NCD980602163_20040203_Warren County PCB Landfill_SERB C_PCB Waste Shipments - Emelle, AL-OCR

PCB Waste Shipments Manifest Estimated Corrected CWMA Document Generator Quantity Quantity (Unique ID) Number Signature OSD (kg) (kg) Transporter Description Disposal Date 940193-01 1 02/05/2003 01/02/2003 16,000 8,473 02/05/2003 PCB Landfill Soil and Debris 02/07/2003 940194-01 2 04/03/2003 02/05/2003 16,000 8,129 04/07/2003 PCB Landfill Soil and Debris 04/10/2003 940195-01 3 05/14/2003 04/07/2003 16,000 11,984 05/16/2003 PCB Landfill Soil and Debris 05/22/2003 940196-01 4 06/11/2003 05/16/2003 16,000 12,773 06/13/2003 PCB Landfill Soil and Debris 06/23/2003 940197-01 5 07/08/2003 06/13/2003 16,000 16,000 07/11/2003 PCB Landfill Soil and Debris 07/15/2003 940198-01 6 07/23/2003 07/11/2003 16,000 16,000 07/25/2003 PCB Landfill Soil and Debris 08/01/2003 940199-01 7 09/15/2003 07/25/2003 16,000 13,735 09/23/2003 PCB Landfill Soil and Debris 10/01/2003 940200-01 8 10/13/2003 09/18/2003 16,000 12,065 10/13/2003 PCB Landfill Soil and Debris 10/17/2003 940205-01 9 10/22/2003 10/13/2003 18,000 18,000 10/24/2003 PCB Landfill Soil and Debris 10/28/2003 940201-01 10 10/28/2003 10/21/2003 16,000 12,220 10/28/2003 PCB Landfill Soil and Debris 10/30/2003 940202-01 11 10/29/2003 10/29/2003 16,000 9,426 10/21/2003 PCB Landfill Soil and Debris 11/03/2003 940203-01 12 11/10/2003 10/31/2003 16,000 11,185 11/11/2003 PCB Landfill Soil and Debris 11/21/2003 294589-01 13 11/11/2003 10/31/2003 16,000 10,714 11/11/2003 PCB Landfill Soil and Debris 11/13/2003 294661-01 14 11/13/2003 11/07/2003 16,000 16,000 11/13/2003 PCB Landfill Soil and Debris 11/13/2003 294662-01 15 11/17/2003 11/17/2003 16,000 9,571 11/19/2003 PCB Landfill Soil and Debris 11/24/2003 295307-01 16 11/24/2003 11/19/2003 15,000 10,977 11/24/2003 PCB Landfill Soil and Debris 12/01/2003 295306-01 17 11/24/2003 11/19/2003 15,000 9,562 11/24/2003 PCB Landfill Soil and Debris 12/04/2003 294663-01 18 12/03/2003 11/24/2003 16,000 16,000 12/10/2003 PCB Landfill Soil and Debris 12/11/2003 295308-01 19 12/03/2003 11/24/2003 16,000 12,818 12/14/2003 PCB Landfill Soil and Debris 12/15/2003 291900-01 19a 12/17/2003 11/24/2003 17,500 12,573 12/17/2003 PCB Landfill Soil and Debris 12/18/2003 295310-01 20 12/15/2003 11/24/2003 16,000 3,492 12/19/2003 PCB Landfill Soil and Debris 12/22/2003 295309-01 21 12/15/2003 11/24/2003 16,000 8,425 01/19/2004 PCB Landfill Soil and Debris 01/20/2004 295312-01 22 01/06/2004 12/10/2003 16,000 22,907 01/06/2004 PCB Landfill Soil and Debris 01/22/2004 295311-01 23 01/06/2004 12/10/2003 16,000 18,115 01/10/2004 PCB Landfill Soil and Debris 01/22/2004 294665-01 24 02/02/2004 12/10/2003 16,000 17,170 28/2/2004 PCB Landfill Soil and Debris 02/03/2004 Total 318,314 kg 351 tons No. of Shipments 25 Emelle
I
HAZARDOUS WASTE MANIFEST
--f-/ (As R,equired By The Alabama 77_,,artment_ of Ervironmental Management)
lease print or type. (Form designed for use on elite (12-pitch) typewriter.) ' J!.;b ' if) Forrd App}oved. OM~ No. 2050-0039. Expires 9-30'.02
UNIFORM HAZARDOUS
WASTE MANIFEST
;
1 1
• ·rntormati\,)·n in the shaded areas is
not required by Federal law.
anifest Document Number '3. I.:: ,,-: t
Gen rater's Na,111e a~d Mailing Address WARREN -COUNTY PCB LANDFILL
RR 4., BOX 426 CWMA
rA, 4. Generator's Phone (
5. Trarisporter 1 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
WARRENTON, NC 27589-9110
l 6. US EPA ID Number
10. US EPA ID Number
B. State Generators 10·
C. State Transporte~s ID
H.Facili~ Alabama H(ghway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D 0 0 0 6 2 2 4 6 4 205/652-9721
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
a. RO, JQ.YDUIUMlED BIMlM.S, 91.D, CJ, 1Jel15, III
12. Containers
No.
13. Total Quantit
14. Unit Wt.Nol.
I.
Waste No.
-"G Disposal Approval # CWM Profile #
E l-,,,.:::::.::.:::..:.:::::.:.:.:::..:.:=ffalJ~Rii;;:::====::.:.:.:::.:..:=..::.:=====:m11,14============~~[a...l~g....lj14+Ll~~~~~-+----,---I N b. E R A T Disposal Approval # __________ CWM Profile#--~------------~ 1-c-.------------------------------------+---'--'--+_.-+-...__.__,___._-+---+---------1
Disposal Approval # __________ CWM Profile# ______________ _
d.
j Disposal.Approval # __________ CWM Profile# ______________ _
'Additional ~escript1ons for Materla!s l:.1~ted Abolle-~ { ·
?• • ~' os,1J · l?t,;:/os .K. Handling Codes for Wastes Listed Above
C.
?late ·of Gen'erati~n IE . b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _____________ _
Work Order# ______________ _ EMERGENCY CONTACT: _ __t,;0Efl'RECll:l'llllll~11.::t1lll11t:~42~+-:'J~Qlt-uER61mu1.1.71L ______ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a prQgram in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the pres·ent and future threat to human health and the environment; OR, if I am a
small quantity generator, I hav~ made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
Printed/Typed Name
--PATI2.1c.. 1 A M.
T 17. Transporter 1 Acknowledgement of Receipt of Materials
: i----=-:---:-:::--:-:-:------:--------------,---::-tr,------------.....---»----::-----------,-:-,----::--,----1
N
~ 1--:~:IAt:.!.!..t.~;LL.La:.f=!:'...,J...:.' ::--..!a.....:.Pt;• :........,.... ____ _j7"6-~IJJ.:t~~~...::::==~;,..:::::..r.:::::::::::..._~~----..,.....l:!...r:=...~1+~~:.i
~ 1--------------'-"---------------.\,----;1<--------------------' :;.•f ___ __, __ __.c,~'-_' ____ ,.
T Printed/Typed Name I Month bay ~ , . I
F
A C
I
19. Discrepancy Indication Space I {
Year
L t---+--,-,---,--.,.......,..---:----,,....-..-"---------=a....----------'---------.._-----------------,!'---1 I 20. receipt of hazardqus materials covered by this cept as note It. Tl----+------',-------+--½----------'----.---------,,L-'---------~--+--------------1..::....-1 Y S~na~re
GENERATOR NO. 2 (Must Accompany Shipment)
'
..
/
,-WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00024 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000294665-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
der my direct instructions, made the ve 'fication that this information is true, accurate and complete . ...
OSD Unique ID Cont. # Profile Disposed Description
12 / 10 / 03 294665-01 CU9614 2 / 3 / 04 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000294665-1
-WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000294665
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver L fifJ
Recordkeeping nd Reporting Supervisor
February 05, 2004
..,
WASTE MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box55
Emelle, AL 35459
[phone]
Manifest# Profile Description Gener/Quantity
0000294665 CU9614 PCB LANDFILL SO IL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
Remit to : WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS . TX 75284-0606
18.91
1.00
P 0.#/Unit Bill er
197159 RWILLIAM
TSCA TONS
TRIP
Invoice Date: 02/06/2004
Customer#: 695-1442625
Invoice#: 2256-0128178
Page#: 1
Rate Total
Svc Date 02/03/2004
llO .00000 2. 080 .10
2.100.00000 2.100 00
Subtotal 4,180.10
Total Due $4,180.10
,wM ·
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00024 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 W ARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000294665-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
der my direct instructions, ma~e the ve "'fication that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
12 / 10 / 03 294665-01 CU9614 2/3/04 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000294665-1
r
k2G
• t
· en, IE. -EIIELLE ; 1
Date/Tl• Ia 2/13/M 7:42
Load Type ---~ \ 0 Transporter STlT IE
tt IEIGIIT SUIOIAIY tt
Groll
Tart
let
82741. .. .• ---
1111m
08:58 02-03-2004 44920 lb G Adj.
IC .II , ~ •• Truck IIIINl' 112 Tmltr/Colltnr fl 245 12 13 ~ ,!1j· let
Rcpt Doc Oocuamt Profile Profile GIMrttor ~t Cnt Total I DCS ~~A,·.::::_ · · .
Lat Lat lmtr Sal.ea Invoicing Cutoiltl' t Code Quan. V Units PCB <:,t~t1t111 · AID I --------------------------------------------------------------~--~-------------
1 1 111129&5 CU9614 Ham QlllTY PCI u 1 CII ltilll.N I · lilogru ,· M · ~rn-'le
••
113114-tllS
l&UtJT(I I: SUBCC Y1lue -m .
Doc Seq t 1 EIE .SBlV EIYIDIIDUL P. 0. Iv■ QI) ltq'd
Sclledllltd Daw 12/13/M Ti• IS:~ 719121·1
>Sll Cl ~11 DQIIS CCIRQ.E) . , ,um.uo flULT t OR I (CIIQ.E) I
,>s11 m cs11 oc 111 nsPD:Tim (CIIJ.E>
"BULi bmtUL mt.J:
SAIPL!D/IISPICTED _________ ..__ ___ ,m LIQUJ~ D!TICrEDt
511.a:T DTBIALID-SEI.EtT JIATIIW. VJID DJSPIIISAL omuu
JIS / Ill
·m; / IO
PBJSJCAL l>ESCIJPTI<I Cl' IAST!: SAIPLII/APPIOHL ------------------------
SPOr SdPL!r_lM-_____ 1_ms. Jii\ilffl(I. _______________ ·_·, __ <,...r,·,'""';,7,....~. ____ _
111).SQEEI~' -· pa; lllL. ·-l I -.... ·-· --------~? ' -..
161.SCIID Pm D6
121 !D.. S F nna. 821 m1T111P. 10 m mCTS _______ "_ ... ______________________ _
pll CPAPD> _________ ----+--~---..... ·-··-----...,...----------------Cl SCllEEI • -SUIJ'IllE SCIIEII • - I .,-, ADDJTI(IAL Alll.ffl('JL IID'Dt J .-- -----P-r-. -.. -, -=-..:...-, ,--.. -..... ,.-.. -,-. .,-
\ O!SClt•• - -·· 0 1 ,.:c , ''--" •. · PCB as. cm, ____ !HIIIII <9131> -,_ an __ . ...;=:, ______________ __,.....__l ______ -_
11121 BJ D'_____ CJWIIE C9111> _____ .TU ljSTI J I -e·· ,,. ,,,c;vv ... -:--
=~TD TF.Sf/ P F SPPJ:. GllYffl ,.~c ')~~i.T ~ ___ ..,._..._/_~_, ---------\-. _
mtP&T. TEST 11 _______ m_m_ ---~~::'-,~"i'!l~~l!(oi!;'t!,,ii,,..!!I";;:...,::,¢--•:~;~---------,-. .....,.., -... ,.----, ..... • ___
lDD'L SPOf SAJIPLE .&TTACBl!Dt_J_I ' ... ,~~-:> \ .•• ,I
DISPmll. &TIii): S S, ST-3 ST-3/PT P·ST-3 P-ST-3/Pf ST-5 ST·5/PT P·ST·f~PT.l I-PD 01'BD_,·_¥,_. ___ _
P-ST-5/PT sr-e sr-em IIC BC CDC IISflCT> F JIC ~' SP-tS JICB-IAC p:&g-i;,, .
P·ST-8 P-ST-8/PT YS--3 --5 lS-8 , . · • ; ....,
IIDICATII PWlffll VJU., BE Clla.ED ,. -lt . C,,_
a-oc LOADS DJIIl6 tlSPICTim mr m 'to BE LISS TIii 511 lllSf '
Bl RETUBl!D TO . W .&ID PI.ACEfl.(I BO. .
RFJ hSED Fm DISPE&L BJ:___,..,...,,,__·...,..,.-_-_-_-_-_-_-_-_-__, _DA_ff_::::_:_:_:_-_-_
' ;
·.-,.
it
, . , . \. ··~~
\:/..'-
,, \ .···}\_
;. .,.~, ,,
. ~r'!; ~~wi
I·• ......
~W'Y' H~~!ut~RQ~.~ ~~§!Ei,M~~}I~§T
Please print or type. (F~ desigi>ed for use on elite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
'I UNIFORM HAZARDOUS .
1
1. Generator's US EPA ID No. Manifest
N I cI R I 0I ijI ijI1I J I -,1 H I H I 21010To1,1J WASTE MANIFEST
3. Generator's Name and Mailing Address
~ · 1-4'> Generator's;Phone (
5. Transporter~ Company Name
Wiil<f~:.M Cnt.lN'fY PCB LANJ>FIU
HP. 4,, BOX 4c!f.
Wi~~~r.N-rnw~ we ,.~7!if.l'~·-9i 10
25}··t71J
2. Page 1 I Information in the shaded areas is
of .L not required by Federal law.
A. State Manifest Document Number
CWMA 295311
B. State Generator's ID
6. US EPA ID Number C. State Transpo~er's ID ~ ................ ________________ _
I N I Cl J.)I ~*I aI U I 71 91 91 11 41 c! 1;P''1''r'ansporter's Phone use.a> :i••~'-ffl4
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
8. US EPA ID Number
I I I I r I· I I I I I I
10. US EPA ID Number
E. State Transporter's ID
F. Transporter's Phone
G. Slate Facility's ID
H. Facility's Phone Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 I A I L I DI O I O I O I 6 I 2 I 2 4 I 6 I 4 205/652-9721
11 . US DOT Description (Including Proper Shipping Name, Hazard Class. and ID Number)
a.
~ Disposal Approval # :\1~4-~ CWM Profile # ,...,,... .• A
N b.
E
A
A
6 Disposal Approval # __________ CWM Profile# ______________ _ I
A c.
Disposal Approval # __________ CWM Profile# ______________ _
I
d.
Disposal Approval # __________ CWM Profile # I
12. Containers 13. Total No. T vnP Ouantitv
I I I I I
I I I I I
I I I I I
I
I
I
14. Unit Wt.Nol.
I.
Waste No.
-ft
: j e
,a
~
., .
~ling Codes for Wastes Listed Above
a. C
:t,·
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# ____________ _
Work Order# _____________ _ EMERGENCY CONTACT __ O_OI_WZC_•_'_i._9 __ ~_-_931t __ OO_i0_1_7t _______ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify !hat I have a program in place lo reduce !he volume and loxicily of waste generated to the degree I have determined to be economically practicable and !hat
I have selected the practicable method of treatment, storage, or disposal currently available lo me which minimizes the present and future threat 10 human health and !he environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
,. I
Sigyiture . Month ili,Y Year y;. .. / '~. J }.",.. ~ .. ,< ,/...,(~ .. ....,_... .... -I' I / · JG, V> W'
T 17. Transporter 1 Acknowledgement of Receipt of Materials Rt-----------------.------------~~---+--------.,..,,.'--~""-------------------i! ~ A inte~/Type~ame ) 1 I i
·J .,,, /
I
Si7 e .//~ . s ~ f--J\ h ( ·~ ,c C,· b SJ I • l Pl---..::::~.:.:..:....:....!L....L _ _j~~~,t._ __ _,:_ ___ L_4L,~~::::::l;_=--,,~L..L~------_J:;LJLlfi~~q
~ 18. Transporter 2 Acknowledgement of Receipt of Materials
~oln/ l(~tJ l;~i , .,,., ~· ,,t-/' . ~,.
,/ ,.~
T Printed/Typed Name
E
A
F
A
C
I
19. Discrepancy Indication Space
1. Signature Month
I I
:
Day Year
I I I I
Lt-----------------.-----------------------------,----------------1 1 20. Facility Owner or Operator: Certification o(recei~t of hazardous materials covered by this manifest ex~ept as noted in Item 19. ·1 , T1-----------------+---'---------,------------',---------1----,----------------1
y Printed/Typedr ame . i ,· I Signature \ \ Month 'Day Yj ar
\ C\ ,. ·, n ·1 ! ( ~ i ·, \. \ {\I'\ , i h ( ·I! J , 1! .l-I I ,.fl
EPA Form 8700-22 (Rev. 10-94) Previous edition is obsolete. "'· -'• \
TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment)
"l L. .. \,
I_,. I•
k28
CWII, lit. -EIEUE ••••• llctipt t 422981 ••••• (0
Datt/Tilt Io 1/22/14 ~51
Laid Typt Jllliiii> ~~
Tranlporter STAT Is:
IIUDS1II II: 44600 ~/JG
Tract II.IIIHI' 112 Trailtr/Coetar fl 211 f2 ~ao
Total I DCS -~ Ftdttal EPl
f3
Rcpt Doc Doculent ProfU.t Profilt Giner.
Lill Lal lultr lnYOiciag c.tom
Cbt eat
• Codi .L. ----aau. f Uiaita PCB Cat Vutt Stat.
l 1 llllffl:311 QIIJ6H DIIEI CIUTY PCB J.A \ l t1 Uilll, N I lilogra
WAIIEl1tl 1K: \ ., . --a,_acc Y1l111 -I)
Doc Seq f 1 EIE SUV EIYIDiErrAL ;. ~ 1 P.O. IUI
Schedultd Datt 11122/M Tilt 1.5s~ 711251-1
>511 mt <511 DEBRIS (CIICLE>
PREFIWJ YAll.T t fll I (Cua.£)
>511 m <511 llC 111 IISP£t1'IXI (CIRCLE>
BULi BT£RIAL flt.ft SAIPLED/DSPICTED _________ ·:_·· .-1, ____ , '_.Fm UCIJfDS DfflCTIDtx
SELECT IIATEIIALID-SIJ.ECT IIATDJAL lllD DISPBRSAL tiTEIIALt
t PIii lllldtttraioule
YES/ I)
YES/ al
tt IEml1' SUIIIAlt tt
&roes awe ••
Tare .N
ltt ••
Adj. .N
&dj. let ••
113114-tll5
PHYSICAL DESCIIPTJ(I (F IASTlh __________________ ___,SdPl.11/APPIIJ'fAL. ____ _
SPOT .SQPLE:_~-. _____ ._IJ'IYS. ~(I. _____ ..,....,.__, ____ ..,_,_,,.. __ ....,_~_..,._~. ___ _ UD.!dlll . ft$ E I ____ · _____________________ _
161.!DliD POS IE6
1121 SL S F PT /S(L 1121111/TDP. ., ml mcrs ____________________________ _
pit (PAJIER) _________ , __________________________ __,,...,,,,_
Cl ~ + -SIUlDE ~ • - I
ADDJTI(IAL Alll fflCAL l!ll'D! Y I-------,-------
DISCRIE: --PCB ca:. emu ____ SlUlM t90> ____ .,.. COOE ___________________ _
%1121 BY IF_____ CYAIIIII (9111) TAI WASTE Y I
PAJIT mm TFSfl p F snc. lihlln IIZ a&.-_PPI ---------------
aJIIIEl1S: ------------------
al!PlT. mT V/ ______ (I __ ID_
ADD'L SPOT SdPLE ITTACIIEDt_J_I _ __, _______________________ _
DISPUW. mDl S SP ST-3 ST-3/PT P-ST-3 P-ST-3/PT sr-5 ST-~ P-ST-5 Sil-PU 1-Pll orm. _____ _
P-ST-5/PT ST-8 ST-8/PT IIC IIC CBC IISPECT) F IIC SP-tS PCI-IIIC P-IIAC
P·ST-8 P-Sf-8/PT tS-3 tS-5 tS-8
IIDlCITtl PWllffll l1U. ■ CIICU'I)
8-11.lC LOADS IIIIJIRIE IEPECTI(I DAT ill FUD TO BE LISS TDI 511 JIUST BE JIETUIIED TOW AID Pl.ACED (I ID.D. _______________________ _
REI-EASED Fm DISNSAL BY: ___________ 9'.tt: ___ _
l
L
. '
WM
· Waste Management, Inc .
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00023 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295311-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), l certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verific tion that this information is true, accurate and complete.
/
OSD Unique ID Cont. # Profile Disposed Description
12 / 10 / 03 295311-01 CU9614 1 / 22 / 04 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295311-1
,, . . . 1.•.!'.'l.
WASTa MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Manifest# Profile Description
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
Gener/Quantity P.0.#/Unit
0000295311 CU9614 PCB LANDFllL SDll AN 019692 WARREN ~97159
PCB BULK L/F -EVENT PCB BULK LF 19.95 TSCA TONS
TRANSPORTATION/EVENT ROLLOFF TRIP .00 TRIP
e_ ~
000029 312 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
25.25
1.00
197159
TSCA TONS
TRIP
Bi 11 er
RWILLIAM
RWILLIAM
Invoice Date : 01/26/2004
Customer#: 695-1442625
Invoice#: 2256-0127767
Page#: 1
Rate Total
Svc Date 01/22/2004
110. 00000 2,194.50
2.100 .00000 2.100.00
Subtotal 4,294.50
Svc Date 01/22/2004
110 .00000 2.777 .50
2,100 .00000 2,100 .00
Subtotal 4,877.50
-----;) C t-L 111 not
w e... 1 6 h t,
v"'eo.._& c_o-,r-ec...-fe. d
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS, TX 75284-0606
OY"\ yY'\Cln i fest,
BCLse. d.
we i~kt-
Total Due $9 ,172 .00
I l
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management)
Please print or type (Form designed for use on elite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UNIFORM HAZARDOUS r · Generator's US EPA ID No. Manifest I Information in the shaded areas is 'l NI Cl RI 01010111 ~,, ?I 010121n IDl~CT1~ 2. Page 1
WASTE MANIFEST of 1 not required by Federal law.
3. Generator's Name and Mailing Address lrlARf~Ef4 COUNTY J)CH u~nrr.u. A cw"MAument Number 29 5312
J~ 4, aux 4(~6
l,i!4J<Rt::1'6T ON, NC ff /51-\~)--t1l_ H-l B. State Generator's ID
4. Generator's Phone ( e··•) "-r~7--1'1U
5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID
ffffff ~ IHC I Ml Cl l)j YI Bl t11 71 91 91 11 41 ,~ D. Transporter's Phone (626) 3%Ni!::ffl4
7. Transporter 2 Company Name 8. US EPA ID Number E .. State Transporter's ID '•i,i:
I I I I I I I I I I I . I .fj 1 ransporter's Phpn,e ..
9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID ~ f/;'!, 1 ··I'-
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility H. Facility's Phone Alabama Highway 17 at Mile Marker 163
IAJLJDI oJ oJ oJ 6J 212 4J 6 I 4 205/652-9721 Emelle, Alabama 35459
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers .. ----rbrar 14 . I. Unit Waste No. No. Tvoe Quantitv Wt.Nol.
m, JU Yl'H..IJU~lfl! D!Mlffl.S, &lll)f 9, tte315, JJ.l l'\ :> ,):,/,· ,, Mt a. .J
JJT _'i) // ,v·
G Disposal Approval # 11~ CWM Profile # 01:lf.!14 <1 Je1 J1 .. re,~. .Ll"-l . .r.::J:A.lr., K E
N b. f E
1 11 R I [!?i; A I t T Disposal Approval # CWM Profile # I I I I I I /2.. 0 R C. '
~
Disposal Approval # CWM Profile# I I I I I I I
d.
• i ·, I ,
Disposal Approval # CWM Profile# I I I . I I I I / A• ' , .... K Handling Codes for Wastes Listed Above J. Additional Descriptions for Materials Listed Above
tJS~ ·, ~ /10 /a.3. l/ C. .
" tt ',
State of Generation ' b. d.
15. Special Handling Instructions and Additional Information
Purchase Order # ~
Work Order# EMERGENCY CONTACT: oonm: 1 ~'!4--9llil IM171
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment: OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
Printed/Typed Name
I
Signature Month Day Year
'' ,-_:·\ .. ' ~-~. I, L::·,, , .. . ( l .I / 1 ·.I , lr;ll J ,ri l"r ;( I ( ".',, ''i-.' .,-, . . ../ r -~ t ~ I .. .: \. /'
T 17. Transporter 1 Acknowledgement of Receipt of Materials ~
I R
/ /., i"' f-
,· I A , ~ri1ted/Typed Name/ /
I
Sign~t\Jre
/// i \ Month Day Year N /\1\4>,p .._-(l /,, \ ·+-It-, I 1111 11,... 1/'JV-/ s I p
0 18.' Trahsporter 2 Acknowledgement of Receipt of Materials I ,; . ( ~ ' I
R
T Printed/Typed Name
I
Signature Month Day Year E
I I I I I I R
19. Discrepancy Indication Space Ii,• / 1 , ' .' ,' ' 1·( I ( .• i , /-' I I / ' i /' I F 'l I sl ·. ~ A •• I \
C
I
L
I 20. Facility Owner or Operator: Certifi~ation of receipt of hazardous materials covered by this manifest except as noted in Item 19. I
T I
y Printed/Typ d Name [-· \
I
Signature I ~ ~r th Day :tear I . \''.(\(\ 1 ( , l t \ \"\ ('\,,
I iU ,\.i \_,\I, 111 I 1· I I \ t .. , I .... EPA Form 8700-22 (Rev.·10-94) Previous ed,t,on ,s obsolete.
TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment)
CD, DC. • EIIELL!
Datent• In 1/22/14 11:51
Hitt Receipt f 4229'.K Hfft
\-, LoadTJpe Dulpl Ftdtffl ,EPA ID 1D981'199142
Tru,portlr STAT IE . IDmJI
Truck Imel' llt· Trailer/Contnr fl 34
:l
Rcpt Doc Docullttlt Profilt Profllt Geatntor
Lat Lal IUIHJ' Saltl Invoicug cast011?
n
Cat Cat
I I Codt
13
l 1 llllffl312 CU9614 IAIIII QIJffl PCI LA 1 DT 16"1.• I lilogra■ t PU1 Undtwraiault
VAIIIEml IC 9IIX falut -m ----;;~_
Doc Seq I 1 EIE SUV EmmaTAL P. 0. lu■ ~ ~-
Scblduled Date 11/22/14 Ti• 15:31718251-2
>511 OI <511 DEIIIS (CIRCLE>
PRErtLLED '111.T Tm I CCIRCLE>
>511 [I <511 UC ltl USPU;Tim (CIICLE)
IIJLI bTDW. Oil.Ts SAIPLED/liSNCIED _________ -__.FIIE U&IIIE nmcrtot 1IS / .,
SILEtT IATDW.ID-SELICT UTF.IUL..._ ______ tllD DISPEISAL UTF.IUl.f BS / aJ
H VEIGIIT SUllllUY ..
