iri~\~~~~~.;;~-v,.:r,.:~L~;•.
o:::-rAS--11Wi.-\{Phooe-\*'r.t~1r;~mn~~~~f:j
t~T;;~;C71~~F-i~±:.!~~'0~
'F:..;~,~-~~§$..~~S~ii\:
12. Conlainero
No. Type
\
'5.. GENERA TO R"S CERTIFlCA TION: I hereby declare O'\a.t 1he content:s 0111\Ja con.,JQn~are fuQy and a.ccurata1Y d•acrlbed a.bov9 by propM ahlpglng n•m• and ar• da.3.&ifi&<"
packed. maned, and labeled.and ar• In ail ,_pec:a In proper-condition lot '1"anapor1 by iuQ;hway according tD applica.bl• lnt.m.atlonaJ and natlonal ~ovemm.ntr--.iuta'Clona &ti,
the la~ 01111<1 Sta.r.o of S<xnh C&rollna.
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tt I am a latga quantity ganerator. I certify that I~ .... a program In plaea to raduc. th• 'IIOlume&nd tu:dc:ty of waa. gar.rated tD ltlo9 deg,.. IN,.,. d•t.nnlned to be economlcsJI
pni.c:ic.a.bl• l.l'ld tnatl h.a,... -leaDd U,a practlc.abl• rneO\od ol tTaatm•nt. storaQ, 01 (lb.poMJ auT91'\0)' availabl• to m,a ""h.ldl minlml.z.ea tha p,.....nt and tutl.lra throal to hum.a
ho.a!ltl and 'Iha ~ronrnem:-OR. Kl am• ama.11 quant1tygenerato,, l ~ ... mad a a good bJm ~tDtlW'\lmi.z9 myw ... • ;eneratton and aelltc:1 tha beat wa.a::. managomant JT'IOtt'lo
~t la •~ to me and that I e&n attanL
Cay Ye, a. ..1., 7 "7,'
;; 17 ent of Receipt cl Material.,
A Month Cay Y"' i l-:=-f~~:.-.!.l.f.::.~~~=----L_.....15:.~L_.LU~~:LL~·W'LL. ~L~.l.LLl'..Ll.12'.ll!.9 ~ teriab
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Month
In,,. • I • .. J..J...JW-.J....1-
b ._J _.__....._.,_. Jibs. d I
If.,.,-,:,-,::-,---,------,----,------------------------------~ 20. Facility Owner or Operator, Certification of receipt ol hazardOll:5 materiah covered by ,;tu, manoesi except a.s noted In Item 19.
Print,d/Typed Name Signature Month
Yi.
{
11"'-
lib.
Cay Ye
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South Carolina Department of Health·
. and Environmental Control
Bureau al Sclld & Haz:ardou, Wasm M.t.
2500 aua Slreet, Columbia. sc :mo,
Pl>ona: (BO:l] T.14-5200
Emeril'"'C'f & Hofiday,: (BOJ)7J-4-:;42◄
PLEA.SE PR!t!T Of TI'PE (Form de:sianed fDr ~ on elite 12-citchl tvt>ew,itet1 Form Atloroved. 0MB No. 2050--0039 Excire:s 9-3:1-88
Manifest UNIFORM HAZARDOUS 1. GenenucfsU.S.EPAIDNo.
WASTE MANIFEST Docu~~ 2. Page 1 Information In the shaded are.as la not
of I required by Federal law, but ls by Stite law.
3. Generator~ Name and Mailing Address New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Gener.ito(s Ph~ne I 919 341-713 9
5. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facility Name and Sita Addresl SRC Inc.
Box 2005
.Columbia SC .. 29202
6. U.S. EPA ID N.umbo<
A
8. U.S. EPAID Number
10. U.S. EPAID Nwnb<r
11. U.S. DOT lle>cription (including Proper Shipping /lams, Hazirrl Clas,, 111d ll Numbetj
d.
15. Special Handling lnstruclioru and Additional lnlormation
_Material Code# 01-137-0101
\
·c:.~si:ite l ~.s-c ~:,?;i.;:,,"¾-i~.r~.::::i~;;_ l
OJtA! LUOWI ~~:t!t:f%Y~~~tt!~~~~-:~; I
't~vT"ri~bllW~i_~'.fil~~=Ift£.~0:~~ I
·,=:~~-Pt'ai.~-?~~S>-~:S~~J~;i 1
6.. GENERA TO R'S CERTIFICATION: I heu1by dociar• U\al the cont.anti of thla con~.,. "If and a.cr:un,laty dHcribed .abQva by prol)ef" ahlpplng nam• and are c:Ja.u.lri.c1.
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packed. mar1ced. and lab.eliOd.and ar• In a.11,-pec:. In ptopot' condlllon lcwtr.n~rtb)'NwlL••t dl,i,g to af)pk:aela UU.maUona.l and na1Son&19ovemmentr...,uJ■a0n■ anc:
Irle L&"""3 o1 tne State cl Sou1h C&roOn&.
HI am a 1-,ge quantity g•n~tor. I c.ar1.lfy1h&I I ha..,. a prog"'" ln p~ ID r..:l1.1celhawfum■and~ofwaaag~to ~ d.,;,,_ I ha.,. d•tennlned to be economic.a.II)
prac:ic.abl• and tnat I hava ae&ectnd th• pr-.ctlc.ablo meoiod of tr-tm•nt. acraga,o,dlapol.■I asrenay ...-.JI.able to me which mlnlmtz.n• Iii• p,....nt and rutur• tt1ro.t.t to humar
h6alth and the oovlranmoo~OA.111 am• am-11 quanUry gonon.tcr, I h&v• made a goodtaJ!n eftotttomlnlmiD my...-genar.dcn and aalect Iii• bNt wa.u. management me1n0e vi.■t L& avail.able to mo and that I can afford.
Signatun>
J. ~
~
1 Ll..ww....w
b._! .L.l...L.J.--'
Moo!h
Month
111o. c I
111o. d I
Day Yea,
27 'i',1:
y.,.
~
Cay Yea
/
111:o.
!1t:o.
·~-------------------------------------------~ 20. Facility Owner or Operator: Certification of receipt of haz.ardou::s maleriah covered by thi:s m&l\m$ except a.s noted In llem 19.
Printed/Typed Name Signab.Jre Month Cay y.,
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South Carolina Department of Health
and Environmental Control
Bun,au of Solld & Hazardqus w._.,. f.4gt
2Sl0 &Q Slree1, Columbia. SC 29201
Phone: [phone]
PLE.lSE PRINT 01 TYPE (Form de:si ned for use on eOte f12•ort:r:h1 tv?e.vritsrl
UNIFORM HAZARDOUS 1. Genoratc~sU.S.EPAIONo.
WASTE MANIFEST
3. Generator', Name and Mamng Addr~
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generatc~sPh~ne( 919 341-7139
5. Transponer 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designa1ed Facility_ Name and Sita Address SRC Inc. .
Box 2005
·-Columbia SC 29202
8. U.S. EPA 10 N.umber
,A
8. U.S. EPAID Nwnber
10. U.S. EPA ID Number
11. U.S. DOT Description (including Propet Shipping /lams. H.uard Claso, ,nd ID Numbti,j
15. Special Handling lnstn.ic:=ons and AIJditional lnformation ,
Material Code# 01-137-0101
Emeriiency l Hof>day,: (803)734-5"2◄
Fenn Aoorcved. OMS No. 2050-0039 E.toirm 9--30--aa
lnlarmatlon ln the shaded lfea:i. ls no1
required by Federal law, but Is by Slala law.
·c:~St&lii~fio·~:)741i_.:::,,~ti·thZ~i1Y~~{:½? I
b;"tia7.wt.71PMoe"Wtt~;f!~~·~t,;J!r~~~,f.;t
t~tTi~.l"'"ii~~Bi2E~~:~1;-~.l
"Fi,-rn-Phoir.9!.~~;:-,:;-!ri;~~~:f~.ii~
12. Conlainffl
No. Type
:..:,..:·•,,,-,. ~•--~,._,., • ..,..,,?;;<
>~,~ 1 1 ! ! 1tp,
~-' , t' ,~
\
6.. C EN ERA TOR"'S C£RTIF1CA TION: I hereO'f doc:J.are that the contlllnts cl ttll• eon..ioruNinl.,. l&,lty aJ'l.d a.c:cun.111'1 deac:rlbe,d above by proper ahlpplng name &nd are c:Ja.s.alrled,
P•ckod. marked. and labeled.and ar• In all , .. p,41C':1, In ptopor ccndlllon lor tranaportbJ' hl;h...,.acc:ordlr,v to appk:able lntar11-aona.1 and na.tiona.l g~nt r.-;iutacona &nd
tho ta~ ol U'\e Stai. of Soult\ Can:1Una.
.., HI am a large quantity gen.,.tor, I certlty l:hat I ha't'8 a program ln placa to redueeU\ewolume andlllaJcitycf wastage~tad to the deg,_ I ha-detann.lned to be er;.onomle.a.lly
practic.a.bt• and in.1 I ha,... -loctod \he P"c::1caClle method ol ~trnent. s1e,.,_._ ordboca&I curnncy ava!lable l0 me which mJnlmlz.a• the ~~nt and tuture ct1raal l01'l1.1mu,
l'le&JU'\ and IJ'l.e envlranmenr;-OR.111 am• .am&ll qua.nary generator, I have made a gccc:I tataieftoftto m.LnJmtz. myWMlllgeiner:iaacn and aelect the beat 'W&ai. managemonl rne11'ocC
th.al 1a a_vaila.b'-i to me and thaJ: I can atfon1. ·
Prin 5,gnallJre
~ 17. Transporter 1 Acknowledgement of Rec.eipt cl Mar.eria.15
A Slgnalure Month Day
N ~r ! f-::~~ran~,pc~~"'~~;--ofw~~et.'.m1e~ntt.o'.\--;:~~~oµ;fl,tef!:.::.,---.l..!:.:f:~~~~~2 -..J.~~~~~~~~C.:::'-----...l..l.JL.l.~J.L
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Month
lib,, C I
lib,, d I
' c-:-:::::-::---::--:--::-c:----:--:--:--,-,----,---:---:-:---:-,---::-,----::------:---:-:-------------~ 20. Facility Owner or Operator; Certification of receipt ol haz.ardou::5 material, covered by ttlil m&ni:fat uce,pt a-, noted ln ~m 19.
Printed/Typed Name · Sign.ab.Jre Month
Cay
Day
Yea
Yea
11t,,.
lib,,
y.,
I South Carolina Department of Health
and Environmental Control
&n.au of Solid l Ha=dquo W83!1> Mij!.
2!ill0 Bua Slreot, Columbia. SC 29201 .
Phone (!03] T.14-5200
~ency l Holiday,: (S/l3l734-5424
'L.E.lSEPRIN1'otTYPE (Fonnd~ nedforu:seoneOte 12•Clrtch Form .l.oorowd. 0MB No. 2050-0039 Exp!, .. 9.;o.aa
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UNIFORM HAZARDOUS 1.Generatcr'1US.EPAIDNo.
WASTE MANIFEST
3. Generator', Name and Mailing Addn= . New Hanover County/ City
·· 414 Chestnut St. , Suite
C. Geoera1o(,Ph~ne 919 341-7139
of Wilmington·
101 · .Wilmington ,NC. 28401
5. T ransporte< 1 Comoan·i Name
7. Transporter 2 Company Name I. U.S. EPA ID Number
9. Designated Facilit-, Namo and Sila Addreso · SRC 10. U.S. EPA ID Numl>or
Box 2005
· Columbia,SC29202 NA
11. U.S. DOT ee.cription (lllclucing Proper Shipping N&ma, Hazard cias., Ind I) Numbetj
a. Petroleum Contaminated Soil (NON-Hazardous)
b.
C.
d.
15. Special Handling hstn.J~tion.s and Additior\al Information ,
~-fet; J ~ o 1 -rs 7. 01Z> I
B 84tro .
2. ~ 1 lnfonnaUon In lhe &haded "'"" b not required by Feder>! law, bulls by Slala law.
,...,_,
00.lDT ~ I I I I 1~-
2 0 YD ~17171717.1~
\
e.. C. EH ERA TOR"S CERTIFICATION: I hereby dee.lat■ that the contants cl tt\l.a cona1,.ntMC'da,wtitr and a.ccura■1,; diNC:rib9d a.tliow by pn:ip«ahl"olno; twn■ and.,. da.sal"ed. I
packed. m.arlcod. and IA be led.and at• ln ail rnp«u. 1n p,op« condltlon to, tranaportby~ to a;iplcablielram&DonaJ and naDOn&l 90ftfTllnenlr99ulallona and
Ule lawq o1 tr'le Sia.ta cl Sou1'I Catollna. · ·
l'
NI am a larg • quantity g■n.11.tof'0 I carUty Iha.ti haw a program In placa to r.:lue9 ~ volumeandb:dcttyof ..... g~'tO Cha deg,.. I ha-..de~ io t,. economlcally
pradc.ibl• and V\al t ha~ Mlec1od U,e plllcilc.able rnelhod CII ir.aon.nt. ~--Ot d-.pow,I a.lWICy avall&bl• 10 me~ mJnl~. Iha p,-nl and tua,i,. av-1 io human
hea.lU'\ and 'a"le enviranmontOR. ti lam a ama.11 quantity g~tcw. I ha,... mad a a good lall2'I dortbminlmlu myw ... o--allofl and ..&eel the bNt•uta managem-nlma1hod V\at la a...-a.itat,to tc mo and lhat I can afford.
L
~ 17 owledgement of Receipt of Material, ,._
N Month
;,: 8.2-J~~~-,:;..,--,!~,P...C..~~~~.,.>-,,~:::,..,---c:4~..ic:.=~~:::_....d~d.L.<.:.i:...::.::~=:z....--...:..--lL,LL
Day
o 18. rans r'.er ow eme eceip.t ol Materials ~ t---=-:--:--':c::--:-.----=----'--"-'---'-'-.;;.._-;__....;:=..,..:,-----------------~-----cc--.---:
Month E
R
F ,._
C
I
L
•~I ................ ~
b~l~~~
I
libs. C I
libs. d I
I f-:::--::--::::---::----::----,---,---,,,--,,----,--,-...,.,..--,------,-,---,-,-,,,-----------:--------~ 20. Facility Owner or Operator, Certification or recaipt of h.w,rdou, malarlal, coven,d by !!ha manill:st e:xeept u noted In ttnm 19.
Printed/Typed Name · Sijinatur, Month
I
Day
Year
Year
111n.
111n.
··y84f
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South Carolina Department of Health
and Environmental Control
&rwi cl Sc!ld & Hazard~uo WIU!lo MIil
2lillO BuQ Street, Columbia, SC 29201 .
Phone (800) T.14-5200
Emergency & Holiday>: (BO:llT.14-5424
PL.EASE PRINT ot'IYPE (Form d nod fcnM on o!lte 12-oitr:!I 0MB No. 2050--0039 ExoJn13 9-JO.U
G
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UNIFORM HAZARDOUS 1. Gcneram(aU.S.EPAICNc.
WASTE MANIFEST
3. Gen=lo<'s Name and Mailing Addnm .. New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · .Wilmington,NC. 28401
4. Gen~f,Ph~ne 919 341-7139
5. Transpo•e, 1 =canv Name
7. Transporter 2 C<>mpany Name
9. Oesignai.d Facility Name and Sile Addres> · SRC .
Box 2005
Columbia,SC29202
&.N Uj EPA IC tiumtior
&. U.S. EPA IC Number
10. U.S. EPA IC Nurablr
NA
11. U.S. DOT De>aiptlon (IJ)c/uding Proper Shipping Namo, Hazard Clas,, and D Numbelj
a. Petroleum Contaminated Soil (NON-Hazardous)
b.
0 0 1 D T
rmaUon tn the shaded areas b net
by Fodor>! law, but ls by Stale law.
0
A
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C.
d.
15. Special Handling lnstructioM and Additional lnformation ,
m~+u:J. wcl 01. l°5 7. b1bl
· w8 841 I,,,
d. CEHERA TO R"'S CERTIFICA TIOH: I h•r•by d..:..tar• that the eontant::1 ol trua conal;n-are W,and accura•iy d•IICrib«i UlOY9 by proper ahli,plnrg name and ar-. c:lu,.lllad.
pac.lr.-1, m&nce,d. and labeled.and a,e ln a.11 rnpec:a In pr0p« condltlon to, ir&naportby !'Y;ti--,aa:on1!ng tD appkabl,alnla,nadonaJ and natkM'l&l 9overnment re,gulatlona and
lh• 1,a,.... of th• StaWI ol South Can:,llna.
Hlamal&tg■quanijtygen.fatot0lcert1tylhatlhaveaprogramlnpl&cttor.duah'fOlwne&ndlmlcttyolwutageneqradta1h,ed9o;rMlhawd•tam\inediabe,econcmlc::.aJty
P"c:icabl• and ~t I ha.,. M&ec:\Od Eh• pracilcabl• melhod or tr..tment. ~--o, dlapoa,IJCWlllftzty &Yalla.bl• tom. which minlmlua the p,...nl and tutu,-air-t la human
hoall:h a.nd 17\e envlronmont:-OR. If I am a small quantlr, g~r.ior,I hav. made a ;ood t.Jtt, eftortlClmln!ml.za myw .... g~ and ..iect1tie b-.lwut. mana;emenlm,eU",od
U\a..t ia an.<lable tc me and ht I can afford. • . . . . • • . . • ,
L. C (.
T 17. 1 Acl<nowledge I Receipt of Material, 2 t-.;:;:;::;;;::-:::7;::=~--"---"-:.;_-'.:;....:....;,;==:_---r,c,-.,---.,...:.--,,--;----;::------c--------:M:-0-,nlh::--;Ca:;:-:y-;Y;:ear::
s ~ ~,:-:a:-. -!T=rans..C..pc..soe.!cer:..J2.f,Acl<n~:!.o..!.w;le<lg:..1.._em_e.ln.Lt c.fl~R~ece,!;::.ipt.!:o~l.,.M.a:--r.-,riaJ-,---.L--:..L....ll::!:!.l!CJ,l.!:!a!!~ab!~~::::'.:~...a<'..-_____ LL.L.L.L..L
i t3nled/T s J:=7cf
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19. OLscn:pancy lndic~tion .Space
'r b I L
I I I I Ju,,, cf I I I I J Jit,,.
J I I I lib,, d I J J I J J lib,, '1-:-:-::--:::-:c---::---~---,---------------------------------'-----T 20. Facility O,...,ner or Operator, Certification ol receipt ol haz.ardoU3 malarla13 CO'-lered by ttu, lnlnllast except a.a noted In 11nm 19. Yj--;:-,--;-:=--;-:-:-'-,--'-----'.C.::.:=:.;_---r.c====-'-'=====::.:..:.;.;:::;..:..::.,_ ______ ..,--,--::---;-;c-, Printed/Typed Name · Sign.tun, Month Oar · Yea,
I I I ' ' '
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South Carolina Department of Health
and Environmental Control
Bureau of Solld & Hallrdou, W43ln Mgt. 2lill0 lluJJ Street, Columbia, SC 29201 .
P!lonc [phone]
UNIFORM OCUS 1. Genon,IDr'1U.S.EPAIDNo. WASTE MANIFEST
5. Transpor1er 1 Comoany Name .
.'.:.-~-;:
7. Transporu,r 2 Company Name
9. Oesignaled Facility Name and Sile Address · SRC . Box 2005
Columbia,SC29202
a. U.S. EPA ID Number
10. U.S.EPAIDNuml>lr
NA
11. U.S. DOT D=ripdon (1nc/uding Proper Shipping Nam-. tiJzird CJa.s,, Ind (l Numbelj
a. Petroleum Contaminated Soil (NON-Hazardous)
b.
Emo<gency & lloildAy,: (80JJ734-S,124
0MB No. 20SO--OIXl9 E.,i,i,es 9-30-U
formaUon In the shaded areas b not by Fodera! law, butb by State law.
es.-.ii'I ... rii~~~']L~•f-~ -.. --·-.--..-,,..,--~~~~~£:
-·"'ih ~4.:#'S' __ .,,.. ··.:~r#.t:
~ ,_ ',' '-'~i . .. ,_,_ .. .,.._,,_
0 0 1 D T
0
A c.
d.
~~~.~~~~1~:~t~•lillti~13~lit~~ . . .. -><•••"Z",-,,~'0 a. Lu-I , , , , t-t , , , I c.LJ_J-1 , , , , 1-I , , r r
~W=I l I I I t-1 I I l_s.~ !-1 ):"
15. Special Handling lnslnJctioru and Additional Information ,
~~•~~DI· (37. VID.I
e.. CO'<IERA TO R'S CERTIFJCA TIOH: I her•by doetara that th• cont.ont:s of !Na conalg~a,w ~ and accurw.11ly ducrlbed ~ by propw 11\11:JQlng nam• &nd are eluAl"lld. packed. rnvked, and t.b91ed,and a,a ln a11,-pecta ln pt"Op,H c:.ondltlon lotlratul?Ottb)'high--,.cc:on11ng to a;iplcabl,a lntitmaaonal and nauon.J gO'nf'Nne(\lJ.g1Jlalfona and lhll la_.. of Iha State cl $0'.tai Catonn,a. ' I r
HI am.• large quantity gene.ator. lc.rtlfy that I haw• program ln ptac. ta r.duc. tho'tOlwneardliZddtyofw&mgan«ated ta the cfe,;i,...1 ha,... detennlned to be ..:onornlcally pn.c:tiabJ• and tn.t I tw_.,. MLe,cte,d th• plllC"llc:...ble method ct ir.atrnent,, .:or.;, CM'~ aaq,nay ~tame wNdl mlnlmizaa the prwa.nt and tutu,. lh,..l lo human health and th• eovt,cnmentOR. If I am• amall q1,,1&1\1fty gen.r11.tor, I ti.awe made a good taJtn eflor11Dclnltniu myW..-~and llefedth• b.et._._. m&n.1g•mentme1f\Od lha.t ia a.....a.bl• to me and U-t I can Alford.
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South Carolina Department~f Health
and Environmental Control
Buroau ol Solid & Hazatdcu, WCla M~
2500 Bull Slroot, Columbia, SC 29201
Phcno: (BOJJ 734-5200
Emorvoncy & Hclld.ay:c (BOOJT.lol-~2,
PLEASE PRIHT Of TYPE (Form d · ned to< use on eOte 12·i:irtch ~ Fenn AconMld. 0MB No. 2050-«J39 E.,cl""' 9~ UNIFORM HAZARDOUS 1. Geoeratc(aU.S.EPAIDNc.
WASTE MANIFEST
3. Generator, Name and Mailing Addres, New Hanover County/ City of Wilmington· 414 Chestnut St. , Suite 101 Wllmlngton,NC. 28401
~-Generate(, Ph~ne . 919 3 41-713 9
s. Transpcrte( 1 Ccmpanv Name ~u* EPAIO N.umbor
7. Trans perter 2 Company Name 8. U.S. EPA ID Number
9. Oe.signated Facility Name and Site Addre:s.s SRC .
Box 2005
Columbia,SC29202
--, .
10. U.S. EPA ID Number
NA
11. U.S. DOT De3cripticn (IIlc/uding Proper Shipping _Name, Hazird ~ and ID Numbetj
d.
15. SpeciaJ Handling lnstnJc'jons and Additional Information
Mo.{wi'cJ ~Ji O[-/57,01°1
IJJ6 S4-71.,,
2. Page 1 lnform~don In l"le shAded ate.a:, I:, net ol requirod by Federal law, but b by Slate law.
riIT.ai:mllc'i[~~~~~:~::rzE~~i~1t,:::-;.
i~~t:·----._.,D~1~~~-c~~:?i~~6::ti.;_
-·s::~~-~~3-..:,:;.;.r..'.!';;1,~~~~:..~~
·-:~:r,~~'~i\;~
'" ' r?:.
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e.. Ci ENER.A TOR'S CERTIFICA TlOH: I hereby declare ai.at tho ccnLon~ 01 thla eoff.ign-.,.ti:ay and a.cc:un.111ly dHctib«I &bow bypropet' ahlppln~ name and ar• da.uiriaod P•Cked, markod. and \ab91od.and a,a In all ,_pecia In p,opo< c:.cndltlon lcf tn.naporttl'f hlgtrway-=c:0fnJng to ~pll.cabl• lntarne.dona.1.ild natlon&J gov.mm.nt r-.gulatlont. anc th• lavrni ol th• State ol Sou1h Cuollna.
F A C
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tt I am a l&rg• quanttty g•ne,.tor, I certify tt\.at I have• program In pl&.ee to raduai tha'IO!iune andlOEfc!tyofw..ateg~ted to Iha da,;r-I hev,a de tannin~ L0 be ~nom/C-11t') pnictic.abla and O\al I ha-aelocted Lh• pnt.c:tc.abl• method ol ~tmant, stor»Q-. or dbpoa.dc:urrency available to ma •hi~ mlnimlu,a th• pnsaont and tun.ira lhro.al LO hum.r h04.ltti a.nd Iha envlronmeneOR. 111 am a :amall quantity generator. I ti.av• made a good taill1 alkwttominlmlz.a my--• gianaradon■nd Ml act th• ~•u:t. management matl"lo<: tnat LI a-.,a.iL&.ble to mo and tti.t I can atfon:1.
~led/Typed Name
'..k'.A~p
•t L. ...... ~_._.lito. C I Il"'-
b I !Ito. d I \k 'f-c-c-::--.,,,---------------------------------------------~ 20. facility Owner or Operator; Certification of receipt ol hatardow rnaterlab covered try tt'u3 manilr$ e..teept aa noted In Item 19..
Printed/Typed Name · Signature f..(cnlh Day Ye.a
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South Carolina Department of Health
and Environmental Control
&uuu at Soild & Haurdou. W"-"" Mgt.
2600 BuD Slree1. Columbii SC Zl201 •
Phone (BOO) T.!4-5200
~ency & Holiday,: (803IT.l4-S.24
PL.EASE PRIHT or TYPE (Fonn d ned for u:se on eOte 12·Pitch Fonn Aooroved. 0MB No. 2050-0039 E.rolro, 9-30-88
UNIFORM HAZARDOUS 1. GonOlllto(aU.S.EPAIONo.
WASTE MANIFEST
lnlonnallon In the 1hadod Meas Is net
roqulrod by Federal law,butls by Sci1a law.
3. Genera!DC'o Name and Mailing Addnm . New Hanover County/ City
414 Chestnut St. , Suite
of Wilmington·
101 · .Wilmington,NC. 28401
4. ~erato(,Ph~ne 919 341-7139
5. Transpo,:,.< 1 Coo,oany Name ... 6.N Uj EPA Ill NW!lber
6. US. EPAID Number 7. Transporter 2 Company Name
o;r•~--.-.--~~•--r-Pllo&i<~'1)s.~:!h.~!l·~'n~~tr=-~
~;,:,-----•·ai:i;.~~..,!!:~JE§.fi½t~.
"Ff~Phol~~$~~l;:!:{;f?~J!fr
9. Oesignalad Facility Name and Sita Addr= · SRC 10. US. EPA Ill Numb«
Box 2005
Columbia,SC29202 NA
11 •. us. DOT De,cription (U1cluding Proper Shipping Name, H=ird ~ and D Number/
l'
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A
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I
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d.
15. Special Handling lnstruc5on, and Addiaonal lnlonnaaon \
~ CiEN ERA TOR"S CERTIFICATION: I h•r•byd.ciar■ lhat th• ccnlllnts ol thla conalgruMfflat11W, and ac:cura•IY d■ac:rlbed a.bo¥9 by prop« ahlp;:ilnQ nam■ and ■r■ i:Ju.alllad,
pac.kod. m&n:9d., and i..beled,and are In &ll rnpec;ta In p-ope, eondlt1on to, 1n.napartbyl'ughwaysccon1lng to ~plcabielntemadonal and nauan.J gavet'1'\fflenl r-.gulalloM and
lh• laws oi lh• Stata of Sou1h Catollna.
N 1 am• Wge qua.ntlty genar.t.of', I cenltythal I ha-a program ln pla.ca to teduca tt\41-.olumeanduddty ol wast. gitn«arad to a,,. degr-1 ha-,. det.ennin.-d io be ec.onom!c.aJly
pf'lld~l• and trMllt I ha'" .. 1.-c'lod O'I• pB.ctlc:.able mett\Od of tre.tment, ~., o, ~ aan-nCy ava!lable to me whld'I mlnimiu• u,a pr.-nt and fl.iGJB. thrMl kl hurNn
h-.Sttl a,,,d ui• environmont:OR, If I am• am.all quantlr., g~tor, I have made• ;cod t&Hn.aort.11:sm11'\Jml2:a my ..... g.,_.tlon and aetec:ltha bNl'lll'&.Ste man.eg•mant rncU'lod
ltl&t 1a aniiablo to rno and 1:1"1.at I can aftOtd.
L. C
Monlh Cay Year
I I
• LI .J..J....L.L~l!bs. C I Jlt...
b I \Ibo. d I !Ibo. i l'.2:::0:-.-;F:-a-ci:;:li:-tf-;Own:---,:-,:-o,:-O;c-pe-ra-to,--r,"'Ce:--rti::fi-ca",:-·o-n-o"'l_rece_,i:-p-to"'t7haza--n:!ou,-:---.,.---,--covor--ed-,,by-thio"·-.--,-,-axcep,---u-no-ted-:-:-ln-,llam--1-9.-----------'-----
Prinladnj?<d Name · Signarure Month Day · Year
I
a
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·~ South Carolina Department of Health
and Environmental Control
Bureau al Solid & Hazardous w..., Mgt.
2lllO Bua Slroe1. Columll" SC 29201 .
Pllcno: (BO:l) 734-5200
Eowg ency & Hollday,: (80:JJTJ4. S.2 ◄ . . . .
PLE.ASEPRINTrwTYPE (Formd~ nedfotu:,.eonmlte 12-oitch IVl>l••iteo 0MB No. 2050-0039 Exolres 9-30-M
UNIFORM HAZARDOUS 1. Gonoralet'1U.S.EP.t.10No.
WASTE MANIFEST lnformaUon In the shaded Meas Is not
required by Federal law, bulls by Stai,, law.
d.
l'
b. LLJ-1 J-1 J-1
15. Special Handling ~lrucijon.s and Additional information
¼}u,·~ ~Jo._ f>[ -t's 7 \
e.. GEHERA TOR"S CER.TIFICA TION: I her•by doclDra that the cant.en ts o! Dua conp;jn~t.,.. Wyand accura•ljd~ abo¥e by prop« ahlpclnv name and ara clua.l.fted.
P•Ckod., rnar'l,;9d_ and Labeled,and a,a ln &ll 1nP4"Cta 1n PfOpet' cond.1tlon lof1nnapartby hi;l'l....,accorcilng to ac,plc;abll91ntemadonal and natlon&I g~t "",lUlaliona and
th• laws oi trle St.I'-al South Catorlna. , · ·
HI am a l&rg■ quantity genetator, I certftythat I han ■ program ln pLa.c. to raoduoa 1N 'l'OIUIM a.t"Gmk:ftyofwastagenerai.dtc the ~, .. 1 hawi detarmlned to tM ecanGm!c.a.lly
pradieulla ~ U\et I ha-w-. Ml.eetod U'\a praC'Ucabl■ meinod or ir-m...nt. a10r-.;-. Of c,.~ ananay ■Yll.llabla tDmewftich mlniml2a• ~ pr..-ncand rut1..1,.. lh/Mt to human
ho.altt'I and tna en¥fronrnent:0R. tr I am a amall quantity generator, I hav■ mad■ a~ tuln .-flottbcln1miu m.y---o-n-aGon and ..i:ec:t tt\11 beat•a.st.e managam.nt meU\Od
lt\&I 1a •n.ilabl• t0 me and V'lat I can afford.
;l; M'7-::::::.,:;::::.:.,.:=,:::::.:~=:::.::.~::'.:!'.::'.'.,;::::::=::._-....,.,r,:---,:-~=---..,.,...---------..:....---:-:--::,----;=--;;:::-i A
N
~~~~::U~.,._,_.:L.!~4:.~::S:.C::l,..l:::L.._-,-__ ,:::L::,,e_...o..!::...C-,IS... __ ,;::.:~:l..lei&:lt..!.!:::l.L::==.:...----1.Ul...lti!.!::1.ll:~ 0 i r~=:7.~.C.-:7':-'====.::..::..:.::=:c:..:::.::==:....---,-:::-\li-----,,-_.l.J..-..,...-.l,::....,,l-,---:------------:cM,-o-n111:--;:----,y::-..,--:-j
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• .. 1 .................... , .... 111:,, c I , , , , ptn.
bJ , 111:,, d,_l .i...,.__._.__._.111:,,
•1-:-:--::--::c--::---,-------,----------------------------------'-----::: 1'2::0:.,. :'f•::o:::'J::,ity'::Own:--'--"':',':"or:::0::pe::::ra::lo::r.:::C.::::rti::·fi.::ca::ti:.:o::n.::o:.:lrecs.:::::ip::l.::ol:.:haza=::.rdo4::::::"':::.::ma::;:l.erial3,:.=:..::=~or~ed::_:byc.:lhi3::·:.mana.,,==:.:axcept=:::::u=-:no=bod:..::ln::bm=..:;19.:.._ ______ -:-::-::--::--:::-,v:::;-
Printednyped Name · Signature Month Day · Year
I
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South Carolina Department of Health
and Environmental Control
Bur-, cl Solid & Hazardquo w.,,,, M.t
2!iOO Bull S1ree!, Columbia, SC 29201 .
Phone (BQ3) 7:34-5200
UNIFORM HAZARDOUS 1. Generalot'1U.S.EP>.t0No.
WASTE MANIFEST
~ency & llolldays: (80:J)T.lol-S.24
Fonn Aoorov,,d. 0MB No. 2050-0039 E.,ol,es 9~
2. :,■;e 1 · lnlann1Uan In tho 1h&dod l<U> b not
required by Fedora! Law, but!> by StiLa law.
3. Gener.ila<'• Name and Mailing Add,... , .. New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · .Wilmington,NC.
4. G<ner.rlc(• Ph~ne 9.19 341-7139
28401
5. Transporter 1 Camoanv Nam•
7. Transport.er 2 Company Name
9. Oe5ignated Facmty Name and SiLa Address · SRC
Box 2005
Columbia,SC29202
&. U.S. EPA ID Number N A ·
&. U.S. EPAIO Number
10. U.S.EPAIONllllll>or
NA
11 •. U.S. DO_T Deocriptlan (including Proper Shipping Namo, Hazirri CJs.s,, ind CJ Numb«!
.. ~T;';1:;._ . ..,. ___ -'lgg~~~~
... -ati~~eP~t!.~~f~
a. Petroleum Contaminated Soil (NON-Hazardous) ~,.-cmrfii:'•a:r·~" G r• 1 I I 1 ,,,, ~ 1--------------------'----'---..;_---!~0.1....LOl+DLT+..LLIL2..LO!-Y-D-+~;?,,· 1~7:::1;::7:::1 7;;1;::7:l:,~;1_;
Ab. ~~ ~ ~L~J.:_L~-'--.1~ ~ r.c.:---------------------'----------t-..,__..,__t"..._t"..._..,__...,__...,__i"_f __ ".;;:_;=i =, =;=, =-:;,m;::•~---
'I'
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a. LL.J-1 I J ' 1-1 I-.:,. ... !"$;''
b. LL.J-LJ......!_I I !-!
15. Special Handling \NtnJction.s and Additional tntormation 1 ~~ wk Of~ 1~7 .o/~(
. . ... \A.)~ gJ\
·• . ts ·';t I I I I k:. -t>-· ------
e. CDIERA TO R-S CERTIFICATION: I her•bydodar• Chat th• contanb oftnia COt'l.lgn~.,. hJfy and a=i.,ra,111ly d•Krlb.cl abc-ww by pn:ipe, ahlpplng nam• and ar. clualll.d,
pack9d, marli:..:i. and Label~,and ata ln ail , .. pteta in plop., ccndlt1on Jo, ira.nt,p0tt't:lf tiJgJ'n,wyac:cordlng to appkat,i,a iramatlonal and naoon.J 9QYe1'T\ffl,,et\t ,.gulatlon.a and ~ la~ ot tna Stat. ol Socm C,.,oltna, ·
NI am a L&tge quantity ge,....\or, I centf)'tt,,at I haw a program ln pta.e. to raduce lf\a'fOlumaandlctdcttyof waa:ta g~i.dto OM; d.g,_ I haw d•tennJn.c! to be .c.onomlcslly
p.-.c::l~I• and tnat I ha-~ th• pn1c1:lc.abla mathOd ol ir-tnwnt. ~., or d~ c.awni:ty a...ailable to mi1 •hich mlnlmlua the p,....nt and fullJ,. tt,rwl tc hum.an
he.a.Ith a,nd the environment:OR. If I am a amall quantity gon.rator,J ha"W• ~• a goodta.lai eflortlDminlmiu myw_. ;-aUan and ..,.-dth• bat•a.ate managam.ntnM11'lod Iha!. 1a aYdabla to mo and aw.t I can aft'Ot'd..
Month
I I
;; 17. Trarupcn,r 1 Acl<J\awledgement al Rec,ipt al MaLarial,
~ Name Month
~ f:--=~==~~--:~:.A~~1:::!,,Z.,,-,--.,..,.--....lL_....f.f~22~~:___c:,.,,,:;.<:~~~..G-----~/J!. :....t=:...i.:~ 0 ;!r::;;::~~~::===:::=====~===:__--,-::-,---,--------...£.----l:1-------;-;::::;:'---;;:::;-~:::-
E A
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•J L-.J..JL...L.J...>! .... libs. C LI ..J...;L...L.LJI...Jl'"'-
b I , , , fibs. d I , fU,,.
'l=-::--::c-:::---=---~--,----,---,.,-----------------------------'----::;: 20. Facility Owner or Operalor, Certification ol rec-eipl of haz.ardoU3 mat.erlall covered by thi3 rn.anaim. e.xcept u noted In~ 19.
PrinLad/Typed Name · Signab.Jn, Month Day · Year
m
South Carolina Department of Health
and Environmental° Con.trol
llumau of Soild & Hallrd~u, WIUb! Mgt.
2lilXl Bull S1reet, Columbia, SC 2$201 .
Phone (80:l) 7:14-5200
Emergency & Holiday,: (80:lJT.14-~24
PL.EASE PRINT Of TYPE (Form d~ ned fat~ on elHa 12-itch 0MB No. 2050--0039 E.tt,l,os 9-M-U
I
I
UNIFORM HAZARDOUS 1. Gen0<1llDt'1U.S.EPAIDNo.
WASTE MANIFEST
, 9. Oiscr~p.ar.cy Indication _Sp.ace
\
lnformaUon In the 1had1d ..-e.as b not
roqulrod by Foder>! law, bulls by Stila law.
Ii, I I I J J I I fibs. CI I J J I J flt:,,
b I J J J J J fibs. d I J I ·' J I fib,. I 1 ~ l-2_0-;. :;:Fa,:c,,:·!i71y;:;O-.~ne-;r7:o-:--rO:"peC.:,.:ra:.:lo::.:r,..:Ce=rti:::.fica=tio:..n:.:.o:.:.l:.:==;p:.:l:::.ol:.:haza=::.:rdou3:.::::.:rna::.:;:teriab::==7'cove,=.::od:.:by:!..:lhi>::·:.:rnana.,,==.=except=:::::u:.:no=ted=ln::.:ltem::::,:1:.::9.;._ _____ --:c,--:---::--=:7
Printednyped Name · $jjnal!mi Month Day ··year
m
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South Carolina Department of Health
and Environmental Control
Buroau cf Salld & Hazardou, WUl!J M;t.