Groa 8554t.•
Tare ••
let ••
Adj. ·•
Adj. let ••
ADEii'
PIJSil'AI. lf.SCRlPTllll (f' IASTE: ____________________ SOPLEl/lPPIOfAL ____ _
cmn, b.. •• ...._ I ..-e ~TWPlftll ·---.... ,. -· -.... : ~.. -,t· 'f!l_~,w.,t~ ... -... ·r~ :r ~;;r -~·2:::::n ·~&.._.~,_.1.,._-_._. --IAD,$1111 ~ IE6 , ______ · __________________ _
161. ,, Pm 11!.B
821 $!1,. S F PT/Sll. 821 dl/TEIP. _, ID IIE&CTS ___________________________ _ ~CPAPD> ________ I ________________________ _
Cl_!DIII_. •-· _SIJIIIDI !DID_•_--'------------------------ADDinmAL Wl.ffl.CAL RID'Df_T_t _______ --,-_____________________ _
DE!Dill?i PCB as.~cm=-,----SU11111=~,,,,,_cge:==31,,,_, ----mm,.,,.,.,..=aa:.,,,,,... ________________ _
U2f ft IF ______ CTAEDE (9111> ___ TAB HST£ T I
P!llT FILTD TEST/ P F SPEC. GbYITt Dl'l mte._PPI ______________ _ CIJIIIDIS, ________________________________ _
CtllPAT. TEST ll ______ ts._111_
~I. SPOT SdlU ATTACIID!_t_l. ________________________ _
Dl8PGW. Bnllt S SP ST-3 ST-3M HT-3 P-ST-3/PT ST-5 ST-5/Pf P-ST-5 stt·PTA I-PD orm. ____ _
P-ST•5/PT m-a ST-a/PT •tc IIAC CIIAC JISPECT) F DC SP-YS PCB-DC P-BC
P·Sf-8 P-Sf-8/PT YS-3 '5-5 YS-8
IIDia'D PWIETII UU. ■ CIICLBD
B·UC LOADS IFJIJW16 IISP!Cfllll TllT di fl1IIID TO BEL& TUI 511 Jllsr BE mumD TO LAB AID PUCID GI 11.D. ___________________________ _
REI ElSBD Fm DlSPWL rt: _____________ Diffs ___ _
,
WASTE MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
Manifest# Profile Description Gener/Quantity
0000295311
0000295312
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF 19 .95
TRANSPORTAT ION/EVENT ROLLOFF TRIP 1.00
CU9614 PCB LANDFI LL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
25 .25
1.00
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS, TX 75284-0606
P.0.#/Unit Bill er
197159 RWILLIAM
TSCA TONS
TRIP
197159 RWILLIAM
TSCA TONS
TRIP
Invoice Date: 01/26/2004
Customer#: 695-1442625
Invoice#: 2256-0127767
Page#: 1
Rate Total
Svc Date 01/22/2004
110.00000 2.194.50
2.100.00000 2,100.00
Subtotal 4.294.50
Svc Date 01/22/2004
110. 00000 2,777.50
2,100.00000 2,100 .00
Subtotal 4,877 .50
Tota l Due $9,172.00
.WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00022 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295312-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under m 1direct ins I tions, made the verification that this information is true, accurate and complete.
I . •
OSD Unique ID Cont. # Profile Disposed Description
12 /10 /03 295312-01 CU9614 1 / 22 / 04 PCB LANDFILL SOIL AND DEBRIS
Page I of I Manifest 0000295312-1
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environm\ental Management)
Please print or type. (Form designed for use on elite /12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UNIFORM HAZARDOUS
WASTE MANIFEST
Document l;l~-
1
1. Generator's US EPA ID No. Manifest
N I Cl RI 01 IDI 0111 JI I I al ~I PIDIC'IOl,;il I
2. Page 1 I Information in the shaded areas is
of J. not required by Federal law.
3. Generator's Name and Mailing Address WOORf::t~ COUNTY flC:A U~l)!: IU.
RI~ 4, Bf.lX -4P6
A. CWMAument Number 2 9 5309
4. Generator's Phone (
5. Transporter 1 Company Name
W~f..'RfJ'fTOH, ~JC p·/!itN·-911(il
c!ti'l··.D''lJ
B. State Generator's ID
6. US EPA ID Number C. State Transporter's ID
I HI Cl DI ':JI 81 61 71 91 ':ii 11 41 2 1-D-. T-ran-sp-ort-er'-s--Ph-on-e -(-8&8--)-JtJG-""''.,...,--2..,.~,-,---1
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459
8. US EPA ID Number E'. State Transporter's ID
I I I I I I I I I I I I F. Transporter's Phone
10. US EPA ID Number G. State Facility's ID
H. Facility's Phone
I A I L I DI O I O I O I 6 I 2 I 2 4 I 6 I 4 205/652-9721
12. Containers 13. 11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) Total
No. Tvne Quantitv
14. I. wtuR1b1 Waste No.
a. liSJ~ m.n:»..tJalf'tlEU Bmaffl.S, SfUD, q, ~Sv III
~ Disposal Approval # ~ t ._.,. • """"':" CWM Profile # ...........
N b.
E
A
A
6 Disposal Approval # __________ CWM Profile# ______________ _ I I I I I I I
A c. ..
Disposal Approval # __________ CWM Profile# ______________ _ I I I I I I I
d.
'
Disposal Approval # __________ CWM Profile # I I I I I I I
J. Additional Descriptions for Materials Listed Above r-· K. Handling Codes for Wastes Listed Above
r.s b 1t l~v I r3 ~ C.
State of Generation C ~ b. d.
15. Special Handling Instructions and Additional Information
Purchase Order # ____________ _
i I"' ; _.,. ~. l I
Work Order # 1 ' 1 • Cf9Tff:t 1-·Bl'IH2+-'9.W Ba171 EMERGENCY CONTACT: _______________________ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have detenmined to be economically practicable and that
I have selected~he practicable method of treatment, storage, or disposal currently available lo me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity generator, I have made .. a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
l"rintedffyped Name
}..-·_..-:,\.. .... ,. , ..... , I I" I ~\ i -I
~ 17. Transporter 1 Acknowledgement of Receipt of Materials
~ __ , ~rriifedffyped Nall)'} / ~ /(, -~:;,-,,fl I, f'i I l I ... .:, I
o 18. Transporter 2 Acknowledgement of Receipt of Materials
Signatur~ , . (-/ I /, . ' i. \. •✓ ,.cf,{.;.,~
>
I
/--/ /'·,._,..r .. -~ -·-"l .,
Month Day Year
1 .. ll 11 1 .. t ,,i,t3
Month Day Year
IOI I 11 l<t 16 I'-/
Al----------------------------~---------------------------------4 i Printedffyped Name I Signature
19. ~ Discrepar,icy Indication Space
, ' , I '{ / '".,l•.°ff;\ _.~_. !' :.
I I !, ,, ./ { ( ,' (
F
A
C
I
L
I 20.
T y
Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Printedffyped Name , I Signature \ '
\ 1, • \s \ , I ,,', 1• j I . \ \ \ '\\C\ ' \ \ \ l \ ' . t . I ' \ ,,
EPA Form 8700-22 (Rev. 10-94) Previous edition is obsolete. TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment)
\'
Month Day Year
I I I I I I
J' . ; l \
/ \
Month Day f tear
. I . I l~ · I ii I
f ,,
••••• llctipt' @18 .....
Datt/Ti• In J~/~-8:31 '-,
Load Tfll@ ~',){'("'f) Ftdenl iJA ID 1:Df8179!J142
Transporter STAT Ia:
IUDD IE
Truck lulhr 111 Tniler/Coetar fl 34 12 t3 l I . , ' '
lcpt Dae DoculNt Profile Profile GNntor cat Cit Total V DCS
Lilt Lat lulNr 511N Iato1cilg Catotltr I Code -. f Uaitt ---~ -~-.. ;;;; ~~;-,;;;--·;;-~ --~ 7 ~; ;--~---; Pl.Fl Olldet.rlilllle
\-\ \:J!);;t:) VdRaTm IE SUG Yllut • IIJ
Doc Seq t l Ell SIAW EltllUIEIUL P.O. la
Sclledultd Datt 11/21/M Tilt ~:31711171·1
>511 mt ~ll DEIIIS <CIRCLE>
PIEFIIJ.EO fAULT f Cit I CCIICLE>
>511 Cit <511 UC 1ft IIShtTlm (CIICLE}
IJLI IUTDIAL (11.Jz
SllPL!D/llSPl:'IED _________ ...,.__fllE LJWJDS DETECTED!
SEllCT IATEIUL/D-Sl!lltT lffllUL ________ VJJD DJ~ JllTDJALt
'
JBS/ I)
lBS / II)
\
1
tt IIEIGIT SU1U1Y tt
&roa m•.• Tare ••
let .ti
;Adj. ••
adj. 11ft ••
1 \,
ADEii
U31M-tll5
PIYSlr.AL DESCllffl(l lJ' VASrl: ____________ ..__ _____ SAIPI.El./lPPIOJAL. ____ _
SPOr SAIPLE:_ ..... _____ t_Piis. IJIDlnJ(I ______________________ _
..U~SQIP ·-~--,,._ lli6, .. ~ ' --• . ;-, . --, -· ... --,.-----• ).: ____ ~ -. -· ------·.'.
161. SCIED Pm IP.&
121 SL. s , ,un '--------------------........ ---121111/TPJIP. ., m mcrs ___ , ____ ...,., ____________ '1,,__ _____ ..,.i_, _____ _
pll CPjpg) ,.._ ,;-:r~_·..,.,~ --,__.....,f, ..... -.... , ____ ,)_' ____ '.......,: .... : .... -..... ~"::..:o-..--L---'-f _l...;;:.j/:..-:.:.1o' .:ai111--
Cl_!Dllll_• _· _SII.FIIIE !DID_•_--' ', -.. \ -I
UDltl<IAL WLffir.AL tm•Dt_Y_l ______________ :Sll'I, ___________ _ ru:a111, __________________ =___,,,s __________ _
PCB cmc. CPPI>____ SIUlllE (9131)___ ftll QI)! D2I Bf IF_.._,.......____ CJWII <9111> TU WASTE-!-,----------------PAm FJL'rd fiSfi P F SPEC. &IHlff . E COE._PPI ______________ _ Q'.11111111S: ________________________________ _
al!PAT. TIST 1/ _______ m_m_ I
!DD'L SPOT smu ATTAC&Dt 1_1 __________________________ _
DISPOSAL IETD: S SP ST-3 ST-3/PT P·ST-3 P-ST-3/rr ST-5 ST-5m P·ST-5 511-nA I-PU orBD ------P-ST-5/Pf ST-8 ST-&IPT IJC QC tQC IIRC1'> J llC SP-YS N:8-IAC P·l&C
P-ST-8 P-ST•3/PT YS-3 9S·5 YS-a ;
. IIDICAO PWlll"ID VW. IE ClllCLID ,.
1-IAC LOADS IFJllllllli JISPICTI(I Tl&T di PIID TD ■ LISS TUI Ml ET
■ 1111111D 10 UI DD Pl.MD (I BJ>. _______________________ _
, IRJIASED ffll DISNIW. IJ: __________ DATE: ___ _
l L.---
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00021 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295309-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under y direct in tructions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
11 / 24 / 03 295309-01 CU9614 1 / 20 / 04 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295309-1
VIIVle
WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O .. Box55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Mani fest# Profile Description Gener/Quantity
0000295309 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
\)\L
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
20 .31
1.00
P.0.#/Unit Bill er
197159 RWILLIAM
TSCA TONS
TRIP
Invoice Date : 01/22/2004
Customer#: 695-1442625
Invoice#: 2256-0127737
Page#: 1
Rate Total
Svc Date 01/20/2004
110 . 00000 2,234.10
2.100.00000 2,100 .00
Subtotal 4,334.10
Tot al Due $4,334.10
HAZARDOUS WASTE MANIFEST
(As Required By The Ala.bama Department of Environmental Managem,ent)-; .r ,
, ' "'1 I
Please print or type~1 (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMS No. 2050..(:)~9.Ex'f1ires .. 9.Jo-02
UNIFORM HAZARDOUS r · Generator's US EPA ID No. Manifest I Information in the shaded areas is Jl Document No. 2. Page 1
WASTE MANIFEST N I c l H I 0 1 Al fti l 11 J I 7 1 Bl ~l l 2 1t'J I() I 1')1,,:) I tJ of 1 not required by Federal law.
3. Generatorls Name and Mailing Address IJIARRf::14 cn~ff,ffV PCH L l4N1>F IIJ._ A. State Manifest Document Number 2 9 5 310
f~ 41 ftOX q26 CWMA . ·
l,JAl<Rl:.MHJN~ HG c?'lt>A':l--~'11. H1 B. State Generators ID
4. Generator's Phone ( {~'lt? c~fl-·:l"ll:1
5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporters ID
f,'f(flt H!C I NI Cl 01 91 Al ~ii "JI 91 91 11 41 «! D. Transporters Phone (awJ) 316·~2304
7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID "<\;
I I I I I I I I I I I I F: Transporter's Phone I' ...
9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility H. Facility's Phone Alabama Highway 17 at Mile Marker 163
IAILIDI ol ol ol 61212 41 6 I 4 205/652-9721 Emelle, Alabama 35459
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. 14. I. Total Unit Waste No. No. T"= 0uantitv Wt.NDI.
a. ~, m. VllUlRlHAll]) DlJ)tEffl.G, ED..IJI, 9, I.H:J15, nx I :?JJIYt) ,~ 'it, ~ '_, -r&~m . '-f:1h( . ,'
G Disposal Approval # UB4fflr5 CWM Profile # t:tm14 (1 l!il I 1. C lf't -J.-+k +f'rlrr lri I'. ;-,, E
N b. .. 1,1
E
R
A
T Disposal Approval # CWM Profile # I I I I I I I 0
R c.
' \I,
Disposal Approval # "" CWM Profile # I I I I I I I
d. ,.
Disposal Approval # CWM Profile # I I I I I I I ~, ~,,. K. Handling Codes for Wastes Listed Above . ' J. Additional Descriptions for Materials Listed Above
DST) 11/)tf/e:~ a. L-C. i, ....
' I
State of Generation 1C b. d. ' 15. Special Handling Instructions and Additional Information
Purchase Order# ~-
Work Order# J.~1-i ft: l J EMERGENCY CONTACT r.~ 1...-+~ 01{•111
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
Printed/Typed Name
I
9ignature Month Day Year
,r ~-. f · ·1 ', .. I: I~ I ; I f l , I . .:: ,-··, \-:r ,, ' . ' " J . .. .• ~ ... .!..~-~ : • ; ,· ... / . .. . .
T 17. Transporter 1 Acknowledgement of Receipt of Materials R
I Signatu{~(:J L A Pj nted/Typed Name /~~ Month Day Year N K., :'"" L / n,h"r. r 11 IJ 11 14 1n l~ s p
0 18. Transporter 2 Acknowledgement of Receipt of Materials I J --F
R
I
T Printed/Typed Name Signature Month Day Year
E
R I I I I I I
19. Discrepancy Indication Space I ' I i ( ( / I : ( f I ( li: I f I i' :
' _f r;_ ·. : i ! f : 'I J /· \ ' ; (, J I ~ ·! F ,. I ·' ' ,.",. A / / -'';,
C ·, I) I\ .. ; I ·It,, L I 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this ma9ifest except,as noted in Item 19. T y Printed/Typed Name
I
Signature Month Day Year
.--◄" I I I .2 I ;,..,12 le-I'<' /J --~~ . ..., . " .... ,,. ,::· ,.,-7. ,-'1 ........ -;. ~· •. ~.,,,~-..... -'-.
EPA Form 8700-22 (Rev. 10-94) Previous ed1t1on 1s obsolete. TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000295310
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver f}O
Recordkeeping and Reporting Supervisor
December 30, 2003
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00020 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295310-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
Reporting Supervisor
03
OSD Unique ID Cont. # Profile Disposed Description
11 / 24 / 03 295310-01 CU9614 12 / 22 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295310-1
J .
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00020 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-91 IO
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295310-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
Reporting Supervisor
03
OSD Unique ID Cont. # Profile Disposed Description
11 I 24 I 03 295310-01 CU9614 12 I 22 I 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295310-1
i k2B
CVII, IX. • EIELLI
.
Datt/Ti11t In 12/22/t3 11:43
Load Tn-Rolloff
Tr1111porttr STAT IE
BUDD IC
••••• Receipt f 422285 •••••
FederJ EPA IO 1D981799142
12:06 12-22-2003
Truck luller 112 Trailtr/Coatlll' 11 231 12 13
Rcpt Dae Daculnt Profile Profilt Geo.trttor
Lal Lal lulNr SalN Ia,oiciag CwltOl&r
t Cnt Total I DCS Sclled Federal EPA
t Code Quan. Y Unit• PCB Cit watt Statu
l i 1111295311 CU9614 VAlm CDIITt PCB U l Cl ~--• I lilogru Y IVB lladftem.alle
,__,. IC-SUltt Yelue • ll
Doc Seq I l EIIE Sll11 FJYIDIIEITAL , P.O. lu
Scbeduled Date 12/22/t3 Tia 15:31 -714612-l
>:Ill lll ~ll DEIIIS lCIICLE)
PIEFILLED HULT Y mt I <ctm>
>,11 la ~ll DC ltl XISfttTilll (CIRCLE>
Ml BfflIAL (ll.Y: · · ~SA1PLED,11SPFXTED _______________ .ma ucam~ immEDt YES , m
Sll.a:T IIATDIWD-SPJ.ICT DTIIIAL _________ VIID DISPERSAL DTDl&Lt YES / ll
u IIEIGIT SUIOIARY '*
Gron sme.•
Tare ..-,,..,o0 ••
tfiE) ·vv •• 'adj. ••
Adj. ltt ••
-· 113114-1115
31,q'd
mStCAL DF!Clffl'l■ Cl' VAST£: _____ --+--------------·SAIPLEI/Jl'PDAL._,.___. __ _
'· '-~·'-: .. -------------------------------------:>·'_: :r: ____________________________________ _
'·: · t,ar SABPLl:_813-_____ I_PBYS. D!SCIIPrl■ ~ · ., _________________ _
· ; •· :IAD.!Q!BI Pm IE6 I --------._ •. . 161.saa!l!I . ~, ~p(I '•1' '-, --~ .· : ·-...,,-_ -., --~i ---...... ---.-...... ---.-........ ~--,;-............... ________ _
121 sm.. s , n,a •-------------------------1121 RII/TEIIP. ml m REACTS ___ 1 _____________ .,.._. _________ ··-➔-_____ _
pb <PAP!ll ____ -______ r ________ '-__ -_. -----;....--·~_,._. _,_._·1 ___ ·~ ___ _
Cl SCll!I . • -SJLFJlt mEI • • I t.
-~ ADDJTtcmL .. , .. mCAL .,o,_,_.------1~-------
---OESCII1£, ___________ __,. __________ __;.. ___________ _
' . .,/ PCB COIC.CPPll ____ SULFIDE <98J __ r_ 1'1111 alt. ____________________ _
JH2t Bl IF CYDtll t9111) TAI UST! Y I
PlllT nLTER TEST/ p , SPIC. 8bfln IIZ aa._PPII ---------------COIIIDIS: . ------------------
CCJDtAT. TtSr v, ______ m __ m_
IDD'L • SdPl.E ,nacmt_,_1. ________________________ _
DISPC!W. IETD: S SP ST-3 ST-3/PT P-ST-3 P-ST-3/P1 ST-5 ST-5/PT P;.ST-5 Sll•PTfl-Pll
P-ST-"PT ST-8 ST-am IJC UC IUC JISPECT) , lit s,.,,s PCB-Ille P-IAC .
arm _____ _
. .....
P-ST-8 P-ST-8/PT YS-3 YS-5 '5--8 '
llDJCATCa PWIETEI IIJLL 8E CIICl.lD
8-UC LOAllS lllllllll6 llSPliCTI(II T8AT AD F1UD 10 B£ LISS Tl.II 511 UT II l£JUIDD 10 UI AID PUCED (11111.D. ________________________ _
JIEIIASD 1'tl DISPm&L 81: __________ DITI: ___ _
/94.,
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) ....
Please print or type. (Form designlld for use on elite (12-pitch) typewriter.) Form Approwd. 0MB No. 2050-0039. E,plrea 9-30-91
0
E
N
E
R
A
T
0
R
T
us
WASTE MANIFEST Information in the shaded areas is
not required by Federal law.
RR 4,, .
WARRENTUI
. Generator"s Phone ( 2fj2 I 2~i7···171;:i
ransporter ame
STAT INC
ransporter
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
Alabama Hi!tl\1\13Y 17 at Mile Marker 163
Emelle, Alabama 35459
A. Slate Manifest Documen1 Number
CWMA
B. Slate Generator'a ID
US EPA ID Number
/
A L D O O O 6 2 2 4 6 4~' 2•9721
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
No.
13.
Total
Quantity
14.
Unit
Wt/Vo
a.
--'
Disposal Approval # (i3084-f&15 CWM Profile# CU9f.tlt (i) 0 1
Disposal Approval # CWM Profile#
C.
Disposal APPfOVal # CWM Profile #
Disposal Approval # CWM Profile #
I.
Waste No.
·.cw
t..:-ng Codes for Wastesc~:ed.Above
tC
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _ ClelTRE{; 1-Mlt-E4-1Jlil0 ERGl171
Work Order# EMERGENCY CONTACT:
16 GENERATOR"S CERTIFICATION: I hereby declarethatthe contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condttion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I certify that I have a program ,n place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which m,nim,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good fa,th effort to m,nim,ze my waste generation and select
the best waste mana ement method that is available to me and that I can afford.
R 1---__,.-.,...,__.-,-..,.,..------------------....,,,,;---+-~..._ ______ ....,.., ___________ -:-e----,--=---..,.,.--t
A
N
: 1--.A,,,,-..-....,.,;;;;,,,.___,p,._.____......,,c,,.;.,....;...~:S.___, _____ .J...lJ,.,,l).~~~~L -ACZ:'2'.U~-----.lL~J.!U~Y2,.J
0 Rt--::-:--,-..,...,.,---,-..,.,..------------------T-:-:-----i~------------------~--:--::---:-:---t T Month Day Year
= '
EPA Form 8700-22 GENERATOR NO. 2 (Must Accompany Shipment)
N
E
R
A
T
0
R
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management)
Form ~-0MB No. 2050-0039. EJCPI-9-30-91
0 2. Page 1 Information in the shaded areas is
of not required by Federal law.
ress
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
JU~ 4,1 E, ))( 4Pf,
l#lRHt.:HfON, Hr P'/\'>i'W . .1;;15.11.
US EPA ID Number
US EPA ID Number
A. Slate Manifest Document Number
CWMA
B. Slate Generator's ID
H. FacHlly'1 Phone.
Alabama Higivwy 17 at Mile Marker 163
Emelle, Alabama 35459 A L D 0 0 0 6 2 2 4 6 4 205 652•9721
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Numbar)
Disposal Approval # CWM Profile #
Disposal Approval # CWM PrDlile#
C.
Disposal Approval # CWM Profile#
Disposal Approval# CWM Profile#
12. Containers
No. Type
13.
Total
Quantity
14. Unit
Wt/Vo
I.
Waste No.
tff
r
' i
J. Additional Descriptions for Materials Listed Above A) 1a1_:__ ______ _ K. HandHng Codes for Wastes Listed Above
/
\ \ \' -q li'~
a. C.
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order# EMERGENCY CONTACT:
16 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator, I certify that I have a program ,n place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage. or disposal currently available to me which min,m,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort 10 m,nim,ze my waste generation and select
the best waste mana ement method that is available to me and that I can afford.
nnt yped ame Signatur_ Month Day Year
I .· . .-J I,,. _,..,,.,,.
T of lleceipt of Materials Rt--..-.-=,,..,..----r-=-------------------T-::,,......---'--+---------,-----r--------:-=------:-.,,...--...,.,.---t A
N s ~ t-1:-:!o~~"""':5f&l-1-~~k~--+~.l.:'~~.,g,..,of::-:M-:-a~t-er-:-ia-:l-s---.....L.....,..1t-::~..;:.~~!,'--;f-:---J~~~.i:,,A.--------'-,11..,1.jlo.,l,..&..l....-'-"'-"-"i
Rt---,,,..,.-..,..,,..--+-=-------------------..-,,-,-------,.'--------------------------T nn ame Month Dt1y Yeer
E R
F
A C I
19.Discrepancy Indication Space
{ t-2-0-.-Fa-c-il_ity_Own __ e_r_or_O_pe_ra-tor-: _Ce_n_if_icat....,.,i_on_of_r_ece_i_pt_of_h_a_za_r_do_u_s_m_at_er_ia-ls-cove--red--by-t-h-is_m_a_n_ifest--e-x_c_ep_t_•-·no-ted--in-lt_e_m_• -1-!I-. ------..-~
Y 1--::cPr..,.in""'t_ed..,./T=-ys,ed\-.,..,-::N-:-a-m-e-------,----, --------""T-=s"'"ig-n-at.,..u-re--\--------,-----,f---------'.._--=-M"'"o-'-n--:th,-. --=p-•r-. ...,~,,.,,-,,-tr
l . (' 1. / ; t· , ---~ \ \ \''\ \ I '· ) \ (\ C' ) ' \ I I:' i : ..,, •
EPAForm8700-22 (Rev.9-86)Previouseditionisobsolele':' .TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment)
t·
.....
••••• lectipt' -t221• ••••• 1 CD, IE. • l!IIELLE
Dlt•ITl• Io 12/18113 7:28
I.old Type Ouapa
TrllllpOrter STAT II:
I t1 VEIGIT SU111RT t1
Fldln~ t1A ID IDW'/99142 GrGal 63461 ••
Tare ·• llllml a: let ••
t 1 ·1n "-4,.J..; r.., ·/ r,. ~ Adj. •• J.~'-.1.8-200-.. Adj. llt •• Truct luller 111 Trailer/Colltor fl 34 12 13
Rcpt Doc Docuent Profile Profile Geatrator Cat Cat Total V DCS
I.DI Lal 1Hr Salet In,otciag CutOltl' I Codi Guan. f Uaita PCB --·; ·;· .. ;;~;;; ~;;· .;;;;·;;;;;·~-~ --; w i:li ;··;~~---;
VAIIEITm E SUBQ: f1lut -ll
Doc Seq t 1 .m: SIA" ElfliOIIFJTAL I P.O. 1111
Sdlldlllad Dita 12/18/13 Ti• 15::. .,.._.l .
>!UX OI <51% DEIIIS <CIICl.£)
PREFILLD YlULT f mt I lCIICI.£>
>SU m <51% BC 11% IISPU.11(1 CCIICLE)
W IIATERIAL C.Ltt SAIPLED/IISPF.cT!D _____________ ,m UIIJIDS 111'.ECTEDt
SELECT IATEIIll.lD-SII.ECT 11.&TDUL VJID DISPEISAL hmIAl.t .
..J '3571/1) 1 h -~
Schld Fedlral EPA J.J b
Cat IHtl Stata
JES' I)
JES / IJ
ADEii'
llllM-1115
CDReq'd
PHYSICAL D!!Dimm ~ VASTE: ____________________ SdPLD/APPROtAL. ____ _
SPOT SllPLEc __ Blr _____ f..;PHTS. IJIIDIPTlC.. ___________________ _
IUft --alll! ii.... _ ·-· ._.. • -. ......,. ;--J ,-4-- -•• ---, -----~ ... ·------·---·--~----·---------_ ..... f -.... · ..... \ ...... -· ....___,_, __ --+(""""" _______ _ 161.scaa POS IB6 ., · -• ..... m .-.. . . . --. . 1 • ◄• 7-,,.. J "'' .... 821 SCL S F P1'/SII. ' • ' -

,

· B2I III/TEIP. 1J m IF.ACTS ______________ ... ______________ _
pll iPJPEIJ -1 ____________________ ._1 __ , __ _
Cl_scml_•_-_SllllllESCIIID_•_-_1 __ -+----------------------ADDITIIIAL AIALfflCAL IEG'Df_Y_I. ____________________________ _ DJ!SCRIBtt _________________________________ _
PCB COIC. tfflU____ SIUJD! 19131>____ ftlll alll __________________ _
D BY IF . CYUIJm (9111> ~ll VAST! Y I PAIIT Pn.1'11 TEST/ P F SPEC. Gbffll ll'Z COIC,__JPI ______________ _
QlldlJS:. ·------------------
mlPAT, 1'!ST 1/ ______ m:_m_
ADD'L SPOT saPLE ATTAalEJ>f_Y_I ________________________ _
DISPOSAL IIETlllh S SP sr-3 ST-3/n P-Sf·3 P-sr-3/Pt ST-S sr-5/PT P·ST-5 Sil-PTA B-PJI arm _____ _
P-ST-S/PT ST-8 sr-8/PT IIC UC CIIAC IISPBCT> F IIC SP-YS PCB-IIAC P·QC
P-ST-8 P·ST-8/P1' YS-3 YS-5 YS-8
IIDir.ATm PWIETEI mL E Claa.£D
B-OC LOADS l!DUIIJE JISPECTICI THAT Al£ F1llD 10 B£ IS TIU 511 lftsr l B! l!TURIED TOW AID PLACED m IDJ). ________________________ _
mEm Fm DISPm.&L Bl: _________ .DA11: ___ _
,,
'WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy I copies for Alabama Manifest Numbers:
CWMA-0000291900
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy OliverPo
Recordkeeping and Reporting Supervisor
December 30, 2003
--WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 12173 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000291900-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
OSD Unique ID
11124103 29196-er
J.ctl qoo
{Jo
A-~&-0t/-
nd Reporting Supervisor
Cont. # Profile Disposed Description
CU9614 12 / 18 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000291900-1
RAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Ma a
, . ._,., 'i' Please print or type. (Form designed for us~ on;jlite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UNIFORM HAZARDOUS
WASTE MANIFEST
1 .. Generators US EPA ID~o.
NCR00~1378020
Manifest
Document No. 2. Page
of 1
Information in the shaded areas is
not required by Federal law.
A. State Manifest Document Number 3. Generate s Name and Mailing Address WARREN COUNTY PCB LANDFILL
RR 4, BOX 426 · CWMA 295:30.5
4. Generators Phone (
5. Transporter 1 Company Name
WARRENTON, NC 27589-9110
2:.57-1713
6. US EPA ID Number
B. State Generators ID
STAT INC 1\.1 c' D 9 tr ;0 ? 9, 9 1 4
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
8.
10.
US EPA ID Number
US EPA ID Number
H. Facility's Phone Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 ' A L D 0 0 0 6 2 2 4 6 4 205/652•9721
11. US DOT Description (Including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers
a. ·,RO, PCL~TED BIPf£NYLS, so.ID, 9, lle315. III
~ Disposal Approval # UB4 111!15 CWM Profile# CIMil4
N b.
E
R
A
6 Disposal Approval # __________ CWM Profile# ______________ _
R c.
Disposal Approval # ___________ CWM Profile# _______________ _
d. I Disposal Approval # ___________ CWM Profile#
I.
Waste No.
J, •. Additional Descri~tion~ for Materials Listed Above K. Handling, Codes for Wa_stes Listed Above
C.
State of Gerieraiidn .d,
15. Special Handling Instructions and Additional Information
Purchase Order# _____________ _
Work Order# _ _,_7 -1a,,o~'t-r-1/--.8,,,_,_J ____ _ etemE 1~-H311 ERGll171 EMERGENCY CONTACT: _______________________ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above b,Y
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
s~all quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
Printed/Typed Name
Pa±.rici o..,; M .
T Transporter 1 Acknowledgement of ReceiA o Rt--=---,--------r-------+t-r-,/---------,--...,,..,.---------,t--------+.-t---------------t ~ Printed/Typed Nam7.
s 6 l-4i:!!'--'-'-:;!l-""""!b"-'i.«,t.-:--'-+:+:l!J-l-,¥-,lo~-::----:-.L...J~~r,.a.:,_.+1+--j1'--....&...-h"-"'-1,,,1-,.ro,,1J""'-""---'bE,bjr"...._..._-Er-----lP'-".,...'v''t,f;.,,,.,'t---'-t"',,!,'.,__...--......,'-'='-'---t
Rt------------------------------r-------------------------..<-.------------1 T
E
R
, "i ;irt1lJ/t 5
• w ~ J110,{if-1ttd ,/M',1,-;1, f /__(p,(t'!Jd!Jr//_J;i,)pj;f/ 03 j
Month Day Year
1 20. Facility Owne. or Operator: Certification of receipt f haza dous materials covered by this manifest except as noted in Item 19. T1--------+-------------+---~----~--------~----------+---.,_ ____________ __,,
v Printed/Type~ Nam
\ \
Month Day Year
-• \ t'.'.J1 ':;;
EPA Form 8700-22 (Rev. . \
'-J GENERATOR NO. 2 (Must Accompany Shipment)
' WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON,NC 27589-9 110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000295308
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Pl an and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver /),o
Recordkeeping and Reporting Supervisor
December 17, 2003
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00019 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARREN COUNTY PCB LA DFILL
RR4 BOX 426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295308-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation ( 18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot perso nally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
fd~d: g~ing and Rcportffig Supecviso,
December 17. 2003
OSD Unique ID Cont. # Profile Disposed Description
11 / 24 / 03 295308-01 CU9614 12 / 15 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295308-1
~ Stiawlhe Shaw Group lnc.n'
January 19, 2004
North Carolina Department of Environment and Natural Resources
Division of Waste Management
1646 Mail Service Center
Raleigh, NC 27699-1646
Attn: Ms. Patricia Backus, P .E.
Project Manager
[phone], ext 308 phone
[phone] fax
Re: Warren County PCB Landfill Detoxification Contract
NCSCO ID #0104401010A, Shaw Project #827062
Manifests and Certificate of Disposals
Dear Ms. Backus,
Shaw Environmental & Infrastructure, Inc.
200 Horizon Center Blvd.
Trenton, NJ 08691-1904
Direct Dial: 609-588-6373
FAX: [phone]
Attached for your records are copies of the following documents, they cover one shipment of hazardous
waste sent from the Warren County PCB Landfill site to Waste Management's landfill in Emelle, AL in
December, 2003 (load 19).
Certificate of Disposal
Copy of Manifest
Emelle receipt -pink copy
Originals of the certificate of disposal and of the generators copy of the manifest should have already been
sent directly by the disposal facility to your attention at the site address shown on the manifest.
If you have any further questions on this matter please contact me at [phone] or at
[e-mail].
Sincerely,
Shaw Environmental & Infrastructure, Inc.
_..,,~~;~
Gary~,P.E.
Project Manager
Duke file c:\mydocs\nclf\corresDENR\manifests 19 011904
WASTE MANAGEMENT
Emelle Treatment Facil ity
f WASTE MANAGEMENT® Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
(205 ) 652-972 1
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ OB691-1904
Manifest# Profile Description Gener/Quantity
0000295308 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MI NIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS !
Remi t t o: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284 -0606
1.00
1.00
14 .13
14.13
14 .13
P 0.#/Unit Bill er
197159 RWI LLI AM
PCB MIN DISPOSAL FEE
TRI P
TONS
TONS
TONS
Invoice Date: 12/18/2003
Customer#: 695 -1442625
Invoice#: 2256-0127183
Page#: 1
Rate Total
Svc Date 12/15/2003
1,000.00000 1. 000 00
2,100.00000 2.100.00
45 .00000 635.85
1.00000 14.13
5.00000 70. 65
Subtotal 3,820 63
Total Due $3. 820. 63
.
WM·
'0!. !ste Ivninagement, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00019 . Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-911 0
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295308-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, ac ting
u~r my {direct i;}f :ons, made the verification that this information is true, accurate and complete.
1.! ~,[If:, fJ-4.0 t£
Dorothy oTe;, Recordkeeping and Reporting Supervisor
December 17, 2003
OSD Unique ID Cont. # Profile Disposed Description
11 / 24 / 03 295308-01
,-
CU9614 12 / 15 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295308-1
WM HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Mar;iagement)
Please print o1 type. (Form designed for use on j/ite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
.UNIFORM HAZARDOUS r · Generator's US EPA ID Q\f'· Manifest 2. Page 1 I Information in the shaded areas is I
N I Cl RI lil l ,>.l l ~I 11 ~i i 7j Bl Bl t~l r l~r ~nl~01? WASTE MANIFEST of 1 not required by Federal law.
3. Generator's Name and Mailing Address tllnHREH COUWfY PCB 1.AHOF!U. A. CWMAument Number 2 9 53 08 f~ 4, DUX 42f~ ,.,, ..
~lARHEf,ff ( )N 'I NC 27~'IB9 ··Y1. U, B. State Generator's ID
4. Generator's Phone ( l~iE ,:!~7---.I. ? U
5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID
nHn~ INC I NI Cl J>I ·'-~ OI c;}j '71 91 YI ti 4111~ D. Transporter's Phone (aaft) 396.-2384
7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID \
I I I I I I I I I I I I F: Transporter's Phone " '
.
9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility H. Facility's Phone Alabama Highway 17 at Mile Marker 163
IAILIDI oj oj o j 6 j 2 j 4j 6 j 4 205/652-9721 Emelle, Alabama 35459 2
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. 14. I. Total Unit Waste No. No. Tvne Quantitv Wt.Nol.
"RU lif.l.YOIJlU!ilU.11 BIPml'rt.S, f:U . .W~ 9~ l.He.1J5~ Ill /? r / .1 l-/ Mt a. ,
~ .... _
G Disposal Approval # i1B4 ~-J CWM Profile # IJ.1%:t~ @IMll I It, Ir ! el,~ K E
N b. l E .. '~· ·;rJ R
A -_I/! •; T Disposal Approval # CWM Profile# I I I I I I I ' ,·
0
R C.
~ :
Disposal Approval # CWM Profile # I I I I I I I
d.
Disposal Approval # CWM Profile # I I I I I I I -~, .. . ~ ''<l•t "' _ ...... If ..... ..ta , , ·~ K. Handling Codes for Wastes Listed Above J. Additional Descriptions for Materials Listed Above
l , ~ C.
State of Generation JC f\ "'· b. d.
15. Special Handling Instructions and Additional Information I
i!'
Purchase Order #
Work Order # 7 ( 11 i F;. J EMERGENCY CONTACT: Ctf:1-mE 1-~~ BU171
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
PrintedfTyped Name
I
Signature Month Day Year
" P--t.r i\1 P--i,,,-k ,,. -j;),.,,iz:. ,, __ ••\..• 9-•{,r . ' , I/ 1"2 It) 13 l t.?.I :.i -l f r i ,......_~ ,).,...J• { I ~ .Ii J "~. J' ,. ... /
T 17. Transporter 1 Acknowledgement of Receipl>'"o~aterials I' ... ,
R A (\ PrintedfTyped Nam/, i I r g)_ature // l Month Day Year N r J, ldtrr. lf~ir,ft,•"'·, vlA.t,,/1 ·?1k,A t ' ' . I I . I s 1~1 I Jfi /,,, ."1 • I•• I I I J I ~ il} 1 r. p .'
0 18. Trans~orter 2 Acknowledgement of Receipt of Materials V , ., --, --------r -r ....... ..,.., ,,,,,.~J," ·, , .. R
I
T PrintedfTyped Name Signature Month Day Year
E I I I I R I I
19. Discrepancy Indication Space I -'I / / .-/ ,iii ' (/ I I . /,(/ (I' ' //( I f, (I:'' -· ' ; '/ / ! .,.-i / ,· / ' ',
F . t I A .1 C ,· )'· i
I
L I 20. Facility Owner or Operator: Certification of receipt.of hazardous materials covered by this manifest except as noted in Item 19. T y PrintedfTyped Na~ _L .~ignature \ Month Day Year
I I ,I I -1-I .I .
' ( I i I i ! ' . ', ....... (, /
EPA Form 8700-22 (Rev. 10-94) Previbus edition is obsolete. ., .•. ,--.,. I I' \ l -------\
. ~ . ~-,. TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment) -.
I•.
J
k28 Q)
·""""•' CW, DC. -1D1ELLE ••••• -1,t I 421994 •••••
Date/Tia h 12/15113 7:11 --!ft• H IIEDaT SU111A1t tt
Load Tnt· Dupe Fedtral tPl m 1E0981799142 er-61961.• =~• -~w
11
s• '. ::31 12-~-2003 327~~~~~1 $ w ~E
ll:pt Doc DaculDt Profile Profile Glalrator ~t Cat Tote! I la .. Scbld Federal tP&
-~! ~ -~-~--~~~~-~~~~ ~-~ ~ I ;i;: ~-~~~ PCI ~~--~~-~~~ '11Dlllf
1 l 11•295311& CU96H llllD CDlffl PCB LA . l DT .Jill..,. I lilogru f M Uadeten111Hlt 113114-1115
· ·.,;/;;~ · . IIIIEITOI IE . SUIIX Yalue -I)
0oc s.q , 1 -m . sa, mnUUITAL I ,. o. 1u
Sobldl1td ht. 1V15/13 Ti• ~:317Ml8l-l
>511 Cl <Sll DEBRIS CCIICI.£> ••. . .
P1EFIW'D fAII.T t OR I <CIICI.£>
>511 OI <Stl DC 111 IISPU:TD CCIICt.£) ,, /
Ill.I ti1DUL mt.I: SUPLID/JBmED _____________ FIIE UGJ!E .JlfflCTEl)t
__ ..f.111.fQ lffllUL/&SIU!CT UTEIJAL fflD DJSPJ!ISIL llflll1L! ns' • JIS, •. ·
QJO,leq'd .
~r-;mrCAL DESCRimti .ll' bST!i SUPUIJ.,,_AL ·---------------------------' I
. / ' '
l , , I
I / t,
I
SPOT SAIPLl:_113-_____ t_ms. lmJPTJIII ___________________ _
bD.9:11111 ,. -'---+------------------------161.SCIID Pm; &
1121 SCI.. S F PT/SIL
1121 Ill/Ta. ■ Ill mcrs ---ph tPAPl!I) _________ ---+----------------------------Cl_!Dl!ll_•_-_aum !DEll_•_-_t ________________________ _
, AIIDtmU. WI.Mr.A IID'Dt .J I __ ----------------------------------DDCIIIE: , --PCB QIC.t"9> ____ !UIJ■ f9lll) _____ PUii aR __________________ _
· D It IF_____ C'f.dllE C91lt>___ TU IASTI J I
PAUf mm TEST/ , , SPIC. &UfJTJ ______ Bl'Z mE._PPI ----------------allllaTS: ________________________________ _
QIIPAT. '11ST l/ ______ m._111_
ADD'L SPOT SOPl.£ AffACJID!_Y_I __________________________ _
DISPfSL JIITD: S SP ST-3 ST-3/PT P-ST-3 P--S'r-3/Pf ST-5 ST-5/Pf P-ST-5 Sil-PTA I-PD onD. _____ _
k P-ST-5/Pr ST-8 ST-8/PT IIC UC tUC JISPE&T> F 1K SP-IS Pel-UC P·QC
, \\ P-ST-8 P-ST-8/PT tS-3 '5-5 tS-8
, JIDJf.AD PWlffll IJU. ■ CIICIJ.D
\ I-UC t.om llllJIRIIB IISPICTI■ mr di FOOD TO 1B LESS TUI 511 111ST 81 IEnlrlED TO lJB AID PLACID ■ IU. _______________________ _
\ REI EASID RI DISPCIW. BY: ________ ___,D&TEt \ ----
\
\
.., HAZARDOUS WASTE MAN:IFEST
(As Required By The Alabama Department of Environmental Management)
Please-print or type. (Form designed for us_e on elite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UNIFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
4. Generator's Phone (
5. Tran sporter 1 Company Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
enerator's US EPA ID No.
WARREN COUNTY PCB LANDFILL
RR 4, BOX 426
WARRENTON, NC 27589-9110
':t
10. US EPA ID Number
I,
Information in the shaded areas is
not required by Federal law.
anifest Document Number
CWMA
8. State.,Genjlrator's ID
H. Facility's Phone Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D 0 0 0 6 2 2 4 6 4 205/65.2-9721
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
a. RQ, Pll.YDUIUNATD BfflEffl.S, nn>, 9, l.le315, III
12. Containers
No.
13. Total
Ouantit
14. Unit
Wt.Nol.
I.
Wc1-ste No.
~ 1-_::D:::is'.'.'.p:::'.os:_:a::_l .::Ap~p:'.:.r::'.:ov:,:a::_I #==~~~~lllil====='.C:'.W.::M:::.:.P.:_:ro:,fi::le:_:#:.====:GJllJii~;:::==::;::====~!3-1'1t,..l.j,-.,ls~:;...lll..~6:..JJ()!:LJ!O~l:0~~--+--_::-,.;;....:._--1
N b.
~ b~
A I T Disposal Approval # __________ CWM Profile# _______________ _
~ 1-c-. ------------------------------------+---"-.__-+-.....,-t-...___.___...__.._-+---t---------.
Disposal Approval # __________ CWM Profile# _______________ _
d.
J. Addilionai Descriptions for Materials Listed Above
State of Generation b. d. •
15. Special Handling Instructions and Additional Information
Purchase Order# _____________ _
Work Order# 7Q j ~// EMERGENCY CONTACT: -~DEOBEC ..... ll.Ul...._ .... 1--81!1H2_....!IIL...:1-3'.~-'P, ...... ·__..ERGl._,, .... 1...._71..__ ______ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government.°regulations
•: If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage: or disposal currently available to me which minimizes the present and tut~re:ihreat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management ~ettfod that is available to me and that l can afford.
~rintedfTyped Name .
ta. u-i c)o-fv1 .• . Eac.·KlA.S Year
T 17. Transporter 1 Ackn.Q.v-ii.~.cil@Eltnent of Receipt of Materials
At---::;;;,,.,--------::7"~----:.------------------,-----------::-----..----------------------a ~ ~ i mtedfTyped Nr/fe Day Year ~ w'~ ,v:..::5:..:::5:.!::r':.....:I!:____ '.LLC:1..1...1...1..·....::,;s L_ ___ _i_LL~~2::__-.e:.~2:====-------.:~-__l.__d;!l.lL.l.!:!.~~tJ~. ~~
~ 18. Transporter 2 Acknowledgement of Receipt of Materials
T
E
A
PrintedfTyped Name
19. Discrepancy Indication Space
Signature
GENERATOR NO. 2 (Must Accompany Shipment)
Month Day Year
,,,
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000294663
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determ ined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver /),o
Recordkeeping and Reporting Supervisor
December I 5, 2003
•J :WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00018 Site Info1mation:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9 11 0
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000294663-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties oflaw for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying thi s
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personall y
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
ng and Reporting Supervisor
December 15 , 2003
OSD Unique ID Cont. # Profile Disposed Description
11 / 24 / 03 294663-01 CU9614 12 / 11 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000294663-1
(
,:1·
' '
k2G
CVII, DC. ... IIIEUL-
Dlt./T11t In M_l/13~~
Load 1'Jpt ~ .LJ-.) ""'~
Trusperter STAT Ia:
IIJl9JI
Truct lllller 111 Tniltr/Contar tl 35
••••• lec:tipt' '21947 .....
Fedtrl1 EPA ID 11:D911799142
12 ' 13
Rcpt Doc Dacultnt ProfU• Profile GNtntor Cat Cat Tota.tOf}is 12-11-~ Fecfer&h~ 1,,__ G
Lnl Lnt la•er Sa1et lm>icilg CUtoaer I Codll Quan. Y Unit, PCB Cat lat• -stitlia -u -----------------------------------------~-----------------
1 1 INl294663 Qf.1614 IARID Qllffl PCI LA 1 DT 16111.N I lllogn1
IIAIIEITOI IC ! SU8CC falue -I)
Doc Seq t 1 El£ 5'8lV EfftmEITAL I P. 0. lu■
Scbeduled Dalt 12/11/13 Tile 15[:31 713511-1
>511 mt ~11 DEBRIS CCIICLE)
PIEFIWl> fAULT Y mt I CCIICLE)
>511 mt <511 UC 111 IISPfX:Tl■ CCIIICLE>
1111 DTERIAL ■LY: · S&IPLBD/IL9BC'IID. _____________ ,m UCIJI~ DETECTBDt
SELECT DTDIWD·SELECT IATDIAL IIID DISPIISlL QTEIUL!
lES / I)
!ES/ ll,
hgt-1
•• IIE1lllT t ..
Gl'olll 75141.N
1'11'9 •• ltt •• Adj. •• Adj. •t ••
aoa,
lmM--1115
aJD leq'd
PlllSICAL Df.SCIInI■ tF DS'l'l, _____ __,. ____________ SAIPLBR/APPIIOI ____ _ ==1--. ..:;.;;:,._ ...... ,-, -----:-Plf!S~~(I .... \ ..
(
161.SCIIII Pm 116
121 91.. S F PT/SO. B21 IDITEIP. IO m IFJCTS. ___________________________ _ ~CP»D> ________ t ________________________ _
CI_SCIDl_+_•_SIUlDE SCIIEl_•_-_t _______________________ _
iDDtmlAL WLfflClL RP.D'Dt_YJ. __________________________ _
DESCIIlls ___________ -1----------------------PCI ~ CPPI> ____ SIUJDE (9131) ___ PIii an ___________________ _
D2I BJ D' CYdIDE (911)___ TlB hSJE Y I
PAIIT FILTD TEST/ P F SPEC. GUYlTY E Qll&._l'PII ______________ _
Qidd!IJS, __________________ ---------------
mBPAT. TIS1' ., ______ m._m_
ADD'L SPOr !WIP1.E ATTACIIED!_JJ. __________________________ _
DISNml. UTIDh S SP ST-3 ST-3/PT P-Sf-3 P-sr-3/PT ST-5 ST-S/PT P-ST-5 Sil-PTA B·PD onn _ __,_, ___ _
P-ST-5/PT sr-a ST-I/PT IIC DC (DC JISPECT) , lit SP-YS PCB-DC P-DC
P-ST-8 P·ST•a/PT YS-3 YS-5 VS-8
IIDlClTII PWBTER VIU. II CIICLEI)
B•IIAC LOIDS IIIIJilllG IISPBCT](I TDT Bl FOOD 10 ■ TUI 511 IIUST
BE lffllRlED TO UI AID PUCED ■DD. ________________________ _
mEASiD ftl DISPOSAL BY: Jim: ___ _
I
·1
1·
-I . ,. -\,
)-
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department oL~vironmental Management)
Please print1 or type. Form designed for use on elite (12-p,tch) typewnter) -/ S ///' Form Approved 0MB No 2050-0039 Expires 9-30-02
UNIFORM HAZARDOUS
WASTE MANIFEST
Manifest
Document No. 2. Page
of 1
Information in the shaded areas is
not required by Federal law.
3. Generator's Name and Mailing Address WARREN COUNTY PCB LANDFILL
RR 4, BOX 426
A CWMAument Number 2 9 5 3 06
4. Generator's Phone ( ii!52
5. Transporter 1 Company Name
WARRENTON, NC 27589-9110
257-1713
6. US EPA ID Numo~r l_t,,,
STAT INC MC D 9 8 0 7 9 ,-1 4
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
,Emelle Facility
8. US EPA ID Number
10. US EPA ID Number
8. State.Generator's lb
/I.I -~ma Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D 0 0 0 6 2 2 4 6 ; 205/652-9721
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
a. RO, PO..YDIJIUNA'IE) BIPtfJIYLS, nm, 9, IE15, III
~ Disposal Approval # UJIIM..aJl5 CWM Profile#
N b.
E A A
6 Disposal Approval # ___________ CWM Profile# _______________ _
A c.
Disposal Approval # __________ CWM Profile# _______________ _
d.
Disposal Approval # __________ CWM Profile#
•J. Additional Descrip.tions fqr."Materials Listed Above
oso
'); Ul"
State of'Generation • .,;'.
15. Special Handling Instructions and Additional Information
Purchase Order #_9_,_., ... ,._( ... ,..._,:z~_.,~~,__,___v___cb
12. Containers
No.
0 0 1
b.
'\
14. Unit
Wt.Nol.
d.
/ I.
Waste No.
llf
Work Order# -~•7,_.._Q_/_9~6--...~-----/ OEmE 1~4-9318 ERGl171 EMERGENCY CONTACT ________________________ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this con_signment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are i~ all respects in proper condition for transport by highway
according to applicable international aiid national government regulations. .,,·,
II I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently,available to me which minimizes the present and luture threat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that l __ can,g!;ord.
Printed/Typed Name Signature Month
H.> ... tv,-c..i tL M .
r'. 17. Transporter 1 Acknowledgement of Receipt of Materials
Ril----------------------------~------~~----------------------------ll A·
N. s ri 1-:-178-. ~T""rat.i:s_p._o"'.'rt._er'-4::-'-:A-c-:--k-no""'w""1"'e""d.,_ge"'m~e._n.1.t o~f,..R~e,._c_e"'.'ip_t_o"'.'f"'.'M"'."a_t_e"'.'ria"'.'l"'.'s------'-----~~~4-'Y--e.,.....;;.=t,,;,-q.,'-1-----------'CL....IL---'< .... J:f...L>"'--'-'--I
Rl----------------------------~------------------------------------ll T Printedffype8 Name •t,
E J,, .':-,~
A
F
A
C
I
19.