2500 Bull Street. C4lumbia, SC 29201
Pllooo: (B031 73-4-5200
Emergency & Holiday,: (803)7:!4-5"2◄
PL.E.l.SE PRINT or TYPE !Form desianed for u,e on ente 112-oitchl tvpewmao Form ADoroved. OMS No. 205C-00:3:9 Exoire:s 9"30-88
UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Generato(sU.S.EPAIDNo.
I I I I I I I I I I I
t.u.nlf••t 12. Paoe 1 llnformatlon In the shaded are.as ts not Docum<ent-,No. cf I . _, by F~ _, ,_ , , , , "', I requir= =••~ law, but~ by State law.
1 Generator's Name and Mailing Address ~~~~~;j~~;Jf!Ji\G~
~~=:~~~~,~~~~~-
New Hanover County/ City of Wilnington
414_ Chestnut St., Suite 101 Wilmington N.C. 28401
◄. G<ner.ito(s Phone f 919 l 341-713 9
5. Transporter 1 Company Name
Wi 11 ms Trucking 6. U.S. EPA ID Number =c.~~i~riri~;;•:;~i(.:;,irrt;i;~1,.::.:-;::2•.~:..
ri~:'timti'oai;::.'ti'~~~~~"".!~·-?ii~~~=!~t~~:.4~;::_72 ,N ,A I I ' ' ' ' • ' ' ' 7. Trans porter 2 Company Name 8. U.S. EPA ID Number E.~Trii~t&(Jt[f!O:~?~YiI~;:;~~±;::Ei~:f:3.;~=;i_
·F~~~-Phoi.i::.?~1~:_;0:::t~~~t.~~;•,•J!"t I ' I I ' ' . ' ' • ' • •
9. Oe.signated Facility Name and Site Addres.3 SRC Inc. 10. U.S. EPA ID Numm ~~~i~{~~1i~~l~i$~~2~1i
, ,-~~~t~l~~f.!i~1~1t~i{~I Box 2005
Columbia SC 29202 ..... ···--11'\P,, ',·,'''
11. U.S. DOT De=iption (including Proper Shipping Name, Hazard OsS3, 11/d 1ll Numbtrj 12. Container,
r
F
" C
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No. Type
' ' ' I ' 0 '
d.
.. . I O O 0
15. Special Handling lnstruc~orl3 and AdditionaJ lnlormation \
Material Code# 01-137-0101
he.. C:ENERA TOR'S CERTIFICATION: I h•r•by dec.J.ar• that the ccntenb cftt1l1 ccn»;~t.,. fully and accurw.ta1Y dea.crlbed at,ov-a by proper ■-hipping nam• and uo clus.ifiitd,
packod.. mario;od., and L.a~led.and ar• In a.JI 1-pec:u In propet ccndltlcn for tn.naponbytu;tzwayaccon1lng tc a;,pll,catll• lnt.matlona..l and nal!ona.l govemmantr~ulatlcru and
the ia-cl th.ti S1.&1-ct ScMm ~Ina.
tf I am • J.atge qu.,uuy genon.tor. I certify tt\at IN...-a program In placai to reiduoa 1he ~andllnJc:tyot •-'-ge.--al-9d to a,,. d~,...1 have daiann.lned to be ~ncmlc..a.Jly
pnictica.bl• and cat I ha"'9 ~ th• pnici=e.abl• meinod cf tr-tm•nt. atotaQ-. or~ o.an-en0y ev•il•bl• to me wh.Jc.'i. mlrtlntlu• the pnr..ent and tut\Jre mr11o1.1 to hum.an
ti-Ith and trle envlronment:-OR. If I am• ama.11 quantlrygonerw.lor, I hawe mad a a good taJZn etlort1Dlllinimlza my•--g--.Ucn and _.OC1 tt\a be.t wast. management m-o1:t'.oc a.at 1a •~ to me and ui..t I can anorc.
P~/Typed Name
. F--A.,/ Iv\ oY\ :)I
1 9. Discrepancy lndic.3tian Sp.a.ca I ( -'
,i / Monlh Day Yw
/L_./4 ,/,/.2.7,9,(
//
-l ( LI.,_, -1....l~L...Jlb,. C LI .J....l.-'-'--'''-'\ib.
!lh1. d I I'"'-
'I-::::-::--::-::-:::---=-----,,--,---------.,-,---------------------------~ 20. Facility Owner or Operator; Certifie3tion ol receipt of hazardou3 mat.erial, Ci:Nered by ttli.s rr.aMBZt except a, noted ln hem 19.
Printed/Typed Name I Signab.Jre Month Day 't'68
' I ' L..L
m
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R
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. . .. :·--~---·.#·;.. ... • •• ,.· .. ··~ ·.
South Carolina Department of Health
and Environmental Control
Bunoau of Solid & Haz.udou:i w..., M;t
2500 Bun S1r001. Columbia. SC 29201
Phooo: (BOJ) 73-4-5200
Emergency & Holiday,: (803)734-5-42<
PLE..ISC PRIHT or TYPE (Form desianed tor U38 on elite f12-oitchl tvoewritBr\ Fonn ADorovecl OMS No. 2050-000:9 E:xoir~ 9-30...g
CJNIFORM HAZARDOUS 1. Genonuc(sU.S.EPAIONo.
WASTE MANIFEST ' '
2. Paoe 1 Information In the shaded iwe.as ts not
of I required by Federal law. but 15 by Stile law.
3. Generator', Name and Mailing Address
N. C. 28401
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington
•· Genorato(sPh~ne( 919 341-7139
5. Transporter 1 Cvmpany Name Willms Trucking
Ii. U.S. EPA IC N.urnb«
A
'C..~~l'~a·D~:,;tJ/i',."¼fi~ti:5v';~-;,i:;:(~;
riJtfflJU0::'7s"~<,;~i'g{~ii~-;ttF~1:~~.r.:
7. Transporu,r 2 Company Name I!. U.S. E?AIC Number
9. Designated Facility Name and Site Addres.3 SRC Inc. 10. U.S. EPA IC Number
Box 2005
_ Columbia SC 29202 -·
11. U.S. DOT .De=iption (inciuding Proper Shipping Name, Haz.anl C!sSl, ind ID Numbetj 12. Coniainer,
No. Typo
l'
F
A
C
I
L
d. 'i~---.. -❖ ••• g,
' ' s\1 ~~~~~,~°":,t'\81
b. Lu-1 1-1 , _, .. •. r.t_;·.'".,.:-,L d.1 -'-I 1-1 ,,~ ,,,, ,';f,1.,.!?,e,,,,,'"3'"'''""· · · · · ___:__..: · --~ · · · -~~ ~ ,.,tt:~<t\;:-,-z-;f;2;1;f~~~,:;r;s:?Zt~,fiitL
15. Special Handling lnstrucUoru and AdditionaJ lnfcrmation
\
Material Code# 01-137-0101
wf) it.o9
8. GENERA TOR'"3 CDtTlF1CATION: I hare by doclar• Chai the contenb ol tnla et1nalg~tare fully and a.cci.,ra1111Y deacrlbed abowe by pro pet" ahlpplng name and ue c.J...,..J!'i.,_
packod, man:od, and labelod..and a,e In all ,_pec:ta In p.-oper condition !Of tranaportby hl;h-y &CCOt"ding to appl5,cacle lntematlona.l and n.tiQn-1 gaw-.mm.r,t r~ulaUona ar.
a,e laws of ?ha Stai. ol Scv1h Carol.In&.
HI am a lar,_io quantity gen.watM, I certltyth&tl ha-a prc,.ram In pta.c. to rwiduea 12\evolume andtaidc::tyof waa%11 g~ted to a,,. d.g,_ I h.eV9 det.arm.ln.d to bo eeonomlca1
prac::ic....bl• and au.t I ha .... Mloc\ad lh• practleabl• m.lf\Od of tr-tm•m.. stor.Qe. Mdlapcaa.l curnncy a..-..il&ol• to m41 which m.lnim!uls tti• p,.._r,t and f!JtlJra 1:tire.,,1 to hutNI
healtn and 111■ onviror,mencOR, It I am a~• quantltyg-....tor, I ha"• mad• a good tam, a-florttD =nlml.e my•--• g-.don and aeleci tn• be$.tv,~ man&Qomont ~
1tl.&t la availaoLe to m. and tri.a1 I can ancwc.
Slgnature Month Day Ye:
l, l -+? ~·
Month Day y~
19. Oisc:ep.ancy Indication Sp.ace
lib,. C I jib,.
lib,. d I lib,
''=---=-cc----,,------,----------------------------------~ 20. Facility Owner or Operator; Certification ol receipt of ha..z.ardou:, mat.eriab C0VM!d by thi.:s manila:t fUC.81:ll a., noted ln lttim 19. /
Printed/Typed Name ·,,,,... J Slgnstun, ~
/ ,;,//1 _jj,,,, j /)1:..
Month .·,
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South Carolina Department of Health
and Environmental Control
&.iniau of Solld & Ha=d~u, W..., Mgt.
2600 BuJJ S!roet. Columbia. SC 29201
Phone: (llOJ) T.l-1-5200
PL.EASE PR!h.l ot TYPE ·(Fann 'c!esicined for u::se on eUte (12-.oitchl lvPew1it:a.t
UNIFORM HAZARDOUS 1. Generato(•U.S.EPAIONa. WASTE MANIFEST
3. Generator',. Name and Mailing Addres,
New Hanover County/ City of
414 Chestnut St., Suite 101
•· =erato(sPh~ne/ 919 341-7139
S. Transporter 1 Company Name Willms Trucking
7. Transporter 2 Company Name
9. Ce.signaled Facility Name and Sita Addres.3 SRC Inc. ·
Box 2005
. _ .Co 1 umbi a SC ·_ 29202
Wilningtori
Wilmington N.C. 28401
6. U.S. EPA ID Number
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT De=iption (including Proper Shipping ~o, Haz1Ud ass,, ,nd JI) NumbOlj
Emergency & HolKi&y,: (BOJ)T.J.1.5-12,
Fonn Aocl"O'ted. 0MB No. 2050-0039 E.roir'° 9.JO--&s
2. PaQe 1 lnfonnation ln the ahaded eraas l:s not of / requinld by Federal law, butb by Stale law.
·c.~Stitai~jfl[)~~~:g$;5,f~~-~i:-t,?
0::(t~~Phoot-~~t~'"l~~~~~;t
t~T:mmi;.,i'"i:f::oc-?&!!}~~2'~~~~~~
·F;~Phcii.t1?~~.i.!t:z.~~~~:
Ga. Petroleum Contaminated Soil (NON-Hazardous) ~;"T"f'f"'0 ~R~b.:------------------:-_:_ _______ 1□::....cO:...L!lfD...1T7.J......l.......l!::2~0iY.'.cD::_f~~::..~z~.'::7:;'.;i£c.;:J7~,.~~!a~
:i I I f I lk~ i~~~------~-~-------------------+~~+~~JJJJ,-,~~~~!=···s'·~'=·~~,~~fhl-
~i)• \ l;l
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15. Special Handling lnstruclions and Additional Information , \
Material Code# Olcl37-0101
d. GENERA TOR~ CDtTIF1CA TION: I heraby dOO-r• '17'\al U'\e conlllnb c,fttlla ccn~n~ are tulyand &CCU~tal)' d•&Cnbed abov. by prep« a.htpclnQ nam• and aro da.uified. packed. in.riled.and labeled.and ar• In all ,.-pec:'tS in P"OP01' ccnd!Ccn lor tn.napc,rt by hlgtiweyaccordlnig to app.llcabie lni.m.aC0nal and nadona.19ow-em,nantr~uJaC0n.a and tti• la-.. o1 the State ol Souih C&roUr\L
If I am a largo qu&11tlty gen.,.loC',l certitythal I haw ■ program In place to Nduc. tho \'Olwne andl(RJcityol wasi. g~ lD a,,. deg,,_ I ha-detom\Jned to be eccnomlcaJly prac:ic:.a.ble ■nd trw.1 I ha'" -ieciad tne prac:lc.aDlo method al troatm•rrt, 110~-. or dt.poaa.l Cl.ln9nGY' rtall&bl• to me •hlc:h m!nlffll2ea the p1'9Mnl and tuture a,,_1 to hum.an hoa.lttl and tho envlronmOt'\t:OR. 111 ■m ■ ama.11 qu■ntlty;onerator, J ha"• mad•• good tal'ln 9'f\cxttoaanuniD my wN• g~tlon and aeleclttlo bea«wa.t.e ma.nagomont mwu-,od tn.at la availabl• 10 me -.rid th■I I can anon:1. ·
19. Discrepancy Indication Spac.e
Month Day
/,/ 2,0
I ... , .1.-1...L..l..l-Jllhi .... , ....,__.._,_.....,!Ii:..
b I \lbs. d I \lbs. JL •f-:-,-=--=-=---------------------------------------------1 ~ 20. Facility Owner or Operator, Certification of ~ipl cl haz.ardou:3 m.atsrlal3 cove,-ed by thi., ma.niftm e.xcept a, noted In Item 19. Mllr$ IJ~? P _t{c ~ & V re /J A (1110 7j; /JA ,eA c:::::,. =---,,-,.,.. ...... ,.
Month Day YIW
I /./ 1.:7 . .¥I 9.,...1
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South Carolina Department of Health
and Environmental Control
Bun>au al SoUd & H=lrdou, Wa:ts 1.4;1.
2600 Bun Slroet. Columbia, SC 2'.l201
Phone: (BOO) T.l-1-5200
Emergency & Holiday,: (80:J)734-5'24
PLEA.SE PRINT 01 TYPE (Fonn d!'!Sioned for me on eUte f12-citchl tvpewmeo Form Acoroved. 0MB No. 205Q..-0039 &cite, 9-JO-& UNIFORM HAZARDOUS 11-Generator'aU.S.EPAIDNo. WASTE MANIFEST , , , , , , , ,
Manu-tJ ... 12. Page1 !Information In the shaded Me.as Is not
, 1 1 .~;n-:'b~Lfl al / requiredbyFederaflaw,butlsbySti~law.
3. Generator'~ Name and Mailing Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generator', Ph~ne ( 919 341-7139
S. Tran,poner 1 Company Name
Willms Trucking 6. U.S. EPA JO Numbo< C:Stitai~8 .. tf:~~;g--4;)Attj':i:ii?,3:,)-'~~£_:\'5';-;;.:
J'l ,A I ' ' I ' ' ' ' ' ' DXtiii.UW-liw'-isPhooi:t'fi:0:f!;,V~:5.r.::~~~~'f.~,~;~,';
7. Transporter 2 Company Name 8. U.S. EPA ID Numbo< t~~~ltSdiOOitb{i'D'.'!1!~.Y.:f!-::.:;:1?~-..::~f:d.'::~~::~_i
"Ff-~,~-~t~~~)':~~::=.~-~~~~t-
9. Oe3ignated Facility Name and Site Address SRC Inc.
Box 2005
Columbia SC 29202 -···
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10. U.S. EPA ID Number
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11. U.S. OCT De=iption (including Proper Shipping Name. Hazard Clas,, and ID Numbe,j
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12. Coniainer,
No. Type
G a. ;t;·-N••rzrj~~ E Petroleum Contaminated Soil (NON-Hazardous) \~ @
ir.b.;------------------------------iO::...c•'0::...1;•l:._pD::..1.•T7"_L'.l'-1'2::.J,~'OfY~D--j@'•;~~;:~.1.~,:~7:::~-?:,,;::,:;;;,~~~ft
A ~ ~ ~ f-:c.:-----------------------------------J:--'LL't..J'L...t--''-'LL'.J'L...t---r.~;;;· ;t:I ::· .. ~l~t::~~1--f}{. ill ... ,_,__,__,___., f:
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is. Special Handling ln.structioru and MditionaJ Information
\
Material Code# 01-137-0101
~ 8. G~ERA TOR'S CERTIFlCA TIOH: I hereby deciar• tnat ttui1 contanb of thl.a conUJn~.,.. tuayand &.o:::un1a/y dHcriblld abcYa by pro pet" I.hipping nam• and are c.!u.a.il'i..:I. paclr.ad., m.an.:er::i. and t.bel.d_and az• In all,-~ 1n pro.p.r condl~on fortn.naportby Ng:tawayaccorc.1n; ta appllcatiie lni.mat1onal and nalional gOV91'1\ffient r'99ula~oru &11d V'I• La'lln, c1 ll"I• SLata of South CMo,tln&. I ·
111 am a lug a quantity genec-alor.1 certify U\at I ha.Ye a program ln pl&ca ta 1'9Clucaa,a't'OWtneandlQ:Llc::tyefwaazageo«alad to the deg..-I ha,... dei.nnlned to be economically pni.C:::ca.bl• and ~t I h.a-Miec:ted U,o pnactic.acJe ITMO'\od of treatment. ac~-. or dl:aQ,oa&J cun:ianay ...-.Jta.ble to me whlch mlnJml.l..n• Iha p,._nt &nd h.Jti.Jr• throat 10 hum.an h-.lth &nd O'le envlnJnm9nt:-OR. n1 am a affi&IJ quantity gen.en.tor, I have mad■ a good tatln etlorttaJrW'Ufflla my--• g_._.a:on and __.act the ~•a.st. manag11m1111nt m.u-.od l;hat I.a available ta me and ui.t I can afton::I..
ISlg Jun,
!lo '9....-. -. .....;J c2 Month Pay Year -i I,/ .z. q, <;;,c. T 17. Transporter 1 Aclcnowledgement of Receipt ol Matariab ' / ~ t-P;:;--M,:-:. i.<1-:--:-;:/T;-yped-:-:Name::----'-, --k.---'---tO--_-_,.,., IS::-lg_na/un, ___ 7,---,--_-1--,-.--A-,--,fr,_,,v----'-----1.4:-:-o-nth:,---::-Oa-y-;;-~:-:-:-i 1-,,,---,,...,...,=D~~~IV,:!I!, /t,'!)2£11 Jou//1~, J,~-£-H~ ,l..____!::."'~~ r--~· 1(i£:!_ ,.,.J:,L:....Jl IL_:. -·d,J --h~~•'-±.i~:'..._ __ .1Ll!.i.,.IJ l•;;J.j,--J.k:L1..!.'t (( o 18. TransDCr.er 2 Acknowledgement of Receipt of Materiais ---. ; r--P~n7s~,t~-:,l~T~yped-~Nam-,--•--''-----'--------r:,1&~9-~-~-ra-----------------------,-M~c-n~.,--::D-,y-~Y~..,~
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19. Cisc:"epanc:y Indication Space
't::-=-:--::::-::---::-----::--:-:--::---:---:-,-,----,----,-----,-----------------------~ 20. Fac:lily Owner or Operator; Certification cl receipt ol hazardOU3 materiall covem:I by thi3 manile:st ex.capt !.3 noted In ftem 19.
Month O.:,,y Yeai
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South Carolina Department of Health
and Environmental Control
&u.au ct Solld & Hazardou, Wa3!0 t.lgt.
25XJ Bull Slroo1. Columbia, SC 29201
Phone: (Bro) 7J4-5200
Emergency & Holidays: (803}7J4-Sol24
PL.E.lSE PRINT Oil TYPE (Fonn deoioned for u:sa on eUt8 12-oitctll tvpewriterl Fann A:lcroved. OMS No. 205IJ..0039 Excire:s 9.-30-8.E
UNIFORM HAZARDOUS 1. GeneratcfsU.S.EP>.tONo.
WASTE MANIFEST
:.t Generator's Name and Mailing Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Gener.ito~, Ph~ne I 919 341-713 9
S. Trans.porter 1 Campany Name · Willms Trucking
7. Transportor 2 Company Name
9. Designated Facility !'-lame and Site Address SRC Inc.
Box 2005
... Columbia SC ... 29202 ..
6. U.S. EPA 10 Numb«
A
8. U.S. EPA 10 Number
. ' '
10. U.S. EPA 10 Number
I I
11. U.S. DOT De,cription (111ciuding Prop« Shipping Name. Haz3nf Class, ind ID Numb,,j
2. Page 1 Information ln the shaded a,e.as l:s not ct / n,quinid by Fedora! law. bu1 Is by S'-to law.
-ci.~i~fuj~;,ti,.=.;,1'1.,q~t:-$V'.;FE.;:~~>.
"ff?tAti-.io&+i.?.~~~!t!~~-~7r..~;;~~~..p:;:~::
E.~TnitmtatAtf·rtf'S:!!!~1C::--t::~ltt~~f:ni
"F!.~~;::4-~~;:3~:;;+~i.~.f!;i
12. Contlinffl
No. Type
G a. Petroleum Contaminated Soil ( NON-Hazardous) ~rT'ft';;;
E O O 1 D T 2 0 YD ¥.tt?l?l]l?J~ i r,b.;-----------------------------------t~~l..:.f...1.!i_J-L.J.:::...C:4:.!:.7~fu~iLH~-~i-~--=-·;Z-:l:\~ ...... ~,t-,L~\.
A -~ t ~ rc.=---------------------~---~--------J-LLt.l.-t-lLL.L.l.-t--'H~~g:t~·:::· -~.1..~,t-~,-::!:,·-;fi:
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15. Special Handling lnstrucior:1-3 and Additional lnfonnation \
Material Code# 01-137-0101
e. GENERA TOR"S CE..RTIFlCA TlON: I hereby doc.i..re Chai the cont.anb of ttll.a eonal,g~ara tuayand ac:un1•J'f deacribed abova by prep« ahlpplng nam• and are da.,.a.itiec:
packod,, markod, and lab.led.and are ln all r-pec::a 1n p(opet c.ondll:1on for ~apcnt,y ~rr..yac:con11ng to appUca.bl11 lntemat1onal and natkinal govemmentr...,ulatlcra an,
the I.a-o1 the State of Sove1 C&n>llna.
1
tt I am a lasge quantity genotator, I c.rUry tn.t I ha-a prog"1n In pl&ce to r...::h.,1c., the \Odumeandlo:dc:tyof wastagon.n."9d 'tD Ola degr-I ha..,. dei.nn.tn.cl to b<'I .concmlc.all
pl"llctic.abl• and Iha.I I have -loctod tne practlc.able m.tnod of tr-trn•nt, .C.O~ll. 01' d\l.QoM.I cun-,oy ...-.JL..ble \0 me •h!c.'l mlnlmu.Ga th■ pr.eent and tu a.ire triro,at to !'\um.&. he&.ll:handthaenvtronmoncOR.lflam■amallquantltygenerator,lha'temacleagoodtattn•ffcl1tz::1mlnitnlnmywaa•g---.donandael.ctttLeb<nl:wacamanagam•nlm.a-.o.
~t la •~'la.Die to in-, and l:ha1 I can afford.
(!_/,,., r,, J, J t<'.... c4J Month Day Ye,
L. I.I ' ,,
' 1 Acknowledg t of Receipt of t.lateriaJ3
Name Signatura Mondi Day y.,
{?_ /z_ 'i'
1S: Trans rter 2 ACXl'lowted;ement of Receipt of Materials
PrintedlType<J Name Slgnatura Monm Day y.,
19. Oiscrep.ancy Indication Space
1 LI ..U...L.l..J lib,. • 1 ' pt:,,
bJ lib,. d I lib,.
<J-:,,,.-,--.,,,.-----------------------------------------~ 20. Facility Owner or Operator, Certification ol receipt of hai.ardou, maleriab covered by ttlil a-.ani!e:slei.c.ept a., noted In Item 19.
<ed/Type<J Name Month Cay y~ le /;rJ?..J::'i ,, I I -~
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South Carolina Department of Health
and Environmental Control
8urNu of Solid & Hazardou, Wa.m t.lgt.
2&lO Bun Sll'oot. Columll;.. SC 2S201
Phooo: (803) 7:l<-5200
PLEASE PP.INT ot TYPE (Fann de:,ianed fer u:se on eilta r12-01tchl ~1itai1
UNIFORM HAZARDOUS 1. Generatc(aU.S.EP>.IDNo.
WASTE MANIFEST
3.. Generator', Name and Mailing Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Gen=10;,,Ph~na/ 919 341-7139
5. Transporter 1 Company Name
Willms Trucking
7. Transport& 2 Company Name
9. Designated Facilit-f Name and Site Address SRC Inc.
Box 2005
Columbia SC .29202
6. U.S. EPA ID Number
A
8. U.S. EP >. ID Number
10. U.S. EPA ID Number
· 11. U.S. DOT De=iption (including Proper Shipping Name. Hazard CJ;is,, ,nd JO Numberj
a
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15. Special Handling lmtruclions and Additional Information
Material Code# 01-137-0101
lv--£.3'iJ7l3
Emergency & Holiday,: (803)734-s..2,
Fonn Accl'0V'ed. 0MB No. 2050--0039 El:oire::s 9-JO..
2. Pagel Information In the shaded 1<e.a:s b: n1 cf \ required by Fede~ law, bul Is by S!ata la,
=c:~.·S:tt;;+Mu...:.a;'iiii14 ~ D ;r"::F.1:i;:,-cy;1~~B?1;:~:;D.~
1:f~t'81-wi.Q.S~~~~!s"\~i~tttt::~~t~,:#~:
·t~t"_w, ... ,~--i"'t'.fl-a~l&~1tI::z:z►?ii:i£~:
F:.:~~;~~~G:J~!!;l'~i-~i;::~~.r
12. Container,
'No. Type
.,_,: w·.
,fj1 I 1
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8. GENERA TOR"S CERTIFICATION: I h•reby doc.lare U\al U"I• conten~ of this eon.,;g~.,.~&nd aa:u~•IY daacrlb«l at>cv,a by pn:ipe< ~Jpplng name and ara c.J&..Ulf.
pecked, manted., and labeled.and ar• In all ,npec.a In P,O;>et' condition fortrviaportt,yN;n-..yacc0f'dlng to &p~e lntamatlonaJ and na~ 9ov..mrn.nt r~uladona;
tn• la~ 01 tt\a State of Souin Ca.tollna.
tf I am a large quanl:1ty oenenatof', I oertlfy tt\atl haY9 • p~r..-n In pi..c. to r.tuce tt1e wolum.andadaty6t waaia getWr&tad to tn.e da,g,_ I t,.a._,. determined to b,a .c.onomlc.
S,1'c::i~I• ar\d ttt.at I ha'lre -leci.ed tne p~ctlc.able rnetnod of troaan•nt, .so~-.ordla;loamc.unwtlly Jvaii.~e to me wNc.h mJnlm1%.na Che p.-...n1 and tuture aira,al to hur
h-Ja, and tt'I• envlronment:OR, It I am• small quantltygencu-ator. I hav• made• good tam, etlorttoa:1Wmlz:e my .. aa11 g~don and ..iec:t: tne beat wa.ate management mot tnat i.. •~ ta ma and 11'\&1 I can anons.
;;,,led/Typed Name
4' /)'I-en-, /l
T 17. Transporter 1 Acknowledgement of Receipt of Matariai, 2 t---;;-n:-.n-:-led-:-:/T:-y-ped--:-:Nam,,---e---=------'--------,--=,-------,,,,...----------~-----,-,--,:----;::---;\
~ o,1v;/1.C.
0 ~ f----::c-,---"-'-=::..:C,,-'-C:...:"--=.:.::c:.:::.::.:.:.::.:.:::::.:::.::=;;.:::.:.. ___ ~5'-g_na_o,~,.'-'....:..-....:.. __________________ --:-1,(:-o-n-,-l!l-::0-ay--:
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19. Discrepancy lndic;Jtion Sp.ace
'1-:c:--::c-:c--::---::----.,,,----------------------------------------~ 20. Facility Owner or Operator, Certific::ation of receipt ol hazardous · red by thil.manifa:st led In ttem 19.
Print.ed/T Name ·
!RR R ~ Cl:I? ,/
Month Day
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South Carolina Department of Health
and Environmental Control
l!un>au o1 Solid & Ha=dqus w..., l.!ijt.
2li00 Bull Stroot, ~umbia. SC 29201
Phone: (B03J T.l-4·5200
PLEJ.SE PR!Hi or TYPE (Fonn de:sianed for use on elite f12-oitd'll t-.,:,en,ite.1
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator': Name and Mailing Address
_New Hanover County/ City of Wil ni ngtori
414_ Chestnut St., Suite 101 Wilmington N.C. 28401
~-Generator's Phone( 919 341-7139
5. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facility: Name and Sita Addre:s.3
SRC Inc.
Box 2005
.Columbia SC 29202
6. U.S. E.0A ID Number
A
6. U.S. EPA ID Nurnbel
10. U.S. EPA ID Number
11. U.S. DOT De=iption (including Proper Shipping Nams. Hazard Class, and Ill Numbet/
Eme,gency & Holiday,: (SOJ)J'J-1-.5"24
Form Aooroved.. 0MB No. 20.50-oo:?9 Elcira, 9-JO.-·
2. Paoe 1 Information In the sh.aded Maas b nc
al / required by Federal law, but ls by St.to i..,
c~-§it.1-i":UW'&'.IS~ri~:r.~'J.i:::;)'¾<et~v;;;.::2~·-~
07timtwhl<iiPhOOi\$;~'t{~i~~ti~!!~r~;~-:.
E.~T-.,.,-~,~-ItHzy;~1£s:;a~J;::t.,-:if~~~;
·Fr~Pho(;.·~?~Wj¥J;..41':Z~}~:t:~.:.:i...,.~'":f
12. Contain.,.
No. Typo
~ a. Petroleum Contaminated Soil (NON-Hazardous) ~,-~--('·•
N 7--------------------------t0~0::..1.:l~D'...l!.T+.LLJ.:2:..1::0TY.!:'.D7-~/j~p~17=1~7t1~7~1 ~ lb. ;r-• . -;-.,.
A ~I I
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C. w, \~! '--.l.....l....-1.....J
-~~-'~ '-·-··-·-·'
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15. Special Handling lnstn.Jc:ioru and Additional lnfcrmation \
Material Code# 01-137-0101
e.. GENER.A TOR":i CERT1F1CA TION: I horeby doclar• that tl'lo contenb of In.la c:ona.lg~ara tuty and accuratafy do scribed above by prop« "I-hipping namo and are c;Ja..u.il
packod.rnarlcod.andlaMl,-d.,andazoln&Jlt-pectal.np<Opof'COndlU0nlortranapor1t,yhlghwayaci::o,d.lf'lljjltoapplicablolmam&J:ionaJanclMUOnal90'1'9fT\tM!nlr1"i,UlaCon.a.
r
tho La-.-of ti""-State ol Soull"I CaroUna. i
tr I am a lotga quanuty gonon.tot", I canity th.al I have a p~"'" In pla.c-e to reduc.lho'IIO!ume and~of w..c. g1NWBl.ed to tr\a d1"i,t-I hawi determ.lned LO be economic
pra~~I• and that I ha--lectod th• pract1c.abl• rnattlOd ol ti-tm•nt. star.go. ot dlapoaa! cun-onl1y ...-.Jl&blo tom. whici\ tnlnimlz.na tho pr-..ent and tutu re tnroal to l'\u1
health and tno envln:inmont:OR. 11' I am a am.all quanl1ry gonera.LOr, I have made a good taan ot'lonu:i mJ.nlm!i. mywaa• g..,....11on and M'lect tho ~'Wut.o management m.t
ai..c ~ avai.J.abl-e LO me and that I can a.ftoni.
Day ' z.q,
.T 17. TransPQrter 1 Acknowledgement of Recei~t of Matariais .,,.....
R f-C','-:c-,-'-C-::,-'-'-,-'=---'-===:..:..::=====--'-.,----,'-'-'-·------..,..~------------Month Day j bP-::-ri#n+ft..t.@_~~~~!::,d~•_,..!:!L2'.~L.....,.----,----1..s_1g_naJura_~/1,,.tp4¥c-::!:,:!,,2!...._~!:::::::~~-----.L!.l.1..LI I I J'l C
~T 1--'1::.a.:..,:.T:.:ran=spc::.:crter=.:.2:.:A.::cl<l\=o:.:w:.:led::.,:g:.•m=•n:.:t::.o:.:( :.:Rece:=c:;~=-=o=-(::.l.!a==te=-ria!==•---~-----.....!/1..I _____________________ _
E Printed/Typed Name Signature Mondi Oay
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19. Oiscrepanc:'f lndic.ation Sp.a.cs
If-,------------------------------------------------::: 20. Facility Owner or Operator. Certification of receipt of haz.ardou, mat.eriab covered by thi3 manifest e.xeept u noted In narn 19.
"ltl!:?3i!!l;r: f}
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South Carolina Department of Health
and Environmental Control
llun,au of Solld & Hawd~u, w..., Mgt
2600 Bull Sir""'-Columbia. SC 2'3201
Pilon« (BO:l) 7:14-5200
~oncy & Holiday,: (l!Ol)J"J.<-i.2,
PL.E.ASE PRIST 0tt TYPE (Form desianed for use on eOte 112-oitchl tvoew1itm\ Fonn Aooraved. OJ.CB No. 2050-oo:!9 E,o;,:,, <l-30-U
UNIFORM HAZARDOUS 11. Genoratc(aU.S.EPAIDNo.
WASTE MANIFEST , , , , , , , , , , , ~:!!n-:iNo. t2. :,i99l lln1of!Ut10n In the shaded .. a.as ·1.s not , , ."i' .;.,":LIi I roquiredbyFodarallaw,butbbyStatolaw.
1 Generator's Name and Mailing Addre:s.5
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generatc~sPh~ne( 919 I 341-7139
S. Transporter 1 ~mpany Name 6. U.S. EPA ID Number Willms Trucking ,'l ,A I I I I I I ' ' 7. Transporter 2 Company Name 8. U.S. EPA ID Number
I I I I ·, I · I I ' . '
9. Designated Facmi Name and Sita Addres.:s 10. U.S. EPA ID Number SRC nc.· ·
Box 2005
Columbia.SC .. 29202 .... ,t'\f\,,,,,
11. U.S. DOT Description (111cluding Proper Shipping Name. Hazud Clas,, v:d ID Numbetj
d.
15. Special Handling lnstrucdon.:s and AdditionaJ lnformation .
Material Code# 01-137-0101
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h 8. GEN ERA TOR'S CERTIFlCA TIOH: I her a by dOQ.J.are !NI.I U'le contenb ol tnla ccn,J.;jn~tare tuey and a.ceun.111lyde11Crlbed abov-9 by prcpet" a.hipping name and are da.ulfied,
packed, m.a.tXed.a.nd labeled, and are In all ,_p,ecu In Pf"opet' condition fortnn,apor1 by high.-ay a=n1.!ng tc applk:able lntam.don&I and naoonal govemm.nt re,;utatlona and
U,e laW3 o1 tne SLD.ta ol SouU"I Cuoiln&.
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HI am a W,;;ie quanUty g•nefWitor. I c.rtlty that I have• progrwm ln pl.aca to r•ch,101 tneYOlume andlic:Ducityol wasiag--».tadto Che da,or.. I ha,.. detannlnecl tot,,. ec:onomlcally
pnic:ic.&ble and O'\.al I hav. -MtC\od U,e pradc:.abl• meai.od of ~tm•rrt, 110~-. Old~ curranay available lei me whlcn m!nlmlua tne p,....nt and tut\Jre tnr .. l to human hoaltl'1andttioonvlronmontOR.lflam■.ama.llqua.ntltygenerator.lh&-wemad••~oodt&:tneflofttominlmiz.amywaa•g~donandMiec:ttrte~wu:tama.n.agementrn,e'tn0d vat la available lei mo and l:h&l I c..an a1ton1.
P!i1>¥1Typed Name
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~ H. Transp'<)rtet 1 Acknowledgement of Receipt ol Matariab
~ 1,..-,P~•ted!Typed Name
;': ',-{,. ,,4,ec!_ 1.,J:.l /,',4,..:;
~ ia Transpcr-..e.r 2 Acknow!edgement ol Receipt ol Materia.b J Printed/Typed Name
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19. Dis.c.repancy Indication Space
,
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,,, /} Monlh Day Year
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Monlh Day Yeai
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I r.,:--::--:;::-;;---,:---,--::-:,:--::---:---:-,-:-,-------:-,------,----:--::-------------------❖ 20. Facilit'{ Owner or Operator; ~rtific:ation of receipt of hazardou:5 mat.eriah covered by lhi.s m.ance:st except u noted In ttcm 19.
Jft/;plJmiJl-1/'CJ. ,? Ch/? t/ I~~, h_ r Y1' Monlh Day y ..
m~---. r,, m .. South Carolina Department of Health
and Environmental Control
Butaau cf Solid & Ha=dou, Wa.,to Mgt.
25Xl Bull Sb'eet. C<>lumbia. SC 292\ll
Phone: (803) T.l-1-S."OO
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Erner.ency & Holiday,: (II03)734-5424
PLEASE PRINT ocTYPE (Fann dcianed fcru::seon eUte r,2.oitc:hl tvi>e••nBl1 Fann Accroved. 0MB No. 2QS0.0039 E.toir~ 9-30-U
UNIFORM HAZARDOUS 1. Genor.Uc(sU.S.EPAIDNo.
WASTE MANIFEST
2. Paoe 1 Information In the shaded ate.a, Is not
cf I roquinldbyFodoraJlaw.bulbbyStatolaw.
1 Generator's Name and Ma.mng Addres, Wilnington
Wilmington N.C. 28401
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New Hanover County/ City of
414 Chestnut St., Suite 101
4. Ge,,erato(!Ph~ne( 919 341-7139
5. Tran.sportef' 1 Company Name Willms Trucking
7. Transporter 2 Company Name
9. Ce.signaled Facility Name and Site Addres3 SRC Inc.
Box 2005
___ Co 1 umbi a SC . 29202
8. U.S. EPA ID Numllor ,A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT De,cription (including Proper Shipping Name, Hazard C:,,S., 111d ID Nun,bo,j
a. Petroleum Contaminated Soil (NON-Hazardous)
b.
C.
d. .. ..
15. Special Handling lrutruction.s and Additional lnlonnation .
Material Code# 01-137-0101
·c:.~~T~f D -~-;f.~2<~;:;.;pi;:,.:.;;1J'~f:i..;:h:~. l
if~.tAE..&.w'i·Phoo.~~'t£!~?i~~~~~t~.'.~~-=:t.~1;
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12. Contain""
No. Typo
0 0 1 D T 2 0 YD
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d. C EN ERA TOR'S C~TIF\CA TION: I horoby doc.J.ar• th.al tn• conteno. cfthla c.an~tatll fultyand a.c:0Jl'llllll,i dHcl'ib«t abov-e by proper a.hipping name and are d...:i.&Jfi.,
packed, marked, and 1.abeled.,and ar• ln all ,_p.cta In ptopercondltlon let tranaportbyhl;:r,w_,. accon::tlng to appllcablo lm.matlcna.l and natk>nal g~nt ,.._,ulatlona an
a,e law-3 of tr\.-Stata of Soulh Carolina.
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NI am a l&1g11 quantity genera tot, I cartitythal I haY9 a program ln pta.c. to reduc. lhevolume and1Ddc:tyofwaata goiwr.i.dta ct,-d.;rN I l\&Y9 daiennlnad to be oc.onomlc..i
pni.c:ic..;abla and tn.al I ha--lec\ed tno prac:lc.aolo m.1:1'\od of treatment, a10rago.or ~c;unw,Cly avaltab!e to me whlc.., minlmtza1 th■ p,.._ntand turura airo.at tD hum.a
hc.alttl and the onvlrcnmont:OR.111 asn a ~I quantity gen.n.tor, I have mad■ a good tam iaftartmo:unlm!u my w-• g~don and .-{ect th• t-.t wa.sta m.anagomont rr-,,.a,.c
tnat i. ava.ilablo to mo Wld in..t: I can arl°"1. . . , . .
/Typed Name
M-<MJ> L
~ 17. Trans rter 1 Acknowledgement ol Receipt of Materiais
;'.; Jjrinted/Typed Name ;:II, ~ l=rw~ C rrU-1< '",,, .,; ,~ 1
~ 18. Transporter 2 Acknowledgement cl ReceiDl of Material,
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South Caroli~a Depa ___ -, _ent of-Health
· and Environmen -· -, Qntrol
'
&niau of Solld & Hazard~u, WC!B M.t
2!l00 Bull Slroet, Columbia. SC 29201
Phone: (BO:l) 73+5200
Emergency & Holiday,: (800)73+5-424
Pl.EJ.SE PRl>-0" « TYPE ffonn desi ned for U38 on eUte r12.0rtchl ~
UNIFORM HAZARDOUS ,. Genera10(sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Mailing Address
New Hanover County/ City of
414 Chestnut St., Suite 101
4. Genera to~• Ph~ne / 919 341-713 9
S. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facilit'[ Name and Sile Addres3 · SRC Inc.
Box 2005
: Columbia SC .29202 .
' '
Wilnington
Wilmington N.C. 28401
6. U.S. EPA IC N.umbor
A
8. U.S. EPA IC Number
10. U.S. EPA ID Number
11. U.S. DOT lle3cription (including Proper Shipping Name. Hazard O.S., and ID Numbetj
Form AD0roved. 0MB No. 2050-0039 Excire:s ~
2. Page 1 lnlormaUon In the shaded ateas t., not
of / roquirod by Federal law. butb by Slate law.
·c~'sta1aiOOiioo'iii?* .. D~..il;;-4~~~!~~-
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15. Special Handling ln.stn.Jctioru and Additional Information . \
Material Code# 01-137-0101
e.. GEN ER.A TOR-S CERTIFICA TlON: I h•r•rI'f declar• that ll"le contents ol uita ccnaign~ .,..W,,,and a.ccura•}y d•acribed ~ t:ry prol)9r shipping nam• and are C:u.a.il'i9d,
P•ckod. marked, at'ld labelod.and are ln all 1-peea In proper c.ondlUon IOt"tr&n-.portbyhlgl'l...,.ac:cordlng to ~pUcable lnbttneUona.t and national 90'YWIT1fflentr.q1.1ia!l0na and U'le la~ of thei S1.ata ct Souih Caratlna.
n I am a 1.,.ge quanuty generator. I cairtlty ai..t I have 11. prog,-,n ln pt.ac.. to reducathe volwniaandlmuc:tycf-..:t. genefalad to tt'lo■ de,gree I ha,,. da1-rmln.d to bo econcmlcally
prac:i~l• and tn.l I ha,,. -Leciod tl\e prac:tlc.abl• matnod o! traatment. stor-oa.or di..pc:uJ curnf"ICy rB.!Labl• tom. ._hlch rnlnimiz..as aie p,...nt and rurura airMtto hum.an
h-..!th and th• .,,.,lronmontOR.11 I am• amaJI quantity genen.tor, I have mad•• good tann eftorttDllll.n.lmtz. my--• g-.don and a,9'~U'l• bea.lw.-. management rn.U\Od
that la avail&cle to me and 11\111 I can atlcn::I..
PPJ:!,!;,ype,J Name ,,_,c/4_ Month Day Year
I rn,on~ L C 3",e___ I, I -4 L
17. Transporter 1 Acknow!edgemenl of Receipt of Mat.eriab
~fTyped Name ·
,?9 J ll L .5 UM-?
18. Transporter 2 Acknowledgement ol Receipt of Material,
Prinled/Type,J Name Month Day Year
19. Discrepanc-1 lndication Space
•! I lib,, C I 11"'-
b! lib,. d I 1io..
20. Fadli~ Owner or Operator; ~rtification of rect;1ipl of hazardow; material.3 covered by~ manilesl: axcept a., noted In hem 19.
~!,T~Name ,;;;, ~ I • ../.f? Mcnth Dav Yoa
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South Carolina Department of Health
and Environmental Control
8uroau of Solld & Ha=d~us w..., Mgt
2Sl0 Bull Stroot. Columbia. SC 2'3201
Ption« (BOO) T.l-1·5200
UNIFORM HAZARDOUS 1. Gonorato(sU.S.EP>.IONo.
WASTE MANIFEST
3. Generator':s Name and Mailing Addr~
New Hanover County/ City of Wilnington
414_ Chestnut St., Suite 101 Wilmington N.C. 28401
4. G<nerato(, Phone ( 919 341-713 9
S.. Transporter 1 Company Name Willms Trucking
7. Transportl!r 2 Company Name
9. Designated FaCllity_ Name and Site Address SRC Inc.
Box 2005
Columbia SC .29202
6. U.S. EPA ID Number
A
B. U.S. EPA ID Number
10. U.S. EPA ID -
11. U.S. DOT Dewiption (,nc/uding Proper Shipping NamB. Hazirrf C:.S0. ,nd ID Numbetj
d.
15. Special Handling Instruction, and AddiDonal Information ,
Material Code# 01-137-0101
Emer,ioncy & Holiday,: (803)734-5"24
Fonn Aocroved. 0MB No. 2Q50.00J9 E.xoire.:s 9~-&
2. Pofage 1 Information In the shaded ate.a:, Is not
required by Federal law, bu1 Is by St.i!s law.
·cYStifaT~.flO~:g.sJt.::i':t;;s;J:.;;,::~i~;;
tf~ttil'@~a~~~z.:Href~.rz~~:r;.;~~~::
t~T?meo:._;av~~~1L~e~r!:"7£~r¥r~:~~:~-:-:
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12. Container,
No. Type
\
a. GEN EJU TOR-S CERTIFlC.A. TlON: I h•t•by doclat• tnal the contanb of th.la con1Ng'~1nfl.a,,and accuramlY d•ICribed abevtl byptopet"" shipping nam• and are c:.lu.ait'iitc.
packod, marked. and 1.abol.-d_and ate In &ll tNP4Ctl In proper condltlan for ln.napartt,yhl;tr.ay~ to appltcabl• lm.rnadana! and n-.dana.J g~nlre'ij'ul■ don.1 an G'le law, of the Sl.aLao of Sou'Ch CUoilna.
HI am a luge quantity Q•n.Btor.l certify ai.at I haw• program In pla.,;a tor.duce th•wdurneandtmx::tyof ___ g__..tltd to the degr.. I ha-.. datarmln9d la be economlca.ll
pnac:ic.a.bte and that I hav. N'-octed tn• pnadc.abl• mecnod of t7oatm•nt, sto~e. ot dlapoa.d~r:ry ......U..bl• tD me wh.ich mlnltr'IU.O• th• p,-.,_nl and f\.ltlJra ltiraal la hum.a
hoa.Jth and tl"le onvlronment:-OR. HI am ■ .■nlc.ll q1,,1ant1r,goneratcr, I have made a good tu:ndoft:1Dmb'Umtz:a my•-• g_...tion and-1.c::tl"le beat w■..i.a management Jf'r01hc
U\at I.a ■.-.il■ble to mo and tha.11 can afford.
cL k , 7 ran oorter w ment of Receipt ol Materials
,,,._ Month Y~ i ~,8-L.J-/--:-:--,-"--'--,l<:<~~C1{.J...L;V':...,.,_-,-__ _1........5~"'-<:::.._..i<:,,..2:::¼::::~:..:..::==-=-----__;--_Lt....li.J:Zu.-tt:4,i...J. ~ ~~=.:C:::~~~==~:::=~::.:;::::::ii:t::0::;f;Ma:::::te:;:ria!:::.:_• ___ r.:: _________________ _:_ ____ _,-,-,,---::,--:;-
~ Name Signatl.Jre Month Oay Ye:
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Printed/Typed Name · ,,,-;:,
AK.A AR. A 1:22:-P--R R v Mcnth Day Ye.
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South Caroli~a. D~partment of Health
and Environmental Control
lluniau <:f Solid & Ha=dqu, w..., Mgt.
2!i00 Bull Stroot. Columbia. SC 2921J1
Phone (80:ll 73-4-5200
PL..E'..I.SE PRINT or TYPE (Form de:slQned for use on eOta f12•Qrl:ch tvDewritat'l
UNIFORM HAZARDOUS 1. Generator1U.S.EP>.IDNc. WASTE MANIFEST
3. Generaiors Name and Mailing Address New Hanover County/ City of Wilnington 414. Chestnut St., Suite 101 Wilmington N.C. 28401
~-GeoeralorsPhone/ 919 341-7139
s. Transporter 1 Company Name Willms Truckin
7. Transportor 2 Company Name
9. Designated Facilit'[ Name and Sile Addre:53 SRC Inc.
Box 2005
Columbia SC 29202
6. U.S. EPA ID Number
A
8. U.S. E?AID Numb«
10. U.S. EPA ID Numb«
11. U.S. DOT Description (lllcluding Proper Shipping Name. 1/aurd CJas,, and Ill Numbe,/
d.
15. Special Handling lmiruclons and Additibnal ln/ormation
Material Code# 01-137-0101
\
~ & Holiday,: (803)7:J,.542◄
Form Aocroved. 0MB No. 2050-0039 Excires 9-30.e
2. Pa9411 Information In the shaded areas rs no: <:f required by Fedenll law. but b by SI.Ii. law
·o7:t~lWti~~~~~":~~~~~-,~-
:t~~--iiE~~-.. fa~¥P~f;=~
-n~~~~£;if.~~~j;_._
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6. C ESERA TOR"3 CERTIF\CA TION: I her•by doc.Iara that U'la ccnc.nb of tfila conaJ,g~.,.. l'ulpand &ecura■ly doacrib.d a.t>oora by prape, a.hipping nam• and ire cia.s.&if'i.._ p■ckod, m&n:ed, and latMlod. and at• In all ,_p.ctl, In pt0µ4f' condition for tranapcrtby hlgn.aJ-=conilng to app11cabl• lntam.tlonai and na~ 90Vef"N1'Mlnt r--;;vt.atlcru an th• laws ot a-.. Stai. of $Q.nh Cuolln&.
l'
tt I am■ l■to• qv■ntlty o•nor■tor, I cartUy that I h■w ■ program In pl■.ca to reduc.1f'I• ~umaanclbdcityofWastagltfMQ.tad to the d-o~• haw d•tarrnJnaid ta be accncmlC&J\ pnae:io.b!• and in.tl na.,. -lectad th• pf'aCl:lc.&bl• rneinod of tro&tm•nt. au,,..,_._ o,d~ cunanay--.u..bl• ta nM whJc:n mJnlmtz.e• In• p,-nt and fl.Jtur• ltuwt to hum.a tlea..lU'I and tl'\e onvlrnnment:OR. Jr I ■m ■ sm.tJI quantity gona.rator, I h■v• ~••good t■ttn eiforttoaunltnJ.tll my•-• genera don .nod ... actlf'I• beM wa.a:a management m.1f"IC. Ula.I la•~ to me and ui.i I can alfotd. ·
19. Cisc:-ep.ancy lndiction Sy.ace
... , J...J...JIL-' .... , ..1...1libs. C ... I .,_. ..... ~~l1t:o.
b I I I {lbs. d I \it:o.
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South Carolina Department c,f Health
and Environmental Control
Buroau al SoUd & Haurdou, W"-"8 Mgt
2WJ Bull Slr""'-C-Olumbia. SC 29201
Phone: (803) 73""5200
~onc;y & Holiday,: (803)7:34-S..2•
PL.EJ.SE PRINT or TYPE (Fonn desianed for u:se on eDte f12•oitch1 tvoe••ilmt Fonn Aooroved 0MB No. 2050-003$ E.xolres g~
UNIFORM HAZARDOUS 11. GenOlllro(aUS.EPAIClNo.
WASTE MANIFEST . , , , , , , , , .. ~rn1!n~ No.12. ~•QG 1 llnformaUon In the shad ad Meas b; not
• , , , , requlrodbyfoderallaw,buti>byStatolaw.
3. Generatots Name and Mailing Addr~ New Hanover County/ City of Wilmington·
G
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414 Chestnut St. , Suite 101 Wilmington,NC. 28401
4. Generato~>Ph~nel 919 I 341-7139
5. Transpor1er 1 C-Omoanv Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address SRC ·
Box 2005
Columbia,SC29202
J
6. U-Ji: EPA ID Numb«
,N' ' ' ' ' ' ,
6. US. E? A ID Numb«
. • • . ' ' ' • . • I
10. US. EPA ID Numl><r
I i ,N~ • • • •
11. US. OOT 0..Cription (u,c!uding Propei Shipping Name, Hazard Clas,, ,nd JO Mimbetj
a. Petroleum Contaminated Soil (NON-Hazardous)
b.
C.
d.
15. Special f-1.andling ln.:stn.idons and Additional lnforma.tion ,
Mltb,1~ UxJe.. t¼--01-l3 l -o In J
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t'-:~T'fi~Wa'O!i',!.)~.:.rs·;s~~7..Z..0.i~=Si~~
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12. Containen 1:J.. Total Cuanti1y llUnil tGW,.\e'~,,::.
No. T)l)e ···. .. . . 'MMrJ. ~~~~~'.~
0,0,1 D,T , , ,2,0 YD
0 I I I I O o
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he.. C EN ERA TOR"S CERTIFICATION: I her•by doc!ar■ thatU'le cont.nt:s of 'lhla conal9n~&r11 Wyar.d ac:c:Jra1a1Ydo9Crlb.d ~ by proper ahlpplng nam• &fld •ro c.l.u.a.ll'i ..
P•cked. tn&n::od. and l■bel~.and ■1• ln all ,_pecm In ptopor condition b tl'&naporttry hlgb--,-=c:on1lng tel ~pUc:abl• lnt:emationa! and nacon.19~nl r.;ulatlol\li •n
t2i• laws o-11ne StaLe of South CatoUn..,_ ·
r
HI am• l.&rga qu.ntity gen.,..tor, I certlty that I have II program In place ta ra,duce Ui.e"toh,un. andll:Dic:ty of waS1II genwataod ta Cha degr-I ha WI datarmlnad ta be economlca.11
pn11::ic;.ab!a -1\d tnal I ha-M'-cied th• prac::lc:.abl• rn.tnod ol tr-tm•nt, storag-. Of" d~ a.nwnlty •..-ailabte to me •hich mlnlmlz..1:ia aia p~nt and tutl.lra thr-l to hum.a.
h-.ltr'l ind In• et1¥lr0nmont:OR. II I am• am■JI qua11t1ty g_,..tor, I ha"• mad• a OOod tam, eftortlD~tniz. my•-• g~don and aeled tn• beat wast■ man.agomenl mwtnc
V\at 1a &¥ail.blo to me and that I can alfon:I.
Printed IT yped Name I Signa~
~0111 1.. , V\ l.) L. C hM.v-c.J. -SI'-, ·1--1. • r; ;;J_ .
Mcn::i Cay Ye, .,,,.,,5,<t,,
T 17. Tra,dcrte< 1 Acknowledgement cf Receipl cf Mawriai, }IJ / j j-'-;p;;;rin;;;~;;;;:rrr~_;; -,.,;,\,i://;;;;;~=~=7-°:~=====;__ __ Ts: 1s1i;;:g~;;;;;-:;;,:r-7;/~(7/.~~:;::::;,---:,n _.,,;::;;;A':-----------.L
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~ Printed/Typed Name lSigr.atJJre Month Day Ye.
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19. Oisc:epar.cy lndication Space
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I IL..J....1-L..J....I...Jllh,. C IL......,....J-'-'-~l'"'-
b J Jib. dJ jib.
•~--------------------------------------------------~ 20. Facility o..rner or Operator; ~rtification ol receipt ol hazardou, materlab c:o,.,ered by this manle:s!: c.xcapt a.s noted ln Item 19.
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• South Carolina Department of Health
and Environmental Control
Bur.au of Solid & Hazardou, w..., M.t
2WJ a..JI S!ree<, Columbia, SC 29201
Phone (llO:J) 7:14-5200
Eme,gency & Hollday,: (BOJjT.lol-542◄
PLEJ.SE PRINT o, TYPE (Form dool nod le<""" on enta 12-oitc!,1 M)eWritarl Fenn Aooroved. 0MB Ne. 2050--0039 &olras 9--30-aa
UNIFORM HAZARDOUS 1. Genorato(sU.S.EPAIDNo.
WASTE MANIFEST
2. Potage 1 lnfonnatJon ln the shaded a<e.a3 13, not
required by Fedoral law, but b by SI.Ila law.
s. Trans porter 1 Comoany Nam•
7. Transporter 2 Company Name
9. Designated Facility Name and Si~ Addres:s SRC . . .. 10. U.S. EPA ID Nwnber
Box 2005
Columbia,SC29202 NA
11. U.S. DOT De,cription (u,c/uding Pro.per Shipping /lame, Hazmi Cias,, and JD Numbetj 12. Conlaineo
Ne. . Type 1i :roti1. cuanlil'f 1t Un., ,t!W~.~ts - . .. . -VMa '.t;;R~~~?<
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15. Special Handling lnstruc~oru and Addition.al Information \
6. GENE.RA. TOR-S CERTIFICATION: I h■r•by dec!ar• tha1 th• contents ol tnla coneJgn~.,.. tuOy and accura•IY doac:ibed a.baw9 by proper ahlpplrt9 nam• and are da.uil'iac
packed., m.arlced., and label-4.and ar• In -.JI ,_pec::a In p!"O?ef' condition Jar tranaport t:?f tugh...,-accordlng la appllcable lnt.m.uonaJ and n.atkmal g~nt r-..;iulaC:o~ an,
C'l• La~ o1 t:-141 Sllte ol Soulh Caralln.a.
HI am a l&rgo quantity generator, I certify O\at I have a program In place to r.ch.1c::. !ha voh.11Mi and ti=Jdty cfwa..i.gen«atltd to~ d.,_r_l ha"9 dei.rmlne,d to be .ecnomlc.a.!1
pradc.a.tile and tnat I ha.YO -iectod U'I• practlcablo m.thod ot ~tm•nt. ao~-. °' db.po-1.&l CU'l.ntly •ra.11-blo tome 'tl'hJd\mlnlmiz.ns Iii• p,-nt and tun.ire thrDat to hum.1,
hoaJO'l apd 1l'IO ~vlronmont::OR. JI I am• ama.JI quantlr., gon,oratar, I have ma.de a ;ood ta:u, erietttomin.lmLz-m1 •aa•ljl--.Gon and a.eled.~• bat wa.aa m.an.agomont mettM>
~11.a ... a.il-.blo tQ me a.ncl that I c.an .al!Otd.
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Month
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b ._j J...1.-'-'--'-
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Printed/T~ Name ' SJgnab.ire Month Day y.,
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South Carolina Department of Health
and Environmental Control
Buraau of Soild & Hawdou, Wil3la M!;t.
2600 Bun Slroot, Columbia. SC 29201
Phono: (BOO) T.l-<-5200
PLE.I.SE PRINT o, TYPE (Form d~aned for 1.t,.9 on ante 12-ortch IV!)ewriter\
UNIFORM HAZARDOUS 1. Genorato(sU.S.EP>.IDNo.
WASTE MANIFEST
1 Generator', Name and Mailing Address
New Hanover County l City of Wil ni ngtoti
_414. Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generato(s Phone ( 919 341-713 9
S. Transporter 1 Company Name
Wi-llms Trucking
7. Transportar 2 Company Name
9. Designated Facilit-f Name and Site Addres.s . SRC Inc.
Box 2005
..... Co 1 umbi a SC _ 29202
6. U.S. EPA ID Numb«
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT Deociiption (111cluding Proper Shipping Namo, Hazitd Clas,, and ID Numberj
Emergency & Holidays: (1103)n4-~2(
Fenn Aooroved. 0MB No. 2050-0039 &oire:3 9--30.
2. Paoe 1 Information In the shaded 11ea, 13 n,
of I required by Federal law, but Is by Staie la,
't.:t·StJieTraiW·w.rc~:~-;i~ .. ~-~ii1:r~-;;,?ry~i.fil!.~-
o;t;;iw:ow1~~~;f!fef~~rtr~1?'~~:
'E.~T~m@~_rcr:~,~:}~E:C=::£1~±:~t
'Ff-~-Phx-~R~~~f:::'t;r;~~f:::~~i
12. Conlainer,
No. Type
Ga. Petroleum Contaminated Soil (NON-Hazardous) ;!itT·,··;•'; E (~ i r►b.:----:-----'--------------------iO:'...l:O~lfD~TT.L..LJ!:2c.J:::'.OTY::,D--};~;;;:,~7_5::z.7::J-~7-~J7~,,.
i rc.:-_________________ .:._ __________ -t.....1.....1-t_j-t_j_J_J_J-tf-_;H!b:~.=· '~'~---~~
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d.
15. Special Handling Instructions and Additional lnfonnation , \
Material Code# 01-137-0101
e.. GEN ERA TOR'S CERTIFICATION: I her•by d~re th.at the cont.onb of tni1 ct1nal;n~ _,. fUl!y a.nd a.ccuratalY ducribod abov9 by proper ahlpoln; nam• and aro du.a.if
packed. m.OCed. and la~l--1.and ar• ln alJ ,_pec'O! In propo<condltlon for ~sport by hl;traay ~ng to ~pllcable lntamatlona.l end nation&I 9~ntr~ul1t10n.a,
tl'\a laws o1 tr\oe St&ta of 5outh C.atoUna. · ·
It I am a 1-.,go quanur., genenatof', I carttty tt"-1 I have a program In pl.a.ce ta r.::luc. tne ~um1 and taa.lc:ty ofwaatagonen.~ ta tne deg,_ I h..-detarmined to be economic
prac:i~l• and ttu.tl ha-Miedad U'la praC':lc.at>la method ol tr-tm•nt, 110,..,_-. or d!apo&l.lc:ul'Rlltly rtal.Labla ta me whlci'l mlnlmLu.1 Ilia p,.._nt and turura ttiroa! to hur
health and tna erwlronment:-OR. If I am ■ ama.11 quantity gonoraLor, l h,ava mad a a good iasa, aftorttaaut\JmLz. my•-• geoen.tlon and ~tn■ be:st't11ra.ata man.agom11nt met.
that la avai.J.atila ta mo &nd l:hal I can atl'Ot'd.
Month Day ' 1" 79
Month Day ' 7 l
' C ,
lib,. C I 11,
lib,. d I ,~
IJ-c-:-:,-,-:-:------------------------------------------~ 20. Fadlify Owner or Operator; Certification of receii;il cl tw.ardOU3 malariab covered by tt\13 rna:nifde.x.cept~ noted In Item 19.
Printed/Typed Name · Slgnature Month Day
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South Carolina Department of Health
and Environmental Control
Sur.au of Solid & Hazardqu, W/UIB M!,I.
2lillO &Ill Stroot. Columbia, SC 29201
Prion..: (B0J] 73-1-5.."00
Emoriioncy & Holiday>: (BO:l)734-5'24
Pl.ElSE PRINT or TYPE rFonn desianed tor me on eUte f12~oitchl tvoewritar\ Form ADcf0V'lld. 0MB No. 2050-0039 E.xoin:o 9-30-U
• U'NffORM HAZARDOUS 1. Gonoralor'sU.S.EPAIONo.
WASTE MANIFEST ' '
2. Pa~ 1
of lnfonnation In the shaded ace.as Is not j
required by Federal law, but ls by Stoto law.
3. Generator':s Name and Mailing Address
N.C. 28401
New Hanover County/ City of
414 Chestnut St., Suite 101
4. GeneralD~sPh~ne( 919 341-7139
Wilnington
Wilmington
5. Transporter 1 Company Name
Willms Trucking
8. U.S.EPAIO Number
,A
'ci~T~.8-iri~1-t~~i~~~it:s,1~!£;1\~il
·o:;;r~~~!i!:t~.:~~~!~~~~'?-'~;; i
7. Transporter 2 Company Name 8. U.S. EPA IO Numbe< t~T:'<·------.-ti~~f.5!?6:£--0!.~~=it~!
·ti~-Ph&.:'";k~·~_;;.'¥5!!":':~~~~~;e-~Ji~{
9. Oesigna1ed Facitit'[ Name and Sita Address SRC lnc. 10. U.S. EPA 10 Number
Box 2005
.Columbia SC 29202
11. U.S. DOT De!!Cription (including Proper Shipping Name, Haziud C/as,, llld Ill Numbe,/ 12. Container.,
No. Type
r
d.
15. Special Handling lnstruc:ticns and Additional Information , \
Material Code# 01-137-0101
e. Ci EN ER.A TO R'S CERTIFIC.t. TIOH: I h•r•by dodJ•r• that U'le contents of tri.la conaign~\.,. fu1y and a.ccun.•IY doacribad a.bow by pro pot ahlpolng nam• and are ciu.aifi.-d,
packa,d,. rnanced.and Labeled.and are In ail,-~ ln ptopet" condition lor tr.n~ by hlgt'lwaJ-=con1.lng to a.ppUcaJ:lle lntema!lonaJ and n.etlonal gOV9t'T\mtlnt re,;1,11•11ona and
aio 1a-Oi' ~ Staia ol South ~In&.
HI am• Woo quantity genOC"ator, I c.nitythat I have• prc,,gn.m In pta.c.. to reduc.U1e~WM andm.latyofwastag__..tad 10 a,. de,grN I haw delarrnlned to b.a econ0mlc.sJly
pra~C-U:llo and ~t I have -&.dad ti'!.• pn.C'dc.atue ~thod ol troa.un•nt. a:10~-. or dbt.pou.l a-nay available to me wl'l.lch mJnlmlus• the pr9aent and h.Jtl.Jr• ttuwt to human
h-itti and tho onvlrcnmeni:-OR. lf I am a small quanlltyg~tar, I have m&da a good ta.to, MtorttosunJmtz. mywu• o_,_.Uon and ~octU1a ba:a.tw~ m&n.agament m.tT\od
1fl.&1 La•~• to me and that I can anon1.
T ~r'-;;:::::;;:;::=:~:'7=========:.._--==---,:_----------------==--;;:::-~ N Month Year
~ (J C/C.
~ l-"18.::...:T:::rans==::pc::rtc.:"":..:2c:A:::cxn::· :::o::w::.led:::2g!.::e::m:::•::.n:.:t 0::,:lc:Rec.e:::::i::pt:.;0::l:::Ma:.:::!e::rial::· ::•:_ ___________________________ ...;.. ______ _
k Printed/Typed Name SignaQJra Month Cay Year
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19. Oisc:epancy lndication Sp.ace
•1 L ..L..JW...~-'llbs. • I , , 11"'-
b I )lbs. d i..l .L.J...J...1...i...Jllh,.
•f=-=--::::---::---:::----,--,,,-,---,--,-,.,.--------------------.:.__---------~ 20. Facility Owner or Operator, Certification of receipt of haz.ardou, materials covered by thi3 ITl.lJ'WI$. e.xcept u noted In Item 19.
·nied/Typed Name . 7? _ Slg'\";\1?' _ L,?
IC 13/7£ ,£} ;...+t;/c.l< // ~ ,,f A I),,; 7 ~ /',./)___ ./1 -
Month Day Ye.a
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South Carolina Department of Health
and Environmental Control
8anau of Solld & Hazardous w..., M~
26110 Bull S!reot. Columbia, SC 29201
Ph<>ne: (l!a3} 734-5200 '
PLEASE PRINT .ir TYPE (Form de:slooed for 1.0,8 on elite 12-c,itchl tvoewritan
UNIFORM HAZARDOUS 1. Genorato(sU.S.EPAIDNo.
WASTE MANIFEST ' ' 3. Generator', Name and Mailing Addre:53
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
•· Generato;,sPh~ne( 919 341-7139
S. Transporter 1 Campany Namo Willms Trucking
7. Transporter 2 Campany Namo
9. Designated Facility Name and Site Address SRC Inc.
Box 2005
___ Columbia SC 29202
6. U.S. EPA ID N.umllor
A
8. U.S. EPA ID Number
10. U.S. EPA ID Number
11. U.S. DOT De3criptian (including Proper Shipping Name, Hazard Class, and Ill Nwnbetj
d.
15. Spedal Handling ln.:struclion.s and Additional lnformation
Material Code# 01-137-0101
~"'cy & Hallday:: (803)734-5-42•
Form hioto'ttld. 0MB No. 2050-0039 E.xcire:s 9'"30-e.8
2. Page 1 Information In the ati.ded we.as ~ no1
of / required by Fode1111 law. but ls by Stai. law.
·c:~&iii:T~-~ri'.~&t;z;~~..1%~j£.::f~;.1
o~;r.-m;i;;,r Phoe.~~~~1:"~v:-;.:r:~~~~ i
E~T:&.oi'-"J(I0~)'1'~7!~~~:ti£':.'!l
·r ;:~-Phoi--~h'~~!~~;:s£::1 .. 1,-i~~i ~
12. Cantainffl
Na. Typo
\
I!!. GE'N ER.A. TOR·s CvtTIFlCA TION: I heroby d~r• that the con Lents oftnla c:on~I\IMffl.,.. 6Jlty ar.d accuratalY de.crlt.d abcrr,,a by proper al'llpplng nam• and ■ro d..,..Jfi~ p■cked, marked, and latMled.and are In &ll rnpe,c:a In proper candlUon lot tnn-.porttrf hlghwa<fac:::onil~ ta appllcabl■ lmam.adon&l and n■.don-.J gov.mm..nt r~utatloru anc
C'lo laws of t:'lo SI.at■ ot SouG'1 C&roJln&.
y
n I am a liuge quantity g•neratot. I c.rtlty UUit I have a proor.m ln pi.e. to r.du~U'I• vohmwanclllDJcit)'ofwu:t■gen.ratad tc the deg..-I ha-d•t■rTTUn.:! to~ oconomfc.a.11) p~c:ic.abl■ and CU.I I h•:,,,. -r.ec:t.d U'I■ pnu::tlc.a01■ rn.thod of tT-tm•nt, ator.ge. Of Cbpoa&J Q.irninlly av&!labl■ to mo whlc:."I mlnlmlura th• p'-Mnt and tua..1r■ ll'lr..,1 to l'lum.u
he.al th and t:'le ■nvlnJnment:OA.111 am ■ small quantity gonont.tor, I h.a"• mad■ a good tal1:l"I atsort:Otrul'Umu:■ my•-• g-,.,.tion and Ml.ct U'I■ ~wa.at■ man■.goment rr..11">0(
1n&t ta aY&il.a.ble to me and tt\at I can otford.
~ 17. Transpor'..er 1 Acknowledgement of Receipt ol Materiah
~ Printe<I/Typed Name ~ I) J7i
Yea:
97.
Month Day Yea
,c
o 18. Transperter 2 Acknowledgement of P.ec.eipt of Materiab i r--,P::-n"'"·n-ted""7'.'./T::-y-ped-,-Nam:,--e--'--'-==-=--==c....c==..---,-Si-.9-na_o.,_,. _____ __;__ _______________ M_0_n7th-::-Ca-y--:-:Y-ea
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19. Cisc:epancy lndic.;ition Space
•f--,--,--,---,---------------'--------------------------'-----❖ 20. Facility Owner or Operator, Certification of receipt of haz.ardou:5 m.aterlab covered by thu manifc:: e.x.c.ept u noted ln Item 19.
/Typed Name · Si OJra
lc lJ fJ IC P r }t P .J.-rJ. 1? o,
Month Day Y &
t// eJ.,fif<l1
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South Carolina Department of Health
and Environmental Control
&nau o1 Solid & Haurdou, w..., Mgt.
2&Xl 6"11 Slroet, Columbia. SC 29201
Phooe: (80:l) J':l.1.5200
~
PLE.lSE PRIITT or TYPE (Fann d~aned for usa on eot.e l12•0itcht tvt,e'Writerl
UNIFORM HAZARDOUS 1. Generato(sU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Maillng Add~
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Ger,eraio~s Ph~ne ( 919 341-713 9
S. Transporter 1 Company Name
Willms Trucking
7. Transporter2CompanyName
9. ~ignaied Facility Name and Sila Address . SRC Inc.
Box 2005
Columbia SC 29202
6. U.S. EPA ID N.umbor
A
8. U.S. EPAID Numbor
10. U.S. EPA ID N-
11. U.S. DOT De=iption (including Proper Shipping Name, HazBni C:..S.. ,nd D Number!
d.
15. SpeciaJ Handling lnstrucijoru and Addition.al Information
Material· Code# 01-137-0101
I I
Emergency & Holiday,: (503}J':l.l.S<24
Form Aocroved. 0MB No. 2050-0039 E.toirm 9--30...a,a
2. ~•991 lnlormallon In the shaded &re.as Is not
•• required by Fedora! law. but ls by St.it, law.
'C:.~Stilai~a"i:>"~:p4~;,.'¾":ftt:.i5'~!t~I7</
·01t~ISOOi«'SJ>hooe~~{-ftsi{f:~e-;;ir-ti1~J1J~~-~~;
12. Containers
No. Type
\
5
e. C EN ERA TOR-S CDlTIACA TION: I hereby d~r■ that U'l• c0nlilnb of ltlla ccn.Jgn~ .,..'-ily &nCI a.c:::ura•IY deacrit.ed &cov. by prop« ahlpplng nam• and are c:Ju.a.ifi..:1. p■ck.d.. m..rl,;od, and Lat>.119d.and ar• In a.11, .. ~ In P"0p,or condlt10n lo, tr.n-.portt:,y hJQtt....,-=con:lng tel ~pilc::abl• lmarT1-tl0nal and naDOf'l,aJ g~nt r.;iulatlgru anc
nie ia-o1 the Stai. ol Soud'I C.uoUna.
y
n I am a l&lg• qu.anUty generator. I c.nifythai I ha,... a prograzn In placa to r.duc.trt• ..o/i.un,aandbll.lc:;:tyol ~ g.,_..1-d to t:\e d~r-1 hawi da1-rmln.d to be ocongm!calf)
pniC:::ca.bl• and that I ha-Mlectad the p.._dcabl• meinod cl tr-lm•nt, storag-.o, dl:a.p,oMicurranay available to me •l'llch m.Jnimlu• 11"1• pra.w,nt and tutura ttlroat to t\1,unar
ho-.Jth and 1:1"1• onvlranmnnt:-OR. If I am a am.&Jl quanary Qef'leBtcr, I hav• mad•• good tann &'ffort'IDD\lnJmiZII my waa• g--.tlon and wlectttt• beat w...i. management~
ai.at la awail,abwt 10 me and tn&I I can anon:1.
~ H. T ement il'.=t of Materia15
A p
N SlgnailJru Month Day Yea
~ k--d-:./l....6.'..j.,..:L.L~::..--,~~~L-L.....1.~...JL_~:1Z,4-,~~....,4¼;'.:;:;;!~~(L-=-___ ..J../..J..,il!:/Ili!r:w ~ ~1:.:8.~T:.cran,=';-X:;rter=.::2C:A7cxn:::.::o:cw:cled:::.,g::•:cm::e:::..::;_:_=::.::::.:::.:.:.:::::;_=---,-::,--------------------------:-:---,--::---;:c-c
E Prir.ted/Typed Name Signature Month Day Ya.a
A
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19. Oisc:-epancy lndication Space
I r.:,-:,--,;:-,-::---::----::--.,.,.-.--,--.-:-,-----,..,..----,----,------.,---------------~ 20. Faolil'y Owner or Operator, Certification of receipt of hai..ardou:3 m.ateriall COYertd by !hi, manamt e.x.cept u noted In Item 19.
Pnnmyped Name . 5\9"!1!'18 j._ \._ /,
~fnAl?J:J 2r.ea v 71Y.7P,R!..L:. n/:. 7\11vL JV' Month Day Ye.i:
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South Carolina Department of Health
and Environmental Control
Bun,au of Solid & Hazatdou, w..,,, Mgt
2600 Bull Sir .... Columbia. SC 29201
Phone: (!!o:l) 7:),4.-5200
Emergency l Horday,: (ll0:l)734-5,124
PLEASE PRINT or TYPE (Fann de!Yaned for use on elite f12-oitchl tvoewriteri Fonn Aocroved. 0MB No. 2050-0039 Ex1>res 9-JO-U
UNIFORM HAZARDOUS 1. Generator'sU.S.EPAIONa.
WASTE MANIFEST
Manlfeat 2. PaQe 1 Information In the shaded 11eu 1, not "';"";-' "°"J of f roquifodbyFedorallaw,butlsbyStitolaw.
3. Generator'3 Name and Mailing Address
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilminston N.C. 28401
4. Ge,,eralo;., Ph~ne ( 919 341-7139 -
5. Transponer 1 C<>mpany Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facmty_ Name and Sile Addres, SRC Inc.
Box 2005
Columbia SC . 29202 ..
6. U.S. EPA ID Numb«
,A
a. U.S. EPA ID Number
10. U.S. EPA 10 Numb«
11. U.S. DOT De,crlption (inclucf,ng Proper Shipping Name. HazMd C:.S,, llld ID Numbe,j
d.
15. Special Handling Instructions and Additional lnlormation
Material Code# 01-137-0101
'C.~Stl-ia"tn.lli..o'br~ -iri ~i~.;~t'EiS:-".it,.~~!.:lR~;~.
0Jtmmcn'~~~ir'i~{~~~~7J~~;
E.~Trai'~fi:l7~'.ri.1.:i!?~fi4~'i"~
·-=:;~Phl)i-❖.(~.;~:7fr!:~{&.:~•~
12. C<>niaine,,
Na. Type
\
a. Ci ENER.A TOR"'S CERTIFlCA TIOH: I hereby dc,par11 that tho contents of t,,!a conalg~ at9t,lf and aca.,raalY ducrlbed above by prep« ahlp"lng nam• uid aro clualri~.
packed. m.a.Ji<Dd, and la~l-1, ancl ate in a.JI, .. ~ 1n P,opot' ccndltlcn fcr'¥&nt,,p,Ortby hlghwayac::c:oc"d1ng to appUcabl• lntamal:!cnaJ and n11oona.l 9~nt re,g1.1la~cna and
tt\e Law, of 11\a SI.a.le ct Sov1h Carolina.
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n I am a larg• q1.1anUty g■netatof'. I cordPyU\at I haye, a program In pl&ca to r■duc::a tt1•'fOlume&ndmicityof w..ca g■rwtawd ta~ dagr-1 ha-detarmln.d tc be econcmlca.ll'J
pr.111.c:iG.lllle and that I haye, -'ed.od U1• pract1c.abl• m.lnod ct tr-tm•rrt. s1c,..,_._ ctd~ a-,,cy rn.ila.bl• tome which minima.ii a the p,-nt and tl.ltl.lr• thrDAt to h1.1man
ha&ltn and ttle envlrcnment:OR.. lf I am• am■.11 q1.1■ntlty gen.rater, I have mad• a good taltn effott».a:d.nlmlu myw-• g--.ccn ■ncl ..iectth• ~C •uta m.a.n.goment m.tt".od ui..c La avail&tue to me and O\&I I can ■tl'Ol'd.
Printed/Typed Name Si~natl.Jre t'7
19. Disc.:epancy lndiC3tion Space
Month Day Year
{ ,'7 9,c
Mont, Day
I ... I _.__.. ........ ......,,II:,. C LI ~..J...J....._tit::.
b LI .L.1...L.J...J...IIU::,. d I lit,.
I r.;:--;:--:;::--;:---:c----:--:::--:;---:-.,..,--c:---,----,--,-------------------------~ 20. Facility Owner or Opera~r; Certification ol receipt ol hazardou:s mat.erbb covered by thi3 m.aniJ2::st e..x.cept a., noted In /ltJm 19.
.-f>ri ted/Typed Name · Si
.f' OP1c.1.J ? EJF,.f Month Cay '(ea
1 /,/~,89,c
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-----· ··--·--·
South Carolina Department of Health
and Environmental Control
Bun,au o1 Solld & Hazardou, WCJB l.lgt
2500 Bun Stroet. Columbia, SC 29201
Phone: (BOJ) 7:14-5200
Emergency l Holiday,: (800)7.-1-5,m
PLEJSEPR!HTotTYPE (Fonnde5iQnedforuseoneUte 12•Ditch tvoew1ib:bt Form Aocn:Mld. 0MB No. 20S>-C039 Eroire:s s.J0-88
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UNIFORM HAZARDOUS 1. Generato(aU.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Mailing Address
New Hanover County/ City of
414 Chestnut St., Suite 101
4. Generato~• Ph~n• ( 919 341-713 9
5. Trans!)Or!er 1 Ccmpany Name
Willms Trucking
7. Transport& 2 Ccmpany Name
9. De.signaled Faolity Name and Site Addre::53
SRC Inc.