Signature Month Day Year
r
Lt--------,-;,,---,.,._ _______ .._....,,. ____ ..... __________ -+--------,'-'.-------------------I
I 20. tern 19. Tt------+---t---;-----+--~~----------r-----t----.-------f'....,..-+----------------,,-------1 y Signature
\_
EPA Form 8700-22 (Rev. 10-94) Previous edition is obsolete. GE;NERATOR NO. __ 2 (Must Accomp~ny Shipmenl)
'
-I
.
WM
-' Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00017 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295306-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under clirect ins ctions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
11 / 19 / 03 295306-01 CU9614 12 / 4 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295306-1
• I
.
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000295306
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver / _/ 6
Recordkeeping fnciiep;rting Supervisor
December 09, 2003
k28
CVII, IE. -IIIELLI
Dat..lTt• Ia 12/M/13 ,,13
Load 1'Jpt Rolloff
Trllllporttr S1'&T Ia:
" \ , . ·, ...
Fldtrll EPA. IO ID9lll'm1\ --IE \
Tralltr/Caetar fl 15 .,, 10. 76 H -• ,.J 13 1 :')_ , ,.., .... OLJ.~. ·'o-... . . , u ·
Rcpt Doc Docueat Profile Profile Geatrator Cat Cit Total V DCS .... J Sctleclt ... ! t:P~
-~~ ~ -~-~--~~~~-~~ --~ ~ :2:--~-~~ ~ ~t'
l 1 . 1111295316 CUIJ614 IAIIEI CWffl PCB LA 1 QI . I n1ogn1 t PLn ~ le
· ORUIIW IC SU1CC Yll• • m
Dae S.. t l m: Sid mtlDIIElifAL P.O. 1U1
Schlduled Bite 12114113 Ti.Ill lS:31 711961·1
>511 m <il~ DEIIIS <CIICLE> .
PID'ILLli) fAULT J la I <Clla.E)
->511 ca <ill UC ltl llSPf.CTDa · <CllCLEJ
JULI IATDW. at:
SHPI.ED/IISl'ICTBD __________ tlll. UGUIDS Dfflt11Dt
Sll&'T lllTllllALID-SlllCT UTIIJAL fflD DJSPIISAL ll&TDIAJ.f
11S1m
1IS / I)
11 IEIGIT Ullllt tt
6rNI 67661.■
fll't ••
ltt .•
. Adj. •■
Adj. ltt •■
&DEi ' ---,---
PIJSICAL DP.SCIJPTI(a If IASTE: ____________________ S&ll'LEI/APPIIOYAL ____ _
SPOT SdPLI: N3-______ t_Pl!S. IIDJffl■ __________ ..,.... _______ _
lll).SCl!lr --:;Pm~ ---~·1 "· · . ,,, ";. · \ ,~' ·
161. SCUii POS IE6
121SIL SF nr.a l _______________________ -·...,._
1121 ID/T!IIP. IJ RD lbC'IS · · ·· I -----------------------.--ph <PAPD> ________ I _______________________ _
CI_SCIIEl_•_-_SULPJJE am_+_• _I _______________________ _
ADDITICIAI. Wl.fflCAL IIQ•Df_Y_l. ________ 1 __________________ _
DtI•=---------------------------------PCB all:. CPPIJ____ SlUlll CU> P1II all£ ... ,_ ll2t II IF___,....,.-_,,___ CfWli C9111> ___ TAIIASYl:-....f---t-----------------
. PAJIT JILTII Tm/ P t SIIC. BbYJTT •. as._ffll ---------------------, Qll!IIS: __________________ .... _____________ _
alPAT. TIST '1/ _______ m_m_
.IDD'L SP01' SdPLE ATTACIIEDt_t~ , · · · · , .. .,, /
DlSNBAL lfflllh S SP ST-3 ~PT P-ST-3 P-ST-31PJ SJ 5 ST-5/Pf_fsr.:, -~l ,r1Jraa,,t'-
P-ST-5/PJ ST-a ST-am IJC lAC (IAC JISKtT) r JIC SP-VS PCI-JIAC P·DC
I
i , l t/1 >
P·ST-8 P·ST·I/PT tS-3 tS-5 YS-8
JIDJCAO PWIIETEI VJU. IE ClltUD
&-DC I.Olm IBIJJIJ16 IISPICTJ■ TUT ME PW1D TO ■ 1!SS TUI 511 IIU9T II mumD TOW AID IUC'.ED ■ IO.D. ________________________ _
. IIJ-IASEP Fm DISPOSAL BJ: ___________ DlTli ______ _
,,.,.
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management)
Please print or type (Form designed for use on elite /12 pitch) typewriter) Form Approved 0MB No 2050 0039 Expires 9-30-02
UNrFORM HAZARDOUS
WASTE MANIFEST
3. Generator's Name and Mailing Address
Document No. 2. Page 1 Information In the shaded areas Is
1
1. Generator's US EPA ID No. Manifest I · · ·
NI t i RI i i tit I !:i)I 11 .JI 7181 ~)I P Ir I ( I JJ I / lb of J. not required by Federal law.
W(~U<f.:N GO\ INT. y PCD I..ANDF!LL A. State Manifest Document Number 2 9 5 3 0 7 mt 4 1 »ox ~Pf) CWMA 1---------------------1 WAARJ.:-_NTUH., NC ;T/~:i!l9·-·~ll Hi 8. State Generator's ID
4. Generator's Phone ( (~~f/-· t 713
5. Transporter 1 Company Name
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459
6. US EPA ID Number C. Sflite•Transporter's ID 1---------------------1 I NI GI DI ~-II l\l fill 71 91 '..JI 11 41 f! D. Transporter's Phone, 1,Bea) .396--ii?,304
US EPA ID Number E. State Transporter's ID
I I I I I I I I I I I I F. Transporter's Phone
10. US EPA ID Number G. State Facility's ID
H. Facility's Phone
I A I L I DI O I O I O I 6 I 21 2 4 I 6 I 4 205/652-9721
1.1.. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers 13. Total 0uantitv
14. Unit Wt.Nol.
I.
No. Tvoe Waste No.
a. ~is,'f,11 ~ 1-_:D::is:::.po=s=al.:.:Ap::.:p::.:ro:.:.:va::.:I #~1[.J1~~~4t:«G0~~~====:=:C::.:W:::M::...:P...::ro::::fil:.::.e.:::# ======0!2!· fj!'Ni!J!,i;!t4~===========-.JJ@u l 0m . .11..!1....jl.G~l.!:11;1.i ii:...J..I ~_LI 21..:..J·~-~_J, ~.::....11t'L, --'-"~~L,.-..,:_ __ _.
~ b. 4,,_ii i I j ~.+;~ ~ Disposal Approval # __________ CWM Profile#_______________ I I I I jJ l iJ!~ ~ 1-c-. ---------------------------+__._l__._l--+__._l-+__.___.___.___._-+_-+ __ ";-----1
~ Disposal Approval # __________ CWM Profile#_______________ I I I I I I I J-rd-.------------------------------------+---'-----+ ...... -+-.............. -.._ ....... ___________ ..
,,
T
R
A
N s p
0
R
T
E
R
F A
C
I
Disposal Approval # __________ CWM Profile# I I I I I I r.
J. Additional Descriptions for Materials Listed 'Above
·os o
r;:-ng Codes for Wastesc Listed Above
State ot Generation ti:
15. Special Handling Instructions and Additional Information
Purchase Order# rb ·(:) ·2;--(~-;S:~-. !,
b. d.
Work Order# __ 1~. ()~/ _'1~~-]~-----EMERGENCY CONTACT __ tlef __ rfiEr._· ,_1_-_•~ __ 4-9JO'.i_. __ £1,l31 __ l_7i_, ______ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable meth.od of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
PrintedfTyped Name
P.·t,. fv/ [' '--¥'CI ,rt , • :),, ,· k' 11 ~-I
Signature +'-j ( .• I { t
Month Day Year
111 i l .... 14/lt-1~
17. Transporter 1 Acknowledgement of Receipt of Materials I
Print;r yped Name I . :r ~r'\,: ':) <n i,bt'~ J I
Signature
·-'-~ .. .,. .
Month Day Year
1 IV 12 t1(./I /1 :.
18. Transporter 2 Acknowledgement of Receipt of Materials '• I
PrintedfTyped Name
I
Sign~ Month Day Year
I I I I I I
19. Discrepancy Indication Space --
I ; ' '.
A Lt---------------------...-------------"-------------------------------1 I 20. Facility Owner or Operator: Certification of receipt of\jiazardous materials covered by this manifest except as noted in Item 19. f Tt------------------c----------,------------------..-------------,,..._~--1
y PrintedfTyped Name : I Signature \ , 1an~.s~>11 fft.ear,
\ \'' ,··(,. \,I ( i._J t\ ,\\(\ r, ' f { !\ l--------I lldf~•bf 111\'f j'.'J;
EPA Form 8700-22 (Rev. 10-94) Previous edition is obsolete.
TRANSPORTER NO. 2 (or File Copy) (Must Accompany Shipment)
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management)
. Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UNIFORM HAZARDOUS 1. Generators us EPA ID No . Do~':::~~f~o. Information in the shaded areas is
WASTE MANIFEST . N C R 0 el 0 1 ~I 7 8 0 2 c) not required by Federal law.
1-,3-. _G_e_n-er-ato...:r.:.'s .;_Na::.;m:..e.;_a=nd_;M:.:;a:.:.ili..:.:ng...:A::.;d_;dr=es.=s...;_ ___ ...L:W~Al::--:=R-!::R,-:,E::!-N~C!:,-JO:,:-i-,l.J,,-M:-!::T::-Y-:1--:P:::-C!::-J=B.&...,-L.J,A,.,N'"'Dl,,-F~I;::L+L~...::..u...~q..,,,=,.,.,.,,.,-.,,"="'
RR 4., BDX 426
WARRENTON,, NC i27589·-9110
4. Generator's Phone ( E52 257-·1. 71.3
5. Transporter 1 Company Name 6. US EPA 10 Number
STAT, INC N C D 9 8 0 7 9 9 1 4
7. Transporter 2 Company Name
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
8. US EPA ID Number
10. US EPA 10 Number
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
a. RO, PCl. Ycti.lJUNATED BIPIENYLS, Sil.ID, 9, IJl2315, I II
~ Disposal Approval # 1131114 11105 CWM Profile #
N b.
E ·Fi
A r· Disposal Approval # ___________ CWM Profile# _______________ _
No.
0 0 1 C 111
~ 1-c-. ------------------------------------1-----i--~-1----~---1---
Disposal Approval # ___________ CWM Profile# _______________ _
d.
15. Special Handling Instructions and Additional Information
Purchase Order # 7 t:, ;() 2. G:, S' P ~
Work Order# -~1~0-f~f~W~1------EMERGENCY CONTACT: __ CIEl'ITREC ____ 1-_800-__ 42_4_-_9300 __ ERGtt __ 1_7_1 _______ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity·generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
PrintedfTyped Name
Pa.:&-,c,,ia...-f1. Ba._c k )n Month Day Year
JI '-lt>3
17. Transporter 1 Acknowledgement of Receipt of Materials T Rl--------------::,------~----------,-----'--'1r---------+t----,,,,;,<--------"'t--------l A
N s p
f
th J
o 18. Transporter 2 Acknowledgement of Receipt of Materials Ri-----,------------------;----------,--',-----,-,-------------------------------1 T PrintedfTyped Name
E R
F
A
C
I
Month Day Year
19. Discrepancy Indication Space
Lt----------------------------------------------------------------11 I 20. Facility Owner or Operator: Ceriification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Tl----------------------------~------------------------------------1 y PrintedfTyped Name Signature Month Day Year
EPA For_m 8700-22 (Rev. 10-94) Previous edition is obsolete.
ST ATE OF ALABAMA (Must Accompany Shipmen~'
-' .~
''lM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00016 Site Information:
WARREN COUNTY PCB :LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000295307-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
Supervisor
OSD Unique ID Cont. # Profile Qis13osed . Description
11 /19 /03 295307-01 CU9614 i2 /I / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000295307-1
-\
en, IIC. -EIIILLl ..... 421672 ..... 1
'Dlt.lTl• Ia 12/11/13 1118 ,. IIEIGIT SllllllT tt
Lold.TJ,t lelloff Federal £Pj ID IRll799142 6roa 71111.N
-·~ Tatt .N
<1'"',fBO lf, ·,-, 1tt·1, •· . j .. ...: (,, Adj -.N
Trulporter STAT lE
111ml w;
;/.. ,'-~ ..
Tnct lulhl' 112 TraUar/Coatar 11 245 12 13 £./ I Adj. ltt .N
tc,t Dae DoculeDt Profile Profilt Seetrator «;at Cat Total I llCS Scllld Fldtnl l>l
Lal LAI IIIIHr Sal.II la,oiciag cat•r I I Cade fluu. Y Uaitl PCI Cit lllte StatUI ADEi I
···; ·;· .. ;;;; ~;~-.~---~-~ :-~ ·;.;· ~?;--;~---; ~-~le U31M-tll5
ldla'IUI. a; 9111CC ,11111 • I)
Dao Sljf I 1 El£ Silt flf~&L P.O. Ila
Scbedllled Date 12111/13 Ti• 1Ss31711966·1
·,->511 Cl <Sll DElllS <CIIU)
mFIU.ED fMJLT l OI I · (CflQ.E)
>511 Cl <Sll UC 111 IIS1'fl:TD (CIIU>
,, . ', IU lltfJll&L OILY s
. SAIIPLIDll~ FIii UCIJDS DfflCTIDT -----------Sll.PtT 111 'IBRI lL/D-SII.ECT UTDIAL mD DlSPIISAL 111TDIAL!
· fflSIW. _IDJIPTI(I CJ' VASTl: ______________ \ ________ SUPI.IR/APPIIOtAL. ____ _
SPOJ' Sllf\lt_ Im-______ I:.,.~•-~~----______ ..,,.._ __ -~_· ______ _
UD.9:mi· -Ni; lll6 I _______________________ _
Ifil.!DIIII ·,a; II&
1121 SL. . S F PT/SL 121 RD/TDP. al m IEACTS ____________________________ _
1 pit tPlPD> _________ 1 ___ --.-_________ __,. ___ l _________ _
CI_S£111!1_•_-_Sllllm SCIIIII_•_--'---+-------________________ _ ADDJTnU. WLffltt.L llll'D!_t_l. ____ __,, _____________________ _ D!SCIIIE: ____________________________________ _
PCB QIC.CPPI> ____ SIUl1I C9D> ___ FIB QII __________________ _
U2t n D' CTWIII t9tltl . TAI USIE Y I
PADT nLm TEST/ , , snx:. &blffl -as._PPI ________ ....__ _____ _
.. allll!ITSl . -------------------
cmPlT. TEST Vl _______ m_m_
lDD'L SfOf SAIPS.I ATTACIID!_J_I __________________________ _
DJSPmat. IITJ8>t S SP ST-3 ST-31PT P..ST-3 P-ST-am 5t .. 5 ST-5/PT P-ST-5 Sil-PTA 1-ffl onn __ -. ..... · ----
P-ST-5/PT ST-8 ST-8/PT IJC UC Cll1C JISPICT) F DC SP·YS PCl•IIAC P·llC
P·ST-8 P-ST-8/PT '5-3 '5-5 -YS-8
llDIQD PWlffll lIU. IE CJICLID
I-UC LOADS IIIIUJIIE JISPICTJ(I TUT 111 '1111D TO IIE LI$ TUI 511 1115T 81 IITUIIEI) TOW AID PUr.ED (I D.D. _________________________ _
lfJIASD Fm DlSNE&L n, _________ DlTEt ___ _
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) ,,
., (/fp;m designed for use on elite /12-pitch) typewriter.) I,>
3. Generator's Name and Mailing Address
4. Generator's Phone (
5. Transporter 1 Company Name
7. Transporter 2 c;.?.mpany Name
----~
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
Alabama Highway 17 at Mile Marker 163
Emell_e, Alabama 35459
WARREN COUNTY PCB LANDFILL
RR 4, BOX 426
WARRENTON, NC 27,589-9110
6. US EPA ID Number
8. US EPA ID Number
10. US EPA ID Number
A L D00062
1,
0
1. US DOT Desc_ription (Including ProQer Shipping Name, Hazard Class, and ID Number)
a. RO, P<lYOl.CIU~lEJ) BIPfBM.S, Sil.ID, 9, IJf.315, III
i
2 4 6
Form Approved. 0MB No. 2050-0039. Expires 9-30-02
Information in the shaded areas is
not required by Federal law.
anilest Document Number
CWMA 294662
B: State Generator's ID
C. State Transporter's ID
D. Transporter's Phone I
E. State Transporter's ID
F: Transporter's Phone
G. State Facility's ID
H. Facility's Phone
4 205/652-9721 ,
12. Containers
No.
14. Unit Wt.Nol.
I.
Waste No.
~
K. Handling Codes for Wastes Listed Above
cu:1,14 C.
I
d. JC
15. Special Handling Instructions and Additional Information
Purchase Order # zaa ;;... IP s:
Work Order# ______________ _
-'is
(
·' EMERGENCY CONTACT: __ OEl __ m_REC __ 1_81l1 __ 424-.AJ:_-C._ ____ aa_~1_71 _______ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations.
II I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or-disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
PrintedfTyp,ed Name Signature Month Day Year
T 17. Transporter 1 Acknowledgement of Receipt of Materials Rt----------------------------~-----------------------------------1
A
N s
p l-:-:::--~,&.-4-L-=::-r.---A~Z....:..l.JL..¥~L-:-:--:-:-:-'.--:-':-----..l-----f~6",A,f-!l\r--~e,.:.r.,\l,~~--\-------...J..../.-II...-J.JW.:;i....i..~~ O 18.
Rt----------------------------~-----------------------------------1 T
E
R
F
A
C
I
Printed/Typed Name
.19.' Discrepancy Indication Space
Curr e 7 -Y ,cl-,
Signature Month Day Year
.,,.,.--
Lt--------+----------+---.------------------------------.,.__...;... ____________ -1 I 20. Facility Owner or Operator:
Tt---------f--------',---i---\,--------,-----------'---------+---1----------,J'-----I Y PrintedfTyped\Na
EPA Form 8700-22 (Rev. 10-94),er
Signature I
. I
\
GENERATOR NO. 2 (Must Accompany Shipment)
(\
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00015 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000294662-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
r my direct instructio , made the verification that this information is true, accurate and complete.
Supervisor
OSD Unique ID Cont. # Profile Disposed Description
11 / 17 / 03 294662-01 CU9614 11 / 24 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000294662-1
,. Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000294662
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper pem1its and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver [lo
Recordkeeping and Reporting Supervisor
November 26, 2003
WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Mani fest#
0000294662
0000940203
Profil e Description Gener/Quantity
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM 1.00
TRANSPORTATION/EVENT ROLLOFF TRIP 1.00
HAZARDOUS WASTE FEE 10.55
ADEM MONITORING FEE 10.55
SUMTER COUNTY FEE 10.55
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORT A TI ON/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
1.00
1.00
12.33
12.33
12.33
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
P.0.#/Unit Bi 11 er
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoi ce Date: 11/26/2003
Customer#: 695-1442625
Invoi ce#: 2256-0126771
Page #: 1
Rate Tota l
Svc Date 11/24/2003
1,000 .00000 1. 000. 00
2,100.00000 2,100.00
45.00000 474 .75
1.00000 10.55
5.00000 52.75
Subtotal 3,638.05
Svc Date 11/21/2003
1,000.00000 1. 000 00
2,100. 00000 2,100 .00
45.00000 554 .85
1.00000 12.33
5.00000 61. 65
Subtota l 3,728.83
Total Due $7,366.88
b~"'"~
r-..11t .... ,~t\
~ts
·1:ic. •. ,, .• c.,
fvt~'•l', "'v· ~ } ·i._
Dltt/Ti• In 11/24/13 9143
Load Type Rolloff
TrQsporter sr,r IE
IIJl)U
Truct luuer 112 Trailer/Contnr 11 211
F~~A.fl~.·:.799.,:1"2., i.u,,.0 ·, .., · -·'''+ 11:i .tdi);J-,
'tJ_tK I d-lj~ °1s-'1J 12
1 ., • *' IEIGIIT SUIIIARY tt
Groa 65861.N
Tue .N
llt ••
Adj. .N
Adj. llt .N
lb:pt Dae Dac,mat PnfUo Pnfilo -tor Cal Cat Tobi I IICS ~ -!Pi ,y -~~ ~ -~-~--~~~~~-~~~ --~ ~ 'f;.;i ~-~~~~ PCI ~~--~-~~~ 21/ ~~ 7
1 1 1111294662 019614 IAIIEI CDJITI PC8 LA 1 CII . I lilagru Y Pl.Fl IJDdtttrtinaHe 11:1114~
llllmOI E !IJID: ftlut -I)
Doc ~ I 1 IIE SOI EIYIDIIEITAL P. 0. IUI
Sclledultd Date 11/24113 Ti• 1,:31711S5-l
>511 «-~11 DEIIIIS CCIICLEJ
Plf.FILLID HULT Y €a I <CIICLE> ·
>511 «-~11 BC 111 IISPftml (CIICLEJ
Ill.I IIATIIUL OILY I SAIIPLED/IISPIC'JID ___________ FREI. LiallllS DETECTED!
SELF.Cr IIATDIALJD.SILECT IIATEIJJL IUD DISPIISAL IIATEIJJLt
JES / I)
BS/ ll
m, Req'd
PIIYSICAL llfS:11"1CI Cf V.ISTE: _________________ ---.:SdPLEl/lJIPDJL ______ _
sror SAJIPLE:_813-_____ ,_ms. iminim. __________________ _
~SCIFI.I
1
. P0S l:f.B ! _ _,... _______________ __, _________ _
IGl.stml POS ·E ',1
821 SD.. S F nr.a 1121111/TDP. mm mcrs ___________________________ ·,...._··
pla CPAPEl> ________ t _________________________ __,....__
Cl_!DFD_•_-_Slll.FIDE SCIDl_•_-_t _______________________ _
ADDinCIJL WLfflCJL Rm'D1_Y_l ____ ---i-----------------------DE!alll: PCB as.--,m---, ----SULn--D!-c9D---> ______ Ftll_am __________________ _
D2I BY IF_____ CUllDE (9111> _ _..._ TAI I.ISTE Y I Pam mm TISI'/ , , · SPEC. m,trr_· _____ m cmc._m ______________ _
4~ COIIIBITS: ··~-"· --------------------
CtJJPff.TESTV ______ m_m_
ara...-seu:,,_IID1!_J_1___,,_____, _____________________ _
DISPOSAL IIETIIOD: S SP ST-3 ST-3/n~P:;ST-3 ,=st-3m sr-s ST-5/PT P-sr-5 511-PT:l B-,1, OTRD_-_~ __ ....._......__
,-sr-5/PT ST-a ST-8/PT IIC IIAC (IIAC I&ICT) F IIC SP-fS'lltl.lAC P-OC \
P-ST-8 P·ST-8/PT YS-3YS-51S·8 1
IIDICAT11 PAblml m.L BE CllCLED
B·l!AC LO&llS ISIUJIIE IISPICTICI TIAT DI FWII) TO Bl 1B TW 511 UT
BE ffllllED TO W BD PLACED Cl m._· _________ _ REIEISID Fta DISPm&L BY: _______ __,DATI: _______ ...._ _____ _
---·HAzARDO ·AsT·E MANIFEST
(As Required ~y The Al ,bama Department of Environmental Management)
. -Please print or type. (Form d~signed,foruse on elite /12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UNIFOl;tM'HAZARDOUS
WA'SJE MANIFEST
Information in the shaded areas is
not required by Federal law.
3. Generator's Name and Mailing Address WARREN COUNTY PCB LANDFILL
RR 4, BOX 426
A~CVVMAument Number 2 9 4 6 61
4. Generator's Phone (
5. l"Jlilnsporter 1 Company Name
7. Transporter f Company Name
9. Designated Facility Name and Site Address
CHEMIC_,A.L WASTE MANAGEMENT, INC.
Emelle Ftcility· • .
WARRENTON, NC 27589-9110
\
6. US EPA ID Number
8. US EPA ID Number
10. US EPA ID Number
B. State Generator's ID
C. State Transporter's ID
~ 0. Transporter's Phone
E. State Transporter's ID
F. Transporter's Phone
G. State Facility's ID
H. Facility's Phone Alabama Highw 17 at Mile Marker 163
Emelle, Alabama 35459 A L D 0 0 0 6 2 2 4 6 4 205/652-9721
11 . US DOT Description (Including Proper Shipping Name, Hazard Class. and ID Number)
a. RO, PCLYDUJWIATED BIPIIJM.S, Sil.ID, 9, lleJtS, III
~ Disposal Approval # CWM Profile#
N b.
E
R
A
6 Disposal Approval # __________ CWM Profile# _______________ _
R c.
Disposal Approval # __________ CWM Profile# ______________ _
d.
J. · Additional· Descriptions for Materials Listed Above ,.' ·.•·.. ., ,_, ., ,
oso 11/1/03
State of Generation
15. Special Handling Instructions and Additional Information
--r /··-/· /, . '. Purchase Order # , r ), -<' • ..,'_ ;J;? ·)
12. Containers
No.
14. Unit
Wt.Nol.•
I.
Waste No.
tit .
....
K• Handling Codes for Wastes Listed Above '
a. ·L C.
b. d.
WorkOrder# 70 J l l-S EMERGENCY CONTACT: -~ctEfflE~~~-l~~~~+-9311~--BB~~l~7l~-------
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and}are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government ri:gulations. " •
If I am a large quantity generator, I certify that I have a progra/ill in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford.
T 17.
Rt----------------=--------------.----r-1~---------,-r--+--'r------------------1 A
N
: ~:-111:~-L ZJ~~~~.i----,.!.;:::...U.L l-:t;~~•~L-;·:._...=-L.--...L---,.l~:27:::::::::.. _____ ~~;...,:::::.~~:..:::..:::=:~---_J...l..ll..ll'.....l'!!iJ.L !.(:.,.I
o 18. Transporter 2 Acknowledgement of Receipt of Materials Rl-------------------------------rl'---+----------------------------------1 T PrintedfTyped Name
E
R
F A
C
I
L
19. Discrepancy Indication Space
Month Day Year
I 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
Tt------------------------------.------------=""7"--,,-----------------------1 Y PrintedfTyped Name Signature Month Year
~$£_ I I
EPA Form 8700-22 (Rev. 10-94) Previous edition is obsolete.