Box 2005
Columbia SC 29202
Wilnington
Wilmington N.C. 28401
6. U.S.EPAION.umbor
A
6. U.S. EPA ID Numb«
10. U.S. EPA 10 Number
11. U.S. DOT Oe,crlption (including Proper Shipping /lame, Hazard Clas,, llld ID Numberj
2. Paget lnformaUon In the shaded areas b not
o1 I required by Feder>! law, but Is by S'-te law.
·c._~-siii; ,-~.---ID ~:~A"t,q,~1~~r:~J.
o::;-r,mrii.·li.?1·Phoo.~~s.m:§~~..{~'ft,:r.;;
t~Trim:xiii;itl);itt~~:a,:~.,:~~£~~
·s:-.£~·pta;.~_?.~~Y~}~~?•~.-.:.r.:~
12. Ccntainets
Na. Type
~ a. Petroleum Contaminated Soil (N0NcHazardous) atr·,-',±'~
NE l::---------------------------fO~O~lTD_JT7-1-1..1:2:..C:!Of-Y!:.D-+':~J/i17f;_ ':z7=Jt7i:J7~_ ~';.ta·_c,
b. --• r --,~~
R YIJIJ,V't ·-·-r····--.... ---·· ,,.
A • ~ ir _________ ...:... __ _:_ _____________________ _;f-L.L+-1.-1....:LL.L.1.-t--E~~~i1=··t·'=·='~-·~~,~~~8~
-·'; I I I I I ,s "ii ~-~~ I __________ (~
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a. LLJ-I 1-LI _J_..L._1-J,
b. LLJ-1 1-1
15. SpeciaJ Handling ln5tructiorui and AdditionaJ Information _ \
Material Code# 01-137-0101
6.. GENERA TOR"'S CSITIFlCA T10N: I h•reby d~ro di.at the contents cl th.la eontJgnrn«tlare b4yanCI a.ccura1aJ'f d..,c:rlbed aboYa by prop« atilpplng nem• 1.11d aro c.!a.u.ifi.d,
P•c:lo;ed, ma riced. &rid labeled.and ate ln aJI ,_pec:a 1n prOp,,H condition fer transport Dy hlQhway IIICC0l'Ulng to ~pUcablelntam.at10nat and n.tlonal g0'V9ff\mentr.-;iul•t:ons and
aio la~ of tt,e Stat.I of Sou1h CaroUn&.
n I am • Wge quantity gen..-.tor. I c.arUty G'\atl ha-a progr.m In pt.c. to reduoa the YOlumeandmJcit)' ofwa.i. g~wd to me de,gr-1 ha..,. d•t.rmlned to boa econcmlc.aJly
pn,.c::ic.able and O'\al I ha,... -leci.d th■ prac:dc..t:11■ meO\Od or treatm■rrt. atcra-ga. Of dla.poaa currw\Cy ........uabl■ to me wh.lch mlnlmlz.es th■ p,....,nl and hltl.lre lhrNI to human
health and_ U'I■ envlronment:OR. ttt a,n a ama.11 quantity gonenatcr, I have mad■• good t&nn .eo.ttD.uum.l:tll my•-• g~tlon V'l<I Mlltdlh■ be.I wau. managom.nt mett\od
U\al t. avail&DI■ to me u'ld 0\&I I can &tfofa.. ·· "* • •
Monlh Day Year
I I :Z L,
;l; 17. T t ol Materials
~ Pnn Sig . ~o~\ ~ Y~
~ !-:'.,a.;--:;T;-rao:-,-oc-n-:-u,-,-:2:--Ac-cxiil,:,..ow!!l,.iedg~e"'m!.e.ln~t.los,f --~~ipt~of!cMa~te'.!rial.::. ::,=:---1--.J;~"'"'!.l~£.~Q~~k~J:,..J..~C::a-______ l.)...l,.l.~:!.l...J!..o'
~ Printed/Typed Name
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19. Discrepancy Indication Space
SignabJre Monttl Day Yeai
•I._ .l...l....Ll...L..Jl!to. c ... 1 -'-'--'--'----'-'Jib,.
b I lib.,. d I Jib.
•!-:-,--=--:::-----,------,---,---------------------------------~ 20. Facility Owner or Operalcr; Certification of receipt cl hazardou:3 mate.rial., covered by this manilmte.xcept a.s noted In tti,m 19.
· /Typed Name · t'9~ L. _ •.✓,l
i.......:....1'--"-'. t:J.=.:.:.,..c;al'.3a,._:/:J=.;;lf"-'"',G~E~t::::....-,(C..:..t?:...;..<... __ --'--'~= ~ /2 . .&:flf a. 1 ..:-f.Mui
Monlh Day y..,
I/, /12.,.J:iC'J (:
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South Carolina Department of Health
and Environmental Control
<8
Bun!au of Solid & Hallrdqu, Wa>!e Mgt.
2Sl0 Bull Slroel. Columbia, SC 29201
Phone: (80:l) 734-5200
~one, & Hcllday,: (80:3)734-5,124
I "\..EJ.SE PRINT« TYPE (Form deol nod for use on eilt8 12-oitcl\ typewrite,l
UNIFORM HAZARDOUS 1. Generata(sU.S.EPAIDNo.
I WASTE MANIFEST
Form Aoof'O'l9Cl OMS No. 20.50--0039 E.lolres 9...:30--88
2. Paoe 1 Information In the shaded ate.as I$ nci
of / roquiredbyFedorallaw,butlsbyStatelaw.
3. Generator', Name and Mailing Address I Nev1 Hanover County/ City of
414 Chestnut St., Suite 101 I 4. Generato(s Ph~ne ( 919 341-7139
Wil ni ngtori
Wilmington N. C. 28401
I 5. Transporter 1 Company Name
Willms Trucking
6. U.S. EPA ID Number
A
1
1 7. Transporter2CompanyName
9. Designated Facility Name and Site Address
SRC Inc.
8. U.S. EPA ID Number
10. U.S. EPA ID Number
1
1 Box 2005
Columbia SC 29202
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Material Code# 01-137-0101
6. G EHER.A. TOR'S CERTIACATION: I haraby doc.lira that tt,e contentl ol thl• conialgnm.tl,tara fully and ac:cura•l't do.eribed abOV'a by proper shipping name and aro duairla<I,
packod. rnanted. and l.ll~led.and ate In all rnpe,cia 1n proper condition tot" transportbyh.lghwaya.c:cordlng to appilcabla lmem.atlonal and nadonaJ gov.mment ra,gutatlona and
171• I.a~ of the Sl.ato ol ~ Ca,oi'.lna. '
HI am • Wgo quantity gan..-.to<, I certify t:Nll I haw a program In ptac. to r..:!ue. the't'Olu.me andlm.k:ttyof .... generaied to 1:J'MI degrN I haV9 datarm!ned to be eeonOmlca.lly
pn,,cticabte and tn.at I na.,.. -loc1od tne practlc.able mett'IOd of troatment, sto.-..;ie. o, dlapoa&I curnnUy ....U.bl• to me which m.lnlmlie• "1• pr-.Mnl and tutur• tt,r-t to human
health and th• onvlronmont:-OR., If I am• am.all quantity generator, I ~v• mad•• good tata, efforttDmlnJmlD mywaa• geiwrw.aon and MlecttJ1• ~wa.ai. rn.nagement m,e1'IOd
tn.at la •vail&tllo to me and trwi.1 l can anot'd.. . . : . · _ .
yped Name
C, A "' ,,; C A C/4.-,/f. Month
'/!-•/ /r'O /I D L. -:z I I ...,),,"?-
17. Transporter 1 Acknowledgemenl cf Rec,ipt ol MaWials
PrintedfType<! Name~ P, Signature C ~-'~
Month Oay Year
00 If iJ 'E ffOlv j,J, /? 9C
18. Transporter 2 Acxnowledgemenl of Receip.1 ol Materials /.
Printed/Typed Name Signature V Montl'I Day Year
19. Discrepancy Indication Space
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~ t;2::;0:-. -;:F-ac"'il;::ily--:O:-w-n-e,-o-,-:0:-pe-ra°'IO_r._, Certi::--:.fi::-ca-:ti-on-ol;-recei--:p-:t-o71 "'haza--,d:--ou,--ma-,-terlab-:-:,-Ct:N-ored--,,.,by-lhis"'•-msnite,t-,:-.,-except--u-no-ted""'.,.1n"'11em--,-=9.---------------
( frn,ted/T~ Name · ~bf•_ p \..y,, Month Day Y68J --~
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South Carolina Department of Health
and Environmental Control
Bun,au of Solld & Hazardou, Wa.m M{lt.
2!iCO BuJJ Street. Columbia. SC 29201
Phone: (BOO) 734-5200
PL.EASE PRlt:T.«TYPE fforrn d=aned for use on elHe 12-oitchl tvpewriterl
UNIFORM HAZARDOUS 1. Generatc(sU.S.EPAIDNo.
WASTE MANIFEST ' '
3. Genera.toe', Name and Mailing Addres:5 New Hanover County/ City of Wilnington
·414 Chestnut St., Suite 101 Wilmington N.C. 28401
(. Genoratc~s Ph~ne ( 919 341-713 9
5. Transporter 1 Company Name Willms Trucking
7. Transporter 2 Company Name
9. Designated Facilil'J'. Name and Site Addre:53 SRC Inc.
Box 2005
. Columbia SC .29202 -·
6. U.S. El' A ID Number
A
8. U.S. El' A ID Number
10. U.S.EPAIDNumber
11. U.S. DOT lle5cription (1ncluding Proper Shipping Name, H:wird Class, ,nd ID Numbetj
Emergency & Holidays (803)734-5,m
Fonn Aooroved. 0"-48 No. 2050-0039 E.tclrc:s 9~
2. Pl;,e 1 Information In the shaded araa, Ls no
ol / r.quirod by Federal law, but ls by Sl:ile law
Oitfu.""awi."'".o;~';\¾e'§!;.r¥.i~~~4'.i. t~~f_.. ____ i'"i'.FST'rEEi-35~..Y£~'-J=f5
.Fi.fiafi:ciC~it~ifftwii.:::1~..:t.i~~};~;:_..-~,r'
12. ConlaineD
No. Type
13. Total Ouantily It Unit ii.Jiiiiii/Nuiel,et,
.. 'M/VrJ ~~~
G.. Petroleum Contaminated Soil (NON-Hazardous) rr"TrF'f''~
E O O 1 D T 2 0 YD ~17 17 17 11} ! r.b.:-__ :...... __ :...:.....:.:...:.:...:.:...:.:...:. ____ :...:.....,....: __ .:....._:...:. _______ f~!..l:~:..17....JL:L1=-~f~f,;!:iw~;=···~;:• ~---~-: .. ··~,iti'i:
T ~ i ·Ed ... 1 t_ t.: ~r.c.:-----""'"--__: __ ..:_ ______________ ....:_ _______ --\-'LLt..L-tJ~LL.Lt---\.§f~~·l~:_~:_t:~.1.::_~~
y
r~ I J J I I "'•N•---•-••---~•,
15. Special Handling Instructions and Additional Information \
Material Code# 01-137-0101
a. GESERA TOR"3 CER.TIFlC.1. TIOH: I hereby dOc:.iare tt\al U'le contenl:I oftlila consign~ an !utly and accun.talY deaatbed abowe by proper shipping name and are c:.Ja.uif'i
packed, tn&rlo:ed. and Labeled. and ara ln aJI , .. pte;a ln pt Opet'" condltlon fortrana.port'&:rf hf;hway-=c:otd.lng to appl&cabla lmamatlonal and nation&I govemm.ent regulallona •
G'\o l.aW11 of tn• Stai. of Soud1 Carolina. • . . . · . . . . . . . . . ·. . . . . . ·
HI am a Luge quantity gen.,..tol', I c.rtlty that I ha.,..■ program ln place to .-.duce the 'fOiume andlOXlcityof waal-9 gen.rs tad to CM da,o,_ I ti..-datarmlned to be .eonomlc.i
practic.abl• and tf\at I ha.,.. -lod.od tn• pn.ctic.ablo metn.od ct tr-tm•nt. .:o~-. or dll.Qol.al cutftf'ldy available to 1TM1 wh.lch m1nlfflU.Ba tli• p,._nt and tut1.ua 0,re&t to hun-
hoalttl and ttl• enyironmont:OR.11 I am a am.all quantlr, geno,ator. I have mad• a good tam, anon tolnln.lmini my•-• g-.aon and select ttla ~ w..i. managamant mott
litl-at ia, avail&bltt to me and lhal l can atfon1. · . . , . . . ·.
Signature Month Day Y,
/,/ J.7°1
i 17. Transpc
y ::. Printed/Typed Slgnalura Month ~ f:-:-::-----,--,---la=c.:~~~µe:e,l!:L,::::.5;::d~?,z...L __ _!;,==::::l:::::i~~.;K::.£::"L!:.~~:'.:::0('::'..!.~,.-:___7_11_/ Ll.d.LJ...!.?
0 ~ r,;;~;;;;~:::;Ji;~;;:~--"---'---,,....;":::_--'-----,r,:-:--:;---;-----,--:-;-;,'--'--------------;M-;-o::n::;th:---;;::::-,y
~ fZx
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19. Discrepancy lndic.ation Space u
'1-:::--::---:::,.--::----::----:--,---c-----,--c------'------,---------------------~ 20. Facility Owner or Operator, ~rtifiC3tion of receipt ol haz:ardOU3 maleri:al.3 covered by tt'li3 ma.Nm5l e.xcept as noted In lt!tm 19.
Printed/Typed Name · Signslura Month Day
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South Carolina Department of Health
and Environmental Control
aw-, cl Solid & Haurdqu, Wa31B Mjjt
2!i00 Boll Slroot. Columbia, SC 29201
Phone:: (BO:l) 7:14-5200
PLE.lSE PRIH7 or TYPE ffonn desianed for U3lt on elite r12-oitch1 tvoewrite.1
UNIFORM HAZARDOUS 1. Goneratc~sU.S.EPAIDNo.
WASTE MANIFEST ' ' ' ' 3. Generator': Name and Mailing Address
New Hanover County/ City of Wiln1ngton
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. G•m,rato;., Ph~n• I 919 341-713 9
S. Transporter 1 Company Name
Wi 11 ms True king
7. Transporter 2 Company Name
9. Designated Facility Name and Sita Addre:s., . SRC Inc.
Box 2005
Columbia SC .29202
6. U.S. EPA ID N.umbor ,A,
6. U.S. EPA ID Number
10. U.S. EPA ID Number
-,
11. U.S. DOT 0..C.-iption (including Proper Shipping Name. Hawd C:.SS, and JD Numbetj
d.
15. Special Handling lnstnJc!ion, and Additional lnfcnnation ,
Material Code# 01-137-0101
Emergency & Holiday,: (B03}7:l4-S,124
Form ADonlV9d. OJ.AB No. 2050-C039 E.t.oirm. 9-30-88
2. Page 1 Information In the shaded ate.a, J:s not
cl / requirod by Fadoral law, bul la by St.la law.
·c.;:,•§i'taii;.;.;;•;.;d .. D~;;~s .. ';.~+:..·,i-i.tt"s$·~.1~~1::;,.;:-:;~_
O~<Tis~ ~-~~~~"{t:~~~tt;£~~;?J.;~~,f.~}
t~~Trii~iri:~af~?Ir-£~:til:tr~~~~,~~~.~
·s::~;-rn~-*~Zil&~,:,;;;~~~i=it~jifr
12._ Contlinffl
No. Typo
\
e. CENERA TO R'S CERTlFlCA TION: I h•r•by de<J.ar• 1hat U'lo contents o! tnla can-.lQn~ue luDyand accura•l'f dHc.rlbed a bow by prcper ahlpp!ng nam• and aro da.:u.llied,
P•ck.ed, marked, a.nd latMlod.and are In all ,_pec-:s ln ptOpot' cond!t1cn for tnnaportby~l'rw.y&CC:0n!ing to &p~•lntematlon&I and nacon&J governmantre,,;iufadon.a and
tt,o La~ of tne Stata of Sou1h C.uoUna.
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111 am ■ la1go quantity ;•norator, I certify tnat I ha,...■ program ln pi....c.. to rllduc:e tn• 't'Olum.andlaDcityofwaa:ta g•neQtaod t0 er... de,,;i,.. I h,.,..,. dat.,mln.cl to tM oconcmlcan.,
pni.c-:ic:..bl• and at.at I h.a--lectad tho prae1:lc.ablo nMtnod of tr-tm•nt, 110raQ._ or d~ cwn,,,tly av.il&t>L. tom. wh.lch mlnlmizaa tho ProNnt and tut\.lro lt\r-t lO t\um.ar
healtt,~dtnoonvtrnnmont:OR.lllamo.-n\&llquant1tygonor.tor.lha'Wom&doag00dtartn.nortto~myw-11gen«ad0nand.,..-=tno~wau.managemont~
Vla.t b. ■-.il.ablo ID me and 17\at I can at'lon1.
rt.cl Signawre
;'-..
Month Day Yeai I.I .2,7 '7, <
V
..L..J....c....J-JII!:,. 0 1 p1:o.
,._._..L..J....c.J.-1111:,. d I Ill:,.
•I--,,--,---------,--'---------------------------------------~ 20. Facility Owner or Operator; Certification ol receipt ol hazard003 materlals coveroo by m mani!est except as noted In Item 19.
Printe(j/Typ<d Name Signature Month Day Y~
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South Carolina Department of Health
and Environmental Control
lknau af Soll<! & Hazardou, w,.... Mgt
2510 BuQ Street, Columbia, SC 29201
Phone: (B03] T.l,1-5200
PLEASE PRIKT « TYPE !Form de:sicned for me on eUta f12-ortchl tvoewrimrl
UNIFORM HAZARDOUS 1. Generato(sU.S.EPAIONo. ·
WASTE MANIFEST
3. Generator's Name and Mailing Addre:s:3
New Hanover County/ City of
.414 Chestnut St., Suite 101
,. Generato(s Phone I 919 341-713 9
5. Transpor'.e< 1 Company Name Willms Trucking
7. Transport,, 2 Company Name
9. Designated Facilit-[ Name and Site Address SRC Inc.
Box 2005
Columbia SC 29202
Wilningtori
Wilmington N.C. 28401
6. U.S. El' A ID Numb«
A
8. U.S. EPA IO Number
10. U.S. El' A IO Nwnber
11. U.S. DOT Deocription (including Proper Shipping Name. Hazard Cl&s,, and ID Numbetj
Emorgoncy & Holiday,:: (803)734-5'2,
Form ADortMld.. 0MB No. 2050-0039 Ex.cire,; 9~
2. P1oe 1 lnfonnation In the shaded areas b not
ol I roqulrod by Fodera! law. but Is by Stw, law.
·c.~·szitii'~.S ... ri.~:P.+ti~ ... 1q-}i.:UEit~~~.::2~~~f.
o:t~&tr~12~t£tf7·~~~~!~;&!~;1
t~T~ill~fa-+~§"'ld?~~i~~~~
"Ff:~'Pb:xi.~~~~::;~:-~~x.~
12. Containo<>
No. Typo
~ a. Petroleum Contaminated Soil (NON-Hazardous) ~t';"; ·;n~
N 0 0 1 D T 2 0 YD :JF 17 J7 17 I·:; ; rb.;;:--____________________ ....,: ____________ f.J:::..l.:f:..L7.....lLL.l'.:.f:fc!:'..7Gr~->,ii, ~.E,:. =,~·=··~:z-,~~,1l~n:
~ ~c.::--------L--L----------------------'rL.Lf..l.i.....l-LL.Lf--,{=~~.::'?:··=···~'::. ~~:i:1.7'~,rd•
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~711 ' ·~q
~4 ~r 1,4_,, ,____ _)~
15. Special 1-'.arid!ing ln5truction.s and Additional Information , \
Material Code# 01-137-0101
6.. Ci ENE RA TOR'S CERTIACA TlOH: I hereby dociar• tl"lal U'le cont.anti 01 tnla conajgn~.,.. fuOy and aa:u.-.1111Y d.....crit,.ad aboYa by propor a.hipping nam• and ua c!~fia<!,
packed. rnarli:Dd. and l&btltod,and are In all r-~ In proper condition lorU'Vlapon byh.lghway-=ordlng to appUa.01• lntemado.nal and n.tlon&I g~nt ra,gul•tlo,u and
aia La~ of~ Stat. of Sou'Ch CaroOna..
HI am a la.rga quanUty ganflf'alOr, I certify thal I have a proQnun In pl&ce to raduc.i tha volWNi and IDxk::ty of~ g~ to~ da,gr-I haw dai.nTUnad to be economlc.aJty
prac:i~I• and th&! I ha,... -loc\od tna pnact1c.atl!a m.ai.od of troatmant,, a10raga. or di:apoMJ cun:an~y avait.bla ta ma wh.!c."\ mJnlmJz.oa the p,.._nl and fut!Jra ltlr-t ta human
hoa.lth &i:d_ 11"1• envlranmontOR. 111 am• ama/1 quantity gen.n.tor, I hava m.da a good tun .tiorUoriinlmlza my•-•g_...tlon and--'-= tha ba.twu:ta management m.u-.od
1Tl.at la avail&ola ID m. &nd tnaa I can alfon::I.. .
Prinled
I ~,-:::-,.,,.-.,,.----,--------------•~---------------------------------~ 20. Facility Owner or Operator: Certification of receipt of hazardOU3 mat.lriab covered by thi3 rna.nHtd. ucept a, noted 1n Item 19.
Printed/Typed Name Signature Month Day Ye.e '' '~
.---~--·-:·. --· -· -...... --.... .
~ South Caroli~a Department of Health I ~ and Environmental Control
Bun,au at Solid & HazardoU3 w.;,,, 1.41,t
2500 8ulI Stroot. Columbia. sc :mo,
Pllona: (Bro) 73-1-5200 ,
Emergency & Holiday,: (BOJ)T"'4-5"2,
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PL.E.ASE PRINT ot TYPE . (Form de:sicined for use on eOte r12-oitcht tvoewriten Fonn ADoroved. 0MB No. 2050-0039 Exoires 9~
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UNIFORM HAZARDOUS 1. Genorato(s U.S.EPAIO No.
WASTE MANIFEST ' '
Material Code# 01-137-0101
\
2. alPag,e 1 Information In lhe shaded we.as ls not
n,quirod by Foder>l law, but Is by State law.
C. GENERA TOR'S C:E.RTIFlCA TION: I hero by docli.r• thal tho ccntenb of tNa con~n~..,. tuayand a.ccura111if deacric.d at:,oy,a by pro pet .t11pplng name and are c;lu.&ifiad,
pecked., man:Dd,.. and labeled.and &ro ln all ,_pec:ta ln p,opo<candltlon lottranapon.t,y l'ugtiway KC0t'ding to appUc;;a.ble lnt.matlonal -1\d nadonal 9ovetnmant ,.._ulal!on.a &rid
tho la~ of 171.e State of Sou1tl Carolina.
tT I am a large quandty gen..-.tOl'. I cel1tty that I haft a program In place to r•ch"c. o,e -.oi""'9 andmictyglW-..Wg~ to ai. deg,._ I~-detennln9d ta be economic.ally
pn1c:ic.a.ble and tn.at Ina--'-clad the p111C'dc:.a0le metnod of b'eatment, storaga. o, d\apoa&JCJIIW\ay available ta ma wn.lc."I minlmiza• the pr.-nt and fl..lrure lhrNI to human
health and tne onwlrcnmont:OA.11 I am a amall quan0'.ry gon-wa.tor, J ha"'• mad• a good tatl2'I .norttDmtnimt%9 myw-• ;_,.,.don and ael.ct U"I• beat wui. man.a;•m•nt ~
U'\&t i. •....aatii. to me and that I can atton:s. '
19. Oisc.repanc-1 lndica~on Space
'l-::-::-:::c-,::---,::---::-c-:--.--:--,-----,----.,-----,-------------------------~ 20. facility Owner or Operator, Certification al receipt ol hazardou, materiab covered by ttla rnanifmte.xcept u noted In lll!m 19.
Pri),<\,d/Tjl)ed Name · -:, ~na_)um· · / L✓,?
f-s.--D .P ,f? £i /? r1 /<: £"PO V '-cf', A fl ,tr,· = /l/l I/\.• ~ .,__
Month Day YW
• I I. , a.Or\
1• ··• ... ·; ~--· ,_,._'.'··"-.cc::"'..; c~.~-••-.i· · . ·, ,_ ·:: !: "·"', ,_,, -' 'O' : ,, , , . ,o:-: ". , ,>:-:·: ;,,_-·.-.-,:-:-.' ,:,;;; • .-:,-, ;,,:0::-::.>..':i,:·,:, ;;, .:·:-,::,,_;,: -'.-~:ice\;-;,,:.-__ ; C'.-::c ,_:_ -, _-,.; . .-:"'.':-
~ South Carolina Department of Health I ~ and Environmental Control
l!uJuu cl Solld & Haz.lsdou, WlUlB Mg,.
2&l0 Bull Slroet, Columbia. SC :mo1
Pllcn« (B03J 734-5200
Emergency & Holiday,: (B03)734-S,'24
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PL.E.lSE PRINT« TYPE rFonn deslaned for u,e on eUte r12.0rtchl tvpe.A,riter, Form ADoroved. 0MB No. 2050--0039 E.zoira, 9--3Q.....88
UNIFORM HAZARDOUS 1. Gonera1x>(sU.S.EPAIDNo.
WASTE MANIFEST ManJt-t 2. Pa;e 1 Information ln the shaded .. au 13 not "°"";n-'~ o1 I roqi,ired by Fedora! law, but Is by Sbto law.
3. Generator's Name and Mailing Address
· New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4, G<nerato(sPh~no( 919 341-7139
S. Transporter 1 C'.lmpany Name Willms Trucking
7. Transporter 2 C.,mpany flame
9. Designated F acilit"t Name and Site Address SRC Inc.
Box 2005
Columbia SC . 29202
6. U.S. E? A ID N.umbor
A
8. U.S. EPA ID Number
10. U.S.EPAIDNumbs
11, U.S. DOT Dexription (including Proper Shipping Name, Ha.=d Clas,, 111d JD Numberj
ii
15. Special Handling lnstn.u;~ons and Additional lnformation ,
Material Code# 01-137-0101
C~·st,-t;-tl:iiiOO/ti.'~•10·.~.;~~i.;'.,.~i~-:i,;~~l~1.:-.
ri7t.ai.iiolw'irPhoe.~1.L\'.{&t~;z~~~~
t~~y .. --...~-a""i:i~t~~~~~::f};Ek
"Fi.itaiiDOfW'i),vi.;-~~?~~~~~""j:~
12. Container,
No. · Typo
\
a. GENERA TO R'S CERTIFlCA TION: I horel:ry dod.re di.at tho ccntanb of111Ja con.;;n~are~ and -=ura-i dHcr!bed 1boY1I by proper I.hipping namo &nd aro du.&ifi.-d,
pack.a_ marked. &nd l.abOllod.and &10 In all ,_pecta In Pfoper condition lottrana;,ortby I\Jgll■ar rd.Ing tc-.:,pllc::ablo int.m.tlon&I and n.tion&l g~ntr--.iula!lcn. and
'(
Irle laws of the Stata of Sou1h Ca.tolln&.
HI am• l.atge qu&11tlty gon--.tor. I certify U\at I ha.,.■ program In pi..c. tc rwcluc. irio\Ouzne &ndl:DJc:ty cl wasz.ge,-.ied tau,,. deg,_ I ha._ datam\lned io be economic.ally
pnic:ic.b-lo and in.at I ha..,. -lectad tr,o practlc.1blo ITMltr'Kld cl tr-tm•nt. sto~-. or d~ an.nay •va.11.•.bl• to me whlcn mlnlmlz.oa Cha p,..,..nt and tuturo 1:rmw.1 to hum.an
hoalth and ttie onvlronmeti~OR.11 I am a am.all quantity gDl'\el'1ltor, I havo ma.de a goodt&ltn .notttDDUnJmlra my...,1111 gwieratlon and Mt.ct U"lo ~ wa.aie management m.1l'IOd V\al I.a a..-ailaolo to mo and lha1 I can atford.
~ emenl of Receipt of Matariab
A N Signature Y=
s 0 .~~1~8.~T~ran::-,-~-r.~~-"-:2~A~cxn'f'-,0-w~l~~~,~.~m~e~n~t0:f~R~ceceLi~~-0~f~Ma-,-~-rial~-~.----1---...1.~~~Z.,,..::-,k~~rJ.t.~e,..-~--------1Ll.!...t::Z..l.!'...f::
J Printed/Typed Name
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19. Discrepancy lndic.:1tion Sp.aca
SlgnabJra Monttl Cay Y""'
IL.I .I..J...1..J,..J...Jllb,. C ''-L-1-J'--'-'-'llb,.
b I lib,. d I J jh f f-:2:::0-:_ -;:F,-aeo"·"1ity:-;:O~w-n_e_r-=-0r-:O::-pe-ra_1o_r __ -::c,-rn ... _,:fi-ca::,:-.0-:n-:o-;-f-=-,_~p-, o"t7hazat--d~=--ma-lari.ili~-=-ered--:-bJ:-ttti, .... :-rn&nilmt---ettept--..,-no-lod..,,.ln_he_m_1_9. __ ,:_ ___________ _
/ Si/)"')Jvr' Montti Day Y..-
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South Carolina Department of Health
and Environmental Control
Bureau at Solld & Hazatd~u, Wa31B Mi;t.
. 2600 Bull Slreet, ~umbia, SC 29201
Pl10no: (!!OJ) T.).1-5200
Emergency & Holiday:i: (80J)i.l+S<2,
1LE.&.SE PRIHT ot TYPE (Fann d~aned for~ on eOte r12-oitchl tvPewmeri Fonn Aoo1'0¥11d. 0MB No. 2050--0039 E,olres 9-30-aa
UNIFORM HAZARDOUS 1. Genen1tcfsU.S.EPAl□Na.
WASTE MANIFEST
Manll..-t Doc;u,n-,s,..No..
' ' "'f f
2. Pag&·1, ___ JnformaUon In the shaded iwe.as Is not
at 1 requirodbyFodo~law,butlsbyStatelaw.
3. Generat0f'3 Name and Mailing Addres,
New Hanover County/ City of
414 Chestnut St., Suite 101
4. G<!nerato~s Ph~ne ( 919 341-7139
5. Transporter 1 Company Name
Willms Trucking
7. Transporter 2 Company flame
9. Designated Fadity Name and Sile Address < SRC Inc.
Box 200s
Columbia SC .29202
Wi l ni ngtmi
Wilmington N.C. 28401
6. U.S. EPA ID Number
A
8. US. EPA ID Number
10. U.S. EPA ID Number
' ' 11. U.S. DOT Desc:iption (including Proper Shipping twne. Hazard Oas,, ind D Numbetj ·
d.
'C:~'§iiiT~t ... lO~E;~\q':ftit~t~.:m~~"-
·o:::.tAe-~~~~H~f~I~~:-Y.:m~.i-t?-'ft:::~7:.
E.~Tnia~i'"ii~i~Jm!dir.l..~¥il~:305~
"F:~~Phf,i;.:zt~);.1f~~~Zii:~-·if;...,~~
12. Containffl
No. Typo
~~,~~-~~~~;&~~l~~iffi~P'~~~~,g~' 1e···•-···,~.c&\oi.i,;.w-=-u.ii.l·~~%"ii~t'i:
a. LL.J-1 1-1 I c.LL.J-1 1-I ::
:_~-! 1-1 I . d.4.J-I 1-1
15. Special Handling lnstruc:ioru and Addition.al Information ,
Material Code# 01-137-0101
a. CEHEJU TOR "S CERTIFlCA TION: I hot•bydodata lhat th• c.ontents of i,-.1.a conalgn~..,. flJIJand a=n•IY deacrib.cl &boYe by proper a.hipping nam■ and aro cla..,.alfi.-ci,
packod., marll;ed. and labelod, and ar• In au , .. pecm In proper candltlon ror tnnapartbyhlgftwt)'accon:lng ta appik;a.bJ• lnt.m.t!on&I and nationa.19ov.mm.n1 ,--.,ulacloN ar,d 1:h■ ta-o1 the Staie of Soo.to, Cuollna.
111 am a l&i;e quantity g■nOl"'alOf", I c.ertlty ai.r I ha.,.■ program in pl.a.ca to r..::h.u:• C,■woh.1m. .-nd~of __. g■nen.~ to~ d.-;r-1 ha.,. dal.llnnln.d \0 be economlCLlty
.prac:ic:a..b!a and tn.al I have MLoctad tn• pracl:lc.abla matr\Qd of ir-an.nt. stor--.,e. o, cilll,poMJ ~tty avall&bl■ tome whld'I mlnlmiz.aa aia pr.Mini and futlJra thr-t to human
hoalttl and :ti■ ttmtlronmiM'lt:OR.111 am a sm.a.11 quantity gon.rator, I ha'W■ mad a a good tanfl eftol'I~ my w .. 11 g_,,.,.Uon and aelectth■ ~wa.ate management IT"llr!hod . lt\AI la avail&.Di. to me and 0"1&1 I c.u, altot"d.
Montn · Day Year ,/ z, Cf, 9,c ;J; 17. Tran · I of Maleria!:!
A Prin N Mcn!h Year
~f:-:--:;----:--:--:--c-/.-,!:.,...:l--£-c-:LL,...C..,..,_fL._2.....,...L_.,L.::::i:.I:::Q~;,_L'...£L:'-':~~2--_;_ __ .....}~..J.:d;:2'.l\! o 1a Transccr'.er 2 A owledgement of Receip..1 ol Material,
[l,J
~ t--;;P:;rin::,:-ed:;-1;:;T:-:yped::-';-;Nam:;':--=-'•'-'-'-'==:.::.:.c:=.:::;:;.:.=.;:;;::.:.. ___ r.:Si:-.g-na_w_ru ______________________ -:--:--:;:--;~--,;;
Mcn!h Day Year
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19. Disc:epar:q Indication Sp.ace
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~ 20. Facility Owner er Operator; Certifi~ti9_n ol receipt or haz.ar~ mat.eriab covered byUli.1 manamtuce,pt a., noted In lt!lm 19.
lib,. C I \lbs.
\lbs. d I \lbs.
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South Carolina Department of Health
and Environmental Control
Bureau af SoUd & Hatardou, w._,., M;t
2liC0 Bull Slreof. Columbia, SC 29201
Phone: (BO:!) 734.5200
Pl.E.lSE PRIITT oiTYPE (Fann deslaned for use on eUte r12.0itch1 tv?flwrita.1
UNIFORM HAZARDOUS 1. Generate~• U.S.EPAIDNo.
WASTE MANIFEST
3. Generator's Name and Mailing Addres:s
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Geo.,;,to~, Ph~ne ( 919 341-7139
5. T ransportef 1 Company Name
Willms Trucking
7. Transporter 2 Company Name
9. Designated Facilil Name and Site Addre:53 SRC nc. ·
Box 2005
Columbia SC .. 29202 ..... -------....
6. U.S. EPA ID Number
A
a. U.S. EPA ID Number
10. U.S. EPA IC Number
11. U.S. COT Ce,c.-iption (,nc!uding Proper Shipping Nam., Hazard Clas,, ind ID Numbetj
' '
Emerilency & Holiday,: (80:J)7J.l..5,m
Fam ADDnNed. 0MB No. 2050-0039 Ex0ire:1 9...J0...8.t
2. fl981 lnformaUon In the shaded woas ls not
al ( n,qulrod by Fodoral law, bulb by Stato law.
c:i~i"-=-~-,,, .. # ro~:g1~ ... ~~~~£5,RE:~-~~-
oitAimn"W..·~~~~!~1'~~~~~
t~T~~i"'ri~~"f1E:&&f..Z:7"-;".Sfft£~~
"Ff~'Phol.;~f.'~-~-~-}:~i·z.:.'-'....-s:.•.:~;rtt
12. Conlainer> 13. Total Ouanlily 14. Unit {r,~..-~~
No. Type . . W.!Vr:J. --~~~?-;
G a. Petroleum Contaminated Soil (N0N-Haz,ardous) ur~"T'('~ ~ 1--.....:. __ _:__:_ __ _;_ ____ .....:......:. ___________ ---i:o::....i:o::.J.::1:.+o.JT.!....!--'-....L-1::2..Eo.J.v!.!o::.....~·i/.1~_,t::2~1::::2~,2=.::::,2=,~l
~ b. l.i_ ··_ ·_; __ ··";_-_-_··_; '",~
T iv .1...1 J 1 1.}! ~ rc.---------------------,--------------t-'--'-t-'-t-..._-:--'--'-r-i:;f~;;:-;::I ::::,:::,=::::=:,rt
~~-~-'-'---~--J-~-
d.
15. Special Handling Instructions and Additional lntormation \
Material Code# 01-137-0101 w F3 ITT tr
15. C EJ,jfRA TO R'S CERTIFlCATIOH: I hereby dedara that the contont:s ol !tua cor..,J,gn~ are fldlyand a.=ra.i'f d•~ aboww by pro pet ahlpolng nam• and ar• cl.-ifi.c P■ckod.. m.&rk-.d. and 1.abeled.and u• In &U , .. poca ln pl'op,et' condilicn 10f'tl'Vla.9Qn b'f hltilh...,-accordlng to qi~ lntematlonal and national gcrvenvnant,.,_ulatlona az,
th• Laws of~ Slat. ol Soulfl C&roUna.
N lam a largo Quuidty gen.,.tor, I cartlty 1:hal I haV9 a p,ogrwn In pl&ca to r.du0111'\e-.dum. and tolddtyofwaatg.._.tadta a-d~,,_ I ha..,. detarmlned \o be .conomlca.JI
pnu:::ic.abl• and that I ha--loa.od V\e practlc.able rn.tnod of troatm■nt, sio~-. Ot d~ CWT8fflty --.itable to ma which rninhnJ.zaa the p,,_nl and future a,r-l to numa
hoaJIJ'\ and IJ'\e ef"lvlronment:-OR.11 I am• am.all quantity gone.rat.or, I have m&d■ a good tatin ~re =nimlza my •--generation and-.lOC'I tl'\a ~'WUU management meU"lo
trl.at I.a avai.l&bi. \o me -.nd Cha1 I can at!Ot'd..
~ 17. 1 Acknowledg t cf Rec:l?ipt of Material3
A
i f:-:--J-~e:::;~4~~~::L-~::!..:....-4<~:t:.C:.:::'.::L.L_.LJ....~Z:::'.:'.l'...::~::'.::::::..:~-...\..2C...~?;t:~===::t!c__.L:::.JL..t::I...L.r ~ ~1;.:a.c_,::.,ran=s:.po:.,rter.:::...c2:..Ac:cxn=oc:w::.led:.::,gc:e.;.m::•.;.nt::o:.:f.;.Reeo=::i:::pJ:.::c.::.:::.==~--~-----------------,f,L----------::--::--
T Printed/Typed Name E R
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19. Disc:ep.anc-j Indication Sp.ace
•I .................... ~libs. cf .. _._,_., ........... ~11""-
b I fibs. d I \lbs.
·~--=--:::--::---,-----,,------,----------------------------------~ 20. Facility Owner or Operator; Certification ol recgjpt of hazardOU3 mal..erials ro,,,ered by !his mani:le:ste.xupt a., noted In ttem 19.
~{Typed Name · ~gna_J!Jre •
l---1"RR r<Cil?A R.r--Pl? Y V\,,, A /-, -n,. ~. ,__,,._,, IV Month Day Ye.
• J ,<,;7§l9_
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Buraau o1 Salld & Ha=dou, W""" M!jl.
2!iOO Bull Slr..r, Columbia, SC 291ll1
Phone: (BOJ} 734-5200
Emergency & HoHday,: (BOJ)J'J4-5"2'
PLEASE PRINT ot TYPE (Form de:!Licned for u:se on eilte U2-oitch1 tvoewritBl1 Form ADcroved.. 0MB No 2050-0039 E.toircs 9~-Ba
I.
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Malling Addres:,
1
1. Genorato(s U.S. EPA ID Na.
I I ! I I I I I I
New Hanover County/ City of Wilnington
••
a.c.an11eat ·
1
12. Paoe 1 =~1,No. of I
• I 1 t"f '::J
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. G<neratorsPhona( 919 I 341-7139
6. U.S. EPA ID N.umlier
llnfonnation In the shaded auJ.as b not
roquirod by Federal law, but ls by State law_
5. Transpon,,,-1 Company Name Willms Trucking
7. Transportor 2 Company Name
,A I I • I • • • • ' '
8. U.S. EPA ID Number
' I I I ' · 1 • • . I • •
·o:t~isooa-r~~~'!!!t:t{W$;1ttm~~~~tr
't~t~~~{if~~!f~·,-1~..Z;ti¾~{~~
r.{.~'Phtii.~?~~%?.!tz~~'-i~x.~~
9. Designated Facility Name and Site Address SRC Inc. 10. U.S. EPA ID Nurnb,r
Box 2005
Columbia SC 29202 ,t\A,,,,,, ' . '
11. U.S. DOT De=iption (111cluding Prop« Shipping Name. Hazim Class. ind D Numbe,/ 12. Container,
Na. Type
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d.
' . ' ' ' ' '
15. Special Handling lnstruc!ions and Additional Information \
Material Code# 01-137-0101
he. C. EHER>. TOR"S CEHTIFIC.A. TION: I h•r•by dedu. that 1h• conllllnts ol lhla con.JgMMWlt.,.. fuly and ad:uraalY d..,c.rib-1 abova by propel" shipping nam• and .,o c.!u..a.il'iad,
p•clr.od. mArXod. and tab91od,and are In au ,_p,9Cta In ptope, condition foftrv,aponbyhl;rr--,~ to ~p1k:abl• lntamatlonal and na'don&l govemtnent r~ulatloru and
th• la~ o1 tne State ol SouU\ can:itlna.
HI .am a largo qu...ntlty g•nenator, I carUtythat I ha...., a program ln place ta r.duc. th•'IIOlume andmJQtyot waa:ta;enaraWod tc, tne d.-J,._ I h.awi d•termln.d to b9 -.conomlcaJly
p~C::cabl• and '"-&t I h.av-e -loctecl U'l.• practtc.aol• m•lt,od ol troalm•n-t. a:torao-. o, d~ a.inw,ay rrall.abl• to me which mlnlm12.na th• p,..,_ntand tl.ltur• lflrwt LO hum..n
ho.,Jtn and th• onvlronmont:OR. H 1 an, .a am.all quantity ;onerator. I h.a11• ma.cl• .a good taith af'l°'1mamn.lml.%9 my•-• g..,....tlon .and-1.ctth• be&.t w-..ie m.a.nag11ment m.t:hod Iha[ la availabl• cc me and that I can atton::L
l;Ji;nlediTyped Name
'/<4t/~r, ./ , / Month Day Year · , , I,/ ,.7. 9, '7,<'.:
T l 7. TransP0rter l Acknowledgement cf Recaipt ol Materia.13 A , 1
Rl--;;-:-:--:,::c-~---'------'--------r::---/i'-{----,---,---,-----------,-,--,-::--,:--j ~p1cf!j('je, V (F('J y I/ a/ rt-, ISig;tf:rx /,u~, ~ /1 1,/n '. A 11,(/J .J}-{/";;
~T }-1"8.-;;T::;ran:;:-s';l)O:;rt::-ce':-r'."2-;'A;-:cl:n:-:-o....cwl::.edg=e.::m.::e.::n::.I ::.ol.::Reco==ipt:.o:.l::.Ma:::.;te:;riaJ.::' :;''---,:::--------,~//;._ __ _;__ _______ _; ____ -;-:-:-::-:;:-~--::--~ Printed/Typed Name I Sigr.alllra v Monlh Oay 't6.!!
F ,._
C I L
19. Oisaepancy lndiQtion Space
I I J J J J J
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lll:,.•111111\1"'-
llb,. d I I I I I J \I"'-
,I r:;;;--;:--:::,--;:----;:------:,--:,::-:,---;--:-,-7:---,-.,----,--:-c-----,.,--,--,------,-,---------------
1~ 20. Facility Owner or Operalor, Certification of receipt of hazirdou:s mat.eria13 covem:f by ttu., manilml: except a, noted In lttim 19.
~T~_!l•me ~ , l I~•"• L , -Month Day Ye.ti.!
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South Carolina Department of Health
and Environmental Control
llutwJ of Solid & Ha=dc_Ul W..,. M;t
2500 Bull Stn••· Columbia, SC 29201
Phontc (803] ™-5200
PL.EJ.SE PRINT or TIPE O:orm dasioned for u:,.e on eOte f12-oitch1 typewriter\
UNIFORM HAZARDOUS 1. Generatcr',U.S.E?AIDNc.
WASTE MANIFEST
3. Generato<'s Name and Mailing Ad.dress
New Hanover County/ City of
414 Chestnut St., Suite 101
4. G«ieratc~,Ph~ne/ 919 341-7139
5. Transpcrter 1 Cumparry Name Willms Truckino
7. Transporter 2 Company Name
9. Designated Facility Name and Sile Addresl . SRC Inc. .
Box 2005
Columbia SC 29202
Wilningtoii
Wilmington N.C. 28401
6. U.S. E? A ID Number ,A
a. U.S. E?A ID Number
10. U.S. E?A ID Number
11. U.S. DOT Dexription (including Proper Shipping Nams. Hazard C:.S., and ID Numbetj
d.
15. Special Handling lnstruclior13 and Addition.al Information ,
Material Code# 01-137-0101
Emergency & Holiday,: (llo:JJ™-5424
Form .locroved. 0MB No. 2050-0039 Eloire:s 9-.::30-88
2. Pa;e 1 Information ln the shaded acaas Is not
of / required by Federal law, btrti, by State law.
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12. ContainM>
Ne.. Type
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e.. GENERA TOR'S C~RTIFICA TION: I hot•C'f doclar• trial U'I• alntenb cl trlla con~n~ ~fl.dty arid -=n•JY d•M:l"lt.od aboYw by proper shipping nam• and ara cla;u.lfilld
packed. rn&n:ed. Uld t..botled.and at• In all , .. pec:a In Pf'opet' condlllon lo, tranapon by ~trway~ to a.ppllcabl• lrrtamatlonal &r1d natk>nal govemment,.,_ulallons anc
17\e laws ot t11.a Stata 01 Soud1 c.arotlnL
y
HI am• Wge quantity g•noratcw, I certify thal I ha..,.• progr.m in placa to reduca tha W>luma and 11:D.Jcityol•..ta1g.,_.tad to !he degtM I ha,..,. d•l.ilnnlnaod tab. eeonomlc.a.ll)
pl'llc:iG.2.ble and In.al I ha..,. -iectod lh• p1'C:Gabl• mainod 01 tJ-tm•nt. CCraQ-. 0f"d~o.m11nt1y ....-..11.abl• tom. which mlnlmlz.ea tna p,._nl and tub.Ir• thtMl to l'\urnar
healtn and the envlronment:OR, II I am• am&JI quantity QIN'\e.nltor, I hav• mad• a good tantJ -11ont1:11ninimlzil mywu• g--.tlon and N'lac:'1 th• ~t•..t. management tTN'thoc:
V\al la avail.a.DLe to me and tt\01 J can afford.
~/Typed Name 1::.A /1'1.<fYl.1) L
~ 17. Transocrter 1 AcUlowledgement of Recei;::t of Material.s
~ Pnnled/Typed
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Month Day Yea
0~ f;-;;--:;:=:::~~~~=~~~~~;::::=---L-....:t.~§,l~=--7,;J+.~¢;..t&a::2~---------1Ll.L.IL'..l.-:-1 r.er ACXJ'lowl~ement of Recei ol fv'.ateriab
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19. Oisaepancy Indication Spa.cs
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Pnnled/Typed Name Signarure Month
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·· South Carolina Department of Health
and Environmental Control
Bur.au cl Solid & Ha=dou. Wa,,o M~
2!iOO Bull Slreot, Columbia, SC 29201 ·
Phone (80:lJ 734-5200 . . . .
Emergonc;y & Holiday,: (803}734-S.2• · · ·
Pl.ElSE PRINT or TYPE ('Fann de:si ned for u:sa on elite 12~prtch ~w1it.erl Form Aoornved. 0MB No. 2050--0039 Exol,... 9~
UNIFORM HAZARDOUS 1. GoneraOJ(sU.S.EPAIDlio..
WASTE MANIFEST
~tt-1 2. Page~-·· lnlormalian In the shaded Meas Is no· ~ cl requkod by Foder>! law, but I, by Stato law:
:l. Generator's Name and Mai.Ting Addres:s New Hanover County/ City of Wilmington·
414 Chestnut St. ; Suite 101 Wilmington,NC. 28401
A. Generatof,Ph~ne 919 l 341-7139
·c:.:s,,-;;-rru..rote?i .. lO~~'b:t~~~4:;~:;::;-2;_1-:-:t'
05.tAii-lmi.'&Phoe.~!-:::1G-~~t£:..~1;J#'!t-:{::
7. Transporter2CompanyName 8. U.S.EPAIDNumber E~T:'<-•W----·-1D~t]~~3:t~,,;JE:/.f.S.:i-.t
.Ff~~~':-q2.Z.~~~i~i-f~~~:f.~
9. Designated Facility Name and Site Addres.s SRC · 10. U.S. EPA IC NwDl>er
Box 2005
Columbia,SC29202 1NA
11. U.S. COT Deocription (including.Proper Shipping Name, Ha=d C/8s,, and ID Number! 12' Containers
No. Type
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15. SpeciaJ Handling ln.stn.Jctions an~ Additional lnfcinnation , \
8. GENE.RA TOR"'S CllTIFJCATlOH: I her•by dodat• thal tho contents of lhla cona,J,gn~aretdy'and accurat11IY doaaibed abov-e by pm pet shipping name and ar• clua.iri•
packed, rnal1i:Dd, and lat>.led,ancl at• In a!l t.-apoctl In prop« eondlllon fotlntUporttrf hlgbwayac:of'dlng ta appllca.!nlntllrnallon.al and naUonaJ gOVWTnrnentrwgulallon.a 1., a,• la~ 01 tn• Stai. 01 Sou1h Carollna.
NI am• La/go quantity genonitor, I can.tty UU.t I ha-a program In plaGo to reduca ltlAI -.olumeandcu:dc::ty cfwastogOl'Wn,lacl to ui. d.;,_ 1 haV9 d ■tart?Un.ct tc bo .conomlc.a
p~c:ic:a.bl• and tt\..&t I ha--lectod th• pnu;tlc.abl• m•t:1\od of ~tm•nt. .to~e. 0t db.poaalcutTenC)' avallabl• tern. which mlnlm.J.z.iu tt\e p,,.,_nt and tun.it• lhr-t tc hum
he.&lth and tt\e envlronment:OR. HI am a ama.11 quanllry goner.to,, I ti...vo ma.do a good ta.Ith eftof1110adntmiz.a myw ... g~tlon and a.elect the ~twa..ai. managem-,nt l'T1'0<:h-
ui.t I.a available ta me and 1f\.al I c:..an &ltOld.
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Month y,
Month Cay y,
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'1-::-:-::--:::-:---::------,--,--,------------------------"---------~ 20. Facility Owner or Operator; Certification ol receipt o! haurdoU3 matarla.b coveced by ttti., mamest e.xcept as noted In 111,m 19.
Printed/1yp,ed Name Sigr.a!lJre t.\onlll Cay Y,
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South CaroHna Department of Health . . lluruu ol Salld & Hawd~u, Wll'8 Mgt..
:2liOO Bull Slroot, Columbia. SC 29201
Pllono: (SOJJ 734-5200 and Environmental Control
Emorg'"1Cy & Hollday,: (!o:llT.14-5'24
Fenn OMBNo.==&ot,...g-:30-88
2. Pao-1 lntannaUcn In the shaded· Meas ll not
cl ,1 requftodbyFodol1ilaw,but~byStalalaw.
d.
15. Special Handling ln.stnJcfom and Additional Information ,
I!.. C D(E.RA TOR"'S CERTIF1CA TION: I h•r•by d~r• that th• cont.ants of tnia conaS,;ntMl'\t.,.. t,ty and a.a:u111•IY deecrlbad &baN by prop« ahlpp(nQ name and.,. cia.Mlllad,
pac;.kod, m&n:ad. and .._o.,~.and ~• In &11, .. ~ ln PfOpet' eondlll.oo Jorin.naportby highwayaceordlng to appilca.t»e lntamadon&t and nat!ona.l government r.g1,1lallona and
C"I• la._,. of tne Sl.al9 ol Sova, Carolin.a.
Hlama!.-,gequ.ntltyg•~tor.lcertltythatlhaveaprogr.mlnpl.a.e.tor9duc.ttt.e'IOl~ardmJdtyolwaatitgeniwatadtacti..deg,...lhawd•tannlnedtobe.conomlc.a.11y
prado.t:le &nd tnat I hav-e ~ U'\e practtcabJe m.triod ol ~im.nt. 111::ir--.;i-. orCia.;ioaal c,,nanr:y avall&ble to tne...tud'i mlnim!uia Iha p,-nt&nd Ntt.i"' lhtMt to h1.1man
h-.lth and_ !he .,,.,1,onment:OR. IJ I am a amaJI quantity go,n.,..aLof', I han mad a a ;ood tata, affortmmlnlmtu my w_. g__,.Uon and ..ieci:1"\a bat w..te m&NQ&ITHlnl m.-thod, cr,.a1 la •~I• tc ma and lhal I can anon:1.
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Signature Mcnth Day Year
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Sign.ab.Jr& Month Day Year
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South Carolina. Department of Health
and Environmenttal Control
Buroau of Solid & HazardoU3 WCIB Mi;t
2&lO &U Slroei, Columbia, SC 2:llll1
Pl>On« (803) n,:~"00
-EASE PRINT or TYPE t'Form de:sianed for use on~ f12•oitr:h1 tvPfJWritan
UNIFORM HAZARDOUS 1. GenerallJ(s U.S.E?AIO Na.
WASTE MANIFEST ' ' ' ' ' 1 Generato<', Name and Mailing Address
Msntr■st Docum..,t~ ' ' ,o ,'1
New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generator, Ph~ne I 919 341-7139
5. Transporter 1 C:impany Name Willms Trucking
7. Transporter 2 Company Name
9. Designated Fadit-f Name and Site Addre:53 · SRC Inc.
Box 2005
. __ Columbia SC _29202
6. U.S. E1' A ID Numb«
,A I
8. U.S. E1' A ID Number
10. U.S. EPA 10 Numb« ' '
' '
Emon,enc;y & Holiday,: (803JT.l-4-5-424
Form Acoroved. OMS No. 2050--0039 E.ioires 9-J0-88
2. Page 1 lnlonnatlon In the shaded are.as 1, not
of required by federal law. but Is by State law.
'~~Sta!al'r'ffliOciWi·v~~F\~,-"!.=i~:&iti:-;S.1,::~~~-5.::!h~f.
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11. U.S. DOT De,cription (including Proper Shipping Name. Hazard C:.... ,nd Ill Numbe,j 12. Container:,
No. Typo
15. Special Handling ln:struc~oru and >-dditiona.l lnfcrmation \
• Material Code # 01-137-0101
e. GENERA TOR'3 CERTIFlCA TION: I h11r11by ddra tn.atthe cont.enb 0ftn!a conajgt\l'Mntan fulf and accura•iydeacribed &bow by ptapet -.hipping nam• and are c.J&3.&.ifi9d, '.
packed., m.ari<:Dd. and a.be led.and iue In &11 t"pect. 1n pc-oper condition lot iiwtapot"tbyhtghwayac:conilng to a;iplk;at,Je lmamatlct\&I and n.adonal gov.nvnent ,.;iulallon.a and :
a,11 la~ ol tn• St.ar. of Sovih C&rotlna. • i
It I am a largo quantity g11norw.tor, I c.en.ltyth&t I ha,... a program In pl.a.ca to r.cluca tn11 ~uma andlm:ic:tyof ._...g.,_..tad tD the deg, .. I hsw d11tal'T?Unll<f to be .eonoml~!y .
pr,ac-:iCU>I• and th.al I ha..,. aaloc:tad th• pn.ctlc.a~• mainod ct tT-an•rn. a10ra,_., or diapow cun.t\tl'f --.il&bl• to 1n11 whld'I mJnlmlz.a• tn• pra.aent &nd hJtur•.ltlr-t to num.an ·
hoaJO"\ and tna onYlronment:-OR, If I am a Slnall quantltyganerator, I h&'te mad• a good iata, .nortia..Wmtz. mywaa• genera don and -liK:ttn• ~t wa.ata management l'l"rll1hod
lhat 1a a-.ilable to ma and th&1 I can anon1. . . . . · • . . . I
L Month Ca]. Y.., I I .I 2lt 9 u
1~ 17. Transpo ement cf Receipt cf Matariab
';'.; Printedny
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o 1a. Transpcr'.er 2 ACXI'lcwledgement of Receipt cl Material, 1i ~=-=P"nn::t::ed.::/:::T;.yped:..::.Nam=:::.:::.:::;:::::::::::.:::.:.::.:::::.:::.:::::::.:::::::_ ___ ~s;-·-g-na_OJ_re;_ ________________________ -,---,.,--
Month Day Yw
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19. Discrepancy lndic.alion Space
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South Carolina· Department of Health
and Environmental Control
au,_, ol Solld & Ka=dquo w_.,,, Mi;t
2600 Bull Slroot, Columbia. SC 29201
Phcne: [phone]
Emergency & Holiday,: (800)734-5'24
Pl..£ASE PRIHT or TI'PE (Form desianed fc( use on eUte f12-gitch1 tvoewrit:eo Form Acaroved. 0MB No. 2050-0039 Exairllt! 9--30-88
UNIFORM HAZARDOUS 1. Genorato(sU.S.EPAIDNo. M&nlfect
Doc.um.n No. 2. Paqe 1 Information In the shaded Meas ts not
al 1 n,quirod by Fodera! law, but!, by State law. WASTE MANIFEST
3. Generator's Name and Mailing Addre:.s New Hanover County/ City of Wilnington
414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Gener.ito(sPh~ne( 919 341-7139
S. Transporter 1 Cvmpany Name Willms Trucking
7. Transporter 2 Company Name
9. Designated Fac:\ity Name and Sita Address SRC Inc. .
Box 2005
Columbia .SC 29202
8. U.S. EPA ID Number
10. U.S.EPAIDNumber
11. U.S. DOT De,cription (1nc!uding Proper Shipping Namo, Hazard Clas,, u,d ID Number!
d.
is. Spedal Handling lnstruc<$ons and Additional lnlonnation
Material Code# 01-137-0101
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12. Container>
No. Type
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e.. CEN ERA TOR"S CERTIFlC.A. TION: I h•roby dec:Jlr• th.at U,• contents of tnl• ccnlilgn~ arahllty.ncl &.CCUBlaly d•IGribed aboW by prapo< ahlpplno n ■m• and aro cl~filtd
J)•cked.. rnarlled.. and Labeled, and &1• In aJJ ,-~ In ptop,ar condition f0f" tranGpOrt't:ly hJghwayaccc.-d.1n9 to appllcabl• lmama.QonaJ and n.atlonal gO"-t91'1\tT1,ent r99ul1itlona ant
U1• laws of tt1<11 St.ate of Sou1h CatcOna.
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tr I •m • t.sgo c;uanttry g•nonitor, I c.erdty ai..t I have a pro;iram ln pi..c. to t.cluo.1he'IOiume and rz:matycfwurag---.wd tD ~ da,g,_. I h,a,,. d•tell"TUned to be oc.onomlcaJI:
pnac-:ic.a.bl• and tru.t I h&...,.. -lectod tn• pt'li~c.abl• meinod of tr-lm•nt, 11D~e.0t ~ ~ avallatila to m.wh.lc.., minlmlU• Ui• p,....nt and fl.ltl.zr• tr"lre,at tc hum.a,
he.aJtn -.nd :2io .nvlronment:-OR. If I am a Sl?WI quantl'ryg-.-atar, I h&ve mad•• good taJU19'tlortromlnlmtz:a mywu■ gen.ration -.ncl a-'ect l!i• beatwa.i. man.agomont rn-th0<
V\&t la •v&.i.J..a..ti.1-to me and tnat I can at'lon1.
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~ H. Trans rt.er 1 Acknowledgement cf · taria!3
A Printed/Typed Name i f),
o 1a Transpcr'..er 2 Acltnowledgement of F.ecei~ i f---:P:-ri:-n-,ed":--:,T:-yped-:-:Nam..:..._..:.e_...:., __ :c..;.==.c...--"--'=..----,,--Si,,._9_na_lll __ re _________ ...;... __________ ,.,..Mon-th---:O:-a-y"'""'Y.,-.,
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19. DiscrepanC'/ Indication Sp.ace
11-,..,--,---,--------------------------------------------------~ 20. Facili~ Owner or Operator; CertifiCJtion ol receipt cl hatardOU3 materiaG covered by tt'lil mani:f~except as noted In nem 19.
!Type<: Name ·9
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. ~ South Carolina Department of Health eur..uo1So!ld&H.mrd0_u,w .. 21..1.i. · ~-.. and Environmental Control ~Bu0~~;:.._sc 29201
· 11 EmeqjM<y & Holiday>: (S/)3in-4-S424 l1i :>.SE PRIMT., TYl'E CFonn deol nod lcnzse on e111a 12-oitdl onn kl roved. 01..18 No. 2050-00:)9 E>clro, Q.JO.aa UNIFORM HAZARDOUS
WASTE MANIFEST
1. Genan,1e(1 U.S. EP-' JO No. lnformaUon 1n th• ah.adtd .,a,u b net requ~od by Foder>! Jaw, bvtl, by S!aL& law.
I d.l ~i·-,,;---,,,,,·,i?J
111 .[t~~~Uairo@o"u,i:,-f~0il"' <'-->,,-r:-t:;..-::,s,,-:;}-i,T{,.t-.;."'i,~'e¼'<;;;\'f;''-I('.; ...... '" . ,_._, -.w.i!m!~~~;:~~ ~ ...... ~;.:..~;:-~~r-~:=-)7.r•~~~•tt;;~~~~I:.rr~~. ~ ~-;,._~::.:Sj/;h_i,.~;;..•.... · -~ ~;:;-~::JJ'il.~<iJt• -~-...•-::-m-F~=;;:~i\:.@·,.:.s.~&.<).-r.'·•~L.;,~,:.~1>.-.. ..~J-•4~·=--..:"-.!~' _,r,; ·--~ ....... .......,.~s;;, • ..1,,,.,~ ~••· ;._1,;,; ___ • I -~-07 h 'e ""-Pl ,s;:$ •. -,<> -~ -,..::. ',;;,i,:,.;,= ~~~~~,:r:r•i..'} i.. LL.J-d ' ' 1 ' )-1 I J ' 1-,_ -1 L.-l'-''-'-' "."~~~4~~---: l R _ · . ~~1-:!~~:t-tf
I II a,_ CDIUU.TOR'3 C£RTIFICAT10N: lh-et•byd<Kl.at•lhallt'le con~nb oltNa conal,;n~u. ~and u:cvn,llllyducrlbedabow by prol)4'f' &hipping tu.m• &nd 1r• e!&.Ul"e-d. I pac:.k-.:1,. rn.&t'Aad.. and lab.led, and Al■ ln all ,_p«::ta ln pl'Opet ccncilllOl'I tor tn.naport by hlgh~ ICCOt'd.lno ta AP~ WMm-.tfonaJ and n.alk,naJ 5~t,..._ulallcna &l'ld th• laws of~ Sta-1-ol So.rt, CuoUn.a..
HI am ■ I.&/;• quantity ;•~tot. I e.nlty O\at I h.&'1'9 ■ program ln r,la.c. ta r.duc. 12"4 'l'Olume &ndmJdty olw■.-t. g,._..t■d 10 tNI d.gr-1 ha..,. d1t..ffTW\.d lo be .conomlc.i.J1y pr-adc.able Uld U'\.at I t,,,a..,. w~ lh• prac:1jcabl• m.lhod ol tre.tment. ~--et C:~ ~n.ey avall&ble tc rn.•l'!Jc..'\m.lnlmlu• th.e p,..._nl &l'ld h..CJr-e thr .. l lo hum.a.n l'le.a.llh &nd ~ .-nvt,onment:OR. ti I a,n • am■1J qu■ntir, g.....,..tor, I have made a good tam\ •rlort tl~ myw...-g_._..don &nd a.(ect th• ti..t w...t. m&n.19•ment fM'-tr'oOd I
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IJ\a.t la anilabi.10 me &rid a-..t I can ■llord. • . . . • . . . .
\,F,ruit,,d/T~ Namo 1/, I'\ ""° 11 c, L, C /.._._.(t. c_j,'-t---,......----"-'-r'-----'----17. Trarupcrler 1 >.clcnowledgement of Rec,ipt ol l..laterials T
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18, Transpor,er 2 "°'1/owled<jement cl Rec<i.i ol l..l.11.erlab I f rint,,d/T )'?<d Nam•
1 Sil Oiscrep.anc-1 lnc1c.ation .Sf.ace
I 1 ................. ~1 _.(Ito. • I
b! JI 1\1to.d!
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20.IF•t1lity Ownes or Oper.ilor, C«tificatton cl rec-eipt ol l\aurdou3 ma14rials eov,,,d by thi, nw-.ao.t exupt u noted In bm 19. .
,,Ir, ....... r ..,..,_ "°'
South Carolina Department-of _Health
and Environmental Control
l!uruu ol Solld & t!wrdqus WU!o 1.11,1..
2W0 8"11 Slroec, Columbia, SC 29201
Phone (80:J)™-5200
fme«;Mcy & 11cildays: !ao3J™-~24
(Fonn de,! nod 11:>t""" on ellte 12-oitx:h -•-1 Fonn Aooroved. 0MB No. 2050-oo:l9 Exolres 9-30-M UNIFORM HAZARDOUS 1. Generato(aU.S.EPAIDNo. WASTE MANIFEST
3. Gene<2to(1 Name and Mailing Addnm . New Hanover County/ City'of Wilmington· 414 Chestnut St. , Suite 101 '. .Wilmington,NC. 28401
',I. Gen.,.i;,;,, p~. 919 3 41-713 9
19. Oixrepar,c/ Indication S,,.,ce I 1
1· . . . I I 11. 11 1 libs. CI i.. . . . . ,;J . b I I I t t t )lbs. d I
I .!. 20. F;~o1ity Owner or Op,eralor; Certific:a~on ol receipt of l'l.a2.ardou:, male.ria.b coveced by ~~wd. ucept u naled In l8m 19.
I I I )!b.
.1 t I )lbs.
. Prt>d/T c' . S~Nll!Jro A t} /7 /...J ~onlh O•Y ·· Y= -c'-7,.J . .
:e South Carolina Department of Health
and Environmental Control
&ruu of Solid l Hawdqu, Wa.,t,, l.li;t..
25l0 8ull Stroot, Columbia. SC 29201
Pt>onc: (BOO) T.14-5200
Pl.EASE PRIMT or TYPE onn deol nod lot use on ellta 12-pib::h
UNIFORM HAZARDOUS WASTE MANIFEST
1. Generatofa US. EPA ID No.
3. Genento<', Name and l.wling Mdniso , , . New Hanover County/ City of W1lm1ngton· 414 Chestnut St. , Suite 101· Wilmington,NC.
~-~erato(sPh;,,,, 919 341-7139
S. Transporter 1 Company tlamo T,vU:.:
~ency l Hollday,: (Bo:ljT.14-S,m
2. Pa;t: 1 Information tn \he aluded are.as Is not ol I requlrodbyfoderallaw,bulbbySta~law.
28401
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E 'Printed/T~ Name ';naiuy Monlh Cay Yw A I
I 19.. \°'screpancylndic-tion.Space
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b I , , 1 1 1 1ll:o. d I , , .1 1 1 1ll:o. I~ I I ~•r.:::~-:::c-::c---,.--,-7'"=-:;"--,--,--,-,---------,--------------------'----7 20. Facility Owner or Operalor, Cer1ificaHon 01 rece;pt ol haunloo3 matoria!, eov"'<>:! by !his rn,r.3o,t except u noted In Item 19.
E .-South Carolina Department of Health
and Environmental Control . .
&ruu cl So!!d & H.=rdo_us WC!O l.4gt._ 2500 Bwl Stroe1, Columllia. SC 29201
Phone (80:l) T.14-5200
Eme,gency & Holldays: ~™-~24 Pl...1.SE PROO otlYPE O'onn de,! nod tot""' on ollte 12-pad\1 UNIFORM HAZARDOUS 1. Genot>,,(111.S.EPAIDNo.
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WASTE MANIFEST .
L G-.lo<'a Nome and Uaiilng Address • • I . New Hanover County/ City of W11mington · 414 ,Chestnut St. , Suite 101 '. Wilmington,NC. 28401 .'-G<ner.ato(s Phone [phone]
l'i-Transpo,:te<~ Com~lwn•_ .. ,13{', ~UjEP>-lllNumbe<
07. Transporlar 2 Company Name a. U.S. EPA Ill Number I . .
9. De3lgna!ed Facility Name and Sllo Add,.,. I · SRC
Box 2005 • · Columbia,SC29202 NA ,
10. U.S.EPAIONUIUba'
11. U.S. DOT Oeoeriplon (including Proper Shipping /lame, Hawd Clas', and ll Numbe,j I ' . .. . -... :
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I 15. Special Handling U)Olruclono and Additional Information , I \ rn,-1,,,J w.._ <>t-<37-0'"'
• I I eJ C""ERATCR-. CU\TiflCATION: lhe,tbydocla,o lh&llt,o <ontont, ot!Na =&Ion~.,. "'1and■=no~tid•ocribodabo-n 1,y,,.,,....,,,.,lno nomo """an, clu.lnod, U... lawt Ci Q'\e St&ta ol Soult\ Ca,,ollna, ·
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packa,d. rn.&.nl-.:1.. &nd lab<allld, and a,a ln &11 rnp,ec-:a ln ptcp.t" co,wjlllon bt ~f>port ~ tugh...-, &a:::Onilng l:Q &'3~ lntam.llon.J and na.D0t'\&l g~ ,...1.1lalf0na &nd
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-. s;in.dahl• &nd 'a"-t I ha-.. lec:Uid. 01. pn1CUc.abl• 1T14a\Od cf tr-Mtmen\, f;ton,Q .. Of dbOouJ Off91'11ty -~1. tDme •Nc.h mJnlmtz.a, ui.. p,.....n.land ru~,. lhrw.l to hum.an ti-.!tt1andtl'l•~lr0nmen~OA.1flama.amallquantlrygenetaku-,Jha-v•l'r\&d•a;oodtalln•tlo'1
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V\at i. ■n.a...b.!4, m rne and ai.1 t can all'Otd. • • . • • • • . . /Typed Name ~na ·• Month Cay Ye.u 1--+..:,...~.!.;;.,;..:i:.::...i.:.::.-l.1 C.J .. ...,r'l-c:.,/,._ ra.... ,;J.__ <.':l I 17.1, Trazuportet 1 Ad.now ement of Recei~t of Malerials
Slgnaturt ,. / C ;; e..K 'Z/~1 c;., l ~~~-:f-Jd-_~~~~--}~~~.:=:..;_,~~__lil;,;~~ 18.
fMled/Typed Name Slgnali,r• Month O•y Yw R I
J l J lib,,
·' J J \1b1
Month O•t · ··y= -• ... _...._,..,A
:··-• South Carolina Department of Health
and Environmental Control
Sutuu ol Soild & Hawdo_u, WlUla Mgt.
2500 Sull Slreet, Columbia. SC ;19201
Phone: (llo:l) 73-l.5ZXJ .
Emergency & Holiday.: (BO:l)734-5"124
r LEASE PRINT Of TYPE (Form d=i ned for use on e!lta r12-ortr:h Fonn Aooroved. OJ.CB No. 2050-Q039 Ei:cir~ 9...:JO....aa
I \ UNIFORM HAZARDOUS 1. GenOta1XJ(1U.s.a>.1.10N<>. WASTE MANIFEST
2. Page 1 lnfarmallon ln the shaded a,ou b not ol I requlrod by Fodera! law, but Is by S1-te law.
3. Generators Name and t.lairu,g Ac!dnm \ · New Hanover County/ City of Wi l ni ngton I 414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. G<nerato~s Pi,,;no f 919 341-713 9
I 5. Transponar 1 Company Name
I Willms Trucking
6. U.S. a> A ID N.umbor
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7. Transporlar 2 Company Name
9. ee.ignaled Facili!'i Name and Sile Addre,, SRC Inc.
Box 2005
Columbia SC 29202
8. U.S. a> A 10 Numbet
10. U.S. a> A 10 Numbar
11. U.S. DOT. Oeocri~don (Including Pto{}6f Shipping Nama, Hazirri Cl=, ,nd ID Numbol/ ... ,· .. ,, . . •. ' 12. Coruainm. 13. TclalQuanlity \(.Unil No. . Typo ., · '·,. YNV~
I Ii .. Petroleum Contaminated Soil (NON-Hazardous)
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15. Special Handling ln:sll\Jcilono and Additional Information , \
Material Code# 01-137-0101
IS. GENERA TOR"'S c:an,FlCA TION: I h.,•bydeciar• lh.al th■ content:I ofthla canaJgM\en1.,.. tul!Jand accu~•lid•ICJibed abow by pro pot" .tllpplng n•m• lll'ld are c:!u.&lfi9d, packed. matx.d. and labeled.and.,. ln au, .. ~ In prop«c.ondltion fo,tranapont:,y hlghway~ to appll.e;a.bia lnwmaUon&l and naDOf'l&J government r~utatlona and Che laww Of the St.ata of Socm ~ · . . . ' , ff I am• I.an.• quanUty g•n«ator. lea,tlfyU\atl ha,...• program ln pl.a.ca to raduca U'I• 't'Oluma&ndllmfcity ofwaat. g•,-ataa to tt'9 da-QrM I t-i.ve d•IAm\Jn-.d la b4 KOnomlca.Jly PRc:tic.abl• and a,a,; I ha .... Nlec:'8d tna p,.c:tlcabl• malhod of troatm•nt, s:ara;-. 0t d~ cunwiay •-.!I.a.bl• lam. -.h.lch mlnlmiu• Iii• p,....nl.and f'Lltur• IJ'\rNl la rium.n hoa.Jth and lh• arwinmmant:-OR. ffl am■ small quanUtygoner.tcr.l t'L.Yemade a good tllith etlcrttomtnlmlze·my ..... • gener.aon and Mlect U,e beat wa..ie rnanagem•ntmett\od lf\&11.a •~ CO m. ■nd Ir'■& I can ■non1. .
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,~1-::'c-:--c:::-,:c--c:-----:--,--~-,----,-----,--------------bl _____ l_llA_d_l ___ '_'_'lt:>.--j ::; 20. Facility Owner or Operator, C«tmc:ation of rea,lpi ol hazardous malerl>ls cove<ed by !his rnwa,1 w:ap1 u noted In Item 19.
\ Printed/Typed Naalo · S/gn.atun, l.lonlh Car Year
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South Carolina Department of Health
and Environmental Control
\
Bureau ol Solld l H.u.rdqu. We"' Mi;t.
2fiOO Bw1 Stroot, Columbia. SC 29201 .
Pl>ono: (80:lJ r.,M200
Emo,gonq l Hollday,: (SOOl~S-424
e. C~E.RATOR"'S CE.RTIFICATION: lh•r•bydedar• lhatthe ccntanb ol trua cotwc;i~I a.-. hJlyand acc:ura111lyde1Gribedabow byprop,wahlpglnQ Mme a.nd ar• du.,.lfflod. P•Clr.-.d_ rn&nr;ad., an.cl lab-4'Ied,and are ln &ll t"pecta 1n ptop.t"" c.ondltlonJor lnJ"la.part by hJ-;h....,.~~ ID app.llcaNe kttamadot\&J and n,aison.J s~t"e9Ulat!0na and ~ taws oi th• Stai. of SouU'I Catalina. . 111 am ■ Latg • qu&nti1'f gen«atof', I c.ertilytt\&t I han ■ program In pla.e. 11D r-.duc,a tl'\e -.o/Wn4and kmdtycf wa.sta ge,,.,..iad la 1h41 de,gr-1 haw d•tannl.n.d 10 ti. .c.on.omle&lly prac::lc.bl• and 11\.at I ha,.. wleded Q'l.e pn.ciic.abte m.11\0d ol ir-tnwint,, ~--°' d~ ~ a....n.ble t.o me wt-Jc.:, mJnlmlu1 !he p,.__nt and futu,... ttvwl 10 hum..n h6&lth and th• .,,vi,onm..,tOR. If I am ■ am.a.II quandr, g.n.rator,I have m&d• a good blJth 41t1o,1,:i lldNmiza my,..,.. g....,..,DOn and Ml'.ed. ihe bat •..at. m&l'l,lg•ment rrM1f\od 11'\Al t. a~I• ta ffl4 and U\&11 can atfoni.
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JJ JJ illb,.
South Carolina Department of Health
and Environmental Co('!trol
8uroau of Solid l H>wdqu,Wubo M,t.
2Sl0 Bull Stroet, Columlli&. SC 29201 .
Phone (800) T.l-1-=
Em«gonq l Hollday,: (600j~S<2<
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11 ' innled/Trr,ed Name · . ,~,;.,'?' ' I<. A-1/m. o >1 .b '-. t:::J.. u. fl...c._h T',i_ I~
17. Traiuportt< 1 Acicnowledgemenl or R,a;p1 of M.a!erla!s I / I
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Monlh Dat Y=
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Mcn::i Oat Ye.u
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11 i-t,:-:;-p;:-i::-led:-/T-~~":Nam:-'.e:-::------:-------l.ls._••_' .. _'"_" ___________________ ..J...J....1. 19 ... O=\· epa,,c-1 lndic.ation .. S,,.c, I I$ :]~ '-'--'-~
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Y 20. f•,c,lHy Owner or Oper.ilcr, C.rtificaHon of reco;pl of hawdous matarlal:s c:ov.rod by llus mar.a..t uupt u no!<xl In Ion, l!l. I ~~/T~N~m• . -,:;, --t ~' c· d -•. A
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.~ South Carolina Department oi Health
and Environmental Control
PLE.lSE PRINT c, TYPE (Fonn de:sl ned lance on eOte 12-oitch
I UNIFORM HAZARDOUS WASTE MANIFEST
1. Gen001lo(1 U.S. a>A 10 Ho.
. New Hanover County/ City of Wilmington· I ... \Gon=to<'a Name and Malling Addl1ISS
414 _Chestnut St. , Suite 101 · .. Wilmington ,NC .
. G<nerato(sPhone 919 341-7139 ·
s. \T=P"':"' 1 ~ ~;~ _ la Id law i; ~ uj EP" 10 liwnbet ·_:...~==~=i.:...:....--1....1....J..J-1...J....J.....1.-1-1--1....4;,;;:
tr.nspor1er2 Company.Name a. U.S. EPAlO Numbot
!l.10e3ignol.ed Facility Name and Sita Addre>o · SRC ·
. Box 2005 . · Columbia,SC29202
10. U.S. EPAlO Numb<,
NA
11l U.S. DOT Oeoaipdon (including Propor Shipping Name, flazird Cla5o, and CJ Nur.:l:e,j r . . .. .