GENERATOR N6' 2 (Must Aecom
·-ic2e
Cl!. IK. • ElllUI
Date/Tl• In 11/21/13 . CJ141
Load Typ. lolloff
Tnelports-STAT .IIC
BUDD
j HHt lewipt f
~ EPll0D981799142
10;39 11-20-2003 Ir:
truck IUll@r 112 Tra.Utr/Coatnr 11 l 12 13
' N-\.,i "".,
~ ~
421516 .....
H IEIGIT mllllf H
Grola &1161..
44120 lb G Taff ,' •·· , o/?O'{O ::
Adj. let ••
Rcpt Doc Docu.lent Profile Proflle Getwrator
Lot Lill luller SllN Invoiclng Cutoar
t Cat Total I llCS Sclled Ftdtnl D>A
I Code Quan. Y Unita PCB Cat waste Status
.. 1 1 1111294661 CU9614 IAIRD Qllffl PCB U 11 Cl 16111. • I 1i1agru I f IARUITOI Ir: !IIICC falUI -I)
I Pl.Fl llldeterainaHe
ADEii '
lJ.3114-1115
f_··.· . Dae Self I 1 £IE 58'1 ElfIDIF.ITiL P.O. la
f. Sclladtaled Date 11121/13 Tt• 15t3171Ui&l-1
QI) ae.•d
[_::··... . ,~511 ■ <511 DEBRIS <CIRCU) · ~ . ·'8EFW,EO UULT J mt I CCIIDJ!J .
, · . >511 DI <511 liC 181 IISftXTitW tctltt.E)
1IU llTDlAL -.11
SOPLIDil&l!CTID PIEi LlflJJ116 DfflC11Dt
SFJ.ICT IATIRIAL/D·SEIJ!CT lllTEIIAL. ______ rm DISPIIISAL IATDIALt
US/ IO
JES/ I)
PRYSICAL DBDimCI Cl' IASTE:. ____________________ SOPLD/APPIOYAL. ____ _
.SPOT SAIPLE:_813-_____ ,_ms. iibimm. ____ ----------·--_.,..· .... ·-' · ... · ··..,....._
L-,-···-•,-·-·~•-P.EII ---pq; ,,Ill ,, ' '"'I -'-------------.....-....----~----........ ~.,....,....oiojoi.
I '.·" IGLsmEI POS -'
D SO.. S F PT/SI. U ID/TDP. E RD IEACTS. ____________________________ _
ph <PAPD> _________ t ________________________ _
Cl_!DEEl_+_-_SUIIIDI aal_•_·_I ________________________ _
ADDlfftml. AQLfflClL a•ot_YJ. __________________________ _ DESCltBE, _________________________________ _
PCB as.·cm, ____ SULFIDE ,,..> ___ ,_ ca.__________________ rt
lB2I BY IF_·____ Cf&IID! C911t> YAB ,ASTE Y I f ,PUIT FlLTD ftsf7 P J SPIC. GbYJff . '. IIZ a&.__;_PPll .,..__..,....... _______ .......... ____ __.;, '1
. ·~,. ~., • ' __ /) A.! ''l ;~; ✓"--1%/ ; 'l
._-a le.ti _____ ____, _us-.,:_ I /,;1 ,,,...-~' · " ; L(!; ~ _____________________ ,.,.,.., ....... :/ . .,,,.,/
Al>D'L SfU1' S&IIIU ATTACIEDt Y I .,
DISPfBAL IITD: S SP ST-3 5t .. 3i,r P-ST-3 P·ST•iin ST-5 ST-5/PT P-ST-5 Sil-PTA 8-PII
' .
man. _____ _
P-ST-5/PT ST-8 ST-8/PT IIC UC nw: IISPICT) FIE S,,.YS PCB-DC P-IAC
P-ST-8 P-ST-1/PT YS-3 YS;.5 YS-a
IIDICA1'tll PmmD VIU. 11E CIICLID
B•lllC ·LOAII llflJDII& IISPl&TJ■ 1'1lf &II FOOD TO 1■ USS 1BA1 Ml IUST
Bl lfflllD TOW dD PUCID Cl m. ____ 1 ______ --------~-----.IBIEASID Q , DJSPOSIL BY: ___ _._ _____ ..._ __ Dl11t ___ _
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00014 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000294661-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under m direct instructions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
11 /7 /03 294661-01 CU9614 11 / 20 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000294661-1
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000294661
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
I
Dorothy Oliver;.<_/ b
Recordkeeping a;:a "ke~:rting Supervisor
November 26, 2003
WASTE MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691 -1904
Manifest# Profil e Description
WASTE MANAGEMENT
Emelle Treatment Facility
® Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
Gener/Quantity
CU9614 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
P.O #/Unit Bill er
197159 RWILLIAM
CONTAINER RENTAL OPEN TOP BOX RENTAL 1.00 CONTAINER RENTAL
SEPT 2003 RENTAL
CONTAINER RENTAL OPEN TOP BOX RENTAL 1.00 CONTAINER RENTAL
OCT 2003 RENTAL
0000294661 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P 197159
PCB BULK L/F -EVENT PCB BULK LF 18.52 TSCA TONS
TRANSPORTArION/[VEtF RO!...LOF.F TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS . TX 75284 -0606
1.00 TRIP
RWILLIAM
Invoice Date: 11/24/2003
Customer#: 695-1442625
Invoice#:
Page#:
Rate
Svc Date
275.00 000
275.00000
Subtotal
Svc Date
110. 00000
2,100.00000
Subtotal
Tota l Due
2256-0126714
1
Total
11/21 /2003
275.00
275.00
550.00
11 /20/2003
2.037.20
2,100.00
4,137.20
$4,687.20
i ,.
. (
i
HAZARD6t1SivASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) ..
Ple;,.se print or type. (Form designed for use on elite (12-pitch} typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-02
UijlFORM HAZARDOUS
VI/ASTE'MANIFEST
3. Generator's Name and Mailing Address
4. Generator's Phone (
5. Transporter 1 Company Name
STAT., INC
7. Transporter 2 Company Name
RR 4, BOX 426
WARRENTON, NC 27589--9110
257-1713
6.
2. Pag~
of l
Information in the shaded areas is
not required by Federal law.
A. State Manifest Document Number
CWMA
B. State Generators ID
C. State Transporte~s ID
9. Designated Facility Name and Site Address
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
10. US EPA ID Number G. State Facility's ID
H. Facility's Phone Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6 4 205/652•9'721
11. US DOT Description (Including Proper Shipping Narpe, Hazard Class, and ID Number)
a. RU, Pll. ~TQ · BIPt£.NYLS, 9l.ID, 9, IM2315, III
12. Containers
No.
14. Unit Wt.Nol.
I.
Waste No.
~ Disposal Approval # CWM Profile # D19614 0 0 1
N b.
E
R
A
6 Disp0sal Approval # __________ CWM Profile# ______________ _
R c.
T
Disposal Approval # __________ CWM Profile# ______________ _
d .
Disposal Approval # __________ CWM Profile#
J, Mditibni l ·o~~criptions fo,,,Materials Listed Above K. Handling Codes forWastes Listed Above-
,Cu f/f, J'-/ $.R6 111
osJ> 1ol:v)a3 a.
b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _____________ _
Work Order# ]Q tJ ~ ~ 7 oemE: 1~+-9318 ERGl171 EMERGENCY CONTACT: _______________________ _
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by
proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by highway
according to applicable international and national government regulations .
. If I am a large quantity generator;·! certify that I have a program in place to reduce the volume and-toxicity of waste generated to the degree I have determined to be economically practicable and that
I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat tq human health and the environment; OR, if I am a
small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to ('10 and that I can afford.
Rt-----------------------------r-------------------------------------1 A
N s
P r~-:!--¥...+-L..:~"".'"""~~~1t-~~.....,-.,..,..,--,---....;:...,...._ ...... __ +-~.P--A---,,q,~a..::.....,6,£-=~-------Y.....it-..1-1-L/-..LW~:H O 18.
Rt------~~------------------------------------------~--------------1 T
E R
,Signature
\ GENERATOR NO. 2 (Must Accompany Shipment)
Month Day
-
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000294589
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver / iJ5
Recordkeepin~teporting Supervisor
November 17, 2003
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00013 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000294589-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under direct ins ctions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
10 /31 /03 294589-01 CU9614 11 / 13 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000294589-1
: ,,..
, I
k2G
en, :ta:. -EIILl.l
Dltt/Ti• Ia 11/13/13 13s 14
Load Tr,t Rolloff
Trllll)IOrt•r STAT IIC
llUDS1ll IC
I ••••• llctipl f 421379 -llttt
Ftdtnl I EPA ID ~142
1 J --1~ 71 __ rJQn7 J .. ~ ..... ~ '-I ~
ttVElGHT!RJDARY tt
Gl'OII 69861.•
Tant ••
46~~,io lb G. let
\ Adj.
Adj. let
•• •• •• Truck lulhr 112 Trlil•t/ColtDr 11 IT142t j•2 13
Rcpt Doc Docullat Profile Profile GNerator t Cnt Total I DCS Scbed Flderal EPA
Lnl Lnl lulHI' Stltl Iawicing CustOlltl' I Code Quan. Y Units PC8 · Cit lute St1t111
----------------------------------------~l-----,o--,t"/·
l 1 Jllt294S89 CU96H ldlEI aaTY PCB U 1 Cl lf.181:a I lllogru
hllfl'a IC SUia: Yala • I)
Doc Seq I 1 _ DIE SIIAV EffIIDIEITAL P.O. IUI
Scbedllltd Datt 11/13/13 Tilt 15:31711265·1
>511 ta <Sll DEIIIS lCIICLE)
PREFILLED YAULT T llt I (CIICLE>
>511 (II <Sll DC 111 IISPfl:Tlla CClllCLEt
BULi UTERIAL OIi.Ts SAIPLED/IISPBC1!D ________________ FIBE. LlaJJDS DETECTED!
SEL!CT UT!RIAL/U·SELICT OTDJAL fflD DISPERSAL IATDJAL!
ADEil '
PHYSICAL DESCRJmm CF WJSTE: _________________ _.;SDPLEI/APPIOYAL ______ _
SPUF-SAN:-----......... _ -· • 1 _._PHJ& -lGlllmca--·---··-·-----·---____ -_· __ -------•--___________________ __ bD.SCIEII PIE l!8 I _______________________ _
161.SCl!II PCS IE6
821!0.. S F PT/91. 821 mna, . ., m aucrs ___________________________ _
pit CP&P!I> _______________________________ _
Cl_!Dm_•_·_SII.FJIS SCRIEl_+_·_J _______________________ _
ADDfflCIAL WLMCAL DD'D!_T_I __________________________ _
D!SCllll: -----------------------------------PCB allC. (PPI> SULFIDE C9131> Pl'.II m>£ lB2I Bf IF ----CUIIIIE (9811) ___ TAB VAST!_! _I _______________ _
PAllf FILTII iisf, , , SPIC. lilllm Ill a:._m ---------------COIIDIS; ___________ __,.. ____________________ _
CIIIJ>lT. ff.ST 11 ______ m_m_
ADD'L SPOr SdlU lffACDl)t_YJ. ________________________ _
DJ!NW. mD1 S st ST-3 ST-3/PT P·ST-3 P·ST-3/PT ST-5 ST-5/PT P·ST-5 911-PTA B-PII OTDI. _____ _
P-Sf-5/Pf sr-a sr-a,,r 11c BC tnc ~Ji:(.~\ SP-ts PCB-uc ,-1AC
P-ST-a P-Sf·IIPT YS-3 YS-5 YS-a . · r IIJ>ICATm PWIIETD VJU. IE CIIQ.ED · -·-', · \ \ f. .,.
1-uc LOADS mm1I1S 11SP1CT1m TUT m ,oon · TO • LESS TUI :six msr ,1 ,. -\ . , i BB lrnlllED TO w m PUC2D m nn. _____________ ~_, ........ _,,, __ ~· ___ ... _i _\__. __ _
IE.IIASID DISPUW. BY: _________ DATEc ___ _
• .,
WASTE MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
Manifest# Profile Description Gener/Quantity
0000294589 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
***. PAYMENT DU[ 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284 -0606
1.00
1.00
11.81
11 .81
11.81
P.0.#/Unit Bill er
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoice Date: 11/17/2003
Customer#: 695-1442625
Invoice#: 2256-0126587
Page#: 1
Rate Total
Svc Date 11/13/2003
1,000 .00000 1. 000. 00
2,100.00000 2,100 .00
45 .00000 531 .45
1.00000 11.81
5.00000 59.05
Subtotal 3,702 .31
Total Due $3,702 .31
0qrf.# /678'7?',. .io'X.::/t= 703 I
;HAZARDOUS WA.STE MANIFES1\
(As Required By The Alabama Department of Environmental Management) CW!fI
Fonn Approwd. 0MB No. 2050-0039. Expires 9-30-91
2. Page 1
of
Information in the shaded areas is
not required by Federal law.
WARREN COUNTY
RR 4 BOX 426
WARRENTON
A. CWMAument Number 9 4 0 2 Q 3
4.
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
1 .
B. State Generator's ID
US EPA ID Number
US EPA ID Number
H. Faci '° Alabama Highway 17 at Mile Marker 163
Emelle,.Alabama 35459 A L D O O O 6 2 2 4 6 4 2 •9 721
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 12. Con1ainers
No. Type
13.
Total
Quantity
: Q, POLYCHLORINATED BIPHENYLS, SOLID, 9, UH2315, III / / / ~(
14.
Unit
Wt/Vo
I.
Waste No.
e i/3CQ 't -6occs-CWMProfile# cu 9b!'/ • /--+-"'-i-,,,.r-r'w.,&, NH R 1--r::.::..:...:=...:..:!:.!:..:.~.::....:::::::::::::::=:::::::'.:::==:::::::::::::::::=::........::....:..:...:.~.::..:.::.:...::.....:==::::::::::::::::::==::====--J~~~~4"-!.....L:::..L..!~~~L-...:--{......--__:__-I
A
~ Disposal Approval# CWM Profile# ___________ /oJ
C.
Disposal Approval # CWM Profile #
Disposal Approval # CWM Profile #
J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above
. CU9614 ERG-171
Cs D 10/31 /03 V C.
State ol Generation C . b. d.
15. Special Handling Instructions and Addltional Information
Purchase Order# _______________ _
Work Order# :()C,J. ~[• EMERGENCYCONTACT: (800)424··9300
1 6 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international
and national governmental regulations.
&~.··
If I am a large quantity generator. I certify that I have a program in place to reduce the volume and tox1c1ty of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage. or disposal currently available to me which min1m,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to min1m1ze my waste generation and select
the best waste mana ement method that 1s available to me and that I can afford.
Month Day Yaar
~ 1 . ransparter 1 Acknowledgement
A yped Name
N / I : a_.,1,,.._,,
of Receipt of Materials
Signature t
c-<..-,~~-" t..,....._ ~~
0 18.Transporter 2 Acknowledgement of Receipt R1----:-,-...,....,,.---,-....,..,.------------------~--------------------------------T Printed/Typed Name Signature
E
R
Month Day
19.Discrepancy Indication pace f-. J . _ L .J-r >I~ -, -;P-• -· ,/;; ..,,.,f • P · ·
F ¥ fla:/.1iJc~/l,.{£.f'-1tC. (!£:,(.it u:-r_,.. ~-$-:ivy/t/,l,t_c-~_(~;~1lf:'1t~r/' ✓fl-!:.</.;-(..,, t:tJ'
A ·7'•:,j... --;.·. ~2,;;; 4 'f vJ-~fiA):( _a,,.ui,d, .. -( I ~~ac.t,:.•,CW,f/ ~JL-fc·4?,,r, I 1·~1-l,d1 'I\ ~.\,.lit, c ---c,,c,<.,..,, ~ •....... r--t., • ,, ~ -r I r-· I . :, · ·v · · I / .-' V' I, L I _,,.-✓
} 20.Facility Owner or Operator:', Certification of rf<:eipt\of hazardous materials covered by this manifest excep as nqted in Item 19.
yt-,-.,..,.-,--,..,..,.--,--....----------+--------~,,..-.....,...---+--+------+---;__-------:,:,--:-.,,..---..,..,.--1 Printed/Typed Tame , Signature
I. '.\:-\
EPA Form 8700-22 GENERATOR NO. 2 (Must Accompany Shipment)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940203
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264 .12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver / ~
Recordkeepin~ i~orting Supervisor
November 26, 2003
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00012 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940203-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under direct instructions, made the verification that this information is true, accurate and complete. ,,
OSD Unique ID Cont. # Profile Disposed Description
10 / 31 / 03 940203-01 CU9614 11 / 21 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940203-1
,......._. .. ,,,, ~-. ' . , -r" • . t· .. ....... • .. ·,, •
...
en, IJC. • 11ELL1 ::. flftt ltctipt f 42l'35 ttttt
Date/Ti• Ia 11/21/13 ' as~
I.old Tr,e lolloff
Tl'llllpOl'ttr IJIIIE D 11D II:
Fldtnl EPA ID Wll67138891
DWmITE AL
Truck hlllr 215 Trail.tr /Caltar t1 1131
Rcpt Doc Doculnt Profile Profile 6-rator
Lal Lill IUlltr SalN IatOtciag CatOlll'
l 1 1111941213 al96H IAIIEI aQffl PCI LA
lmatOI I:
Doc S.. I · 1 PllE mAV EPIBIEITAL
>5ll ta <Sll DEBRIS (CIICI.E)
PIEFILUJ YAOLT J (I I (CIICLE)
>511 ta <511 UC 1ft lWTtm (CIICLEI au IATDIAL cat: SAIPI.ED/IISPICTIO ____________ ,m Ulllm JEICTIDt
SILECT llTDIALID--SII.ICT llTDIAL 11• DISPIISAL DTIIJALt
YES J m
1ES / ll
dfll I
fflSJCAL IIJDI"1■ IF IASTli _________________ ____,5A&'LEI/AfflOHL. ____ _
SPOT SAIIPl.li_E-____ 1_ms. Dl!DIPfl(I __________________ _
IAD.SCIIII Pm & ! _______________________ _
I&I. !DIii Pm 116
· 121 SL S F Pr/SI. 121 III/TIIP. ll m IEACTS. ___________________________ _
pb CP&PD> ________ I _______________________ _
CI_SCllll_•_-_!D.FIDE Stllll_•_-_I _________________________ _
ADDmllAL WLfflQL IP.U'Dt_YJ. ____ ___.., _____________________ _
DE!DI■: ---------------------------------PCB alE. <PPII ____ SlUlll t9d> ___ Fl'.III QR _________________ _
Jl2t n IP CJAIIDI t911tl TD IAS'IE Y I
PAin FILTEI T!ST/ p , snc. libfln -all&._PPI ---------------COll!IJ'S: . ------------------
aJIPAT. ff.ST ., ________ m_m_
.IDD'L SPOT 5'W ATTACl!Df l 1:,,,....,,..-=-,,-,,,.=""~-=-.,,,...,,,,~,.,,,...,,...,,,,..,,..,,,,,_..,,-,....,,.,.,........,-=,--------------DISPC&L &TD: S SP ST-3 ST·3JPT P-ST-3 P·ST·3JPT ST-5 ST-5/PT P-ST-5 SIJ-PrA t-PII OTJID ------P-ST-5/Pr sr-a ST-am IIC llC (UC IISP!CT), IIC SP-'5 PCI-UC P·UC
P-ST-8 P-sT~a/PT '5-3 YS-5 fS-8
llDICAffl PWMffll ltIU. BE CIJICllD
I-MC LO&DS mutllE IISPICTD TOT di FIUID TO ■ USS 11d 511 et
E IETIIIID TOW AID PLACED (I DD. ________________________ _
REI EASID Fm DISPCEAL lf: ____________ D!TE: ___ _
•
I
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00012
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
W Afil{EN COUNTY PCB LANDFILL
RR.4B~426
W ARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940203-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under (( direct ins_?uctions, made.,. the verification that this information is true, accurate and complete.
/ -
OSD Unique ID Cont.# Profile _ Disposed Description
10 / 31 / 03 940203-01 CU9614'" 11 / 21 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940203-1
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Fonn Approved. 0MB No. 2050-0039. Expires 9-30-91
ZARDOUS 1. Generator's US EPA ID No.
WASTE MANIFEST
ARREH COUNTY PCB LANDFILL
R 4 BOX 426
ARRENTOM
Generator's Phone
NC 27589-9110
252 1257-1713
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
1 .
o. 2. Page 1
I of 1
Information in the shaded areas is
not required by Federal law.
A. CWMAument Number 9 4 Q 2 Q 2
B. State Generator's ID
C. State Transporter's ID
D. Transporter's Phone
E. State Transporter's ID'
H. Facmty's Phone
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O ,,0 0 6 2 2 4 6 4 205 652-9721
12. Containers 11 . US DOT Description (Including Proper Shipping Name. Hazard Class. and ID Number)
No. Type
13.
Total
Quantity
14: , ! i I ;,_,J
~o' '-wast~ No.
~ 8RQ,POLYCHLORINATED BIPHENYLS,SOLID,9,UH2315,III
N
E Disposal Approval#
R
CWM Profile #
A
T
0
R Disposal Approval# cu 9~14
C.
Disposal Approval# CWM Profile#
Disposal Approval# CWM Profile #
J. Additional Descriptions for Materials Listed Above
. CU%14 ERG-171
CJSD ID /2 9·'/0 3
Ne> I" tJ, CA I(() I,µ 9.« I State of Generation
15. Special Handling Instructions and Add~ional Information
Purchase Order_# _______________ _
K. Handling Codes f9r Wastes Listed Above
b. d.
Work Order# fc 9 9 / t.J 0 EMERGENCY CONTACT: ( 800) 424-9300 '
16 GENERATOR'S CERTIFICATION I hereby declare that the contents of this consignment are fully and accurately described above by the proper sh1pp1ng
name, and are class1f1ed, packaged, marked and labeled/placarded, and are 1n all respects 1n proper condition for transport according to applicable 1ntemat1onal
and national governmental regulations.
If I am a large quantity generator, I certify that I havc1i program 1n place to reduce the volume and tox1c1ty of waste gene1rated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage. or di sposal currently available to me which m1n1m,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to mm1m1ze my waste generation and select
the best waste mana ement method that is.available to me and that I can afford.
rinted yped Name ignat e Pa.:t r · c;,j lvt .
T 17.Transparter 1 Acknowledgement of Receipt of Materials Ri---~-~--~~-------------------..----------------------------------1 A Month Day Year .,.., N
/"~.,_ o: t-=-=-,~""-i~,;;,+~-f,:""'"'"""":--'-!''-'-'..4--~~~-~-:--:--~----..._-----:,-.a;.-t'e.....,.'----+-f--.;-"'....:.__,,;;;...:;;,e..:---4 _______ __,,+-~ ...... ..a.."--"-=i...-t of Receipt of Materials
R t---=""-:--,-,..---::--:-:---------------------..-=---------------------------,,-:--:----:::----:-----11 T Signature Month Day Year
E
C R
EPA Form 8700-22 (Rev. 9-86) Previous ed~ion is obsolete. GENERATOR NO. 2 (Must Accompany Shipment!_
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940202
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264 .12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AH'vVMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorn thy Olim l/ If
Recordkeeping {: Reporting Supervisor
November 05, 2003
WM
Waste Management, Inc.
•, Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00011 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940202-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under direct instru tions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
10 / 29 / 03 940202-01 CU9614 11 / 3 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940202-1
e
WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Manifest# Profile Description Gener/Quantity
0000940202 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
*** PAYMENT DUE ~O DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
1.00
1.00
10.39
10.39
10 .39
P.0.#/Unit Bill er
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoice Date: 11 /07/2003
Customer#: 695-1442625
Invoice#: 2256-0126434
Page #: 1
Rate Total
Svc Date 11/03/2003
1,000.00000 1.000.00
2,100.00000 2,100.00
45.00000 467.55
1.00000 10.39
5.00000 51.95
Subtotal 3,629.89
Total Due $3,629.89
. '"
., , en. IX. • EIIIUE
Date/Tl• 11 11/t3/13 9:13
Load Tri-lolloff
Tnuporttr &'TAT IE ... IU!D
HIit ltaipt' . 421121 11111
•
Faral f7A ID ~142
IC
Truck lulNr 112 Tniltr/CoGt11r fl 231 12 13
0)
1
u IElGIT SUIIIURY 11
6rOl8 68.%1 ••
Tare ••
ltt ••
Adj. ••
Adj. let •■
ltcpt Doc Dooulmt Profile Profilt Generator C4t Cat Total_ I })(iS -.• ')f)()7iScbld ~ F1I G
Lal Lal lnHr s.J.11 Invoiciag CutOllr ii Codt ~.~ Y iaitQ.) 'l'Cl~Cat lutt Stata ADEii I
---~ -~-.. ;;;;;; ~~;-,;;,;-~·;·;:. .J~ -~-= ;--~-y ~ i\ ~~;; ...
IOllEl'IOI IE SUtlfc'Talut • ■ \ ['6 U
Doc Seq I 1 El£ SllV f.fflDIEITAL P.O. IUI QI) Rlq'd
Schldaled Dltt 11113/13 Till 15i31 699146·1 ,_
>511 OR <511 DEBRIS <CIICLE>
PRml.LED YAULT T OR I CCillU>
>511 ta <511 DC llX ~ (CIRCLE>
BULi IATF.IIAL CILT: ' _,,,,,.-Sl!IPL!D/IISPECTED __ i1 ________ _.FIEE UCIUlllS DITF.C1'EDt YES / I>
SELF.Cr OTF.IIALID·SF.llt'F OTDIAL. ______ IIID DISPEISAL OTDIAL! YES / IIJ
PHYSICAL DEDIPTitw II' IASTE: __________________ SdPLFJ/APPIOYAL ____ _
SPOr SAIJPI.I: • __ __, ___ , ms. -,aimm
,. ... ' ---SCl!El-,-~,m; -----~-•••· :::.:., I~,-_-_-__ ._----_•_•• _-•·:-s:-:3!•:-•:'-::_• .... _._. _. _____________ _
181.9:11!!1 m; IE6 ma s , n,n 12t IXIIT!IP. 11> m mcrs ___________________________ _
pb IPAPEl> _______ -.--1 __ __.. ____________________ _
CI_SCIIB!I_+_• _SlUlD£ SQBD_+_•_I _________ ---------------ADDiflllAL WLfflCAL l!D'Dt_J_I. __________________________ _
ID'.IIIII: _______________ ..,__-,__ _______________ _
PCJ ale. CPPI> ____ . SUl1IDE (9131>____ ,-ail -••-o ,: ,-• -/
IJl28 BJ IF CYBIi! C911t) TAl'l&ST! "Y I ' ,, ·' ---------------PA m FIi.TD D'ST/ P F SPf.C. &IAYiff ll'Z cm:._PPII ----...------------ctll!ITS: __________________ -----___ .,_. -------------
' ) I
ADD'L SPOf S1JIPLE Aff ACIIEDf _t_l _
DISPmW. IIITBOlh S SP ST-3 ST-3/Pf P-st-3 P-ST-3/PT ST-5 ST-5/PT p .. Sf-5 Sll·PTA l·PD OTIIBI. ____ _
P-ST-5/PT ST-a ST-8/PT IIC DC toe IISPICT) F IIC SP-'5 PCB·IAC P·IIAC
P-ST-8 P-ST-8/PT YS-3 YS-5 '5-8
IIDICAfll PWIIETEI IIU. ■ CIIQJ!D
1--JflC UlADS RJIIIIE IISPICTltw THAT lB FfllD TO Bl USS 11d 511 IUST Bl IEnlE TO UB AID PLACED (I DD. ________________________ _
1£1.IASID Fm DISPtal. BY, ________ DATE: ___ _
I ! I
t ,: . / 1h \'-, .
/_/ (_.i ;\ .. -
I
H AZAR DOU S WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) CWKI
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459
1 . US EPA ID Number
ALD00062
11 . US DOT Description (Including Proper Shipping Nama, Hazard Class. and ID Number)
A. cWMAument Number 9 4 0 O 1
8. State Generator's ID
C. State T ransporte(s ID u~~-----------~ 1 D. Transporte(s Phone
No.
13.
Total
Quantity
14. Unit
Wt/Vo
I.
Waste No.
:
8RQ,POLYCHLORINATED BIPHEHYLS,SOLID ~9,UN2315,III
N
E Disposal Approval# i 1"3 00 lf-0000 S' CWM Profile # C 'tr °f ~ / I-/
R ~::::.::=-.:.~.:;.:.:::.::...:::::::::=::==::::::::::===:=-----=-:.:.:.:.:..:..:.:.:=..::-===:::::::::::::::::::::::===~~:'._l:~::....l!....f.~!:::..J.::::..J.:::::::..L~~....:j!!i.------f
A
T
0
R Disposal Approval # CWM Profile# __________ _
C.
Disposal Approval # CWM Profile#
Disposal Approval# CWM Profile# __________ _
J. Additional Descriptions for Materials Listed Above K. H ling Codes for Wastes Listed Above
• CU9614 · ERG-171
OS'D JOj').1/03 a. C.
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase'Order # _______________ _
Work Order# EMERGENCY CONTACT: [phone]
16 GENERATOR'S CERTIFICATION: I hereby declare that the contents olthis consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator, I certify that I hava a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which min1m1zes the present.and
future threat to huro.__a n health and the environment; OR. if I am a small quantity genera1or, I have made a good fa,th effort to minimize my waste generation and select
the best waste mana ~ement method that 1s available to me and that I can afford.
rinted yped Name Signat Year
Pa.tr-,c,e-.,' f"f Ba~'t:us,. ' ~
T 17.Transporter 1 Acknowledgement of Materials
: t--,..r:cin:::-:t"'ed:.;,..-yped=;;--;N:r:a:-"!!m::ce:-------lc.::-----------,;;c----:-....--------,,,---:,4'-'"7''-----------:-:---:-:,---::-----:-:----t
i :r »mEs
o 18.Transporter 2 Acknowledgement Receipt ~ t--""Pr..,.in--:t-ed..,./T=-ypect--:--:N"'"a_m_e-----------------,-r.:,,.-.,,._----------------------:-M-:-o-n--:th,--""D-ay---:Y-:-e-a-tr
E
R
EPA Form 8700-22 (Rev. 9-86) Previous edition is obsolete.
Item 19.
GENERATOR NO. 2 (Must Accompany Shipment)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00010 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940201-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under clirect in ctions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
10 / 21 / 03 940201-01 CU9614 10 / 30 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940201-1
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940201
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264 .12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dornthy Olim /;13
Recordkeeping and Reporting Supervisor
November 06, 2003
" WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Manifest#
0000940201
Profile Description Gener/Quantity
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MON ITORING FEE
SUMTER COUNTY FEE
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
1.00
1.00
13 .47
13 .47
13.47
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284 -0606
P.0 .#/Unit Bi 11 er
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoice Date: 10/31/2003
Customer#: 695-1442625
Invoice#: 2256-0126390
Page#: 1
Rate Total
Svc Date 10/30/2003
1,000 .00000 1. 000. 00
2,100 .00000 2,100.00
45 .00000 606 .15
1.00000 13.47
5.00000 67.35
Subtota l 3,786 .97
Total Due $3,786.97
k28
co, ta:. • EIEU.I
Datt/Tile Io 11/31/13 7:24
Load Type lolloff
Tnu,omr STAT IIE ... IE
Truck IUlltr 112 Tntler/Coetar 11 67
••••• 'llc:lpipt f 421918 •••••
Fl!dtral f.Pl ID D981799142
'
12 /)' · 13 !
' \
\
Rapt Doc Docultat Profiw ProfU• Gliltrator
. Lftt Lnl lulNr S.lN Intoicllg Cultoler
' ~t Cat
'Codi
U~9-"8 . · .::. Jn--::a "O .. Total · DCS" -L OJ Scllld~ .,
Quan. 'Unit, PCI Cat M• StatJ
•••• ••• ···-···· ·····-· ······-··-·····-·· ------· J"Z:l::?}::;::, -·-'·-~ -·---·-· --····------
1 1 111f.K1211 CU!lfiM UIIEI Qlffl Pel LA 1 Cl 1&111.11 I lilogru J Pl.Fl UadttKliDllw
VAIIDQ IE SJla: falw • I> ~
Doc Seq I 1 .. fJE SIAV EkfDORDTa&. P.O. la ()
Sdlld'lllld Date 11/a/13 Ti• 15s31691823-1 -~~
>511 m <Sll DEBIIS CCIICL£) L7'
PIEFII.Ul) f&til.T J la I (CIRCLE>
>511 ■ <511 DC lfl IISftt\'ltll lCim>
Ill bTEIUL Im.ti SdPLED/llSPICl'ED __________ __,PID UGUIDS D!i!CJ'ED! YES / aJ
1ilLECT llTDUL/D-slt.BCf IIAT!IIJL ____ ...,...._IIID DISPl&l. llTDUL! 1F.S / _,
.. ~-SUIIUIY ..
Gl'CMI , 72261. N
Tart r .N
ltt .•
\ Adj. .N
'itfj/ltt ••
ADEi t
1131M-tlm
QJ) llq'd
PIJSIC&L n.11"1(1 Cl' IASTEs _________________ ____....S&IPLII/APPDAL ______ _
SP01' SOPL!l......:..=iiJ-----___ . t:Jll!S;-,.lailIPTJ■. ___ ------~*-*-·· ------UD.SClll!I pm;. II& l _ __........., ____________________ _
IGL Dlil!I Pm II&
821 sm.. S F PT /Sil. 1121 mna, . ., m IEACTS ___________________________ _
ph CPAPD> ____ -___ I _______________________ _
CI_SCIEll_+_•_SULnJlE SCIIII_•_-_, _________ ---------------ADDin(IAL WLfflCM. l!D'Dt_Y_I ____________________________ _ OISCllBEs ________________________________ _
PCI CDC. CPPI>_-___ SIUI1I C9131> ___ Pml am _________________ _
1821 IT IF CUIIIII (9111J TAI VAST! t I PAIIT mm TEST/ , , SPF.&. mnn ll'l as._m ______________ _
aJIIIDTS11 •. -------------------..
allPAT. TIST v, ______ m_m...:.:
llll>'L SPOT SdPLE ,i1TAClll>t_Y_:,_J ________________________ _
IU8Nal. 111111 I Jf at-S at-SM t'-1\'".'3 P..aT-31Pf ST-5 ST .. ~PT ,-a,-s • ..,,, l·Pll mm ____ _
P·ST-51PT ST-8 ST-am ~ llC UC:CUC DSPIC'I> Flit SP-YS Pr.I-UC P-UC
•· _.. P-ST-8 P·ST.;,1/PT YS-3' YS-5 YS-8 1 ·
· 11DICATii PWlml VIU. 8 CUCLED
B·UC LOADS IIIIJllil6 IISPP.CT1(1 TllT di FtllD TO IE Lm TOI 51l UT
IE REnlllD TO W AID PUa!> (I Ill.I). . ----------R'BJ nsan ,. DISPOSAL n: ______ -___,D!TI: ___ _
..
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) CW!'II
~lease print or type. Form Approved. 0MB No. 2050-0039. Expires 9-30-91
WARREN COUNTY
RR 4 BOX 426 WARRENTON
4.
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
1 . US EPA ID Number
2. Page 1
of
Information in the shaded areas is
not required by Federal law.
A. State ManWest Document Number
CWMA 940 205
B. State Generator'$ ID
H. Facility's Phone
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6 4 205 652•9721
12. Containers 11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
No. Type
13.
Total
Quantity
14.
Unit
Wt/Vo
,. I.
Waste No. ! Q, POLi'CHL,~NATEO B
1
IPHE~LS, SOLID, 9, UN2315, III
: i-;:Dis::'.:p.:.:osa=l..:..:A!:!pp::.:ro:.::va::..I #:.:....=i '=J=O=~==l=-=~==w.=~=· =......:.C:..:.W.:..:.:M::....:P...:..:ro::.:.file:::....::...# =c=v==9=G=/=1-.=/====-~L...l=...::~J)~T'~'cl...!::8'..l.· ~():J..!O:::.i..!04 K_' ---4 __ N __ H __ -I
A
T
0
~ ~ ,r q /o:i
A Disposal Approval# CWM Profile #
C.
Disposal Approval # CWM Profile #
Disposal Approval# CWM Profile#
J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above
• CU9614 ERG-111
OSD 10/13/ 03 a. c.
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order# EMERGENCY CONTACT: [phone]
16 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condrtion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator, I certify that I have a program 1n place to reduce the vol ume and tox1c1ty of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which min1m,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to mm,m1ze my waste generation and sel'ect
the best waste mana ement method that 1s available to me and that I can afford.
Printed yped Name s~· na re A . . d,.t y i c. i" f.l... M. 13~ Cle: t..<..S 'tt:4 ..... -t,,l..a.,,,,
Month Day Year
~ 17.Transporter 1 Acknowledgement of Receipt of Materials
A Printed y,ped Name Signature _../·, i ..,__._o_-_r?_v_·,_d.......:1.,;;::;0...;.#..;.,' ..;:;L_I l""'_)'-------------'----=--;...,.,.,.:.C;,;;;,,k..;;:;..:_l-=-~..;....----------~......,;;...i.;;...-'-'-.,__..__.
O 18.Transporter 2 Acknowledgement of Receipt of Materials ~ t---..P,..,ri~n,..ted-,-,/T"'yped--,--:,N,-a_m_e __________________ r-:S,-ig_n_a-tu_r_e _____________________ -:M-::o-n_t,..h----,D=-a-y--:Yc-e-a--11r
E A
19.Discrepancy Indication Space
GENERATOR NO. 2
1
{Must Accompany Shipment)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940205
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264 .12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver fa ./ 6
Record.keeping a~ ;;porting Supervisor
November 03, 2003
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00009 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940205-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under d"rect ins ptions, made the verifica ·on that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
10 / 13 / 03 940205-01 CU9614 10 / 28 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940205-1
. """'~ WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENT AL
ATTN : ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Manifest# Profile Description Gener/Quantity
0000940205 CU9614 PCB LANDFI LL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOI CE***
THANK YOU FOR YOUR BUSINESS 1
Remit to : WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
21.68
1.00
P.0.#/Unit Biller
197159 RWILLIAM
TSCA TONS
TRIP
Invoice Date: 10/28/2003
Customer#: 695-1442625
Invoice#: 2256-0126248
Page#: 1
Rate Total
Svc Date 10/28/2003
ll0.00000 2.384.80
2.100.00000 2.100.00
Subtota l 4,484.80
Total Due $4,484.80
__ , __ ----------------
k28 '
CD, lit. • EIIBLLE
Datt/Tilll In 11/28/13 7:52
Load Type <Qlll61~""--¥
Tl'IDlpOrt.r R088IE D 111D Ia:
DOLOIITE AL
Truck 11111hr 122 Trailer/Coatar fl 329
Rcpt Doc Doculeat Profile Profile GeDerator
Lal Lat lulfff Sa1N Invoicilg CustOltr
1 1 INt.Mt2t5 e&l4 vma mm PCB u
VARIEmll a;
Doc S.. t 1 00: SRlV EITIIIOlmTli.
>51% OR <Sll DEIIIIS (CIRCLE>
PREFILLED YAIILT J OR I (CIRCLE)
>Sll OR <Sll UC 1ft IISPu:Tllll (C'IRCLEJ
BULi llTDIAL OIL'fs
~
:·-'
ttttt l!ctipt, 421837 fftff
12 13
Cnt Cot Total V DCS ~
I Code Quan. Y Unite PCB Cat Vast. Status
---'r,"f ------------
1 1-.■ I lilogra■ Y Pl.Fl Undtter■indle
SUl(,t ,11. -.,
P.O. 1111
!WIPLED/llSPIC'IED __________ ____,Fm LllllDS DETECTED! TIS Im
TIS/ I> SELF.CT ll!TEIIlJ.ID-SWCT IA111UL VJID DISPERSAL IIATEIIAL!
It fflGIT SUIOIO'f H
Groa 76841.•
Tare .N
ltt ••
Adj. •■
Adj. •t .N
ADEii' ,------
ax, leq'd
PBYSICAL D!DIPT1(1 IJ1 VASTEt SdPLEll.lfPIOYAL --------------------------
SPOT SAIIPLli_Bl'J-_____ ._ms. DESCIImm ____ --------------------RAD.SCIIED Pm IE6 I ________________________ _
161.SCIEEI Pm 116
82191.. S F PT/SIJ. Jl2t DI/TIIIP. a> DI REACTS._-__________________________ _
pb CPAPl!ll __________________________________ _
CI_SCIDJ_•_-_SIUJDE SCIIEI_•_-_, ________________________ ..,..
_ADDin(IAL WLmCAL IED'D!_J_I. __________________________ _
DE!DJBE: ___________________________________ _
PCB aac. ,m, ____ SIUIDE (9131) ___ Flllll C(IE __________________ _
D21 BY IF_____ CJAID C9111J TAB VAST! 'f I PAIIT FILTEI TEST/ P F SPEC. SUYIT'f BIZ QIIC._PPI ______________ _ CCIIJIElrs, ________________________________ _
allPAT. TEST 1/ ________ m_m_
ADD'L SPOr SAJIPL£ ATTACBED!_t_l _________________________ _
DINA!. mD1 S SP ST-3 ST-3/PT P..ST-3 P..ST-3/PT ST-5 ST-5/PT P-ST-5 Sil-PTA B·PJI OTREI _______ _
P-BT-5/Pf Bf-I Bt-6/Pf UC UC tilt JIIKC'f) f IIC SP-ts Pel-DC P·IIAC
P·ST-8 P-ST-8/PT YS-3 YS-5 '5-8
IIDICATM PWDTD VJU. IE CJICLID
B·IIAC LOADS &IDJI& JISPECTI■ flllT All FCIJID TO Ill Lm Tlld 511 IIUSJ' B! fflUIIIID TO UB dD PLACID ■ BD. __________________________ _
REI-EASED Q DISfflW. 81: __________ DAtt: ___ _
f.
..
., .... ..,-
(Form designed for use on elite (12-pitch) typewriter.) Fonn Approwd. 0MB No. 2050-0039. Expires 9-30-91
HAZARDOUS 1. Generator's US EPA ID No.
WASTE MANIFEST 2. Page 1
of
Information in the shaded areas is
not required by Federal law.
RREN COUNTY
4 BOX 426
RREN'fOH NC 27589-9110
252 1257-1713
ame
INC.
ame
ress
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459
US EPA ID Number
1 . US EPA ID Number ,., .... ·: ~ ,,\ ,.1_\' ,1./_i. \) I l
A L D O O O 6 2 2·
11. US DOT Description (Including Proper Shipping Name. Hazard Cless, and ID Number)
: Q,POLYCHLORIHATED BIPHENYLS.SOLID,9,UN2315,III
N
A. State Manttest Document Number
CWMA
B. State Generator's ID
C. Stele Transporter's ID
1 D. Transporter's Phone .
E. Stele Transporter's ID
r's Phone
14. Unit
Wt/Vo
940200
I.
Waste No.
E / [J()()L/,-,Q{)C()/f( CWM Profile# C 1J 9C;i / J../ R ~::!:::~'.:'.::.:.=.::-=::::=~==:~==:~::......::.:.:.::.:..:..:.:::.:.::.:::...=:=::'.::~::::::::::=::::===~:..J::.J:~...J::...µ_..!E.L!..::L.!::::'.1..!4-~-+-~--1
A
T
0 R Disposal Approval#
C.
Disposal Approval#
Disposal Approval #
CWM Profile#
CWM Profile #
CWM Profile# __________ _
J. Additional Descriptions for Materials Listed Above I
/1
I
I
K. Handling Codes for Wastes Listed Above CU9614 ERG-171 ,
O~D q /18/03 ~ C.
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order# 69735""'/ EMERGENCY CONTACT: < 800 l 424··9300
1 6 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condijion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I certify that I have a program 1n place to reduce the volume and tox1c1ty of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage. or disposal currently available to me which m1n1m1zes the present and
future threat to hlJ man health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select
the best waste mana ement method that 1s available to me and that I ca n afford.
rinted yped Name Signature Month Year
R~tri c/0-M Bo, . ku..
T of Materials
: r--l!rn'.=z!::n;..-:::::::nr..-::=~-r--.-------------,;::c:---:-:-T-:"--,,------r---,f--------------:-M:-o-n-:th-D-=a-y--:~c:-e-a--tr
N s p t-,-,,--,!1--...... =-----~-,-.,.... ...... __, ..... __ ..... ___________ ..__..,._-;:::="-----'-+""--'---------------' .............................. """"' o r1 a.Transporter 2 Acknowledgement of Receipt of Materials R1---:-e---,--,=.-----,--,-,---------------~---~------------------------------T Printed/Typed Name Signature Month Day Year E R
19.Discrepancy Indication Space ,
l _j//!,t.rJ;.J,:,{jf;f_}t,{< 1(,> (:..it Ul C { / H • (t. t u/1-a tr t( l cl il/u ~~() c,._J J,../J C c:dJ !.l u (.//l 1 ,fLe,-.,, 1 /~u._l ,l_>;d(k' ?1 lu.A l0u),, l)l7e;p:j I r -',
+ 20.Facility O materials covered ljY this manifest Y 1---P""r.,.in-:t-ed7/T=-+---:-:.,----------.----+--------.-o:S.,-ig-n-at-u-re __ __,/ _____ ,__ __________________ __
l
EPA Form 8700-22 GENERATOR NO. 2 (Must Accompany Shipment)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00008 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940200-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under m the veri 1cation that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
9 I 18 / 03 940200-01 CU9614 10 / 17 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940200-1
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940200
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264 .12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Olive/4
Recordkeeping and Reporting Supervisor
October 23, 2003
~-~-~-~~-------.~~-, '\~. -. , . ·-'
Htfl 1
Fldtnl EPA IO Wll61138891
•• IIIGIIT 5UIIIIART H
Groll 63121..
Tr11Ctlultr2M
AL
Trailer~Coltar fl 3115
lcJt Doc Doclllent Profit. Profile Gtnentor
Lat Lit 111hr SllN I1wiciag Cllltowr
l l ..._ Ql9614 UlltJ aaTY PCB LA
VAUDTtl a;
12
Cnt Cat
'Code
1 Cl
13
Tan
ltt
jdj.
'
\ Adi. ltt
. ----. l. -:., I i. '--V DCS Soblcf Fara! EPA
, Units re, eat _,IIIIAj~N,'ue iit--t17--20G.1 _____ .Ji? ______ : ___ _
I lilogru T PU1 Uldttlrlinule 113114-tllS
I) .
•• •• •• ••
. Doc S.. I l EH SIAV ElfIIIBDTAL . ~lauu QlO ltq'd
>Sll m <Sll DEBIIS (CIICLE>
PIEFILLED Y&ll.T Tm I (Cil£LE>
. >Sll m ~ll UC 1ft IIISPD:TI<II (CIICLE)
IU llTEIIlL OILY:
SOPLED, tlSPICTID __________ ---.:nll UCIJlllS DETD!11D1
SILF.C'r llTEIUL/D-SII.ICT IATDIAL IJID DISPIISAL IATDI11.!
llS / ll n:s /.,
PIJSJCAL DE!DIPTI!a (F VASTE, __________________ __,SdPLD/APPIO'f.&L _______ _
1 SPOT SAIIPLl:_JE-________ ,_ms. DISQJmm. ___________________ _
UD.SCl!EI Pm 11!6 t ________________________ _
1■.scam rm DG
1121 !IL ' S F PT/SL ._121 mrm, . ., m mas ______________________________ _
pb CPAP!ll _________ --------------------------Cl_sal!Zl_•_-_SIUJ■ SCll!ll_•_-_f _________ ----------------&DDITim&L WLfflCAL IEQ'D!_Y_I. __________________________ _
Dl!SCIIE, _________________________________ _
PCB .cmc. ,,,., ____ !Ulm <9131> ___ mm all!. _________________ _
ml n IF CJAIJ■ (9111) TAI UST! J I
PAJIT nun TESr/ p F SPIC. &IAYITY BIZ aac._PPI ----------------antl'l'S: ________________________________ _
aJIPAT. TPSf V/ _______ m_m_
ADO'L SfOT SdPLE AlTM:l!Dt_J_I ________________________ _
DJSPCmL UTD: S SP ST-3 ST-3/PT P-ST-3 P-ST-3/PT ST-5 ST-5/PT P·ST-5 Sil-PTA I-PD 01'1111. _____ _
,-sr-sm ST-8 ST-8/PT IJC UC cue JISPl!CT) F IS SP-YS PCB-IAC P-IAC
P·ST-8 P-ST-8/PT fS-3 YS-5 YS-8
IIDlr.Atm PWIETII IJU. ■ CIIQJI)
8-IAC LOAl6 lflmtll6 IJSPICTlla tilt .&II fflllD TO ■ LISS TUI 511 111ST Bl 1111111D TO UB AID PUCID m 11.D. _______________________ _
RElhSED Fm DJSPmAL BY: __________ DATEi ___ _
WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
SHAW ENV IRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Manifest#
0000940200
Profile Description Gener/Quantity
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
*** PAYMrnT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS 1
1.00
1.00
13.30
13.30
13 .30
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
P.0.#/Unit Biller
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoice Date: 10/22/2003
Customer#: 695-1442625
Invoice#: 2256-0126005
Page#: 1
Rate Total
Svc Date 10/17/2003
1.000.00000 1. 000. 00
2,100.00000 2,100 .00
45.00000 598.50
1.00000 13.30
5.00000 66.50
Subtotal 3,778.30
Total Due $3. 778.30
.... ----=---~-·~__..1-d-~~--1..,-p;~.-, f-.0~1-j-~-e~ t.r;;_iJ"'t{~
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) CWKI
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Fonn Approved. 0MB No. 2050-0039. Expires 9-30-91
a11ng
WARREN COUNTY PCB LANDFILL
RR 4 BOX 426
1. Generator's US EPA ID No.
WARRENTON ·NC 27589-9110
4.
ress
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facil ity
1 .
{ ! t
US EPA ID Number
US EPA ID Number
2. Page 1 Information in the shaded areas is
of not required by Federal law.
A.CWMAumentNumber 940199
/ /3. State Generator's 10
t
G. State Facilty's ID
H. Facility's Phone
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 ALD00062 2 4 6 4 205 652-9721
-··-1'. ·1 •.• ) 12. Containers
11 . US DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number)
No. Type
13.
Total
,.., Quan~ltv
14.
Unit
Wt/Vo Waste N,..Q..
G '.?' _._,.;, ! Q,POLYGHLORIHATED BIPHENYLS,SOLID,9,UH2315,III 30 z ~~?. ,i/.P
: ~c.:.=:.~.:..:..::..::...=/J=3=D=D=l/=-=C(;~tfJ=S-=-.:...:.CW..:..:..:M.:...:..:P.:...:..:rof.:.:.:..ile..:..:..:# =C=U=9:::::::::::::l, =' 'i====--J=-..~~...J:!..+.J-L.1..!=ts..L!G~o l...!::o'-f------1--N -H_-----I
A
T
0
R Disposal Approval # CWM Profile #
C.
Disposal Approval #· CWM Profile#
CWM Profile #
Additional Descriptions for Materials Listed Above
. CU9614 ERG-171
0.$1.) 7/:J~/03
State of Generation
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order#-,; 6 9 4 }S 4 EMERGENCY CONTACT:
K. Handling Codes for Wastes Listed Above
' \
C.
b. d.
{800}424-9300
16 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condijion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I certify that I have a program in place to reduce the volume and 1ox1c11y of waste generated 10 the degree I have determined 10 be
economically practicable and that I have selected the practicable method of treatment. storage. or disposal currently available 10 me which m1n1m,zes the present and
future threat to human health and the environment; OR, if I am a small quantity generator, I have made a good faith effort to m1n1m1ze my waste generation and select
the best waste mana ement method that 1s available 10 me and that I can afford.
nnted yped Name igna re Pa.t.r-, c., c-... f',1 .
Year
; I I leH.:!.,v
EPA Form 8700-22 (Rev. 9-86) Previous edition is obsolete. GENERATOR NO. 2 (Must Accompany Shipment)
•. I
,.
S a W The Shaw Group Inc:"
Waste Management
P.O. Box 55
Emelle, AL 35459
Attn: Carol Weldon
Re: Manifest# 940199/00007
Weight discrepancy
Carol,
Shaw Environmental & Infrastructure, Inc.
Box 426 Route 4
Warrenton, NC 27589
252-257-3603
FAX [phone]
I understand that the roll-off load from the Warren County PCB Landfill Project that was
accompanied by the above referenced manifest had a bulk weight discrepancy.
By issuance of this letter, I authorize you to covert my estimated manifest weight (we don't
have a scale on site) to the actual scale weight.
Sincerely,
Shaw E&I, Inc.
David Ditcher
Project Superintendent
Oct-02·03 02:45pm Frcm·CWM CUSTOLER SERVICE 205652828Q
WASTE MANAGEMENT
P.O. BOX 55
HWY . 17 @MILEMARKER 163
EMELLE , AL 35459
T-751 P 01/01 F-928
PHONE: [phone] OR 205 /652-81.55
FAX: [phone] OR 205 /652-8102
Dave Ditcher/Shaw
252-257-4218
!'HON c N l" MllI!lt:
Wart~ Counry PCB Land611->-10%
Bulk Wt. Discu.,--pancy
FAX COVER SHEET
FROM,
Carol Weldon
10/02/03
ribe manifested weight for MF#940199/00007 is 16,000 K The act'..w scale weight
Converted to K is 13,735. Plea:ie give u~ auchorization ro convc:rt the manifested weigbt
to the actual scale wcighr.