I· L LLJ-:1 , , , , ,-LI_,......,'-'__, 1 · ~b--i-]-1 , , , , ,-, , I 1-1 I
LI.J-1 , 1-1 I: 1115! Speclal Handling Jn,Jrucloru and Additior.al Jr,fonnaion .' I \ Mo.-b1'aJ Cake.. Ol -\"3 7-0\0 \
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llutuu of Solid l Hawdqu, WU!e IAi;t. 2500 Bull S1reot, Columbia, SC 29201 .
Phone (50:lJ T.l+~
~ency l Holldays: (80:l)T.l-4--~24
0MB No. 205£).()()39 E,olres 9'30-M
lnfonnaUon 1n lh1 shaded areas I~ not required by Fodera! law, but I:, by Siata law.
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I '!__ Id. ~D4EJU.TOP."'S CERTIFlCATION: lh•r•bydKiar• 1hal1h• cont.anbol tJ"Ja c:onalo;nff'NMtar.ll.ilyandaccur.■1-id•&erib.-dabove by prope,ahlpplnQ Mm• and are da.ullla-d, packed. rn.&nl..:1, and l.a~l-.d, and ar• tn all'"~ 1n p,op« ccnd.ltlon b tranaport try t-J;h...., scco,dJ.t'IQ tc &9p.lk::&.b6,a lnt.m.adanal and n..tlon&I gO't'lffi'\ffi,ft n-gulalfcr.• and 1:1'\a ta_.. cf lh• Sl.ata al Sou"1 CucUna. . · 11 HI &m • l.uge quantity gen.f'W.tcw". I c.erUtythatl ha.,. a prognun ln pl.aai to r.duc. ~ vol'u.m.e and1=1dtrolwa.sta ;eneraiad 10 ~ d.._, .. 1 h-. ... d1i.cmln.d to be ..:onom.lu.lly 1 he.allfl&ndtf'leefMronment;OR.trl&maam&llquanlftyget"le,.tof'.lhaYeff\&.deagoodtaana~ortlO~my•
... g----Clonandae(ect~beal'lfUieman.e;•tn.ntme'thod I ,;., pradc.abl• and 'al.el I ha ... M'-cted O\e pra~c..bl• UMO\Od ol 1"-&tment, siOB-ge. or dl:apca.a.l o.n.ncyavall&ble lonM •hlch mJnimJ.ue the p,._..nt and h.itu1'9 lhrN.l lo hum.an r,-1 t. a'r&i\able tc rne &ncl INat I can &ll'Otd. • • . . • • . -• •
~ · llinled/Typed Name Mon<h 0,y Year
I 19. ?LSCrep.a.r.c, lndiuticn _Sp.a.co
! ·1 . . . . . . . . •I , )k cf 'i I . . . . bj ,, , lk d I L . . ~-~~~~ I : 20. ~-c,1ily Owner or Oper.,lor, C.rtificaion ol receipl ol haunlou3 m.atariab eov.,ed by ttu, m,r,o,sl ucapt u no""1 In b,n 19. . I Iodn~11am;;_ . . · . · . CJ.fl, ~ Monlh Day /yw
1 / ,;l, v\t<", Q.,.-;
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. S01,1th Carolina Departmen.t of Health
and Environmental. Control
Bureau cl Solld & H.u.lldqu, Wu1o 1.igt 2WJ Bun Slroet. Columbia. SC 2'l21l1 .
Phooo: {WJ 7.4-5200
Emergency & Holiday,: (l!OJJ™-:.424
ASE PRINT or'TYPE (F0m1 de:s:Jqned f0f' U3e on elite {12-pit:ch; fonn Aocroved. 0MB No. 2050-CC:?9 Eic!ra1 Q--30-aa I UNIFORM HAZARDOUS 11. G011era1XJ(~U.S.EP>.10No. 1 WASTE MANIFEST , , , , , , , , , ,
Manl~:~91 12. Paget 1nrormaUon In th• shaded Mtal b not , , , ,~ ,'-t,"tl ol / requlredbyFodef?-llaw,bvtbbyS!atolaw.
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1 ~ GD4ERATOR"3 CERTiflCATION: lh•r•byda<.1.ar• Iha\ th• contilnb olthia con.,J,gn,;..,t.,.. ~U\d ac:cu111.WIYducrlt.dabavti ty ptap,H t.hlpclno n.am• and ar• c!ualll.d. si•c!r.lod.m&rltad.&M lab-91.d,and are lna.ll t-~ ln P'ope, i:.onGltlon lo.-tr&l\1-p0r1byhJ-;hwr,accon!lng to &;ip.11,a.bl•ittt.matlo~ and na.~gav.mm.ent~ulatl'oru and I , l:he·Lawa o1 C'le Sta.l.9 ol Souu, Cuollna.
H I am a t&ig • q u&r1tl ty g • Mra lCM', I ea rtH)' t:i.at I ha ft a program tn pla.¢,a to r.du c. the •,oh,tme andmfcty o I wa.ste g•ne,rat..d to tha de,grM I N,.,. d•i.nnir..d to ~ ..eon.omic.a.11:, pni.=~I• ind ~t I ha,,. -w,c'1,ed th• pn1C"'Jcabl• ITM!hod of ir-tn\ient,,ator.,;, o, d~ Cl.n91'\Cy av&llabl• tom. •hlci\mlnlmlu1 Q'\a p,_..nt&r.cl h.l11Jr-. c,rwt ta hum.al"I I ' t'i-.11:%'1 and 12'\• envlronm.,,~OR,,. tfl am a a.m.&ll quantity gen.ratar, I h.av• m.ad, a good taittl 11fortamlnJinl.u my•u• g~ISan&nd .,.9d.U\• b-Ml..,uia ~g,rrwnl~ V\&11.a an.,l&bl• 10 m. and tl'\al I c.an &.'fO<"d.. , •
I t-;-1= po.· :c-,t,o;;/T;-y?<d----,,Namc--•----:.-------r:,S¾l::-. -na-:-'"1>--•-,1---------r /f-/-. ----, f __ ,---,-,1.10-n-:-lh-::Oa-y---::Y-:-:eJt:i :-l-+'/~<'"~·"~"':nCL!z..,P,..,..'--~ch.,a;::ll:!:!;1"-~vl,_~--:r-;2,;1L.~ . .L---l~'7.~;t:;·-~-~ -1::,fl::...,::;-2...~/~-;:~~~/~:..._1..1t!,.i;,?~ • .,..,ld...?il.f::.119,0_ l~r1~7~-~T=~•~~,rte,::::.i1~.l.c.\n~~o~w~ledg=•~m~•~nt~c~l~Ree<=~;p~t~cl~Ma=terial=·~·'----.:::--:---~~'--7f-'--='<""---------v-----::-::---::,---;:-it
I ': l}';il)!edlT!# Name _ I SI~ ( ,., ,f' c) ../. l.lonlh Day Year r.(i~.1/J~o~ ,,,f~,!l(~=-f--'f,/,:.,'fi~m~!-;';~(¥.,.,-y/J.;-;-;-:-;-;---1=v-'-7'2:..·u.,_// vi, A:u= L::;:_--,,,1-/4.:a:::;1/,?'~,f,,!i•u.A• ·:1.:-~::.....-=---6L~=r,-,'.L'' ':..__..;·11.LJJ' It;_ 2.i.:::. tOou>'.J.;:!.l{/.l!:,Oc...! I~~-18~ Tran,pcr.u 2 Acxr:owledgement cl Rec.tip.! ol Mat.er.ab / : I
I -' r.;::;-1 P-;:nn:;-· _"°_/T_)])Od,....~Nam-:--:;-•,--::------~---------1'-Sl-~_'"'_"'_"' ____ ✓ ________________ _.....,._.....,;.._,_,,.__,
1 ~.'\ Discrepancy 1ndiC4~on_Sp.ae.e ,~ •I~ .................. ~ I b)
Monll'\ o,y Y=
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I I ! I J (lbs. d I I I ·' I J (lbs.
It 20.I hci1ity Owner or Opera!or, ~rtification ol receipt ol ha.urdou:3 m.a
1
~. __ CCvtted by tt-.U 11\.Wtist axupt u notsd tn tam 19. r'l"ri~/T~ Namt1 • -•
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I ~ and Environmental Control
Buraau of Solld & Haurd~u, Wa.,'8 Mjl1. •
2!iOO Bull Stroot, Columbia. SC 2S<'J1 .
Phone (80:ll 73-1.5200
Emergency & Holld4ys: (llro)7'34-5-42◄ I
~-;_ :.1.~. So. uth Carolina Department of Health
PLEASE PRINT or'IYPE !Form des! nod lot use on ell!o 12·0~ Fonn AoortJYed. 0MB No. 2050-0009 E,cl,-. 9-JQ.ga
I
I UNIFORM HAZARDOUS 1. Generalc(aU.S.EP>.IONo. ....,,,-, 2. Paget · lnlormaUon In the ahadod a,u, I, net WASTE MANIFEST Ni ol / requlrodbyFedor>llaw,bvtlsbyStai.law.
(!_ C EN ERA TOR~ CERTIFICATION: I h•r•by declare ht U'I• cont.nts ol tf\la ain.;,;nN\t an tu1y Ind accun.•IY delCribed &bow by prop.r al'llppl"'-nam& a.nd .1r1 c.JLM-lllaod, P•cklld_ m.ar1la,d,, and Labeled.and at• In a!I '"P4'Cta 1n p,-ope,,-condltlon b, :ran.port by high...., aa::on:1lng to a.pplcable lntamationaJ and na!Sof'lal govemm.ent r..;iul1tlor..a and Irie la-. of lne St.a ta al Sou1h CatoUN.
ff I am• L&rg• quantity g,,,.,..tof'.I c:.rtlfy lhatl h&va • progrw.m In plaal to roduc. it-..-.olWM and lc::ddtycl 'llfut. ge,_..lald to It-.. d99rN I h&vw d,i.rmJn.d to boa ec.on.cmfc..Jly pn.c::l'.cabl• and tnat I ha--'4c1.od th• praC:UcatM• meihod ol ~tm.nt,, ston.ge. o, d~ ~ available to me •h!ch mlnlff\U.a• 1h.e p,....nl and f\Jt1Jr. ttirMl to hum..11 he.altt'I and tl:la eovl,onm'"'t:OFI., U I arn a Ml\&ll quantity lilOMrator,I have m.&d& a good taith 1Nott10o:dnlmtx.a my wa.a• g_._.don and Ml'..c!U'la bsst•ut. tn&NQ 1m.nt m.thod lh&t la a ..... l&bi. ID me &nd a-i.t I can anon1. , • • . . .
19. Oi=epancy Indication .Space
;: 1 .. , ...... ,_1__,_.,_J~llbs. c LI ...L.L..I....L.1...J!lo,. Ir bl , , , libs. d' libs. I L;;' I-;';:-;:-::;::-,;:---:;:-~---::-,,:--:;-'-:-~-,,_--,--------.,.,---------------------'-------, 2p. Facility Owner or Op,ei.!cr. Certifie3,t!on of receipt ol ha.urdous malertal3 coveced by thi3: IJ\l1'.imt except u noted In bm 19.
I ----.--~ ~
South Carolina Department of Health
and Environmental Control
&roau o!Solld&l!awdqu,Wa.,to Mi;t.
2!iOO eun Slroot. Columbia, SC 29201 ·
Phone: (80:)) T.l-1·5200
E..,,.,,_on,:y & Holld.ly,: (llO:!jT.14-~24
Form Aocrovod. 0MB Ho. 2050--0::rl:9 E.tcltc, g--oo..u •l.SE PRlllT o,TYl'E !Form deo!onod le(.,.. on elite 112-P;tdil
I UNIFORM HAZARDOUS
, WASTE MANIFEST 11. Genm1o~1 US. EP>. 10 No.
I I I I I I I I I I I
~~1!~:~,-I 2. Pago t lnfannaUon ln lhe 1h1ded Mau 13 net , , ,"Ti'-/'J:1 d '"'l'J~od by f o:l•ril law, but~ by Stai. law.
I J. 'Gener.ito<'s Name and Mailing Mdnm • • , . New Hanover County/ City of-W1lm1ngton· · 414 Chestnut St. , Suite 101 ~ilmington,NC. 28401 I~. c;.n.,.to;.sPh~n,r 919 l 341-7139 . '
5. U}: EP >. ID Number s.ir=po""' 1 c,.,..,._,,., ~-· Lad0w Eri; ,N,,,,,,, I ' 17-iT=portar 2 Company_Namo 5. U.S. EP >. ID Numb« -... .. ,,,,,,.,, ' · ..
9. O..,ign.ai.d Fa°"il)' Name and Sita >.ddr= 10. U.S. EPA ID Numt.«
I SRC. .. Box 2005
Columbia,SC29202
' I ,N~ I I ' I ' 1 i. U.S. DOT Oe,aiption (including Proper Shipping Nvno. Hazard a.so, and D Numbe,j I I ... .
N "-\ Petroleum Contaminated Soi 1 (NON-Hazardous}
0,0,1 D,T I;; b.l
u I ' ' ' o o I ' A c.l
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111
11
,a_ CE)jEJU.TOR-:i CE.RTIFIC.1.TION: l~r•byd-.clat• th.1.111'1• eant.nb of 'ltlll c::ont.l,t;n~t&n tuf:ya.nd &CC\ln1.W1lf duc:rlbed atov. byprop.t ahlpglnQ l'IAm• and 1r• d&.Ulll.d. packed_ rn&.n;a,d, a.r.d \.&~led. and at• tn all ,_p,Kta ln ptop« c.ondltlon lot tn.na.port ~ 1-J-;h....., aco:::wclng to ~pi.a.bl• Wft9mation.a.l and n&tiofl.a.l g~,...._1,11a~ona and I th• l.awa of In• Stai.. ol SoiA, Cuolln&. , · . ti I am a {._,g• q1,1a.ntity g•.....-. tof", I c.rtlty O\atl h&v-. a p,o,;~ In pta.c. to r.,,iuc:,a ~ -.olu.m. and m!dr/ of-wastai g•,.....taid tD U-.. degrM It,.._..,. d•t.rrnln.d ta boe .co,'1.0rnlc.aJI:, 1 pn.d~I• and tn.atlha...-. wl.ec"tod 111• pr-actlc.abl• nwilr\Od Oltr.atn-..nt,, 11o~e.crcl\l.po:l.a.lQ.1rRrtltyavall.a.ble 1Dme-.hl~m..lnlmlua the p,.......ntand fl.I~,... lfVNI lo l'lum.1n I . tie.ala, and tti• ..,vlronment:OR. lfl am a a.,,.all q1.1a.rillty i;•n..-.tor,t ha.,,• ma.d• ;a good ta.1h•flOl'tl0m.lrJmiz.9 m:,w .... g.n.11dcin and M(ec:tlf'\e bat-.ut. m.&r1-1g1m..nlm.thod O\al I.a ann.&tlle le m. ar.d 'CNl I c.a.n aJl'Ot"C1. .. . I I PD!\le<l/T~ Name 1 .,; ISignal.!,a; -, (' / · ,,/ f_ l,\onttl Dar_ Yea.l. rt-/' ,/1() D ,1..JJ L I h,, 11(//,,_ Ta. rp_· tJ ~ //..-.... ,/,,., .• { .z..o.s, ""J,C.
Ii 17. Trarupcrt.er 1 Adnow!edgement of Rec.eii;:t ol Materia!:i f
I '; I Prini.d/Ty,:,e<l N3mo L A ISlgnat.m, 0 -/1 ~ ii),, -,,, ( rf /tf >-, ra ;.J ---i--._ --tJ O ..,,, f -Y --~
I RT~ 18. Trarupoitei 2 Aanowledgement cf Rec.eir:t of Mattrlal:i I i I p rint,d IT )",)«J Nam• T Oisc:epancy Jncic.,ticn _Spaco
•1 I I I I
b1 I I I I i
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Monei O.y Year
:11 ,710,<Z19,0
Mon~ Day Year
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Ill:,. d I r I -' 1 1 111:,.
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South Carolina Department of Health
and Environmental Control
&ruu of Solid & Ho=d~u.s We:,, JJgt.
:l!iXl Bun Slroet, Columbia, SC 292':ll
Phone: (S<ll) l':1(.5200
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E.-ne,genq &Holiday.: (roJ]n-4-S<l<
cl.SE PRINT orTYrE (Fom, deolonod lo< use on e111e 112-pad,l • Fonn .A,,orovod. OJJB No. 2050-0039 Elcl,.,, 9'30.1,3
I UNIFORM HAZARDOUS ,1. Genera1C(1U.S.EP>.!0Ho. o.!::"'lf••• l2. ~g,,1 lnfonn1Uon In tho 1h>d,d """ 1, net WASTE MANIFEST , , , , , , , , , , , , , , / , -1,'11 / roqu~odbyFo<1,r.i1aw,bvtbbyStii.1aw.
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15. Special Handling !n.,truclcru and Additional lnlonnaoon ,
Mo.+e,yi'a,,Q Cake.. Ol-\37-0\C\ \
Cl. CDiE.RAT0R"'S C£RTIF1CATI0N: lh•nbydKJ.at• lhal d'\• co~_Lanb ol IN.a c:on,.J,gn~tanll.ilyand aec:u1'titlY d•ICl1.be,d•~ by prop.( a.hl.=Q!~ /\am• a.nd are du.a.ltiotd. paek-.d. rn&rklld. and \&~led, and &1e In &!I rnpec;tll In pt Opet' condlflon bf 1tvl~rt b)' t\Jghwty a.::con:!lng to a;,p.kabl,a lnwmadol'W and n.anon.J govwnvn.e-nt ""1,11,1la0'0,-.. and a,e laws Of"'• St&i. ot Sou.-. C&J'ollna. I .. ti I &m • Mil;• quat'ltity ;•n«-lot', I c.an:lty that I h.a..,. a program In ptac. to ,-d1.1c. ~ \IOUINI and t::dcity Of'Waste Q•,-'11,\ad to the d~r-1 h,a,... d1termln.d to b,e t<-O("iOmlC-&Jly prad!CUll• al\d ~t I NI.,...-~ th• p,-ctlc.abl• m.ir.od or ir-Mtmen\, stora,ga. ot d~ ~ a....n..bla ta m,a •hlch mlnlmWn the p~nl and h.itl.lr. ttltMI to hum.an l'\'61111 andlfl• -,,v!ranme-nt.:OR. lfl •m• amall quanlltygen.aratcu', lhav• mad• a good tal1:h •nortam!nlmiu myw.,.ag.,,,...tklf'land Mfk1tti• ~twut. m.an.11-.,rn,nlm,,,rtt">Od 1h&t La •·•-.ilable 110 rn. and lhac I can at!Ot"d.. • I . • · · · ·
~~~ L C /._,~ -r,l IS(g'"'~7 I .-1 ( ! .. /_ d--.. :;~ .~~l 1'.o
17. T=oorter 1 >.clulowlodgemenl cl Ree<i,t ol Materials I ' 1
Mor.th Day 'r'e.l!
·11 ,'J.,/l rl ff D 18. T=,portu 2 Adulowledgemenl cl Ree<ipl cl Maleriai, I , I PrinledfT~ Name Moni:-i O;iy Y!W
I I I ' ' ' 19. Ol><repanq lndica,on_S;,a~
•I I I I I I 111:o. '1 I I I I I I'""
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I B · South Carolina IDepartment of Health ·· · · and Enviro~mental Controi I I • I
&ruu or Solid & Hawdqu, w..,,. Mg1..
2600 8uB Slroai, Columbia. -'iC 29201 •
· Phone (80:l) 7J.l·:l200
Emo,goncy & Hollday.: (aOJJT.l,1-S,2◄
>UCASE PRINT o,TYPE (Fonn desloned 10<""' en ollta 112·om:h1 Fenn Aooroved. 01.48 No. 2050--0039 Elolros 9""°.gg
15. 1=po~I =~-~· I r. T=sporuir 2 Company Nam•
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,1 • 19. Discrepancy lnC<c,tion_Sp.,co
It
L ~ · I s.. uj: EPA ID Nwnb« ·c3&,}i·-r ~ .. -iD"t'.Jt'.t.~~~--~-r$:~~:-,-r:-., 0i1d(ciw I r11 11sP. ,N, , , , , , , , , , , fo,t~~-~-;;Piloo..~nu:~~~1;~,v::f:t· I a. U.S. E? A ID Hum.bee "t~~~'ii,;'if!g:.ma:~e€i::t.~~
.. I I I I t 1 I • t t · t t . t ' 1 ~ ~~~~~~£.1.~~J<.f:
10. U.S. EPA 10 Number
0,0,_l 0,T , , , 2, 0 YO
• 1 1 1 , , 1 \lb,, •IL ..1.J ..JJ_J1....1.J ..JJ...J\lb.
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South Carolina Department of Health
and Environmental Control
Bureau ol Solkt & l!aurd~u., We:. M.t. 2500 &II Slroet. IAluml>ia. SC ~201
Phcoc (BQ:l)rn,5200 I .
PRIHT ot TYPE !Fenn de,Jonod lot""' on elltal12-oaz:h; ·
Emet]joncy & Hol'44y,: (BQ:l)T.l-1-5-124
Form Aoorovod. 0MB No.== ucl,es 9-la-M UNIFORM HAZARDOUS 11. Genata10(1U.S.EPA10No. WASTE MANIFEST • I ' . I I ' I ' I I I
~;~12. Paoe1 llnformaUon In the ahaded a<u, b not
1 , 1 , / ,'T,.51 cl / requlredbyFodori,ilaw,butbbyStat,law.
010 11 0
1T 1 ,
1
2
10 YD
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'e.. CDlERATOR"'S CE.RTIFICATION: lh•t•bydK.1.ar• IJ'\.atl.h• c0nC:.nt:10I tr1J.a con~nm.nt ani tJ4rand aa:un.i.lf d•~abov-a by prop« lhlpplng l\a.m• &rod 1r• elu.&111-.d. pack..:l..rn&.rx.d.andl..~1-,,anda,aln&Ut"pe,ctalnp,ope<cond.lllonk><tr.nap,crt't,fhlghw.-y&CCOn!ll"IQta~~lntam.-.t!ona.
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I~ ;-; \ ~rry,><d Name il \ ISl;nay\___ '\ / /,,-,,. I 1'/CY1c1r.l\ Cl'i].E-)'(.,.-,,.,_/,::: ~9-0. A" > 18. Trouper.er 2 Acxnowlec,;ement cl Rec,;~ cl M,r,rlal, I ~ \ Printed rr )'Ped Name
I
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11 Si;natura
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Month Day Yw ·, I ,2,,-,,,n 7c~
Men:, Oay Yeat
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bl,1111\ibs.dJ
11111!ft,,.
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IY 20. F,al;ty Owner or O1><r.itcr. C,rtification cl rec,,;pt cl haurdou3 mai.n.r, c:overod bylhi, mwoootueopl u nolod In 114m 19. [ ~'":!J:r~ ti_•m~ · --;) _ ~ , I I Sien,.,-~ ,
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•• South Carolina ~e-partment of Health
and Environmental Control
"~'"E PRINT o,lYPE IFonn deolanod 10<""" on e!l1.o l12·Pilchl
I .
llurwl cf Solld & Ha=dqu, Wa.,to t.1,t
2lilO Bull~""'-~umbia. SC :mo, ·
Phone (80:lJ T.14-5200
· £morvoncy & Holiday,: (5CJJT.l4-s.<2,
. I UNIFORM HAZARDOUS
WASTE MANIFEST 11. Genor,to(a Uf EPA ID t"1.
f I I I ·• • • • • f I
0,xu~~-~~0,..12. ~~ t llnformaUon ln the ah.tded 11u.1 b not
, , , I ,4,JI / nqu!rodbyFodorallaw,bvlllbyStalolaw.
13. Gon=.ID<'s !lame and Malling Addrm I
I . New Hanover County/ City of Wil~ington·
414 Chestnut St. , Suite 101 · .. Wilmington ,NC. 28401
'-G,nem,~1Ph~nol 919 I 341-7139 I
I · · · Lal~ 0 n!nSP·
6. U.S. EPA ID Numb« N ,A, , , , , , , , I. Is. Tr=po~1 C<,moanyNa,n. I • 1/ W ~, . · \
I 7. Jr=pon,r 2 C,mpany_llam• ..... ..!
I 19. 'ceoignai.d Facility llamo and Silo Md,.,.
6. U.S. EPA ID Numb«
1 • olt-.... -~~i:.~00~~~·.r;,.~\ ... :;-::~-::'.
1·~T"-... :ac;~~¼-v .. zr-e!'?i~~~
• I I I I I · I I I • 1 ··1 . I •· -~~~~~~j:!£~~--~
• · SRC Box 2005
I. 11 Columbia,SC29202 , , ,N~ , , , , ,
11(. U.S. COT Oe.alpdon (111cluding Ptof'"' Shipping Name, ~ Clas,, and ID Numl:elj
I -t--~ . . . ··-. . . rL Petroleum Contaminated Soil (NON-Hazardous) ~. .. I . 010 11 01T , , ,2,0 YO
IS. Special Handling lrulniclono and Additional information ,
Mo.-\ev-i'aJ Cale.. Ol-\37-0\C\ \
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15. Special Hatldling IN!ruclcru and Add;ticoal ln!ormaticn ,
Mo.+ev,·cJ Cake.. o1-\37-o,a, \
uJB
Buruu ol SoUd l H.lutdqu, Wa,"' M,t..
2!iOO &II Sl!eot, Columbia. sc mo1
FI\OM: .(800) 7.,1.5200
Eme,gency l Hollday,: (l!OJJT.14-~H
i ' ,2,0 YD
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' ' ' '
' ' ' '
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he.. CENEJ\ATOR"3 CERTiflCATIOH: lherebyd-c.la,• that ltlaco~tanb oltr.J.a con~n~&r1 ~uw:I accura•/yducribodabow byprop,e<t.hlpoln,; t1.1.m• and ar■ da.ull'led.
p•cka,d.rn.a.n:..:l,andlabeled,anda,eln&IJrnp.c::alnptop,tt"c.ondlt1onlotln.l\&9Crtb-jl'u;hwr,a=on:ilnQtoappbbl,almama!10r\&1andn.a.dofw.J51avel"T\l1'Wlnl~ul•tlcM1.nC1
lh• laW11 of Ena St.at.a ol So,,,m C&tolln&. I ·
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NI am• l&tge qua.ntlry g1neratot, I c..rtl!y U'\Atl ,....._•program In pl.a.ca tc r9duo. !he vo{wne andnddtyofw..-;,,_._tad ta 1tw d99rM I ha.VII d1t.annln.-d \0 b. .c.O!'\Clmlc.a.11y
pn.c:iu.bt1 and tnat I haYII M'ec\ed th• praCUc.abl• melr\Od Of trulment, ~~--Of dlapoaal cun.nl:ty a...iiabl1 tarrM 'Which mlnlmlu1 'Ctwi p,...nt &nd h.Jtl.l"' INW.l lo hum..n
h6&lltl &nd tha eovfrontnent OR,, tr I am a am.all quan!1ry gene.ratol', I ha\11 m&d1 a ;ood tar.ti 1ffortlca:tlnlmlu rny._..,1111 g_._..OOn and aelectltl• bM.t wut.a tn&l\,lg ,mc,..,l r . ....u-.od
that ta a~I• to ffl4I and tr\&1 I can &JtOt"d. • I ..
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·19. OWer,aN:J lncication.~~
Mcnci O,y Yw
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b I , , , , , 111:s. d IL..1.I ... ,_,L..L, .... , ..,\11:s.
•l'-------------------~-------------------------'------l ~l,.2"-0'-:.F,,;•,.,"'1.;,,;ty:'-::,o...n_•.,.r:'-or __ O:..:pec.:c.:r.i...:lor.:..:,.:..c,.c.rti_·i...:ca.:.ti...:o...:n..:;c...:!ree,,=:..:;p.:..lo:.l.:;hallroo<.l,===:mac.:;:larlal,:,=:.e<m(=:.od=t,y"-"'lhi,=·.::w.an...t==ucapt=="=no:.tod:.:.:ln.:;lam=.:19.=----------c---:7.--l ttf'iAJa~ N:i.m.«i --... I I _1::L.-............ lJ,..,.,..., r'\c,v . y,._ ... ,
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I • South Carolina pepartment of Health
~ and Environmental Control
lluruu cf Solld l Hawdqu, Wa,l!! t.1\jt.
2!ilXl Bull Slroot, Columbia. SC 29201
Ph<lnc (&)JJ T.l<-5200 •
. E.'""'!lenq & Holiday.: -~734-:;.424 I ~.. ·. I I • ISl!PRIKT or'!Yl'E IFonn de,Jonod let u,e on ellta 112-pm:hl . . Fonn Aoorcved. 0MB No. =o::o9 uclrc, 9.J0-88
I UNIFORM HAZARDOUS 11. Gen=tc~ali.s.EPAIONo. ~11-• l2. ::;e/1 lnlonn,Uon In the ahaded areo I, net
1 WASTE MANIFEST , , 1 · 1 I, , , , , , , , , ,/,"S,.l't roqufrodbyFedmllaw,bvt~byStaLolaw.
17.\Tr.wpor1.or2 Company.Name \;· 8. U.S. EPAIO Numbet
.... o o o I I t · t I I I
'9. ~ignatod Facility Name and Sile Mdr= 10. U.S. EPA ID Number · SRC
\ Box 2005
Co1umbia,SC29202 • I ,N~ t I t I I
~~Y:"_ ... Ti:Firl~~~~~-Ji~:'f
··, . ' ~ -~~~~~~~~~-:i-"~J<ji
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I he. GEHERATOR"'S CERTIACATIOff: .. lhei,ebydKJ.are lhat th• cant..~t:s ol IN& t;0na.J,;in~tar. !i..fy&nod accura'IIII,: del0'tbied abov-11 by pro~ &h!ppl"9 n.ma and are dual119'd,
pack ad_ rn&n:ed, and lab.led, and &1• In &11, .. ~ ln !)le~ condluon b ir.ris.pon. by hl<;h_.., aa:on1lng to ap~kttilm.don&I and n.a~ gov.mmei'\t '99t.1la!l0na and
I tha ia-. ot ine Sz.&t. ~I Sovd'I ~lna. \
tr I am a I.at;• q._.an,n·, g•n.natot, I cartlfy lhatl haw a program In placa tor.due. the -.,olum.e, a.rdmlcty ofwaat:a ganM&t.d to the de,or" I ha..,. d•~m'1n.d kl ti. .c.onomli:....!ly
pn1dQ.b1-Vld V-..1 I ha-.. Mi.cwct U'\• pnc:1:lcabl• m.Q\od ot ir....rm.nt. st.c~-.01' dnpo:a.al o.."1\lfl' avall&bl• tom. ._hlch tnlnlmlz.a• a-,.. p,,,_nt and h;~r,i 1t1t.,.1 to hum.an r he.&lth al\d th.-~wbonm..,tOR. ti I am a ~I quantity gen.l'aLot, I have m.ad• a g,ood ta.11:t\ enort IDIDWm~ myww.a g---.tlon and Miect ttle but ...,a,r_. m.4r,.1.g,m•nl m.U'IOd I l--'1-=..,'"-·:-: ..... =---:-'·,.,"'_"'"_.,..._.,.,._._, _=_ .. _-________ "'1,.,.,_. _. -''-------------'-::---------:-:.....,,_=-=-i I pjl;ledfT'fP<'l Name ,... 1 ~ 1 , ~ I Signa~. . /7 ..., _ /) , · J Mon:; O,y , :_w
1 • ••• ,-.[) L ~.-~ ~-. . ·. . -< ~-/A . ,/./,0,3,,,i''
IA~ 17.ITraiu6oru,, 1 N:knowledgement ol R=iit of M.1teriab I / /
I i f~~~~::_ ·V/,.-5 A_,',, -.. , ,,,, 1s:t,!c1'.//_flj. '·cbd'~.~/4 "; ~, ~ .)
l~E 18.1Tran.spor'.e.r2Ad:nowled<;ementofRecei~of1.bYna.J.s \ ,,,,;:::,,,--
t.cor.::i Day Yw
·, i ,0 ,r,,,.:11.q,1,
1 ~ -~'.'"f'::nn'.'"· _tod_rr_yped_:-:Nam-:--.·---,,-------,------·-.l.1s._·,_na_llJ_re ____________________ ..l,....l.....l....l.-l-l..
19. DLSClep.anc-1 locfic.aticn _Space
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I • South Carolina: Department of Health
and Environmental Control
&real.I of Solld & Hawdqu, Wu'8 I.I~.
2!ilXI &JI Slroei, Columbia. SC 2S201
Pt>ooc (SOJJ 7:14-5200
fm«1l ency & Holla& y,: {80:!)734-~2.
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I UNIFORM HAZARDOUS 1. Gen~1of1U.S.EPA10No.
WASTE MANIFEST
3. Goner.ito<'a Name and Llaiilng Address • • ' '
farm.11.Uon In the 1t\aded we.u h. rict
byFedmJ law,butb by St.la law.
f \ . New Hanover County/ City of W1 lm1 ngton · I 414 ,Chestnut St. , Suite 101 · .Wilmington,NC.
•· G,nem,fs Phooe 919 3 41-713 9
28401
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I 5. Transporter 1 Company Name I/ -er-· • I 1 • ·-.,. -· L.£l1~11w ,n.,.,,,jP
7. Tr=portar 2 Company Name 8. U.S. EPA ID Number
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Box 2005 · · · · • .-Columbia,SC29202 NA
11. U.S. OCT ee.crip!on (fncludlng Pt0par Shipping Name, lmard cia.s,, ar.d ID Numbotj . . . ' II I~ a. Petroleum Contaminated Soil (NON-Hazardous) ~1 1 1 , ~ ~ l----_:_ ____ __:. ________ _..;. ___ -1-0-1..0.1. _1 l-o..L.1µ.....1...1-2.1.0-i-v_o_.µ!b~.1=7'=7='==7'=7.~,,~; I
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15. Special t!andllng lnstrucilons and AddiUonal in!onnalion , .. ·. . -It-. ,noJe;;J lok. 01-r~,-0101
8. GOiE..RATOA~ CEITIACATION: I har•bydec:iate that lhe eofttanb ot 1h11 ccnaJ,gntNfttara '-ilfand accuraafydelCribed &bow byproP41ahlpplng n.amea.nd .,. cl&Ulfflkl', pac:ltad_~andlabel.cl,andaretnaD1npectalnptop«cof\d.US0t1blnnaportb-fhl;hW97a:mrdlngta~plc&bl,elntamation&landnatk>naJ9~,.,..ulall'.ona&nd
1M 1a ..... of 1:h4 SI.a.ta of Soul'\ Catollna. . . ~ 111 am a lat;• q'-'&ntfty gen.atcw. I e.rtlfythall haw a program WI p1a.ca lo reduc.U\e-.,olwne&ne: IDlddty of 'tlf&si.Qeneratecl to lhe de,QrN I ha,... d•~lo bl econamlC&Jly ::·pnac:tfc;abl.ean,dQ\atlha .... ~lihllp,-cUC,abl•m.thodol1raatment.~-.o,~CJn9111Gy•vallabl•torne•hkhminlmlu•~~n1andlutut.lhtNJtohuman Y' , ·· heal1:1'1 andvwa ~tOR. ltl am a Mn&JI quanarygenerator, I have m.ad• • ;ood tdh dotl~a:itnlmb:a my w..-g~ and Nlectlhe bealwute ~"MMntm.u'IOd lr\&llae~tam.andlhallcana.ft0n1: -~••:·•.-.:·~·-···· .•
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South Carolin~ Department of Health
and Environmental Control
lluruu cl Solld & Ha=dguo w..., Mgt.
2&lO Bull Stroot, Columbia. SC 29201
Phono: (50:l}T.lol-5200
Emergency & Hoilda!" .. (803)734-5-424
LEASE PRINT o, TYPE !Form d nod for usa on ellta !12-oilchl ~ Form Acoroved. 0MB No. 2050-0039 El.cir~ 9-J0--88 · ··
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Gonora!Dt'a U.S. EPA 10 Na. . ' Manlf••t Cocuman No. 2. Paoe 1 lnlormaUon In the shaded weas Ls noi cl I required by Federal law, but ls by Stalo law.
3. Generao,;s Name and Mailln',I Addn= New Hanover County/ City of Wilnington 414 Chestnut St., Suite 101 Wilmington N.C. 28401
4. Generalo~s Ph~ne ( 919 341-713 9
5. Transponar 1 Company Name . . Willms Truckin
7. Transporter 2 Company Name ·
9. ee.ignau,d Facili~ Namo and. Slla Addr= . SRC Inc. . . ·
;_ Box 2005 . . •
::..::.Columbia SC _29202
. 6. U.S. EPA 10 Numl>et
A
6. U.S. EPA ID Number
10. U.S. EPA ID Numtar
11. U.S. DOT De>cripdon (Including Proper Shipping Name. Hazard Clas,, 111d ID Numbotj ·,_ .... ·.-;•· ·,. :' . ·· .. :.: ~ :: .. -, . .
15. Special Handling lmlnJcUons and Additional ln(ormallon . . . .. ~~ -, .
Mater\a1 Code# 01-137-0101
1-1
12. Con!ainers 13. To • No. Type -_" . ~-'' ·
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'e. GE>iERATOA"5 CERTIFICA TIOH: I h•r•by d-.C:We thalU'l• ccntanb oftl'\l.a con~.,. tllDJand a.ccu,...i'f daacribed a.boYa by prop« shipping nama and are clu.a.ltllld, packad.tnan:ad.andtabaled.anclarelnallrnpec:alnptop«COnclll:lonfcrtran.ponbytur;hwayllCCOC"Cilngtoa;iplic:abteineamadonalandnadonalgov.nmentr--.ulatlonaand
O'la I.a~ 01. ~ Siate al Sau1h C.uoUn&. ' n I am a latg• quandty;•nenator, I cen:ttythal I have• program In place to r.duc. lh•VGWIM and bldcity af w...ia genwa.tadtz:I d'MI degree I haw de1-rmlnecl lo ti. .conomlc.Jly prw.Ccabl• and 1:n&J. I ha-N'-dad th• praci1c.abl• m.cnod al treatment. CDt"aga, or~ cu.nwiay ava.iLabl• to me which m.inlmlu• th• p ..... nt and ruru,. thrwl to human hoaltn and aie environm-,t:OR. HI am a amall quant1r,gon«a10r, J ha"• m&d• a goad tallh.norcio lldnl~• my wu• ;---.don~~ aelec!:tha beat •u&e man.agem.nt m.U\Od 1:n&J. la•~ to~ and U'\al I can &tlord. . . . . · . .. ·
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EJ.SE PRINT o, TYPE : lfom, dllOI nod for use on ellt8 12-oilz:I\ Form Aoon>vod. 0MB No. 2050-0039 E,ol, .. 9-JO-&
I I UNIFORM HAZARDOUS 1. Generatofs U.S.EPAID No.
WASTE MANIFEST :
3.I Gene12llll's Name and Mailing Addr"" New Hanover County/ City of Wilnington
lnfcrmaUan In the shaded a,eas b not
roquirod by Federal law, butts by State law,
\ \ 414 Chestnut St., Suite 101 Wilmington I :1:=~::;;1:. 341-7139 6. U.S.El'AIDNumber 'fi,siilol'""" ___ .-tij~~~;§u\;5)).i;,,:Z''-,~
11 I Wi 11 ms True k i n A o'rti.,.uitt.'."~~1~!§}:,;;-;,;,'.:;!,lfJii'~v.r.:;
N.C. 28401
I I T 2 Co Nam a, U.S. EPA ID Number t'l§.1,,;r-·--ll~~.:!;~#,-'~',w,i 7,1 ransporter ,, m,_pany'' • F:----~"~N'~~'i,~j'i\l
, 11 9.I Desig7~!"1[i and Sila Address 10. U.S. EPA ID Numbor l,·~;:,-;: ... ,.==·ccllt"':·;:,';,,,::I::,-. • ~ ;.:.t~~/'~
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15. Special Handling lnslnJc':loru and AddiaonaJ Information ,
Material Code# 01-137-0101
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II s1 GENERATOR., CEITIFlCATIOH: lhareby decJar■ lhatU\■ conlarlts cfthil conaJot\lNlnta,w fl.iltyand a.ccura-1y d•~ abo1n1 byprcperahlpplng n■ma and ar• du.a.I ft ad,
• packed.m.a,x.d.andlabeted.,and.,.lnailt~pecta~prop«c:.ondltionfcttn.n1190nbyhJgh-yu:=,dlngtoappUcabl•ln&emaU0na.lanclnatlcnalgavenvnantregulatl0ruancl
a,ela._..ot~StataofSouthCuollna. · "•· · · · ' · i . · . · .