If you have any questions, please give me a call
TI1anksl
'WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00007 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940199-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under m irect instructions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
7 / 25 / 03 940199-01 CU9614 10 / 1 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940199-1
·wM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy I copies for Alabama Manifest Numbers:
CWMA-0000940199
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver / {!5
Recordkeepin~~porting Supervisor
October 08, 2003
VIIVI.
''WASTE MANAGEMENT
, WASTE MANAGEMENT .·
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ OB691-1904
Manifest#
0000940199
Profile Description Gener /Quantity
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS'
1.00
1.00
15.14
15.14
15 .14
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
P.0.#/Unit Bill er
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoice Date: 10/07/2003
Customer#: 695-1442625
Invoice#:
Page#:
Rate
Svc Date
1,000.00000
2,100.00000
45.00000
1.00000
5.00000
Subtota 1
Total Due
2256-0125772
1
Total
10/01/2003
1. 000. 00
2,100.00
681.30
15.14
75.70
3,872.14
$3,872.14
·I' ._, , I . ~ ... #n ... ➔ -. . ..
icae ;~ . ..-i,;~
CW,IK.-RmU ''''' llc:eipt t 421211 '''" Page-1 ·-Datt/Ti• h 11/11/13 7:N
I.old Type lolloff
Tnuporttr I08ll£ D IIOOD IE
Flderal t1A ID Wll61138891
IWllm AL
Truck luHr 214 Tniltr/Coatar ft 26846
Rcpt Doc Dacullllt Profilat Profllt Glntntor
Lat Lal luhr Sl1N ln,oiciag CustOllr
12 fl
Cit Cat Total V DCS
f Codt Quu. f Ualtt PCB ---~ -~-.. ;;;;i;; ~~;-,;;·;;;·;-~ . --~ -~-~s;--~i~ ··;
•AIIIEIT'm a; ace ,11 .. -m
Doc Sell f 1 aE SUV EltirmTaL P.O. hi
>51X (I <511 DE81IS <Cita.E>
.PIEFtl.UD Ylll.T T (I I (CIRCLE>
>511 Cl <511 IIAC 1ft IISPltTD <CIICLE> au IIATFJUL CIILY: SdPLEDJIISPICTEl>. ______________ Fm UIIJIDS fm!CIBDt
SILECT DTDUL/D·Sll.!CT bff.lIAL · VIID DISPDS&L bTDIAL!
n mGIT SUIQIAlf ..
&roll 67948.N
Tare .N
ltt ~-
Adj. ••
':'>,-:, Adj. ltt • N
• / J ;:: f"'..;/6~·
,.. ' ~-·· ,,,) \ ..•. / . 'l..J~
ScMd Fldtttl WA b 6
~--~'lc,,~o ~-~
PU1 UJdtttr11aallt 113114-IIIS
PIYSICAL IIDIPTIOI Cf ~------------------SAIPLD/APPIOHL._ ___ _
SPOT SdPLl:_813-____ ,_ms. .-imm. __________________ _
. UD.SCll'J'.I .,· Pm 1116 ' ! _______________________ _
.. ISLDIII --~-• h ll2t SL S F PTIS(L 121 ml'IEIIP. • 111 mcrs. ___________________________ _
pb (P8). _________ • __ ......., ____________________ _
CI_SCIBII_+_;_• _SIJIIIDE !DIEl~•-·_t _____________________ ..,,-. __
AOOmllAL WLmCAL ll!D'D!_Y_I. _____ ...__ ____________________ _
llBSCIJE:. ________________________________ _
PCB cs. emu ____ SIUIDE t913t> _____ mm all£. ___________________ _
1821 IT IF CYWDE C9111> TAB IAS'II Y I ,,m ,nm TFS/ , , snc. mmt m CDE._m ______________ _
allEl'IS: ________________________________ _
CCIIPAT. TF.sr 11 ______ ,Cl_m_
ADD'L SPOT SAIPL! ATTM'.IEl>t Y 1._..,,.,,....,........,.,,,.......,,,,,,..,,,,,...,,,...,,,,,...,,..,,,.,,,...,,,_.,,...,,.-.,,....,,,...,..,,,.,,......,,,~,------------DISPCBIL UTD: S SP ST-3 ST-3/PT P-ST-3 P-ST-3/PT ST-5 ST-5/PT P-ST-5 Sil-PTA B-PII OTIID ·------P-ST-MT ST-8 ST-am IIC DC (DC JISPECT) F IE SP-'5 IQ-DC P-IAC
P·ST"'.8 P·ST-8/PT fS-3 YS-5 YS-8
1DJCA111 ,...,_ VJU. IE CIICU'D
8-bC LOAm 1111111.l■ IIISPECTl(I TIAT DE FIIID TO 8 L& Tbl 511 JllBf Bl liEtidl) TO LAB OD PUCED 111 IU. ________________________ _
REJ IASD Q DISPOSAL BY: ____________ DATE: ___ _
).
loacf=# /6°1/?3 i]ox.qt.; _305-z_
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) CWMI
Please print or type. (€~~dflsi1ned for use on tJlite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Explres 9-30-91
HAZAR.DOUS 1. Generator's US EPA ID No.
WASTE MANIFEST
.RREN COUNTY
4 BOX 426
RRt.:NTOH
Generator's Phone
NC 27589-9110
252 1257-1713
ame
INC.
ame
ress
CHEMICAL WASTE MANA(SEMENT, INC.
Emelle Facility
1 .
US EPA 10 Number
US EPA ID Number
Information in the shaded areas is
not required by Federal law.
A. State ManWest Document Number
CWMA·
B. State Generator's ID
-:-,:; l'/Y' ,U .}.ij} HJ fJ
C. State Transporter's ID
r's,Bfione
H. Facility's Phone
94019&
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6 4 205 652-9721
11. US DOT Description (Including Proper Shipping Name. Hazard Class. and ID Number) 12. Containers 13. 14. I. Total Unit
No. Quantity Wt/Vo Waste No. or.::------------------------------------t----r~~t-------r---i----------1 e .Q,POLYCHLORINATED BIPHENYLS,SOLID,9,UN2315,III
Type
;}?,,.,ALI --c c-C"7T 9bl'.J = ~D:.:;isp'.:..:o:.:sa=l::..A~pp'.::.ro::..:v:.:a:..:I #::..=:=:=.,)==:LJ:::::l= •7==-=(.=_.):::X):::::::Cl:::::0==:_:C~W:_::M::_P:_:r:.:_of::::ile:..:#::...==::::::::::::V==::::::::::-=:::::=':::· ===-+:-L..J:.~:....C.::....J..Ll!:::'...l..J..jl.J:l.J.1::!.+.--4--......:.::.......::....._ _ _j
K N.H, oo
A
T
0
R Disposal Approval# CWM Profile#
T
c.
Dispo.sal Approval# CWM Profile#
Disposal Approval# CWM Profile#
J. Additional Descriptions for Materials Listed Above
• CU9614 / ERG ... 171
C).$1) .7 / II /03.
K. Handling Codes for Wastes Listed Above
V c.
State of Generation , b. d.
15. Special Handling Instructions and Additional Information
16 GENERATOR"S-.,CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condttion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I certify that I have a program ,n place 10 reduce the volume and Iox,c1Iy of waste generated 10 the degree I have deter,;;,i'ti~d t9.-J:>
econ.9mically practicable and that I have selected the practicable method of treatment, storage, or d1 sposal currently avarlable to me which mm1m1zes the present and ......_,f -~-~~
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to min,m,ze my waste generation and select
the best waste mana ement method that is available to me and that I can afford
Printed yped_ Name Sign' tur Month Day Year
Pa.tric,·o... tv1. a.ck us 'tltw
R t--...-,-,--,,,..----,;--.-,---------------------.-=--------------------------,-,-----,----"-11 , .. : 1#:17 ....
~ l-~18~.-;T-ra..;n:...s_po.:,rt-:-e.::r'-=2:=:;A=c~kn::o~w::ll:-e-:d-ge.lm~en~t ..... ~~~~:+,,;<,~~~.....Jl:::J"-,..J..~::::~;..:;"-...:::s...--.,,_!:::::::::~..::::::::==-=:s;.:::::::~:.:::4 £:J...._....t:..a,1-"-'..i.,.1-J.~~
Rt--=-e-....,--,=----,,---,-:---------------------.-=---------------------------------1 T Printed/Typed Name Signature Month Day Year
E R
F
A
C I
L
19.Discrepancy Indication Space
/ I
{ _2_Q ___ Fa_c_i_lity ___________________ o_f_h_a_za_r_d_o_u_s_m_at-e-ri_a_1s""""' _____ ,....m_an-i-fe_s_t __ ........ __ n_o_t_ed_i_n_lte_m __ 1_9 __ ---------11
y t--""'P""'ri-nt,-ed....,..,/T,.,....;--,,..--:,:'!<---'r-------+----r----,-----.-S=-i=-g-n-at-u~ri-------+-----;---.......,~----------,,-,---,----,,-------11_..
\
EPA Form 8700-22 GENERATOR NO. 2
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00006
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940198-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S .C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under direct instructions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
7 I 11 /03 940198-01 CU9614 8 / 1 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940198-1
. . WM
Waste Management, Inc .
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940198
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to infQrm you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dornthy Olim k?
Recordkeeping and Reporting Supervisor
August 04, 2003
..
• I
IMVIS
WASTE MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
Manifest# Profile Description Gener/Quant ity
0000940198 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS!
Remit to : WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS . TX 75284-0606
17.79
1.00
P.0.#/Unit Bill er
197159 RWILLIAM
TSCA TONS
TRIP
Invoice Date: 08/08/2003
Customer#: 695-1442625
Invoice#: 2256-0124314
Page#: 1
Rate Total
Svc Date 08/0 1/2003
110 . 00000 1. 956. 90
2,100 .00000 2,100.00
Subtotal 4,056 .90
Total Due $4,056 .90
CVII, IIC. • EIIELI.E
Datt/Ti• In 8111/13 8113 ' I
,,,,, n1pt, 418688 ••••• ~
Laid Type Ralloff Fediral tl'l ID Wll67138891
Truepart.r IOBBIE D IIOOO II:
llWJIIITE AL
Truck 1111Hr 2M Trailer/Contnr 11 3152
Rcpt Doc · Oocu•t Profile Profile Glntrator
Lnl Loi luller Sales Invoici119 CutOltr
1 1 1111941198 CU9614 VARREI CUll11 PCB U
VARR£IIOI I:
0oc 5eq , 1 EBE so, m-1umr--1L
>511 cm <511 DEBRIS (CIRCLE)
PREFILLED YAULT Y OR I (CIRLUJ
>511 OR <511 IAC 111 IISPfX.'TIOI (ClRCLEJ
8lU IUTERIAL OILY:
12
·Cnt Cnt
'Code -------
1 Cl
13:25 os-n1-~oo~ wJ. £., j
13
Total V DCS
Quan. 'Units PCB ------------
16111.N I lilogru y
SO:C Yalue -I)
P.O. lu
35300 lb G
PLFB Uadettr■inule
SAIPL!D/IISPICTED. _________ -+-__,PIEE UCIIIDS DITECTED! YES / ll
SELECT DTDIJL/D-SELECT DTEIUL VIID DJSPEISAL OTERUL! YES / ll
t1 IEIGIIT SUIOWlY t1
Grosa 71888.N
Tare .N .
a.t ...
Adj. .N
Adj. let .N
113114-1115 .
COD Req'd
ms1c.u. DESCIIPTl(I ti' IW: SAIPLER/APPIOYAL ---------------------------
SPOT SBPL!r_813-
RAD.SCIP.II Pm 118 : _ms. °'f IPTUI
1&11. SCIEEI pa; DB
1128 SIL S F PT/Sl. 821 UI/TIIP. IO RU mcrs ____________________________ _
pb (PAP!R) _________ t __ __,,. _____________________ _
Cl_!DIEl_+_-_SULFI■ SCIBEI_•_-_t ________________________ _
.lDDITlm&L AULfflClL JIEQ'O!_Y_I ____________________________ _
DESCIJIE: _________ __, _______________________ _
PCB cmc. emu ____ Sll.FIIE c9131,_· ___ Ptllll am. _________________ _
lB2I BY IF CY.WDE (9111) TU l&STE Y I PAIIT FILTER T!ST/ P F SPl!C. 61Aflff BIZ aJIC._PPI ______________ _
au!ITSi ___________ -______ ---------------
mJPAT. TEST v, _____ __,.;m_m_
ADD'L SP01' SOPLE lTTlalPJ>! Y I ...,....,,· ,,,,...,,...,,...........,...,,,,,....,,,.,,..,.....,.....,,.,.,,.....,,...,......,....,,.,.,...,,.,.,....,....,,.,,__,,..,.,,,,...._ _______ _
DISPl!W. DTJII): s SP ST-3 st-3iri P-ST-3 P-Sf-3/PT ST-5 sf-S/PT P·ST-5 Sil-Hi 1-PII ofm ------P·ST-5/PT ST-8 ST-8/PT NIC IUC (IUC IISPECT> F Ill: SP·YS PCB-IUC P·DC
P-ST-a P..ST-8/PT VS-3 YS-5 vs-a
IIDIC'.lTm PJWETD WILL BE CIIIQ.IJ)
B-IUC LOADS IEQUIRIIG IISPECTIOI TIAT !IE FOOD TO BE Im TUI 511 111ST BE RETUIIID TO UB AID PIJCPJ) Cl IQ.D. _______________________ _
REJEISID Fm DlSPmAL IY: __________ DlTEt· ___ _
,,,
?Jo /x 4--i If-o t
HAZARDOUS ~WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) C-WIH
.. ___ -~::. ' \·.·~.., ~·~..;. -..;,~·... t.\ ...
Please print or~' • (F<mh designed for us~ life (12-pitch) typewriter.) Fonn Approved. 0MB No. 2050-0039. Expires &-30-91
AZAR DOU s· 1 · Generator's us EPA ID No. 2. Page 1 Information in the shaded areas is
WASTE M~NIFEST of not required by Federal law.
a1mg
WARREN COUNTY PCB LANDFILL
RR 4 BOX 426 WARREHTON.
4.
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facil ity
1 .
A. State Mannest Document Number
CWMA
B. State Generator's ID
US EPA ID Number G. S acility'a ID ----\
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 ALD00062
H. Facility's Phone ",,;
2 4 6 4 20s· 652-9721
12. Containers
11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
No. Type
13.
Total
Quantity
14.
Unit
Wt/Vo
940197
I.
Waste No.
N
E / / J OOJ./ -O(XX) S: CWM Profile# CVC/b/4 K N.H.
R
A
T
0 R Disposal Approval # CWM Profile #
F
A
C I
L
C.
Disposal Approval # "'ii CWM Profile #
..... .. "' Disposal Approval # .a, CWM Profile#
J. Additional Descriptions for Materials Listed Above
• CU9614 ERG-17f
OS'b {?/1-3/03
K. Handling Codes for Wastes Listed Above
Lv-C.
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order # _______________ _
f "-';'_,,,,...., \ Work Order# !Q (') . .) -., EM ERG ENCY CONTACT: [phone]
1 6 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I certify that I have a program 1n place to reduce the volume and tox1c1ty of was1e generated to the degree I have determined 10 be
economically practicable and that I have selec ted the practicable method of treatment. storage, or disposal currently available to me which minimizes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to m1n1m1ze my waste generation and select
the best waste mana ement method that is available to me and that I can afford.
Month Day Year
() 7
19.Discrepancy Indication Space
,1-----------+------------..... ----------------+-------,------,,,.------------------1 T 20.Facility OvJrer or Operator: Certifica/1on ~f receipt of hfzardous materials cove ed by this manifest ex pt as noted in Item 19.
y 1---~---,-,=--+-,--,.-----------'-------+-----,-=----~---------+--\-------------,-,--,--,,--....,..,----P r int ed /T ~ N\me . 1 (° r·. t Signature ! I .~ \ '. ;,\\ri\ \t. { '' \t l i
EPA Form 8700-22 (Rev. 9-86) Previous edttion is obsolete. GENERATOR NO. 2 (Must Accompany Shipme~t)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00005 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR 4 BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940197-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (I 8 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section( s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under m direct instructions, m de the verification that this information is true, accurate and complete.
Supervisor
OSD Unique ID Cont. # Profile Disposed Description
6 I 13 I 03 940197-01 CU9614 7 / 15 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940197-1
.WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy I copies for Alabama Manifest Numbers:
CWMA-0000940197
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dornthy Oliw j/6
Recordkeeping and Reporting Supervisor
July 17, 2003
. VWVI.
WASTE MANAGEMENT
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
'n1 'est# Profile Description Gener/Quantity
: r:· -~940191
......
CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK LF
TRANSPORTATION/EVENT ROLLOFF TRIP
*i<-1< PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS!
17 .09
1.00
·em; t to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS . TX 75284-0606
P.0.#/Unit Bi 11 er
197159 RWILLIAM
TSCA TONS
TRIP
Invoice Date : 07/17/2003
Customer#: 695-1442625
Invoice#: 2256-0123750
Page#: 1
Rate Total
Svc Date 07/15/2003
110 .00000 1.879.90
2.100.00000 2.100 .00
Subtotal 3,979.90
Total Due $3,979 .90
/ . RcfBBIE D. WOOD. INC. DIIIVERS: WHEN FILUNQ OUT THIS FORM, .w.B1IUHi HARD SURFACE, PRESS BBMLY wrnt B4LL·P01NI PEN tOAD# ___ _ ROLL-OFF BOX # I I I I SIN tRACTOR # .-~l -----DELIVERY INFORMATION -------------DRIVER SIGNATURE C ,.,,,. ,,, ,, .1 1: 0,1 r.~,: DATE: _ -· __ _ PICK-UP INFORMATION LOADED BOX: DATE: . I ,,. J TIME: ----AM/PM SHIPPER -•·t Unloaded at __________ _ I Drop Loaded at 1 ,, • 1 ,' '"'~ ..f.,,/t -;-.'.,..~·,; :. ., J, . ; Box returned to: ----------PN CllY • ST. £ l SIGNATURE P,. ;::~ &UL , EMPTY ,BOX DELIVERED TO: CONSIGNEE __________ _ EMPTY 0 I ,,_ ~ ~ ,... CITY, ST ," _,, C. p .,f. • ' LOADED 0 MANIFEST# Ct,JJt/A-9~~fl> . ,, SIGNATURE . "/ -. · -TAILGAV"~ LATCH ASSEMBLY UNDERSTRUCTURE ASSEMBLY SAND LATCH ASSEMBLY Indicate below any damage done to roll-off box by circling that portion on the drawing below. ' I Condition of Tarp: __ , __ Condition of Bows: __ _ No. Bows: ' Form 373 Eaton Printing 426-2647 I ~ . SIDE ASSEMBLY / " ~ SIDE ASSEMBLY ~-~-'\. -White-R.D.W. Yellow • R.Q.W. Pink • ConsignM FRONT ASSEMBLY HINGf ASSEMBLY _, ~ ~ u. J . -.. TAILGATE ASSEMBLY Goldenrod • Shipper
k28
ant, IK. -EIIBUE 418222 ..... '
Date/Tilt ta 7/15113 8:52
Load Typt Rolloff
Tnnaporttr IOBBIE D ID IIC
Faral tPA IO Al.DC7138891
DWJIIITE AL
Truct 111hr 2M Trailtr/Cootnr 11 411
Rcpt Doc Docueot Profile Profile Generator
Loi Lnl luHr Sales In,oiclng Cat011r
1 1 1111941197 QJ9614 VOREi amrt PCB LA
VARREITCII:
Dae Seq I 1 EBE Shi ElfIROIIIEITAL
>511 OR <511 DEBRIS <CIRCLE>
PREFILLmYAULT t Cl I (CIRCLE>
>511 Cl <SlX IIAC lll IISPl:TIOI (CIRCLE>
BULi IATERIAL lmLY:
12 15 •• £".5 0137 '.! ' -15-2003 353~ lb G
~t Cnt Total V DCS ~cbed Fedtral A I , Code auaa. , lJaita . a
-r-*------------•--•------• -·· -· -'.
1 Cl 16111.N I lilogra1 t Pl1B UDdttlrlinalle
SU8CC Value -a>
P.O. IUJI
smt.EDtllSPECTED ____________ ,m UCIJIDS DITECTIDt
SEUCT IIATERIAL/D·SELECT IIATERIAL VllD DlSPERSAL IIATDIALt
hgt-1
u VEIGBT SUIIUlt tt
Gron 69541.N
Tart .N
let ••
Adj. .N
ldj. •t .N
113114-1115
COO Rtq'd
PRYSICAL DE9:1Iffl(I CJ' IASTE: __________________ SAIPLD/APPIIOYAL. ____ _
SPOT SAIPLE:_113-____ I_PHYS. iisi;iIPTim __________________ _
IAl).scml Pm; IE6 '------------------------JGI.SCIEF.I Pm; IF.8 -
821 n. S F PT/Sll.
1129 ID/TEIIP. IO m REACTS ___ ---~---------------------pb <PAPD> ________ I _______________________ _
CI_SCREII_•_-_JULF1M semi_•_-_1 _______________________ _
ADDinmAL dlLfflCAL ll!l'Df_Y_I __________________________ _
DESCRIBE: __________________________ ..._ ______ _
PCB tm:.tPPI> ____ SlUIO! C9'31> ___ f't1III an __________________ _
D2t BJ IF CYAIJDE (9111> TAI IASTE Y I PAIIT FILTER TEST/ J> F SPIC. BbflTt Bl'l alC._PPI ______________ _
CUiuiEITS: ------------------
allPAT. TP.ST 11 ______ 11_m_
ADD'L SPOT SAIIPLE !TTICIEDf Y I ___________ _._. __________________ _
DISPllW. IETDt S SP ST-3 ST-3/PT P-ST-3 P-ST-3m ST-5 ST-5/PT P-ST-5 st1-n! t-PII OTIIII ------P-ST-5/PT ST-8 ST-8/PT IIC UC UW: JISPECT) F llf SP-YS PCl·IIAC P·IIAC
P·ST-8 P·ST·IIPT YS--3 '5-5 YS-8
IIDJClTtl PWBTER IJU. BE CJIQ.BD
1-IIAC LO&DS IEIIJJIJ■ JISPICfla TBAT di F(IJII) TO IS Thi ~I m;T BE IE'nllED TOW AID PLlCED m 111.D. ________________________ _
REl-'J!iiED Fm DISPl&L BY: _______ __,DATE: ___ _
Please print or type. Form Approved. 0MB No. 2050-0039. Expires 9-30-91
G
E
WARREN COUNTY PCB
RR 4 BOX 426 WARREHTON HC 27589-9110
252 1257-1713 Generator's Phone
ransporter
ROBBIE D WOOD, INC.
ransporter
ress
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility ,
Alabama Highway 17 at Mile r.(larker 163
Emelle, Alabama 35459
US EPA ID Number
1 . US EPA ID Number
ALD00062
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
Q,?OLYCHLDRINATED BIPHENYLS,SOLI0,9,UN2315,III
Information in the shaded areas is
not required by Federal law.
A. CWMAument Number 94019 6
B. State Generato~s 10
C. SIBie T ransporte~s ID
G. State Facility's ID
~ t._)
12. Containers 1'3.'
Total
Quantity
; 14. I.
No. Type
· •Unit Wt/Vo Waste No.
: ~~~~~.:H:::.~~l::::=~~~_:C::.'..W~M:.:P_::ro'.'..'..'.file:....'.ff'.....:· =c:=~(J~C/~t,-,:::::/~'i~===-~~~~-l-1:lll:l::fzl~~K--L---· _N:....._H __ _J
A
T
0
R Disposal Approval # CWM Profile #
C.
Disposal Approval# CWM Profile#
Disposal Approval# CWM Profile#
J. Additional Descriptions for Materials Listed Above K. HandUng Codes for Wastes Listed Above CU9614 ERG-171
OS 'b s/1b/03 V C.
State of Generation / b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order# EM ERG ENCY CONT ACT: (800)4'24-9300
16 GENERATOR'S CERTIFICATION: I hereby declare thatthe contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper cond~ion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and tox1c1ty of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which m1nim,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator. I have made a good faith effort to mInim1ze my waste generation and select
the best waste mana ement method that 1s available to me and that I can afford. \
rinted yped Name ,Signature Month Day i Year r:h. Cy c 1 0-M. Back u \. 1-cLf-r:,,_ -' tLc ,/4-u_
T 17.Transporter 1 Acknowledgement of Receipt of Materials
: 1---=P~ri-nt_ed..,..,=---,~~------------------~-----------------------i-"--------,-,---------1
N s ~ 1-1~a="'.T~ri::;..~~~~~...,:.;;;;.."':--J:.:...l'-,,L~::::;it:;..L;.::;~,;:.L~~---...l..--~..:;...::..::;....,;;..,.;~.:::;......,i;-jj~4'!~;;:.::::....c;..~.i-==-..11ii::;.J,lj~~l.lirl:JG<:..i;;:.:f
Rl---=-e--:---:-::---:,,_.,...---------------------,--=-----------,-',:Z-.---------------:c-:---:---:::----:-;----t T Signature Month Day Year
E
R ,,,.,
19. Discrepancy Indication Space...,-,-··'_ tt 1
/ ' I • ·r 0 ~!-
I
~.
I
i
EPA Form 8700-22 GENERATOR NO. 2 (Must Accompany Shipment)
WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00004 Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110 W ARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940196-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
y direct instructions, mad e verification at thi · formation is true, accurate and complete.
Doro hy Oliver, Reco d
June 26, 2003
OSD Unique ID Cont. # Profile Disposed Description
5 I 16 / 03 940196-01 CU9614 6 / 23 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940196-1
W astc Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WA!\ RE N COUNTY PCB LANDFILL
RR LI BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enc:osed is/are your Generator Number Two copy/ copies for Alabama Manifest Numbers:
CW\1A-0000940196
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in tlie approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHW,\L\1A Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Domthy Ql;v e< -DtJ P
Recon1k.ceping and iePrting Supervisor
June 26, 2003
CVI, ta:. -DELLI I ••••• 1ec11pt, t1111• ••••• ..
.,,., Date/Ti• In 6/23/13 8z51
I.old TJpt lolloft
Truaporttr ROBBIE D 11D IE
Federal EPA ID W>l6n3889l
DOLOIIITE AL
Truck IIIIHI' 214 Trail.tr/Colltar 11 362
Rcpt Doc · Docaent Prof ilf Profile 6'1ffltor
I.DI Lnf lohr SalN Involoiag Custollr
1 1 1111941196 019614 VARIEI QIJffl PCB U
V.dREITOI I:
Doc SINi f 1 EIIE SHAW ElfI"'1D111E1--u1.