IT pracuc.able and thall ha..,. Mlociod th• praettc.anl• rrMlhod ol traatm•nt. stcra;-. o, cli..;.,ou..t CUl'TW\tly avall.&ble tom. •Nch mlnlmlua th• pre,Mnt and fUture lhr-t to hurn.&n
. h&&lthandthe.-l"lironment:OR.Hlam ■&n\&llquantl't'jQ~,lhawemadeagoodiatth•nortu,mlrumi.umy•-•gen«ae10nand_.ectthabeatw...s.■managa,n•ntlTM1hod I 1· ;' la available ., mo -, "'"" can ol10<d. :
HI am ■ l■rg• quantity ;eneratot-, I cenlfythal I t\aw • p,ognun ln pl&ee to reiduc■ th•-.olume an.i tmtctyof waa1e ;•.,....ted to OMi de,;;irN I ha~ cl•tarmlned tot>. ec.oncmlc.aJly
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I ~ uuum ~a,um,alucparuucmu, ncauu
· ""~ ' . and Envir9nmental Control
Butuu of Salld & ~us W1131a M;t.
26IXl Bull Slroet, Columbia. SC 29201
Phane: \803) T,l,1-5200
Emergency l Halldays: (80:l)T,l,1-5424
I a, .EASE PRINT OIITYPE 0:orm deslaned for~ on elite 12-oitchl ~ Fann Accroved. 0MB No. 205Q-O'.X39 Exolres 9~-M
I UNIFORM HAZARDOUS 1; GonenilXl(s'U.S. EPA ID No. 2.Pa991 lnfannaUan In lh• shaded ., .. , la not
I , WASTE MANIFEST : ~~~·-·.is-~.-~~~~~~~~~::~
I 3. GonetalXlr's Name and Mailing Addnsss , ,"1· -~ ., _ _,,..,,.,. ':)"~~~~Wt/;!
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,,,,-:;.·r New Hanover County/ City of Wi 1 ni ngtori ~-""~~F:-i1i!!mll~;1;...,,~
.. • '"';\.414. Chestnut St., Suite 101 W1ilmington N.C. 28401 ac.·~.¥.,P~~F~~;;~'t',
11 :I:::.. .. W•~,-~l l•m~sgT~ru•ck·,·. 3n41-7139 i 11. us.A EPALDtiwnr« ci=;:'~-=!;,:;
b:'7tlftm'7.~~i~~~~~~
15. Special Handling INlnicilons and Addl~onal lnformalion : \
Material Code# 01-137-0101
I I · • • ti. GENE.RA T0R"'S CERTlFlC.lt. TION: I h•r•O'f dociar• that tn• contant:1 of 1111a can~nment &Ni f'utrand &CCUrat11ly dea.c:rlt.d a bow by ora~ ahlpolno name and are cJu.a.lfie<I.
packed, ma.rll:ed. and la.bel-.d.,and &r• In all,-~ In p,op,K coiidlt1cn fof'tranaport'trf hJQhway'ICCOrdl"'i3 to ~pllcabl• lntllmallona.l and nal:XHMU government ,.,_ulatloiu a,,d
lh• 1aW9 ot lt\a Sta.ta ol Sou1h Carolln&. I
I ti I am• Large qu.antUy generatOr, I c.ardtyU\atl haw• pn:>gram In Ptac.e to red~c. aie 't'Oh,une andta::dc:ty ol waatagatlefW.tad m ai. de,;ir-1 ha-detarmJn.d 10 be ec.onomlc.a.Jly
prac:tic.a.bl• and Iha! I ha-Mlec:tad tn• pradic.abl.• method of tt-anent. aioc.ge. o, dl!l.poM.i curwr,ay avaJa..ble to !T'141..,h!ch mJnJfflU.es the pre.Mnl and t.Jture ttirwt to hum.an l\ealthand_tt1eetmn,nm-,t:OR.lflam■sm.ailqu■nurygeneramr. jJh■v•m■d•agoodrun..non=mW.mlu .. my•-•g.,..lio_~-~M(eclth•~ute'D!D:!Q~~·-1·
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·south Carolina Dt!paiiment of Health
and Environmental Control
I •
""1uu ol Solid l t!aurdo.u.i W,ulB l.lgt.
2600 Bun S1roe1, Columl>ia. sc :ma 1 ·
Phone (BOOJ 734-5200
~onc;y & Hollday,: ~734❖124
Form Aoomved. 0MB No. 2050--0:Xl9 Elclre:s 9--30-e.a
UNIFORM HAZARDOUS 1. Genorao,(aU.S.EP>-IONo.
WASTE MANIFEST 2. Page 1 lnformaUon 1n tho shaded Mus Is not
of I requllodbyFoderallaw,bvtbbyStitolaw.
3. Gener.toc'a Name and l.lailirv,i Addre,, . I •. New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 ·· .Wilmington,NC. 28401
.t. G<nemc;.,Ph~n• 919 341-7139 !
S. Transpo~CompanyName , .I'\\ · . , ~.U.S.EPAIONumbor ~ -W 1 "'~ Trv~n .NA
S'sii1iff"'""_... ... ,,~ ;-[)~~~~~MfJ.=!S't~,1
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9. O..igna~ Facillty Namo and Sito Addr ... · SRC 10. U.S. EPA ID Number
llox 2005
Columbia,SC29202 NA
I a. Petroleum Contaminated Soil (NON-Hazardous) .,,_,.,.,-f-H .. ,s-:-.,
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S. CiDltR.A TOR"S CERTIFICATION: I ~r•by declare U'\al lh. contant:s ol Na c:on~NNIIU ai, t1atr and ao:un11ly d•acrlb9d abow by prop.. ahlpglng n.ame and,,. cla.s.&lll-.d,
P•i;kad. m&rllad. and \abeled,and a,■ In all tflp.cta In ptopei c.ondltlon to, ""'"90rtbJhJgh-,sc:con:11ng 110 &'3pkabielntem.at1onal and natMxl&l gOV9fflffl4nt ~,,.1at1ona &l'ld IN iawa o1 lh• Stat. ot Som Catotln&. '
HI am• large quantity genec-alOt'. I cenily1hal I have a p,og..,..:n ln pLac:. 110 r.duca the ~andmlctty otw ... gltNl"&ladto the de,liJtN I ha,,. datennln.-d 10 be ..:.oncmlc.ally
pndlCM:ILe and 11"-t I haw M~ O\e praC1Sca~• m.lhod 01,r.,acn.nt, 11o,....., o, diapo:w,I cwqnQy avall.abl9 tom. 'Whktl m!Nmiua the p,._nt and fl.lCJra IIVNl 10 human
l'le.&lth&l)dthee-nv\ronmentOR.tllamaMNUlq1,1anl1tygenetalof",lha"•mad••ooodtd:heftottDmlrumlz.amrw-•g---tSonanclMIK:tthebNlwut.ma.nag•1Nnt~
lh&l ta a...aaatil■ ID me and~ I can affOtd. I • . . . • • . • .
19.. Ci>ctepanc;y Indication _Space
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::; 20. F aolit-, Owner or Op,ralor, =fication al 111C11ipl al hauidou, materulJ c:overed by lhis -ucei,t u nolod In llom 19.
Prlntod/Typed Nomo · Si\! T1 " II '<] a -n ~ . (Y/ • ~ -/,> t
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10. U.S. EPA ID Numl>or
'IS. G£HE.P.A TCR"S CUTIACATION: I Mrebydeclar• th.at U\e cont.ants ol th1a conaJgMWW\t art Wyand a=ura■IY d■acrlbld aboYe by prap,wahlpglng name and.,. du.alfted, pac.Jc;ad_tn&n;ed, and l&belad.and at■ In all tnp,ecta ln ptop,w c.ondltlon k>ttranapc,it,y I\J;hwayacc:on:ilnQ to applca.bl. lntemadonal and natlonelgovem.m.ent,-.;iulattcna and · IJ'Mlt&W$o11M6l&tao1Sou11'1Catoiln&. . I • • '. , • . I ., , . HI am• lat;■ quanttty ;•,..,.tor.I cenllylt'.atl haft a program In place to reiduoa a,,noh.una andmfcftycifwutag.n«atadlD l:he degrN I haw Cl•tannlned &a be eeonomfcaJly pradle&ble and G'\at I ha...,. M4-c:1ad Ch■ pracdcabl• method ot treazment,, star-a,;, or dliapouJ cnan!ty awalla.bl• ID me whkh mlnltnt:u• Iha pta,anl and ru~ra lfVMl 10 human h..ittland~~onmentOA.lllamaamallquMlll't'flil~.lha"Vem.ada&goodtaltntftoc1'-alnlrnlumyw...-g....aonandMt-..:tltlebMt•utamanag•m.ntrne1r\Od
· lhal la an.Aable to me and lhaU can aJrotd. . · ·. • 1 . . : . . . · . .
19. Diocrepancy Indication _Space .,
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~ 20, Facmty Owner or Oporalcr, C.rti!catton ol receipt ol hazardouo malorlal, Cr:J'lfJ( by !hi,~-except u notsd In lorn 19. t,I .;:~:;:-;:tsd:;-;/T:;:::)'?td::7;-;:Nam=:-e ,-;--, _.--_-, --...;.;.'-'--'--==;:;I ;=s;,;,:· ;;,;n 7'i='f,"-:.:..;;_'-,,-', _-'_""17~;;,;/7.:::..;?;;.,;.J:,:;;_;;;:_-----;'.M::'.on:-::lh:---;O;::ay'."'.·-:,;. y;;:..,:;;_
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Lu-1 1-1 , --15. Special Handling instructions and hlditiooaJ lnlonnation .·LM~-~,·J >Cake-.. o\ ~ \3 7~;,4,
· •• '" w. .'fl>· '?i 13
I!. CDIERATOR-S CUTlflCATlON: I her•by d.:iar■ lhat the C.OntanQ ot lhla c:anaig~lt9 f1Ay and a.ccuralllllY d•aaitled &bow by proJMf ahlppln; nam■ and,,. c.lualfled. P•"-.d.marbd.and\a~andataln&llrn~lnp,ope,-condUSonlot'Cn.napgrtti,N;h....,ltCCCN'dlngto~plc&bialniwnadonalandnadon&lg~,.._u1ati:onaand
. Che la._. of IN St.ate ol ~ c..roun.. . . , . ' . tr I am a t&t;• quantity ;•nretatot,I CMU!ylhall ha.,.• program In plac. ID Nduca l:t'MIYOIWM andmidty cf'W..-g.,....tadto lt'9 degrMlhave d1tannln.-d &o ~ -=onomlc.aJly prac::tlcable and V\at I ha" Mlac\ed lihe pn,cUcabl• cneO\Qd ol trMtment, stara,ge. or C!apoa&I o.n.nlty aTaJl&ble to tM whJch mln1m1za• 111.9 p,...nl and tutu re IIVMl \0 human · bul.1:2'1 and~ ~tOR. tll am a amall qwanUr, g..,.,..tor,I ha"• made a goodt&A:rl, a1Sort1:111ll.n.!mlu mywua g~&nd Mt41Ctltle bNt w&wa m.na;1menttM1hod lt\&ltaa....a.ni.10m.&ndlt\&lle&n&lt0td. ,1, , . . . • · . . : . .
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19. Ci>crepar.c-, Indication _Spac,,
•1 ! I
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Monlh Cay Year
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South Carolina!Department of Health Burau ol Solld l Ha.urdqu, W..,,, M.t,
2SXJ Bull~ Columbia, SC 29201
Phone 18CXl) 734-52Q0 and Environmental Control
ned bru:se on eDte 12-ort:ch
1. G..,enilll~a U.S. EPA 10 No.
Emerljenq & Holldays: (8C3)734-5424
Form ,.,,..,,_j_ Ct.Ill No.=-= Exoln,s 9-:)().ea
2. Paol ge I lnfannaUon In the 1h1dod 1<us Is not
requirodbyFadorlllaw,bvtls by Stai. law .
. 11 it. U.S. COT Oescrlplon (,nc/uding Prope, Shipping Name, H.uird Clas,, and ID Numbetj 12. Ccnlalner1 13. TotaJOuantitt t(.IJnj\ {l~~'.is, I . . . . . . .. .. . . : . . No. Typi ,. . . . 'M/'1~ ~M
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8_ GENERA TOR~ CERT1flCAT10N; I her•by declar• lhat th• c:onlants ol ltJ.a conalgn~ &r1 !uf't&l"od ao::urataiyd•acrlb.d abaw by prop.r&hlp~lng nam• a.nd .,. dua.111.-d,
packed. manted. and \ab91ed,and are Ln eJJ rn~ In PfOPff c:cndltion lof lnn&?Qrt b)' Nghw-r&c:COl'd.lno to &l)plcabi,akttamadonal&nd natlon&I gQ'Yemtnaf\l ,-...,ul•tloM a.nd Iha lawa of a"I• Sta.ta of &oue, Catollna. I
lllam ■Latg•qu.ant1r,g•n....tM.lcart!tyU\atlhaw ■prograrnlnpl&cetoritdue4tN1¥QlwneandlmldtyofwutagenaratedtoU\adeQre.lhaV'9d~iarmlnedtob<teconcmlc.&lly
pradc..a.ble UM1 lif\al I hav-o M'-Ct8d lh• p,-.ctic:abl• ffMltnod ol tr-Ntm.tnt. 11t0~-. or da.poa&i ~12}' ■Y■llabl• tom. whid'I mlnlmtu■ 111a p,....nl and h.Jtuq, ll'U"MI Lo human hNJtl'\a.n.dtha.,,vlronm.,-itOR.lllam•M\&llqu■nttr,gene.-.to<,lh&"•m..d•&.goodtaia'l•ffortt>mlnJmlumyw ... ;..-dotlandMLectU'lebeltw■ataman.ag■rn.nt~
that la ■-.l&.b'■ 10 ma and Iha! I can a!l'Otd. . . i • • , , • • •
19. Oi5aepar.cy lndicaoon _Space
cLL'
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PLE.lSEPRIHTo,TYPE nedlotu,eonellto 12· ib:11
I UNIFORM HAZARDOUS 1.Gene,at0(1US.EPAIDNo.
WASTE MANIFEST
t 1 Gener.ilDnNamellldlolaillngAddnm
I
;, New Hanover County/ City of Wilmington·
. 414 ,Chestnut St. , Suite 101 · ~ilmington,NC. 28401
4. Generator's Phone 919 · 341-7139 :
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T=spo~ Coin_ pan-/ Name · l. U.S. EPA ID Humbor _ w;\\wc.s T..vc.\!..·~ .N A
i. Transporter 2 Company Name a. U.S. EPA ID Number I. . '··
111 i O..igna~ Faciliiy Name and Sito Addn••• · SRC .
Box 2005
10. U.S. EPA ID Nwnber
' llw'uu of Sclld & Hawdo_us Wuto Llgt 26:lO 8ull Slroet, Columbia, SC 292':ll Phone (803) T.IH200 _.;·.. .·,
Emetljenq 6 Holldays: (80J)T.l4-S.24
MB No. =-oo:l9 Ex lros 9~68
on tn th• shaded 1<u:s l.s not law, but Is by Stato law.
I \ Columbia ,SC29202 NA ··"' ";i, I ,;1. ~-.S. ll9T D=iptton Qndudlng Proper SMppin~_Name. Hazf'd Clas,, and ID Numbe,J , . . . .. ., •:;~
•' II 15. Special Handling inslruttion. 111\d .l,dditional 11\lormation · , .' -1 m~:\ertaJ Cake.. 0\-\"37-o,o r
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·· I w· a. 12 _. ·.:;.-:· r_; ...:> I 'e. GDi£RATOR"'S C£RTIACA TION: 1 i,.rebydec.tar• that d'l• eoni.nb ol lt\la ccna!,gnlNM\t ar. Uy-and a.ccu,.-.ly described abov9 by pros,« ahJpplnQ n.ame and are clu.&ll'!lkf. pac:klld.mar'aed.andta~andareln&llrftpec;ialnptop.,-eondluontottranapor1;bJhlghweyac:c:Mdlngta&'3pl,c:ablaintamadanaJandn.atk>naJ9~re,gulal:!onaand
I lhe&a ... ott:he6tataof&outhCaldlna. . · i · •. ·· It I am a latga qu.antny g__,_.lor.l C.Ut')'ll'\atl N. .... a p,og,-,n In p_lace 10 reduce the wohJtM andmlc:tt-/ otwa.mglt1"lelmed ID Iha ct.orN IN~ d•tennin.d lo bl .c:.onamlC&lly I p~dlcablli and tnatl ha'f'O ~ lh• pracUeabl• malnOd ollr'U,m\en\, 110ra,g-.,ordlaQOM.ICl.ln9nGy •vallabl• tom.which 1Nnlmiu• 1he p,.....ntand tutu,.. av-110 human 1'1.,.JthandlhaenvitontMnt:OR.trlamaamallqual'ltl'l'/g~.lh&-v<J1mad•a;oodtdh•ftort~c1nl.m1:llrnyw ... oe,wadonandM(ec:tlh•bMtwut.m&NQ•1NntrM'thod ltl,&t la•~ tD ITl9 and lh&l I can allotd. • 1 • , , • • · . • • .
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19. 0i>trepancy Indication Spa~
I !L.1...1-.1..L.I.
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... Llonlh Cay
lib,, • I I I I I
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Year .,0
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South Carolina Department of Health
and Environmental Control
Buruu cl Solld & HaL21dqus Wum l.lgt.. 28lO Bull S1rool. Columbia, sc :mo1
Phono: (80:lJ 734-5200
E:ne,genq l Holldays: (BO:ljT.lol-!◄24
PLEA.SE PRIKT 0<'IYPE O'onn deol nod tor me on ellta 12-m:h
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Genm10r'1 U.S. EP>. ID No.
3. Gon=lo<'s Name and l.laillng -. New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 ·. Wilmington,NC.
◄. G,,,er.ito(s Ph~n• 919 3 41-713 9
5. Transpon,r 1 ComF'l Name W '[/ ..,-· -- I ' ,,,5 ,;vc,I:'.,.,,
fom, Aoorovod. 0MB No. 2050-oo:39 Expl,es 9-30-Ba
onnaUon In u,,, 1h.ad1d MU1 ls I\Ol
le law.
28401
. : ... "'~},
--:-~~Slfr~~.W..\:f::i:t
I Box 2005 \t.i~~~W:£@k'&'r. · · :ae'lT'\l\'.
I ' Columbia,SC29202 NA ~~~~_......~:;:;:~{':
l~-,,-.. -U-.S.DO_T;_Oeocrl __ pl_o_n;_(1n_c_/u-di-ng-Pro-por--Sh-/p_p_ln_g_Nam_e,_Hazard __ c.J1L,,,.J.-an.Jd_lD.J....N.J.umbe,j-'-...L.J.....J....+-l2..J.No.-Conla!nen:'-":T"'Yl>O"'"iF,1:.:.T:=~=lal::::Quan=:atitt:::. 71:::~:::\/M:.::d;,,~,;l~;::.;, .• ;,,_:;J~:,;.····'"~!::.i:!,;::!i;;Jj
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Petroleum Contaminated Soil (NON-Hazardous)
0 0 1 D T
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15. Special Handling lmtrucUono and >.dditio:ial Information ,
MoAeri'aJ Cake.. ot -\3 7 -o\o'
e. CO.ERA TOR"'S COI.TlflCA TION: I hereby d.ciate lt\at d'\e cant.nts ol ltila conalg~ar9 luly and II.CC\lra■ly d•IIO'tbed abow9 by proper ah.lpplnQ name and •r• cJa.ullled.
pecked. rnanted. and Labeled.and a,e ln all tnpeda ln pt Opet' c.oncUtion b'nnaponby ~l\__,.ICCOtdlng IO~plc&bie ~dona.land n.atlon&.I gOVflT\fflMlt ,.-;iulatlON and
lheC.wtioUheStateot&ou,t,Catollna. • -:am•_,, : ·
tr I am a l&r;• quantity ;en-en.tot, I c.ertlt., lhal I haw a program ln pl.aca to r-.duca tha ..dwne andmldt)'of ___ g.,...tedto aw degrN I haw det.nnJned io be ecoMml~ly
pnadic..abi. and Inell ha~ Mlecwd 1h• pnaeticat>le rnelr\Od Ol tr-.atment. ~-.o, dlapoUJ cwn1'1cy •~tome wl\lch mlnlmlu■ ~ p~ntand tut!J,.. tlvMl to hum&n
h6&11h aAd the envt,onm.ntOR, ti I am a lllT\All qualltity gene,-tor, I haw• made a good taJ:l:rl aft«tb~ m1•---C1.---adon&nd Mled:1h• bNt wute management mt1tood
lh&t la aYU&tii. ID me and Iha! I can atto,,:t.
Month Year cL.,L.
1-=4-:-::-::F-~:.::"'.::.lf""'-~.:,..,.-L..._.,.,c;;.;L...=.;.;:;;J;..;.,..,...,..;...."---...;... 1---.:..;.:.~,..,___,_:::::::;..:;d~-~-----~--~~~
;?;I 17. Transpc 1 >.cknowledgement of R,c,ipt ol Malerial•
I . qc
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1
. Prinled fT J ped Name ~ /.? \ --p Y\ , ~I 18. Tran.s~r.U 2 A.cxJiowledgement of Rectip.t or Materlab,
~ PrinledfTyped Name .
R .
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b I I I
Mon<h
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Month , ,
Day
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11bi.
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Day · ··yo.a r.;,,..,/1,,
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South Carolina Department of Health
and Environmental Control
15. Special Handling \Ntruclono and Additional Information ,
fV\o,-\evi'aJ CcJe... Ol-l3 7-0\C \ \
Bureau of Solid l HaunJ~uo Wute Ugt.
2Sl0 Bull Streot. Columbia, SC 29201
Pt>ono: ~ 734-5200
Emergency l Holidays: (60:llT.14-5-124
e. G 0.ERA TC R'S CERTIFlCA TION: I ~r•by dad.at• U\al the c:ontanb of ltua con&l,gn~.,. Pu1y and &eeu,-■Jjde~ aboYe by p~Pffahlpc:,lng nam• and er• cJu,Jllitd, paek-.d. man;a,d. and \a ti.led.and &1• ln ail, .. ~ 1n p,ope, eon.d.ltlon bt trvi&90rt by Ngh....,. aa:on1lng to &p~ lntamatlonal and nadona.l gfl'lemmentr-.;uladona and th• laws ot a,• 6tata ol Sou1h Carolin&. · HI am• targa quantity ci•nenitor. I c.ertlty1hatl haft• program ln pt&a to reduci1 IN 'l'Clume and lm1ctty gl wuta generated la a.. d~rNI hawedatarrnln.ed tot>-economic.ally pradiCU.la and ttw.t I ha.,.. MMtCtad lih• pn.cdc:abl• nMChod or trMtrn.ent, 110~-. or dbr,PQMl c..ftr\tty avaJl.abl• 1a me •hid\ mJnlmlu• N pt'9,Mnt and tutu,,. lrU'Nt to h1,,11Nn "hNlUlandlh.-enviranm..-.tOF\llla,naamallquanl1tyg~tor.lhaY•rna.d••C1oodtam'l•nort~mtnlm!za;m.,,...-~ffandMlad~be.t._utarnanagam.ntni.tt'lod
lhal la a'tM&ble tD m. and lt\al I can afford. . . . . . , . . . .
Signa r-a
11!1. Oisaepar.cy Indication _SpaC<>
Month Day Ye.u
/ L 30 °JD
Monlh Oay Year
1)1J!!1lkc)
bJ,, J,, lib,, d!
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, J , , , Jib,, 'l'::--c:---c:--:-----::-----::-=----,----------------------------------'------l ~ 20, F•etlity Owner or Operaklr, C.rtificalion of recoipl of hazardouo mal&rlal, COV1l<od by lllio -~ u nolod In lwn l!l.
I :l',y,lod/T)ll<d Name · Skirwn · 1 . r /4J · /"(n .,p,o,n_,9,,-, ,?2::r""'v '-..!/"74/\ ri _:,, .· =~., ·
I
I · South Carolina Dep_artment of Health
and Environmental Control
&ruu of SolJd & Ha=dqu, W..i,, Mgt.
2600 6"11 ~ Columbia, SC 29201 .
Phone (BO:lJ T.l-4-5200
Elnervency & Hoilday,: (SO:l)734-5424
!"-i 1·• ~,..,7~;-_?;;""''" ··t~ . I d. ~I J J • I ,~;;: I ~I ,· I J J~.
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1· I
IS. OEHERA TOR"S CERTIFICATION: I her•by d.clare lh.at lhe eontanb ol IJua conal;nrMl'\t u. W, and accura•lid•aoib«l abov• by prop.tr ahlppln,g name and are du.&Jrl.ct, I pack~tnan:..:1. and '6ti.l~,and era ln &!I , .. p+cta In pr Opel' ccindlt!Ofi b lran~rtbyNgh....,.IICCOt'Clng ID applca.ble, lrttllmallonal and nadof\&I govemm.nt r.gulationa and C'\.e laws oi tl'le Stai. ol ScMm Caronna. • · I HI am ■l&tg• quantity genen.tor, I c.rUty l:hatl haw a prog,-m In pl&ee ID redu~ ~ 'IIOll.lffleard 11:1:ddtyolwa.st. gen,wata,dto O'\a d99rM I ha.,. dat.nn.ln.ed to ba economJc.aJly practlC&l:l~andtf\allhav,eael.ec1od1ih•Pracdcabt•molhodot---..inwnt.110nt,g-.ord1-PQMJ~•......n..blatam.wl\lchmlnlmlualt\9p,.._n,andfl.lb.1rathlMttohum&n
he.a.Ith and~ environment OR. tr I am a t,ma.11 quantltygen.ratot, I Nva mad a a good talt71 affort., minlmlu my•NIII g.,....llon and Ml'.ect Iha bal wute m.&n.1gamenl metf'lc)d V\&I la ■Y"&il.&bla 10 me and hi I can allon:l.
I l=l-:-:--,-:P-=/~~L-~·~~~~~~-.::.....JL-~:µ:::::::s...~~::::..::~:a._....1..tJ.U.:.,.:1
· T 17. T ent of Receipt cf Materials IEf-"-~PC-C-,-:,~;_;,,.,,:..-...:..='-.;.,,;=======--~----_;_------r':;...-------------,--.,.,-
;l1--,.-=-'a.!./Il,~s.!-.,...l&~~'--,--,--,-----1--4,,ci.:ts;..::::::::'.!._....:.:::..:::... _________ .L!.t.:...L:'..t:::..U:..J 0 I
cJ_____/L,' Day Ye.u
'J 0 9 (J
Month Day Y=
I I 3 0
li!---::-,c,-':c::-=---'-------'-'---.....;.--_,,~~~-g-""-~-~--U....------------------:-:-,--=---=
I Month o,y Year
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bl I I J !Ibo. d I .1 I I \llxl. I~
L 'r--=--::---:-:-:,----,----::---::--c.--,-------------,-------------------..:...---1 T 20. Fac,1ity Owner or Oper.alcr, Certi6caUon of rocoipl of haurdous malorial, covered by this l!\&/'Jml ucept u noted In bm 19. ly
P~/T~ Namo • _,., 5;,;/\4b.J _ A Month Day · · Y=
·~ ~outn carouna Department of Health
and Environmental Control
Butuu al SolTd l tlawdcu, Well! !.!gt.
2!il0 Bull Slroot. Cclumo..:. SC 29201 ·
Phone (B(XlJ T.14-5<00
· SE PRINT o, TYPE tFonn deol nod lo< uoe on ellle 112-oacll
I UNIFORM HAZARDOUS 1. Gonor:,10(1 U.S.EPAID No. WASTE MANIFEST
L 1Gon=lo<'1 Name and l.laillng Addrmo
I . New Hanover County/ City of Wilmington·
I 414 Chestnut St. , Suite 101 '. .Wilmington,NC. 28401
<l ==tc(s Ph~no 919 341-7139
_' iTr.iuporter _:~Name _ ~d.law T 0-~: s..Nui EPA 10 tfurot.w h. '\;rr.iuporter 2 Co~pany_Name · S.. U.S. EPAIO Numb«
. ' 9. O..,ignaled fdly Namnnd Silo Addr= 10. U.S. EPA ID Nwnw I · SRC
Box 2005 .
Columbia,SC29202 NA
111 \,~.S. ~T D=rlplon (u,cfuding Prope Shlppin~_Nama. tmNrJ_ cia,., ar.d fJ /lumbo,j I L Petroleum Contaminated Soil (NON-Hazardous)
~""'Y l Hollday,: (&l:ljT.l4-!l-124
Fonn Accrovod. 01.18 No.== Elcl, .. 9-30-Ba
2. Page 1 lnfcnnaUon In th• 1h.ad1d .. u, b not cl \ roqulrodbyFod1<allaw,butlsbyS1>telaw.
. :<!ll><~'\!S:~<:!l~ ,···-~r"-ril~~aw~~a:~
I · led/T~ Name
c,.{_.,,.c.,I.. l,lcnlh Oay Yo.r
NH h.D L
T 17. \Tnrupon., 1 Adncwlodgement ol Reuipt cl Rt--';:--:-:-';-:::--:-:-,---=-----'-------=-,--..:....-,_a--.0..,.---:-,--1 Printed/Typed Name ~
,,..., .. .___
Sl~nahn l ), {.;~ J I ; 'H iJ p )=. N TO IL} ): (/,11 [:.;~----·
/ ' . '
Si~nabJra / V
I ~T 18. 1Tr:uupcr.ei 2 Adncwl~emenl ol R,c,il)l ol M.lt,riab
I
r"-, "=p:-:rin-cled-':--::IT::-)?<dc....:c,.,Nam,--e'--'---=.=====~--..,...--...;._.:,_ _________ _
I .
11 ~ 19.rcoa•panq~caicnSpace
1
1 t 20. f 1c,li1y Owner er Op,r,lc<; C.rtfic,icn of receipl or ha23tdcu, materlal:s °""'od by 11'.is /IW'Josl axc,pt u noted In tom 19. .
~ted!T~ Name • ~ • lo. ,? R a r7 a ·-;) .-.,. o • , ~ . I~ , ,,,
-:j"R.;_ I as-: '1 z,
Oay Year
lfc:: 1/' (
Month o,y Year
' t 1J11><•! pt:..
' ' 1 fib< d 1 ' \lb.
Mcnlh o,, ·y oar -
I
I
South CaroUna· Depar\ment of Health
· and Environmentall Control i8
PLEJ.SE PRINT «'IYPE . Offl1 des! nod lot use on ell1a 12· itch I I UNIFORM HAZARDOUS
WASTE MANIFEST
1. Genetalo(a U.S. EPA ID Ne.
8unsau al Solid & llaz:ard'1us WU:. 1.igt. 2fi00BullSlrNl,Cohlml>MI.SC29201 .
Phone: (803) 734--!S21Xl
Eme<iionq, Holidays: (!OJ}nH,2,
MBNa.205G-0039Exi,l,osNo.as
on 1n tho ahadad 1r11, b not
i I Frinled/T)'l)<d Name S.gnati,n, . Month o,y Year
I 19. Oiscrep.ancy tndic.a~on _Space
If I ~ t-2:::0:c! -;;f,-c,::;m:;c1y-;Own:--.,-.-,-=o-p,-,.-:-1or.---c. Ce::-,rti,.,_fi-ca""ti,...on_o__,l_reco___,;,...p1-o-=-1 '"'ha=doo:s--,--.,.----cc,et-'-ed-:--:-b-y-,lhis"·,-mana,,i---exceot--u-no-ted...,.,.ln"'"lem-1-9.----------'----i , l--'-'=,-,--;,::-'::.,C=C.:-
1 i flg7?J-tmur :&~ Y A-,
Month Oay · · Ye.at I .. / .,_"/.LO-,
I
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11
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South Carolina Department of Health
and Envh:onmental Control
Buruu of Solld & Hautdous Wa,1a 1.4.t,
25:lO eun Slroot. Columbia, sc 291U1
Phone (80:JJ T.14-5200
Emo<gency l Hollday:,: (80:JJT.l-1-5'24 I Pl.llSE PRllfl' 0< TYPE (Form deolonedfor""' on ellle (12-piu:hl Form Ao0roved. 0MB No. 2050-00J9 Elclre:s 9~-e
I
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'
UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Genera!X)fa U.S. EPA ID No.
I I I I I I I I I I I
~anu-:1 No.1~ Page 1 llnformaUon 1n the shaded .,.~, Is no
1 , ;"-:1 1 of . requlrt,d by Federal law, but b by Sta~ !aw
3. Gener.ator's Name and Mailing Addr8" • • • New Hanover County/ City of W1lm1ngton·
414 Chestnut St. , Suite 101 Wilmington,NC.
4. Generatof,Phone( 919 l 341-7139
28401
5. Transporter 1 Company Name 6. UJ EPA ID NuiDbor MCO Transport ,N I I I I I I I I
7. Transporter 2 C-Ompany Name 6. U.S. EPA ID Humber ,,,,,,, I I
9. Oe5ignal2d Facility Name and Sile Address 10. U.S. EPA ID Numb« SRC .
Box 2005
Columbia,SC29202 , , ,N1 , , , I I
11. US. DOT De,cription (including Prop,,, Shipping Name. Hazard Oas,, llld D Numbtq
I I I
·c.~Sta!lt'.f' ,,. --.. ,., __ tlD.~i=:1J~V~tr.Bm~
O}f=~--~-·;#-~•, ■··Phr»e~.Ht;·i:~·:::r:r::;;:~1:~~='t:!:;~;
I I I
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12. C-Ontliner.i
No. Type
G a. Petroleum Contaminated Soil (NON-Hazardous) :Jt1·c;c•1·"-,;
I~ 1----------------------'-------l-o..J,~oJ.., _1 J-o..J1_T4-L••u•_2J. 10--l-v_o--1,':"::,!'.'-=' 7='=7='=7=' 7:::::1!
:; b. 1'i'",' j \"'',i i I 1T , , , , , , , ,: I I I I ,_ :~ rc.----------------------------------r ..... ~,~-r--.,_~~~7--ti~:~:::··,:.::,==, =,=,=:
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d.
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15. Special Handling l~tructioru a~d Additional lnlonnation ,
\
1 C. C EN ERA TOR.3 CERTIFICATION: I h•r•by decl•r• thal th■ contenb ol ttila con~n~an l,fy and aa:ura•l"f dHc:tbeod abov-9 by pro~ a.hipping nam■ and ar■.da.,.aHI•'
pack&d., ma111-Dd. and tatMlled, and as■ In &JI ,Hpe,:U In pt Opet condltlefl to, tranaport by hlg!twwf acconilng to applu;a.blolnc.ematlonal and national g~nlr~ulatlona Ill
lh■ laws ol th• SU.LIi cl~ C&rol/0&.
HI am a largo quantity o•n•n.tcr, I eertlty thal l Nl...,. • program In place to r-cluc=-tflo 't'OI-arid ta.z.ldty of wiutaoerwni.d to ai.. de,gr-1 ha.,.. datarmln..d ta bo oeonomlc.a
practiablo and inat I h.Ave -lected tho pra~c:.sblo motr\od QI tr-tm■nt, ator-.ga, o, d~ ~ntty av.JLablo to me •hlch mlnlmlua Iha p,-.enf and l'ut\Jro lhtNI ta hum.
he.al th and trio onvlronmentOR, tr I am• am.all quantity gon.natar, I ha¥■ m&da a OOQd t.lltl eftortl:>mWm.lz.a myw ..... g.nenitson and aelect ltla ba.t •a.t.. m.anag1m11nt m.u-.
tti.lt la ava.ila.ble to me and that I cao al1ord.
P~/Typed Name , I Signature i) -L Month Cay Ye
. (J,,J~..., /, r ).,..,,rc..11 '3" "'-, _1, ('_ I 1/,/,/,S,"',,
17. Transporter 1 Acknowledgemenl cf Receipt ol Material, fl /
Prinled/Typed Name {, p_ F:J /rt'f>.MSC'N /4 I Slgnalura ,P;, -&,,..,,,.; Month Cay Ye
n,T,.. rrir,i --;,"J,.,..l(",,...-,,.,y-,-,.,._ -571/: ~'.JI . ·?~:/' 1 ;, t11,.:if,
18. Transpcr'..er 2 Acknowledgement of Receipt of M.ateriab . //
Prinled/Typed Name I Sign.atura i/ Montt'I Cay Y,
,J /,-1 I I I I I '
19. Disc.:epancf Indication _Space
• I , , I t , 111:,, 'I t I I t I \lb.
b I t , t t , !h d! I t I , I !lb>.
20. Facility Owner or Operator, Certilicafon of receipt of l"L.lurdou:, materlal.s anered by lhurnarimt ucept as noted In Item 19.
'-Aon!h Day Yi
I
I
I
South Carolina Departm_ent of Health
and Environmental Control
Bureau of Solid & Hazardcu, Wa,18 Mgt
2600 8"11 Sooet, Columbia. SC :mo1
Phono: (llo:l) 7:l-1-5200
E.lSE PRINT o, TYPE (Form deolqned lc< u,a on ellte f12·Prtdlf l\'l)eWritB,j
UNIFORM HAZARDOUS
WASTE MANIFEST 1
1. Generate(& US. EPA ID Ha.
Emergoncy & Holiday,: (803)TJ.l·5424
Form Acoroved. 0MB No. 2050-003:s E.xolr~ 9~-&
Manll••• 12. Page 1 llnfo~atlcn In the shaded Meal I, no!
I 3. Gener.a.tot, Name and Mailing Addr~ · I New Hanover County/ City
I I I I I I I I I 1 1 • ~:n-:• ~o. of roquuod by FederaJ law, but b by State law.
of Wilmington· ~~~3.tiii1A~l~!~Mil3/6~f
101 Wilmington,NC. 28401 eJ~'~ltD:l ';;!fs.~~~~ ·•:::+;~ :; ; ;: t·.:c:.~~-::,·,·, ·-.:.: : \ I 414 _Chestnut St. , Suite
I ;'· Generate(> Phone I 919 I 341-7139
1 5. Transporter 1 Company Name
11 MCO Transport
•· '.-... -•-....... :!t •"'--~1-f~~~~~r.:.~:,.;r~;:·f<t~ .. , l'.,.'-~~;-~~~~--:..J.i~~;,,~;·&;..:~:~t;ii~1
6. Uj;EPAIDN.umbar
,N I I I I I I I
C5Sti'in"1'y __ .,.., .. _&~io.~J.\~;t'/;;\:"i.{iX~'.?l~~.:E:~.-.. ;.:~
I I I I 0}.'f' ~-..•. •,,: ·• ... .-·rPhoot\fii-]';:c;'!G :~?~-j;-:~::J!'.i~/id.~~~-:t; ~ I i 7. Transporter 2 Company Name 8. US. EPAID Numbe< ,,,,,,.,,,·,,, ·t~~~ i '< ..,,.., ...... .,. ;i{iif foX~~~i-~i.-'.?!t;;"S;,t;:t~::/i:.S.(_~j
F~·-·Phoc·;.\4.~~__;;:,~y::~;~~~'.-~~~-.!:l;:fX
~~~~~~~N~~1~~~4Jir4t57~~~\~
II
II
9. 0e5;gnated Facility Name and Sile Addr~ SRC 10. US. EPA ID Numbar
.:;,..,....,~~.:;~~s't~4.~t-;::;,.:tr~~r...,:.•.:t~-~-• ... _~c~=,~~~:
Box 2005
Co1umbia,SC29202 • I ,N~ I I I I I f f ~~li~#~~~i~J}~
. 11.·U.S. DOT,De>Cripticn (,ncfuding Propet Shipping Name, Hazard Clas,, and ID Numb«j 12. Contain.,. 13. T ctll Quantity 11. Unit at':~~:;,,
No. Type . . 'M!VrJ ;;f;,/~~~~f;,t
a. Petroleum Contaminated Soil (NON-Hazardous)
I I!
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15. Special Handling IMtruction, and AdditionaJ Information \
'1 IS. GEHERA TOR"'S CERTIFICATION: I h•r•by doc:lar ■ di.al th■ contonb ol th.La cont,Jgn~&r1 WJ &nd a.ccura•l:i dNCrlb■d &bev■ by prop« ahlpplno nam■ and at■ clu...lf'i,
packed. mar1tod. and Labeled, and Al'e In all l"P<Ktll In ptop« ecndltlon kx tr-.naportt,y hlghway~ng to applLcabt■ lnwmadonal and natlooal gO'l■mmenl ~ulatlona a
U"I• La-. ol tt1• Slat.a of &km C&rollna.
h I am• ~g• quantity g•ntira.w, I c..rtlty that I ha..-.i a pn,gram In pla.ca to r.duc. 1'\e~um. andll:Wctty ot~g.....-atad to ttt.. d.-gr-1 ha..-.i dawnnln«I ta bo .eonom/c.,
practi~bl• •nd tna111\.11..,... -~ th• praCUc.abl• m•lhod ol tro.tm•nt. ato~-. or dlapo&&I a.n.ncy ■vaJLabl• ta me whkh mlnlff\U.aa tfl• pnaaanl and tutur• tnr04l Lo tu.om
ho.aim a.nd tn• envlronmenr:.OA.. If 1 am• am■JI c;uantlty gen41tatcr. I hav• made a good tattn •flart1Dcnln.lmll.• my w_.. g--.don and ..iacs 111• beatw...i. ~g11m11nt ~
Q'\at ta &va.ila.l>I ■ ta mo end U\al I c.an afford..
. (] _'}.
17. Tran,po/'tar 1 Acknowledgement ol Receipt ol Material, V
18. Transporter 2 Acknowledgemenl ol Rec:.eip'.t ol Material~
Printed/Typed Name I s;gnallml
19.. Oisaepancy tndic.:ab·on Sp.ace
rP-. ,1 IL
/
03 JI/ fl/
Mani!\ Day Y,
1/,/,/,'5,q
Month Cay Y
·,,,1,1,~·,1
Mani!\ Day \
I ' I I I
•I ... ......__._.........,\lbs. •I
bl \lbs.di
20. Facilitv Owner or Ooerator; ~rtifiCJtion ol receipt ol haz.ardou3 material, covered by thil mar.11:st ~ u noted In ham 19.
South Carolina Department of Health
and Environmental Control
Buruu al Solid & t(aurdoUl Wl3bl l.li;t.
2fiOOBunS11..t.Co1umtJi.l.SC29201 ·
pr,,;.-,c (&()JJT3-4-~
/Form c!elon,:,,::! lo< use on elM 112-e!'VII ~
UIJIFORM HAZARDOUS
WASTE MANIF~ST 11. G8flan1C(1 U.S. EPA ID Na.
I ' t t
.,.•n!le•l 0ocw,..-,,No. ... , 7
Emergency l Holld&ys: (S03)734-~,p,
Fonn ~ofU'WWd. 0MB No. 10,50-0039 E.10'lr11t1 Q.J.')...U
2. P1gel llnlorm1!lon In 11'11 1h1d1d 1,1111 II ne!
gt r,quirtd try Flld1~ Ulw, blll IJ by Stai. law.
1 J. 1 G1~1of'1 Name &rd LlaiUf'9 Addtm:t flew Hanover County/ City of Wilmington· t~~;if~~&J;~t~f3/f-'.·
liittttt~-~@~~~;1.i~:ft~~t~fi 414 Chestnut St. , Suite 101 · ~Jilmington,NC. 28401
,_ Gfflffl!~f', Pl'l~ne I 9 l 9 l 341-7139
i. lruupcru11 C6-TiD&II')' t-wrie ~:::.o 1 ransport
1. lrZNpolUr 2 COmpa.n1 N1,m1
9. ~i911.1.ritcc.il•fy 1-wn■ Vld Sola hld1e1J
Box 2005
Columbia,SC29202
I. U.S. EPAIDNumt>er
10. U..S..EP1.IONumb.-
NA
11. U.S. DOT (}ucsipaon (lllcludinQ Pro,w 5nippin9 ~"-HuvfJ Ou,, &!Id D Numbotj
C:·~T~1 o7>;:f.-,\'.,'j~L~:;_-;.-:.i;..-.:C ·····
O. l~i Pt•;o•.;",c·J;\~·~:·:·,·..:..,-;·;_!"-..'): 1«--·: ;·
E.;si;._,;,·,T~1 O :"1!.l:.fi.:.~'.'°:f:.:...~;~~!("'!':···~
F":.i~~~.i;'!~.::::>:::t~~1="~~-r.'.:
[,~f.~j~!~~~(i'Sf~~~lfi~?;\\
: ;~~1i~;t~~::;}:~1t\~J:KJt;{:-:-
12. Coacainers \l lotlJO\.ia:1~ U.Unrt 'l'.WU::.Nliub6r"'-
No.. • 11P' W'./'id :* ... ~,.~~~~
a L Petroleum Contaminated Soil (NON-Hazardous) ·, ~-; ;rs;=-, 1~
~ f-;:-----'-------------~----~----fo.Lo..l.. '~· ~O.LTtLL..:L2..LOtY_o--t~i~1~• 7:;'~7~1=7~,:;:7~·~::i--"
.. •.·•1···--~~~ A ~ T '. I I·• ~ f.:-------------------------------t-'-'-!-'-1--'__,'-'-l..t-+.,~. ,==~~~,,;:.~~
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1). Spe(W Handling lnstn,,c1oru arid h!d,Don.al lnlo.rrn.non , \
"-CO<(,U, 1011"11 CUITll'ICATIOH: lho,obyda<la<• ""''"'• cont.M,ollN.o""'.IQn~I.,., ,._..,_,.,, og.un•'Fol•,alt>,o<l1-t,y p"°p,o, _,,lpolno ........ ond ••• ciu-o!hsl, pock..i,,.,..,.,..i,&Nll.abolood,andu•lnalltn~lnp,ope,-c.andl■-w--""""""_...,~-..,.,._.-,.,. . .....,....,.,..,_,...,_,,,<911.,I•■•"'"""
th•lo..-. o-l<r>o 11.a,.ol_,C-uol_
lll&molo,, ......... .,. •• _io,,lc.,,"'i')'""''·"""··•""O,.,., ... ..tac. .. ...,,,__..,_and.aldfyof•-•-..... "'-""'111'-·""""" .. ""'""""''°bo-"",;.a/lr pnaUOlo _,,.-••ho-M'4elad v,o pne11c.ol>I• ,......,.,, or .....,,....,.l~a..ord~ .,.....,,.,.. o-.U..Plo"',... wNch mlnl""-1.o•.,.. p,.._,.I and"'"''"""'""'"' hu""'n
ho.J"'""°"'"-''on"',onCOR,llloffioMT>All(IUOIIDl'J'O_.,.IOr,lhavo-.do&flOOdti.lG>orlor1Nailnl<n4a"'l'•--------'-"'•-••....,_,.,..,,_.ll•-nl.........-.od
..,.,., •• .,~••1■tno.....i1na11canan.....,_ -
Prinlt-d!Type,d lw!I• Sigtull!f , Monltl Day Y= '/2..A, l-, C,t..,L~ ,~ r;.
17. lnsupOn,:r 1 Atlno•ledg~mtnl ol Rec.tipl ol J.41e<W,
Prinwdnr~ lw!I• Si;1111urt Monll'l °'' ,-
1a. l nn1P01W" 2 1.d<no•ln'9emen1 or R~i;J el M.l~l'W,
--flnnll!'dllyptd twn, 1)1 s;,11,1a.ir1 zj, Mooo o,, ,~
1-,c__r--,~ 0 1"rJ ,:) I "J\/ 7 ... :,-'V-~t.,;, ,_&; '-t, I C 7
\!i. Oil.eap,lllq'lndlCnonSp.i.~ i •I , .. • I )'ta
'I , .. 'I , ..
' if-cc~...--~-~-~~-~~-~~--~-~~A-----~-~-------~---1 ~ f"'-;;:::i.:!;;':'"i,"::''::"':"'"s"""'"c,~•,•cQs•,;0~0,0,1 ~".;'.C''c'.:"c""',:::c"°"'ecc::=;:;=':'ccrT'-r"'" . .,-:,;;;,=-,--ec:c.:uc~,,,,"'~· :"c""':e::· -'""--------;;;;;;;;-,;;;-,.;;-! /r'f!. TI.,.1/L'. "' ~ L
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25
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--
South Carolina Department of Health
and Environme_ntal Control
lluru.u C1I Solid & H&il,dou.i Wul:8 l.l;t_
2mO U StrNt, Corvmb.&. S.::: 29201 .
. l'r.on.: (Ml) ™·5200
E.rn.;J.-q & Holld.ys: (&O,Jj734-~H
PLU..Sl!:PR1Hl .. TYPE l'Fomidtsian!!Od ft,,~on,i.Ull1•1><!d'll~ fom, AllOl"O'o'.:1. 01,18 No.~ E.J1>;,i,s 11-JJ..U
UNIFORM HAZARDOUS 11. Gtr1er111er', U..S.fPAIOHo.
WASTE MANIFEST .. 00~;::!;:~~ 12. h~ 1 llnlorm1Uon In lh• 1hadod a,u1 l• nol , , , , ,; ,t,, ol requi1..:lt,yhd1~la•,b1tllsbySt1tala ...
l. Getwflllot'I N&tn1 &/'Id l.l&LlinQ Md•a:» Uew Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · W1lm1ngton,NC. 28401
,. ~rn;lall Ph~n1 f 919 I 34} -7139
f~2~{~~~0.f~l@?t~!-
~1¾:~¢~;4f7itff~2fi
!.. TransPOru-<lec.,,p.&nytwn1 6. U,S.EPAIDN\ffbar
MCD Transport /l/\1 , 1 r , 1 1 1 1 1
1. TBNpo111r2Compan1Jwn1 I. U.S.EPAIDN1,1111011'
1 I I I I I I I I I I
E.:~.T~a o-:·,-~-.... ~i.~:;::r~•~~!,:~":-··.;
r .. 1~..,..,,;.;~;),;!:;c.\:::>~~'-..'..·.--:•~
9. Ou;gn.&~f&eaily twn1&nd Sill Ad~rcu SRC
Box 2005
Columbia,SC29202
10. U.S.EPAIDNIJ/flbs
11. U.S. DOT ~don (nc/udin{I Pmpet 5/Jipping Hunt1, HuMfi Clm. &lid D NIPllb«J ' ' 12.Conlainen 1a.Tot11Quan1rty R\JM ·t•.w~Nlnbet.;...,
No. Type 'fM'~ :f~:~~%~~~~
0 L Petroleum Contaminated Soil {NON-Hazardous) ~1 ·, 1 'j ·,-;;,
e 01011 01T 1 1 1 210 YD '~1 171717171~ i ~.------------------------~----7fC.C.fLf-.L.L.LJ.1"...::7~~::!~~~,:J.
A ·lie ..._..._...__,,ii
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WASTE MANIFEST , , , • • •
io_.a~~~H~o~1~~~ty/ City
414 Chestnut St. , Suite
t.Gv,..-a~1F~•I 919 l J4}-7}J9
of Wilmington·
l0l · Wilmington.NC. 28401
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MCO Transport
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Columbia,SC29202 , ,NA , 1 ,
11. U.S DOT Ouat;l'°" r.,dudong fro,,, Sllipp,n~ ,w,,., luUld Clul. ,nd D Nl,tt:,b4,rJ
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South Carolina Department of Health
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UUIFOAM HAZARDOUS
WASTE MANIF=sr 1
1. Gonion11><'1 U5. EPA 10 No.
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414 Chestnut St. , Suite IOI \.iilm1ngton,NC. 28401
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South Carolina Depariment of Health
and Environmental Control
&.n.w ol 5olld, Klurdous Wa.ste l.lgt
2Sll&.d1St_,.Columbi&.SC29201 .
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414 Chestnut St .. , Suite
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Box 2005
Columbia,SC29202
of Wilmington·
101 · ~lilmington,NC. 28401
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South Carolina Department of Health
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WASTE MANIFEST 11. a-,.,.s:,r'aU.S.El".1.llHo.
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414 Chestnut St. , Suite 101 Wilmington.NC.
'-~ffl~SPh~n,r 919 \ 341-7139
5.. l=poNr I CGml),ll"f tl.:lm■ MCO Transport
28401
I. U.S. EPA.IC N=.l)w •
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Columbia,SC29202
1Q. U.S. EPA ID t-l=tM
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South Carolina Department of Health
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l<,r.,... f1I S<lld l ~dou:i Wu11 l.lgt. 2m:1usa--.~scis;:o1 ·
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WASTE MANIFEST I '· G..,•,ult'1 us. EPA 10 No.
. ' ' ' ' ' l. Gtn,u·,110('1 t-Lune and l.l~g Md,..,. New Hanover County/ City
414 Chestnut St •• Suite
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9. Oc..,"]n1~ f.ici!ity H.in,1:v,d S,ta Add,~ 5RC
Box 2005
Columbia,SC29202
of Wilmington·
101 · Wi lmington,NC. 28~01
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8utuu of Solid l k&uidow W,ute t.Ai;t
2ti1X1 U S'IIMI. Cdumbi&, SC 2'3201 . ,...,,_ ieru>™-~ En-ii~•~"" 13a31n4-~24
UUIFORM HA.Z.AROOUS 1,. G.,..,,1;1r'1~ EPAIDHG.
WASTE MAW FEST , . . - -.
1 Ga-,ilOr't H&mt tnd t.Allil,ng Md<-.S
llew llanover County/ C1ty
414 Chestnut St. , Suite
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1. T 1¥1tPOt\ti 1 Compury N.unt MCO 1ransport
1. TnnsporUr 2 Camp.any Name
of Wilmington·
101 · Wllmlngton,tlC. 28401
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WASTE MANIFEST
l. G&llttllto(• N&me alld Llailing Addni:s.,
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New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · Wilmington.NC. 28401
4. ~e-r11c~sPh.;,.,f 919 I 341-7139
5.. 1 l'INpoNf I Comp,IITJ lumt
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9. DuigNlrR~c.iiry Natnt l/'ICI S.111 Addrus
Box 2005
Columbia,SC29202
11. Sp,ecialli&ndlitlgNtn.ic1onsllldAddi~ona/lnloffllUOO,
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pr,on.: (&OJI Tl'-5200
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tlew Hanover County/ City of Wilmrngton·
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•-Gvleni1o~1Ph~11 919 1 341-7139
S. Tnnapc,rttf 1 Com~ Name
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Box 2005
10. U.S. EPA ID N\IIIIW
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11. U.S. COT Ouaipdon ~c/d,g Pro{W S/1/pplnr, Nam-. Hazml 0..U. and D Numbttj
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Phoo«: (!OJ) 134-~
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WASTE MANIFEST 11. GlllflBlll_,,.-IU.S.EPAIDMo.
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l. G~lo<', tum, ard I.Wlir,o Addrni
New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington,NC. 18401
t. Gu,Mil,:,;,lPh~ef 919 I 341-7139
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SRC
Box 1005
Columbia,SC29202
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Buruu ct SolJd I fW..trdO:us Wu~ Ugt..
2WJ e.J11 S.M\ Cclumbla. SC 29201
~ (B0,31134-5200
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UNIFORM HAZARDOUS 1. Gen,rO:l(1U.S..EJ'AIDHo..
WASTE MANIFEST
l. Get'IC'fal0<'1 t.am, and~ Addtim
New Hanover County/ City
414 Chestnut St. , Suite
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1. Trvuponrr I Comp.ut1Nvne
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Box 2005
Columbia,SC29202
of Wilmington·
101· Wilmington,NC. 28401
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414 Chestnut St. , Suite
t.Genff'lto(1P~1r 919 1341-7139
1. 1 l'Vllpor1et' 1 Company 1-wne MCO l rans port
of Wi lm1 ngton ·
101 · Wilmington,NC, 28401
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Columbia,SC29202
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South Carolina Departm~n't of Health
and Environmenl;i/1' Control
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Bun.au c1 SoOd l Ht.utdou.i Wula Mgl.
2WJ Bull SlrMt. Columbi&. SC 2'9201 •
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l'LEASE,1!1~c,,TYPE IFOtTT1d~nedlotusec,neDtall2•D,tct, ~ .. fonn A:,~ 01,18 No. 20SO-OOl9 E.tpl,es 11..JO-U
UNIFORM HAZARDOUS I. Gen~t:1(1U.S..EPAIDNo.
WASTE MANIFEST
1 Ge~ID<'• tum~ 1M LwbnQ Md rim
New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · Wilmington,NC. 28401
~.Gvlffl.1of1P~e 919 341-7139
S.. lnmpcrt.ef I Comp&IT)' tum,
MCO Transport
T. lB11.Sporta1:lCompanytwn1
9. Oe.siQl'Ulirt_Faei,ty Hvnt and Sit. Addfe:u SRC
Box 2005
Columbia,SC29202
L US.Ei'AIDNumbat
10.. U.S.EPAIDNur11blr
NA
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South Carolina Department of Health
and Environmenfal Control
l!urMu ol Solid I H&usdow Wu111 Ligt.
25IXI Bui SlrNt. c.:iiumoi.l, SC 29201 .
Phan« '80,ll 734·~
~ency, Hollda~ l80Jln4-)m
PILI.SE PRUlT o, TYPE !Fo~ d--'-ned for~ on e!ltii !12-Ditchl •-.......... fomi An-.:!. 01.18 No.~ &cit-, 0..JO•M
UNIFORM HAZARDOUS 11. Genentr1(1US.EP>.IDNo. ~~ 12. Pa~1 Jtntannatlan It, Iha 1h&d1d Mus b, Ml WASTE MANIFEST 1 , , 1 1 1 1 ,t 1 / -,.-1 d I r,,qulredbyflldar.aJLt.w,butlsbyStl.Lelt.w.
1 G1n.er.ill>t1 Name and 1,b.iling Add1au New Hanover County/ City
414 Chestnut St. , Suite
~-GtnenUl~i Ph~n• I 919 I 341-7139
of Wilmington·
101 · Wilmington.NC. 28401
S.. Tr.uupciur 1 C=p.;iny Name
MCO Transport l U.S. EP-' ID tiwet.r
,N IAI I I I ' I I I ' •
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Box 2005
Columbia,SC29202
10. US. Ei'A ID NwTit.c
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South Carolina Department of Health
and Environmental Control
buru11 Qi Solid l Kallfdow Wt!!III IJgt
2Wl B<Jll SIie.et. Columbia. SC 29201 .
f>r,onc: ~) n.t-!200
~ l Holidays: (WJ)734-~2(
UNIFORM HAZARDOUS WASTE MMIIFcST 1
1. G!lfl•tU:1(1 US. EPAIOHc:I.
' ' ' 1 Gt~lor'I /w,,, arw::I UIN'IQ Atldteu New Hanover tounty/ City of Wilmington·
414 Chestnut St. , Suite 101 · Wilmington.NC.
4.Genmtor'1Ph~n1/ 919 341-7139
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Box 2005 _
Columbia,SC29202 NA
11. U.S. DOT [)uaipUon (,ncJudmp Pro{M 5/tipping Nam-. H.aurd Cl&n, and D Nlllllbe,j
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South Carolina Department of Health
and Environm-::iltal Control
Butu11 o1 Solld & H&utdou.s Wubl 1.t_t
2ro:JB..iaStrNt.Columbi.&.SC29;.>:Jl .
Pl>Ollll: (WJJ734·~
~tnq' I Holl4&ys: IISOJl734❖12A
rl.LlSE PAIHl 0< TYPE !Fom, ~e,,ionfld to<~ on e0te 112 o;ti::1,1 ~ Fann Acon:m,,i 01.1B No 10.50-00l9 Eiol,es 9-JO-P.'J
UNIFORM HAZARDOUS
WASTE MANIF=ST 1
1. uer'lar11ti(• U.S.. EPAIDNo.
I I I I I • I • • • •
l. Gtl\ff3!o<'I Name and l,lail,r,g Addre:s.s flew Hanover (.aunty/ City of Wilmington· 28401 414 Chestnut St. , Suite 101 · Wilmington.NC.
A.Gv,N"1tor'1P~ntl 919 134}-7139
$. T ,anspo~ 1 Company l'Qme ~:co 1 ransport 5. U*EPAIONUll'lte' ,ll , , , ·, ,
1. Transpon.1:r 2 Company N&m1 I. U.S. EPA ID NUllll)oW
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Box 2005
Columbia,SC29202 •• IN~ I I I • '
11. U.S. 001 Dccriplion (nthld,r,g PropM S111pping tu.ma.~ Cl,.u, and l) HlllllbetJ
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No. ll'P' 'M/Vd :2.b:~%:~~:-~
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South Carolina Oeparfmenl of Health
and Environmental Control
Bur.au of Solld l H.autd0t1-> Wu!:& M;t.
2fiOO&ittSlrM1,Coh,1mOia,SC29201 . ,he<..: (BQJJ 734-UOO
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Genanror'1U.S.EPAIONo.
l. G■nc-n.!Or', t-w,,, and Ulllli!'IQ Addres3 Hew Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · Wilmington,NC. 28401
t, Gt.nmlllr'1 P~1 919 341-7139
5. lnrupoN-r 1 Company l-4mt t\CO Transport
J. TnNport.er 2 Comp.an, N.am■
9. Du~!'II~ F1ta,ry Namt and &1a Adcreu 5RC
Box 1005
Columbia,SC29202
L U.S. EPA IDNUl!lber
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and En'vironmental Control
8urMu o1 Sorld & JuuTdcu.s Wute "4~
2500 Bull sc.i. Columbi.1. SC 29201
fhooa: (803) 7l4-~"'00
UNIFORM HAZARDOUS
WASTE MANIFEST
J. Ga,rwqlo<'1 Name and Maiiing Addre5.S
1. Gerw1.10t1U.S.EPAIDHo.
New Hanover County/ City of Wilmington·
Eziw.;1.-q & Holldly$: 150Jjn+5"2,
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Sox 2005
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Date I I-do ·'2.J SRC Matorial Cod/ 0/; 3 7-C,,/· /) I
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South Carolina Department of Health
and Environmental Control
Bun-luotSollcl l Ha.usd~ ,.w~ 1.Agt .,,,:
2600 lkdl Su..c, Columbi.l. S -29201
f'rioo.: fa0,3113-4-a.."OO ·•
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UNIFORM HAZARDOUS VIASTE MANIFEST 1
1. Gwiart10r', U.S. EPA 10 No.
I I I I t I
l. Ge,..nla<'1 Namt and M&ili"'-Ader"'-' Ne1-: Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington.NC. 28401
•· Gt:nrnlo(1,0hon1f 919 1341-7139
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7. lrwuporttr 2 ~mp.any Nam1
9. Daligna1~1tceihf)' Nam1 and S.IA Add1eM
Box 2005
Columbia,SC29202
a. US EPA JO Numbet
10. U.S. EPA IO Nl,llllbtr
IIA
11. U.S. DOT Oucripuon (,ncJudlnQ Pre~ Shipp111g f.Um11, ~ OU,. &11d D NUlflWj
~lllq l Hd"ldays: (80Jjr.M-5-C2.t
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PhOl"ME (!OJI 73'·2»
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J. G..-wnlo<'1 N&m, and U&iling Addnm New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington,NC. 28401
4. G,.,111tralllr'1P~1/ 919. I 341--7}39
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t. OuiQn,rR~eiLty N&ITlt and S.1.a Addreu
Box 2005
Columbia,SC29202
10.. U..S.EPAIONumblr
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eura.u ol Solid & tuwO:::Ul Wut11 Mgt. 2tm Bull SlrMt, Cdumb...,_ SC 29201· ,.~ (80.lJ n.4•5200
Emerg9ney l Hodda~ (!51131734-SolU Pl.EA.SE PRINT"' TYPE lform de,.iani,d lorusa ort dltl 112-Dilctll~ Fom,.~0l.i:8No.~Eioltes9..JG.M UNIFORM HAZARDOUS IC ......... w. .. AIONo WASTE MANIFEST . ---·
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; New Hanover County/ City ·of W11m1ngton· 414 Chestnut St. , Suite ;101 .\.'llmington,NC. 28401 -t. Genen,tor',Ph~ef 919 I 341-7.139 •~:(O
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9. Oesigrultd f.aoJ.ty l'Wn• and s;i. Addtll&I SRC · · Box 2005
Columbia,SC29202·
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South Carolina Department of Health
and Environmental ~ontrol ,_
&.nau al Solid & Ha.uldous Wut!I Mgt.
2500 Bull~~-C0/1,1mb>A. SC 29201
Pl>an« {M;lj 73-M .. -OO
E/nergltlq '-Holida~ (l!OJl734-~24
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Ge'leflll0/1U.S.EPAIDNo.
l. Gwwnto,'1 t-wn, andMailinQ Ada,a:n
New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 Wilmington.NC. 28401
4. Gvl1N.1tc:(1P~e 919 34}-7139
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Box 2005
Columbia,SC29202
IS. SpN;i.11 Handling Nnlt10115 and Add.Gonal lnlonnUOl'I ,
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Box 2005
Columbia,SC29202
I. U.S. E?A 10 NulTIOIW
10. U.S. EPA ID NU/11.ber
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Box 2005 ,
Columbia ,SC29202_---~
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South Carolina Department of Health
and Environmental Control"
8urua of Solld& Hallsd',!US Wute 1:1111..
7roJ BuQ Streorl. Columbi,f. SC 29201
f'nonc (803) ™·~
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UNIFORM HAZARDOUS I. G.-.wat;(tUS.EPAIDHo..
WASTE MANIFEST
l. GalWl"lllor', Hatnc ard Lwlir>o;I >.ddfeu New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite IOI Wilm\ngton,NC. 28401
,. Genrnlc(1Ph,;,,e 919 341-7139
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Box 2005
Columbia,SC29202
L U.S. EPAID N11m.blr
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South Carolina Department of Health and :nvironment::!! Control But.all cl Solld & H&llldOl.ll Wuta M~ 2WJBu!ISll'NlColllmbia.SC2"..1201 • f'l'IOO< leOOI T.!-4-5.200 vnerg.-.q & Holiday,.: 1803ln4❖424 !LEASE PR!ITT "'TYi'! tfr,m, d~oned t,:,ru..aon ellter12-oitd'IJ~ Form .l.oortMld 01.48 No. 70!,0-00J9 _E:iolre:, 9-JO-aa UNIFORM HAZARDOUS Y/ASE_MANIF:'SJ_ 11. Gt111t1tU:1(1 U.S. [!'AID No. ~~~~~~~-•' a.<•ntl•U 12. h~ l l1ni0nn1Uon In Ille thaded ..-ui h not .o.:=~i7'-~:"._ crl . I !l'1'011Uedb1F9d1raJl.ll.,,,t:IJllsti1SQ.t11L,, .. _ l. Gtr>en!Dt't Namt and t.l&ih"9 A.:la,a:u New Hanover County/ City of Wilmington· 414 Chestn"ut St. , Suite 101 · Wilmington,NC. 28401 •· Gerlffllll;.i P~ne ( 919 _ _J_341-_7 ~~ __ tmt~,;~~1J/:li·~YE~ }l~~¢~ii1?it{~t2f}: 5. Traiupontt 1 Comp.any tum, MCO lransport 7. Tnnsponer 2 Cum.~nr Ham■ 9. Ouil,in.1fRFCeilry tum• &nd S111 "411/C:U Box 2005 Columb1a,SC19101 \ Uj EPA 10 N'umblf I I I I I I I I 1 1 I ! a. U.S. EPA ID H\lmlW 1 I I I _L 1 • I I I 1Q. US. EPA 10 N!llllblr c.·~l~i l),:r,;:t.-;\;'}'>~;~•:!~-;M;;.,1>;•~"· 0.1~,f'hoii.·:~!t!!.>·.-r:.'::·.;,r,::K•-..•:::!;-E.; Stai,, 1~.1 c·::•~\,~{.~·;:~·--'-.'~•f~.".: ,::~ F.:1~ ~_____;___,_.,,;-. .:;.,.. .. :;;,_:__:-· ··-.:.,_;; .~-'.f~i~t]1t~:¥iEt~~li~i;~lE; __LL_(~ I I I I I:~ ------··---,o-c,;;,,.,,,,., ,_ ;.U;!'rt~~,~Q]~f~~~~~ ... ~;'·l!l;iJ,.,·•; , 1 '·"');j.J'i~-~.;1.;."""~/i-f,,,.\.l-v~,~=h,.l':'.,;.'c''I .i..·, 1 \. U.S.. 001 [)uerip~on (,ncivd,np Prope, 5/lipping ~• ~ Oan. utd D Numtwj 12. Conwnen 11 lotaJQuan~ tUJM '.l'.Wa!l~~,I "~ Na. 1,... 'tMrJ ~~:c;?..;;~;:~f:~ 0 1. Petroleum Contaminated Soil (NON-Hazardous) 1, ·; ,-=·; ·1,:;; ~ 00,l0T, 2,0Y0 ~1171717171~1 • R tr,. .. p I , , ,l-~ I A •1 ,--6 1 • 1 , : ] I J I I~~ R c. ·11 I I I ,·!~ ,. ,. ·.,, I I I 1•:: ' ' ' • I I I I ~•-·.=-:._ •• ftw ;~lw f:\ ,E E~~~~~-~~~i~~~~-:~~J):~~:'i?:·i~.8~~~2?~~t~~~--tt,;~~~·~li2~itt~f:S,1 .. L.i..J-1 r , 1 , 1-1 r , t 1..:-, ··~-.c.LJ_J-1 , , , 1 1-1 r r , It-• "l~-r.:..; .. --.~: ... ·---;-,:",'!:'!•,:,~•,<.,r,,';,'.-.... ,-.:-,,r ~';_/.~.;-:.I t ;_ ~;-1·1~-:c:·.1:~~-1 t:::-~-::r::~t {t::::~•~"f'r b.LLJ-J, I I ' 1-1 I 1 I I-·:,-:.•··', d.Li.J-1 I , ' I 1-1 ] , 1 J~· ~~~-~=-..-~~;~ •~-.,;-;-;::._~~:~_·.;-..-::'~;~----'----..=, • ~-•••--•• .r----=--------.!• _,_,_, -•"''~ ,_,.,,_ l -~• 15. Specia,l tundling lru\r\lt,oM and >.c!C1,001W lnlonnnon , \ f\1"'1,,..,-..t /.,;J,, 01-137·0/0\ j,1,. GfM~IU.fOII-S CV\TiflCA.TIO!-l: ll'><or•t,yd~•• ,,,_.,ineconlAntl olN.o«w,oJon,,_..1 u,r ._, u,d ac,;:i,ra•l1h~ ot,o,,e l>ypn:,.,_. _,,lpplng n•ffl• &nd o,e ,:1.,...i~o,4, poc•..i. ....,,,...,_ &NI 1a1>o, .... .,,., ve In &.11, ... o-cta In p,ope,, ~ndl•Oft ID<.,.,,_" l>J 1>191>w-, -"'II D &Qpk&tlle .,..m.uona, .,,d na_...i ,.,.....,,..,., ,.quloOO"-' •nd .,.1a ..... o1.,.:;,.,..016ov1'1c,,,,11,.._ lll•"'•'""t••v&na..,ge...,.....,,lc,o,.,...,IJYll"",..•••ocr..,,,lnpleboD...,u00 .... -.ol..,....a...i-iclTJ'olw-U•---D-deqr-1,..__do"°m.l....,I01>o_.,mlca/lJ o--nc.o1>1• ........ , , ,.. ... --"'" p,-~c..t>I• ..... ..._ .,, --.. l --. o, d--' ~·, •nll&bl• D -..-hlc,n ... 1n1m1u• ... -M&NI """''" ,,,. ... ,.., """"'" 1>-..11n • ....sv,o--t,.,....,..,tOl\n1 • ..,, • .....i10.,.,,1,-,o.,_.io,.1,...,e,....ioogo,o,d_,oft""1D......,~lnJ•--•_,,..,,..,,.,_....,,..,.-,.,,..._..,.,..O•""'"',......_ .... , .................... .,.., ..... ,e,.,..ft ...... Prinl.edflyped t-wne rJZ. A✓ m.m,, __E L. cJ",,_,,). -l"'~"}:,7 P J"-/'--"--l/4,...--..,, __g c--0-/4_ Mcn:n Cny 'r'w l I I I I 1 ~ 17. lr1-1Ut)C~f I Atlnowlr,ogemen1clAi-ui~I cl 1,Ail8n,t!1 /I ,., Prinllld/17~ tafll01. . ·. . M0ntt1 Oly 'r'w N )' .• / ·t , ,/ ,, ' ~ , /. ,. .· , . . . , I/ ... --~ 1a. 1 fVIIPOr.u2 Ackrto..-ledt;ement cl F.Ktip.l ol l-Alttrial1 ~ Printe<:IIT~l'4m• Mon:n Oiy Ye.u s ---------------I I I / ' / , A C \9. D•=t..,&l\C"flnCl,,u.~0nSµc.t --' \f-c,.~------------~-------------~-------~---1 ! 20. Ficil.!y O•·•wor 0P(~l0r, C.,H,;:a~ott ol rKttiptotl'taUrdou:s m,1,tarW.s cave,ed 17-, lhi:i"1&lllial a.t.e,tf:1111nolad lllllam 19. ~nle<:lll~~Jc,a,: 8 Sogn=tin ~ µonlh Dll1 ,....., • I , , ' I , Jtt:& t I I , , , I 1111:1. b I I , , , , llb:I,. d I I I , I I llbs. -:$1r1,,?~/~1-<_f.l J::;Lc,:;1,p~ 4n '.4.f; ',.., ~1>-·:it_ _ ,iAJro,9.0 - - - - -------g ~ '8 \, ·-"-i ·J .J t () .. Ill (.) C Q. --. .2 E .!.'! ~ iii 0 t E 8 U (.,) ~Z...Jgi ,... < "---..... (J ~ .i ti CJ'J~Gii:~ .e-·,. -----., -~· .. ---~•-,·. C ~ ;_ !, --.---.~· :-:: ' - ----
South Carolina Department of Health
and Environmental Control
llusu.1.t of Solld & Hausdou., Wut111.lgt
2tm8u~Street.Columb.._SC292'ut .
f'toon«: {80J) Tl-4-5,200.
UNIFORM HAZARDOUS WASTE MANIFEST
l. G~IOr'1 tum, and U&ilirv;i ~drss,
1. Gen.-.Dr'tU.S.EPAIOHo.. .... , ..... ,
Oocum-,LNR-
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flew Hanover County/ City of Wilmington· 414 Chestnut St. , Suite 101 Wilmington,NC. 28401
~-Gtnen10r'1Ph,;,,,, 919 341-7139
S. l~rte< 1 CcmP""fPuml MCO 1 ransport
7. TB111portetZCompanyNam1
9. Oui;na~ fJ:CUif'J Name 1M &,i. Addrsu SRC
Box 2005 Columbla,SC29202
L U.S. EPA ID NYl!lb«
10. U.S.EPAION1o111blr
NA
11. US DOT Oucnpcon (,ic/uding Proper Sllipping /Wnl, HuMrJ Qw. 111d D Numberj
15. S~twldlil'lgNlnlcloruaodAddibon.iJlnlornu.bon,
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Ema,-g.-iq,, Holidays: 180.Jl™-~-m
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South Carolina Department of Health
and Environmer.tal Control
&,uu of Solid & H.w<Jow W.uta Mgt.
2'61:Xl&inS~oet.Columbia,S.:29201 •
f't>onos: (80JJ 734-~"'00
(F"om, c!ni,:,nod r,,, u:,e on fel:1'! 112-o~I ~
UNIFORM HAZARDOUS 11. Ge1..-.,10(1U..S..EPAIONo.
WASTE MANIFEST
l. G•l'ICQtor'1 N:&n,e ard t.lliling Addre:u New Hanover County/ City of Wilmington·
414 Chestnut St. , Suite 101 · Wilmington.NC. 28401
4.~=tor'1Ph~naf 919 341-7139
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7, l=ponar2C<lmpanyNim• l.U.S.EPAIONumbar
9. ~Nll.tdFaeillf)'~andSi\lAi:ldla., SRC .
Box 2005
Columbia,SC29202
10. U.S.EPAIOH\lmbs
NA
11. U.S. DOT Oucrlp~on (J11cluditip PropN 5Jlippir:p Nlr!1, luutd Clan, and D N~
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South Carolina Department of Health
and Environmen!ai Control
Buruu olSoDd' Haurdoll3 Wuta I.lg!._
26IXI l!<Jll SVNI. Coh~mbi&, SC 2'9201
J>honol:: (90,J) T.k-2))
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UNIFORM HAZARDOUS 1. G.,.,u,f, U.S.EPA.IDNo.
WASTE MANIFEST
l. Ge.ncr;,101"1 twn, and Luilin; Mdteu J S / . tlew Hanover County/ City of Wilmington· ·
414 Chestnut St. , Suite 101 llllmlngton,NC. 28401
,.Gen"'1to;.,Pr,;n, 919 341•7139
1. lnnspcr\N 1 Comp&nyl-kml MCD 1 ransport
1. lnNportu2Compan71-km1
g_ Duigna\MF1ciliryNam111'1d5'leM41es.a . SRC
Box 2005
Columbia,SC29202
~l U* EPA IO Numb.-
I. U.S. EPAID Nlll!'ber
10. U.S. EPA 10 N11111btt
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0 L Petroleum Contaminated Sof 1 {NON-Hazardous) ¾'("t 1 ·;"j;;.
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South Carolina Department of Health
and ::nvironme:-,tai Control
Burw.u of Solld l H&urdou.s Wut11 Mgt.
28:WJBuQSlre,rtColumtl..,~2'.n'01 ·
Pnonc (Ml) 134-:.200
PLLJ.SE P~IMl ..,TYPE 1Fom,d~nedloru..e011~fl2•~itd',l~
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fom, A.noro.....i OV:B No.~ E.<tln,, ;-JO.u
UNIFORM H"2ARDDUS
WASTE MANIFEST
l. C.1~r.1tol1 Nmle and~ hldt~
11. C.1111.,.10(1 U.S. EPA ID Ho..
' ' '
flew Hanover County/ City of Wilmington·
414 Chestnut St. • Suite 101 · Wilmington,NC. 28401
,. Genrn1o(1Ph~nel 919 1 341-7139
S..1nnspotlt'f1Com~twne 6. U.$.E.PAIDtiim. 1-lCO l ran sport fl A
1. TIVISpon.r Z Compan1 tQm1 I. U.S. EPA 10 N.irnbtr
9. ~ign,!f1 Fa,:.ih!y Nam1 alld s,i. Addre, SRC
Eiox 2005
Columbia,SC29202
10. U.S..EPAIDNumbll'
NA
11. U.S. 001 Dul;;ripDOn (includirig Pt0pN Snipping N,mt, lwvd CJuJ,, I.lid V N~
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