>511 (I <511 DEIIIS CCIICLU
PIEFILLED YAULT Y Cl I CCIICLE>
>511 Cl <51X IIAC 111 IISPlt\'IIJI CCIICLE)
BlU IIAttlIAL tlLY:
12
Cat Cat Total V DCS +~ ~ l.~~-~~ ~
1 Cl • I lilagna Y suaa: ,11. -.,
P.O. lut
SUPLll)1IISPEC1ED __________ _.__ ___ FIII UllJIDS DETICTIDt
SILECT QTDilL/ICI-SELIL"t IATDJAL IIID DISPEISAL IIATDJALt
hgt-1
•• VEiat SUIIIARY ••
GrOl8 63221.N
Tut .N
ht . ••
Adj. ••
Adj. •t .•
&DEii'
all Req'd
PBYSICAL DESCIIPTICII CJ' QSTE, _________________ ___,SOPLDJAPPIIOIAL. ____ _
s,ar SAIIPL!,_913-____ ,_ms. ~lffl(II ____ ---------------RAO.nm ,m m , _______________________ _
161.mD PCS IEG
821 SCL S F PMQ. 121 Dl/1'.IIP • ., m mcrs ___________________________ _
pb <PIPER> _______________________________ _
CI_SCIIEl_•_-_SII.Flll SCll!l!l_•_-_1 _______________________ _
ADOJTICIIAL WLfflCAL ID'Dt_Y_I __________________________ _
DESCIIBEs ________________________________ _
PCB a& fPPI)_· ___ SlUlDI C9131) ___ ffllll CCI)! _________________ _
11121 IT IF . CYAIIII C9111> TAB IASTE J I PAIIT nLTEI TEST/ P F SPl'C. libflff ll'l cm:._PPI ______________ _
munrs, __________________ -----------------
a1Pu.mn-v, _____ ~m_m_
.IDD'L SPOI' SlllPLI ATTACIEDt_YJ. ________________________ _
DISPaW. JIETD: S SP ST-3 ST-3/PT P-ST-3 P..ST-3/PT ST-5 ST-5/PT P·ST-5 Sil-PTA 1-PII OTll!I. _____ _
P-ST-5/PT ST·8 ST-8/PT IIC IAC fl&C IISPF.CT> F IS SP-¥S PCI-UC P-DC
P-ST-8 P-ST-8/PT YS-3 fS-5 '5-8
IIDICAT(I PAIAIIETEI mL Bl CIICLID
8-DC Lam IEllllllE JISPIC,11(1 TUT Al£ ftlJID TO lll USS TUI 511 111ST
Bl lll1UIIID TO LAB HD PUCED (ll DD. ________________________ _
HEIEAB g DISPE&L BJ: _______ ___,D!Tls ___ _
Please p~int or type.\ , < . CW!'!I
(Form designed for use on elite (12-pitch) typewriter.) Form AppnMld. 0MB No. 2050-0039. Expires 9-30-91
UNlt·URM HAZARDOUS 11. Generator's US EPA ID No. . Manifest 2. Page 1 I Information in the shaded areas is I WASTE MANIFEST N IC I R 10 10 10 I 1 I 3 I 7 I f\ I 0 I 2 I ~'el/'l'!1nt'f1°3 of 1 not required by Federal law.
~-l>enerator s Name an<! Mailing Aaaress A. State ManWest Document Number 940195 WARREN COUNTY PCH LAHDF[LL CWMA RR -4 BOX -426
W,RRENTOM MC .2758·3-911.0 B. State Generator's ID
4. Generator·s Phone ( ;:52 l 257 -11.13
o. , ransporter , 1,;ompany Name ts. US EPA ID Number C. State T ransporte(a ID
ROBBIE D WOOD, me. ~ I ' ... 1.At1 L I,D 10 16 17 1t 1-' 18 18 19 11 D. Transporte(s Phone 800 ~-7457
I . , ransporter L 1,;ompany Name ts. ' us EPA ID Numl:lt!r ~h E. State T ransporte(s ID I I I I I I I I I I I I . (J;_.Mtmsporte~s ·Phone )
I l:I. ues,gnatea l"ac111ty Name ana ::.1te ... uuress lu. US EPA ID Number G. State F11cility'1 ID ,· CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility H. Facility's Phone
Alabama Highway 17 at Mile Marker 163 I Al LI oI oI oI o I 6 I 2 I 2 41614 205/652-9721 Emelle, Alabama 35459
12. Containers 13. 14. ' I. 11 . US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) Total Unit
No. Type Quantity Wt/Vo Waste No.
G 8 RQ,POLYCHLORINATED BIPHEHYLS,SOLID,9,UH2315,III E \ . ,1-NH N l/3C<:1-OrtC.S-CI/ (/f I'/ K E Disposal Approval # CWM Profile# 0 10 11 C 1H ti-~'1-~ A t>'
b. .
A
T
0
A Disposal Approval # CWM Profile# I I I I I I I c.
Disposal Approval# CWM Profile # I I I I I I I .i:~
d. .
~ ... ,.,
Disposal Approval # CWM Profile # I I I I I I I I
J. Additional Descriptions for Materials Listed Above .. K. Handling Codes for Wastes Listed Above a. CU9614 ERU·111 -
OS]) q/7/ t\.~ a.v .. C.
Ntt"f#I C.At.C,J..tNIJ -. ' State of Generation b. d. .,
15. Special Handling lnstructiol'is and Additional Information -/~
Purchase Order#
Work Order# bf Jl)CJ EMERGENCY CONTACT: 1800}424 9300
16 GENERATOR"S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condttion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I ce rt ify that I have a program In place to reduce the volume and tox icity of waste generated to the degree I have determined to be
economically practicable and that I have se lected the practicable method of treatment. storage, or disposal currently available to me which mInIm,zes the present and
future threat to human health and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select
the best waste manaqement method that is available to me and that I can alford.
Pt'ed/Typed Name --I Sign~tur~/ Month Day Year (. t. \ I ,\.j :, _.'. . /,:, ! . , . '\ .,,,.,-.. ~1. /\ ,. I -••I• ,_,• ,,
I I ·1 ··1 I . 1-
T 17.Tra~porter 1 Acknowledgement of Receipt of Materials ,. R -A PX'{J~J-~ J· l'J1(_ 1., ) It' .p Jt,4..1; I Sigljarire ~~-9\ 1JJ~11-41 IM~/~~aiJ N r _.. s ./ r --,,, p
0 18.Transporter 2 Acknowledgement of Receipt of Materials ; {._,_,,I / j A
T Printed/Typed Name I Signature .,, Month Day Year
E
A ' I I I I I I
19. Discrepancy Indication Space \ ' I I . I i ' ./' ./... .i , < • \ ,)' H:: •. ,..✓ ·, ' I
i ! \
F !
A
C
I
L I I 20.Facility Owner Qr Op"rator: Certification of redeipt of hazardous materia Is covered by this manifest except ,!JS J,oted in Item 19. T ' ,. / _.,_,... y Printed/Typed\ N)me · \ i ~-t ,l I Signature \\\tr\ \' t !' \ ~ Monih Day. tea..{,·
'· '"\-(\(\ \ ts., ·~--,_\. ,_,, ..
I ' '----· I I I I I I .. EPA Form 8700-22 (Rev. 9-86) Previous edition 1s obsolete. TRANSPORTER NO. 2 (or File CopY,) (Must Accompany Shipment) . . . ........ :.~ ,,:
(!J 6:f:. 1 S"' T
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management)
J CWMI
Please phnt or type. (Form desig1ied for use on elite (12-pitch) typewriter.) Form Approved. 0MB No. 2050-0039. Expires 9-30-91
HAZARDOUS
WASTE MAN1FEST
RREN COUNTY
4 -BOX 426
RRENTOU 27589-9110
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
US EPA 10 Number
US EPA 10 Number
2. Page 1
of
Information in the shaded areas is
not required by Federal law.
A. State ManWest Document Number
CWMA 940195
B. State Generator's ID
C. State T ranaportera ID
D. Transporters Phone
D
H. Facnlty's Phone
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6 4 205 652-9721
12. Containers 11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
No. Type
13.
Total
Quantity
14.
Unit
Wt/Vo
I.
Waste No.
:
8RQ,POLYCHLORIH~TED B!PHENYLS,SOLID,9,UH2315,III
CWM Profile # C V qt, J 'i N
E Disposal Ap)Sroval # / / 3 001-C{)COS: R
K
A
T
0 R Disposal Approval# CWM Profile#
C.
Disposal Approval# CWM Profile #
CWM Profile #
Additional Descriptions for Materials Listed Above
. CU9614 ERG-171
0S9JJ '1/1/03
K Hi-ndling ~odes :or Wastes Listed Above
a.t_/ "~~-
State of Generation NtJf TH cAt:OL.IN8 b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order# b 8 J {),S" J. EMERGENCY CONTACT: ( a0e) 424-9300
16 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I ce rtify that I have a program 1n place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have selected the pract,cable method of treatment. storage. or disposal currently available to me which m1n1m,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator. I have made a good faith effort to m1nIm1ze my waste generation and select
the best waste mana ement method that 1s available to me and that I can afford.
rinted yped ame Signature
Pa. . .t. r , :::. 1 ,:-.... fvt . Bo. ckt..t <, · ~~-lit✓-t -t. ,,., }jj • .0 tJ. c /,l.,t--vJ
Month Day Year
DS-:J.;1t>3
T 17.TransPoner 1 Acknowledgement of Receipt of Materials
Rt--...-.~-:;-,,..----,,-..::-::,,--------------------.-...--:;;,--------------lr---,----------c-:---.----::---..,..,---t A N
: k ~~Lt.~;::..,::!::.--,-.::;L:.._!..:.:::.::::!;µ:...!1..,L.J!t:.~~:¥t-L.J\:.Z:.:1~~::-!::::~~.t:i.':J4,d'Ld!::!.~:::!:'.~:!:1---U '.llllL.!S2ULU-1 0 ~ l--=-e-....,...,=---,-,-N,-a_m_e ______________ __,c._ __ --=,--------=------,/!-.;..--------.---l-----,-M-o-n-th.,...--,~,-a-y-...,.Y,-e-a-lr
E
R
F
A C I L
19.0iscrepancy Indication Space
! I
I
I 1-------+------...... ....,...-------,,---.---------------+----;----+--+--------------,------11 T perator: Cenific materials by this rrianifest
y t--=-:-t-;--,,;,----,;---.,;---\:--------t-=--'----------.-s;.,c-.g-n-at:--u-re--+---------;'-----'----.....,.-------c-:---.----::---..,..,---t
f\i'{\
GENERATOR NO. 2 (Must Accompany Shipment)
(
·wM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00003 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940195-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
unde y direct instructions, made the verification that this information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
4 I 7 / 03 940195-01 CU9614 5 I 22 I 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940195-1
.... WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940195
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver-~
Recordkeeping and Reporting Supervisor
May 27, 2003
(Form designed for use on elite (12-pitch) typewriter.)
US 1. Generator's US EPA ID No.
RREH COUNTY PCB LAHOFILL
4 BOX 426
RRENTON NC 27589-9110
4. Generator's Phone (. 252 )257-1713
ame
HlC.
ame
CHEMICAL WASTE MANAGEMENT, INC.
Em.eUe-Facility
1 .
Form Approved. 0MB No. 2050-0039. Expires 9-30-91
2. Page 1 Information in the shaded areas is
of not required by Federal law.
A. CWMAument Number 9 4 Q 19 4
B. State Generator's 10
US EPA ID Number G. State Facility's ID
H. Facility's Phone
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6 4 205 652•9721
11. US DOT Description (Including Proper Shipping Name, Hazard Class. and ID Number) 12. Containers 13. 14. I. Total Unit
No. Type Quantity WtNo Waste No.
~ 8 Q,POLYGHLOR!MATED B!PHENYLS,SOLID,9,UN2315,III
: Disposal Approval# C)O'--oofl~roli're # r j q
R
A
T
0
K NH
R Disposal Approval # CWM Profile#
c.
Disposal Approval# CWM Profile# ___________ _ \
\
Disposal Approval# CWM Profile#
J. Additional Descriptions for Materials Listed Above ~ CU9614 BRG-171 K. ·odes for Wastes Listed Above
05D 2/5/0·3
Nott. t:h (Aro It IV A· State of Generation
a. C.
b. d.
15. Special Handling Instructions and Additional lnfonnation
Purchase Order# _______________ _
Work Order# 67 /n 73 7 EM ERG ENCY CONT ACT: (800>424-9300
16 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator, I certify that I have a program In place to reduce the volume and toxIcIty of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage, or disposal currently available to me which mInim,zes the present and
future threat to human health and the environment; OR. if I am a small quantity generator, I have made a good faith effort to m1n,m1ze my waste generation and select
the best waste mana ement method that is available to me and that I ca n afford. /
T Acknowledgement of Receipt of Materials R1---~--:-:=--:--:-~------------------~~-----++--~-H----+-----t------------------1 A
N s
~ r--=-=-=---~---:~i-"'l,~~•~'-"-f-~~...,_~~~M~a-t-e~ri-al~s----1....----lt:~"""i~u:.o:.;.,.+~Y:i..~~'--------...,,j~-.,.,_-lfl;..&..i.;:;;...i.."'f
R 1---.,.....,--,--:-:=--:--:-~-------------------.-=----~-----ff----------------,-,----,----,,-------1 T Signature Month Day Year
E
R
19.Discrepancy Indication Space
EPA Form 8700-22 -(Rev. 9-86) Previous edition is obsolete. GENERATOR NO. 2 (Must Accompany Shipment)
r . WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-005
[phone]
Manifest Document Number: 00002 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940194-1
Waste Management, Inc. hereby certifies that the above described material ( exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section( s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under y direct instructions, made the verificat" n tha ·s information is true, accurate and complete.
OSD Unique ID Cont. # Profile Disposed Description
2 I 5 I 03 940194-01 1 CU9614 4 / 10 / 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940194-1
r. WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4BOX426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy / copies for Alabama Manifest Numbers:
CWMA-0000940194
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver -01).0
Recordkeeping and J~Jfr}lg Supervisor
April 14, 2003
HAZARDOUS WASTE MANIFEST
(As Required By The Alabama Department of Environmental Management) CWt!J
WARREN COUNT'!
RR 4 BOX 42£
WARRENTON
4.
NC 2758'3-':1110
7-713
ress
CHEMICAL WASTE MANAGEMENT, INC.
Emelle Facility
US EPA ID Number
1 . US EPA ID Number
2. Page 1
of
Information in the shaded areas is
not required by Federal law.
A. CWMAument Number 9 4 Q 19 3
B. State Generator's ID
C. SIBie Transporter's ID
D. Transporter's Phone
E. State Transporter's ID
F. Transporter's Phone
G. State Facility's ID
H. Facility's Phone
Alabama Highway 17 at Mile Marker 163
Emelle, Alabama 35459 A L D O O O 6 2 2 4 6 4 205 652•9721
11 . US DOT Description (Including Prof)IJr Shipping Name, Hazard Class, and ID Number) 12. Containers 13. 14. I. Total Unit
No. Type Quantity Wt/Vo Waste No.
G
E Q,POLYGHLORINATED BIPHENYLS,SOLID,9,UN2315,III H-K N : Ji.JO 01./ -000 S""' CWM Profile# CU CJ b / J./
R ~::.C..:.::::.~:.:..:_:.:.:_::__=::::::::::==:::::::::::::::::::===:=::==::._:_..:..:..:.:~.:...:.:.:.:~.:::=:::::::=:=::::::::======--~....f:'.......J!..~...l.!-+.!..l..!:!.1.~~~f---l--------'
A
T
0 R Disposal Approval# CWM Profile#
C.
Disposal Approval # CWM Profile#
Disposal Approval # CWM Profile#
J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above
. CU9614 ERG-171
OSD ,j~/D"J a. C.
State of Generation b. d.
15. Special Handling Instructions and Additional Information
Purchase Order# _______________ _
Work Order # EMERGENCY CONTACT: [phone]
1 6 GENERATOR ·s CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condijion for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator. I certify that I have a program In place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have selected the practicable method of treatment. storage. or disposal currently available to me which mInIm,zes the present and
future threat to human health and the environment; OR . if I am a small quantity generator. I have made a good faith effort to min,m,ze my waste generatu:fn and select
the best waste mana ement method that Is available to me and that I ca n afford.
rioted yped Name Signal re 1 -p ..J-"A B L \. . ~: . ,1::·~. 0. I , C, I r.l .. I • • lt C r<,, U 5 "· tt,,.-,,;,1..,(., {....( ,,.__, 7 r ,
Month Year
T Acknowledgement of Receipt of Materials
:t--:-..::;=:-:,-;...-:=.-..::-:::--::--------------------r,..,---:-,=--------,,.:;....--:,-----::-------------::-:--;----:::----:-:---t
: cl.st:),,,._, p ..... ,,_ ......... ;;...;. __ .._ .............. =--""'-----=-----------....r.."'"..j,..."""""'---=aa...-~...:...::;;--=-;..;:::=::;;...--------..Lli.::;,,ll.:;.;:Lll,;:;i..;:~-=i.i.-1
0 Acknowledgement of Receipt of Materials
; t---;:-,.--c--...,..,=--:--:cN:--a-m-e------------------..-:-:-------------------------....,M.,.o_n_t_h---:D=-11-y--Y-e-a-ilr
E
R
19.Discr~pancy Indication Space
EPA Form 8700-22 (Rev. 9-86) Previous edition is obsolete.
/\
GENERATOR NO. 2 (Must Accompany Shipment)
··WM
Waste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-00
[phone]
Manifest Document Number: 00001 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940193-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
Supervisor
OSD Unique ID Cont. # Profile Disposed Description
1 / 2 / 03 940193-01 CU9614 2 /7 / 03 PCB LANDFILL SOIL AND DEBRIS
Page I of I Manifest 0000940193-1
WM
Wa.ste Management, Inc.
Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-0055
[phone]
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110
Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON,NC 27589-9110
ACKNOWLEDGEMENT OF RECEIPT OF WASTE SHIPMENT
Generator Name: WARREN COUNTY PCB LANDFILL
Enclosed is/are your Generator Number Two copy I copies for Alabama Manifest Numbers:
CWMA-0000940193
This copy is to acknowledge that Chemical Waste Management, Inc., of Emelle, Alabama has received your shipment.
As a requirement of 40 CFR 264.12 (b ), this letter serves to inform you that this facility has the proper permits and will
accept your shipment upon completion of waste analysis procedures specified in the facility's Waste Analysis Plan and as determined
in the approval waste profile submitted for this/these wastes.
As of September 26, 1997, Chemical Waste Management, Inc., Emelle Alabama (ALD000622464) is operating under a
AHWMMA Permit, issued by the Alabama Department of Environmental Management. (RCRA)
Dorothy Oliver flo
Recordkeeping and Reporting Supervisor
February 10, 2003
t •• Chemical Waste Management
Emelle, Alabama
Generator's Manifest Instructions
Complete instruction for the federally mandated portions of the manifest may be found at 40 CFR 262, Appendix. These instructions
are intended to assist you in completing the requirements at the Emelle facility which also include some of the state information (gray)
areas. Only this CWM-Alabama Manifest may be used for shipments to CWM-Emelle. If you have any further manifesting questions,
please call 800-652-5755 and ask for "Customer Service". Questions regarding waste approvals, profiles and sample evaluation
should be directed to "Customer Service".
Item 1 -Enter the generator's US EPA 12 digit identification number and the unique 5 digit number assigned to this manifest
(eg.00001) by the generator. The 12 digit ID number must be the US EPA ID number for the site where the waste was generated
and from which it is now being transported.
Item 2 -Enter the total number of manifest pages used to complete the manifest, including the first page. Only form
8700-22A may be used as a continuation page.
Item 3 -Enter the mailing address to which the TSDF signed copy of the manifest (generator copy #2) is to be returned.
This address may be different from the address of the site, referred to in item 1. If the manifest must be returned to
the attention of a particular person, please include "attn:" and the name of that person. If an additional copy of the manifest is to be
returned to another address, please write that address in section J or 15.
Item 4 -Enter a phone number where an authorized agent of your firm may be reached in the event of an emergency.
Item 5,6 & item D -Enter the company name, US EPA ID number and phone number for the first transporter.
Item 7,8 & item F -If applicable, enter the company name, US EPA ID number and phone number for the second transporter. (Note:
for additional transporters use the continuation page, form 8700-22A).
Item 9, 10 & item H -This information is preprinted on the Alabama-CWM manifest.
Item 11 -Enter the US DOT (49 CFR) Proper Shipping Name, Hazard Class, ID number (UN/NA) and DOT Additional Description
(if required) for each waste. Also enter the corresponding CWM Profile Number and Disposal Approval Number (if applicable).
Item 12 -Enter the number (use whole numbers) and type of shipping containers (use the appropriate abbreviation from Table 1,
below) for each waste.
OM = Metal drums, barrels, kegs
OW = Wooden drums, barrels, kegs
Table I
OF = Plastics or fiberboard drums, barrels, kegs
CF = Fiber or plastic boxes, cartons, cases
BA = Burlap, cloth, paper or plastic bags
CM = Metal boxes, cartons, cases, rolloffs and
PCB transformers, unpackaged capacitors
TP = Portable tanks
TT = Tank trucks, cargo tanks
TC = Tank cars
CY = Cylinders
CW= Wooden boxes, cartons, cases
OT = Dump truck/Dump trailers
Item 13 -Enter the total quantity of the hazardous waste described on the line. Use only whole numbers, do not use fractions or
decimals.
Item 14 -Enter the appropriate abbreviation (from Table 2, below) for the unit of measure in item 13.
G = Gallons (liquid only) Y = Cubic Yards T = Tons (2000 lbs.) L = Liters (liquid only)
P = Pounds M = Metric tons (1000 kg) K = Kilograms N = Cubic meters
Item I-For RCRA hazardous wastes, put the EPA hazardous waste number (s) (40 CFR 261) (reference yourCWM Profile), for PCB
wastes, put "PCB" in this space, and for nonhazardous waste (as per 40 CFR 261) put "N/H". If you cannot fit all the codes in the
space provided, continue on an attached piece of paper, and place the words "see attachment", or continue in section J or 15.
Item J -Enter the State of Generation in the space provided.
Item 15 -Enter the CWM work order number AND your purchase/release order number here. Also enter the 24-hour Emergency
contact number and any other miscellaneous instructions. If you need more room, use item J.
Item 16 -The generator must read, sign (by hand), and date the certification statement.
After the generator completes items I through 16, D, I and J, and both he and the transporter have signed and dated the manifest,
the generator removes and retains the back copy (Generator #1 ). Any Land Ban notification /certification and/or demonstration forms
required must be signed, dated, referenced to the manifest number (item A) and attached to the manifest, given to the transporter.
(Please note that generators are required to maintain a copy of these forms in their records). The transporter is responsible for
verifying the quantity for each waste type (number of drums, gallons, etc.), and the transporter must verify the safety of the load, (he
may not pick up leaking, corroded, unsealed, poorly labeled, or DOT/EPA unapproved containers.)
For Your Information
40 CFR 262, Appendix requires that this notice be presented to the generator: "Public reporting burden for this collection of
information is estimated to average: 37 minutes for generators, 15 minutes for transporters, and 10 minutes for treatment, storage
and disposal facilities. This includes time for reviewing instructions, gathering data, and completing and reviewing the form. Send
comments regarding the burden estimate, including suggestions for reducing this burden to: Chief, Information Policy Branch, PM-
223., US Environmental Protection Agency, 1200 Pennsylvania Avenue, SW, Washington, DC 20460; and to the Office of Information
and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
...
Shaw Environmental & Infrastructure, Inc.
S aw The Shaw Group Inc."'
February 24, 2003
North Carolina Department of Environment and Natural Resources
Division of Waste Management
1646 Mail Service Center
Raleigh, NC 27699-1646
Attn: Ms. Patricia Backus, P.E.
Project Manager
[phone], ext 308 phone
[phone] fax
Re: Warren County PCB Landfill Detoxification Contract
NCSCO ID #0104401010A, Shaw Project #827062
Manifest and Certificate of Disposal
Dear Ms. Backus,
200 Horizon Center Blvd.
Trenton, NJ 08691-1904
Direct Dial: 609-588-6373
FAX: [phone]
Attached for your records are copies of the following documents, they cover the first shipment of
hazardous waste sent from the Warren County PCB Landfill site to Waste Management's landfill in
Emelle, AL.
Certificate of Disposal
Copy of Manifest CWMA 940193, manifest document #00001
Emelle receipt -pink copy
WM invoice #2256-0120645
Originals of the certificate of disposal and of the generators copy of the manifest should have already been
sent directly by the disposal facility to your attention at the site address shown on the manifest.
If you have any further questions on this matter please contact me at [phone] or at
[e-mail].
Sincerely,
Shaw Environmental & Infrastructure, Inc.
(Jary W. (J)uk._§
Gary W. Duke, P.E.
Project Manager
'
' I
SliawThe Shaw Group Inc."'
Attachments: Certificate of Disposal
Shaw Environmental & Infrastructure, Inc.
Copy of Manifest CWMA 940193, manifest document #00001
Emelle receipt -pink copy
WM invoice #2256-0120645
cc: Jim Cloonan, Earth Tech
Duke file c:\mydocs\nclf\corresDENR\manifest 00001 022403
WASTE MANAGEMENT
WASTE MANAGEMENT
Emelle Treatment Facility
Highway 17 N., Mile Marker 163
P.O. Box 55
Emelle, AL 35459
[phone]
SHAW ENVIRONMENTAL
ATTN: ACCOUNTS PAYABLE
200 HORIZON CTR
TRENTON NJ 08691-1904
Manifest# Profile Description Gener/Quantity
0000940193 CU9614 PCB LANDFILL SOIL AN 019692 WARREN COUNTY P
PCB BULK L/F -EVENT PCB BULK MINIMUM
TRANSPORTATION/EVENT ROLLOFF TRIP
HAZARDOUS WASTE FEE
ADEM MONITORING FEE
SUMTER COUNTY FEE
*** PAYMENT DUE 30 DAYS
FROM DATE OF INVOICE***
THANK YOU FOR YOUR BUSINESS!
Remit to: WASTE MANAGEMENT
P. 0. BOX 840606
DALLAS. TX 75284-0606
1.00
1.00
9.34
9.34
9.34
P.0.#/Unit Bill er
197159 RWILLIAM
PCB MIN DISPOSAL FEE
TRIP
TONS
TONS
TONS
Invoice Date: 02/11/2003
Customer#: 695 -1442625
Invoice#: 2256-0120645
Page#: 1
Rate Total
Svc Date 02/07/2003
1.000.00000 1. 000. 00
2.100.00000 2 .100. 00
45.00000 420.30
1.00000 9.34
5.00000 46.70
Subtotal 3,576.34
Total Due $3,576.34
. 'WM .
Waste Management, Inc.
_Emelle Facility
P.O. Box 55
Emelle, Alabama 35459-00
[phone]
Manifest Document Number: 00001 Site Information:
WARREN COUNTY PCB LANDFILL
RR4 BOX426
WARREN COUNTY PCB LANDFILL
RR4 BOX 426
WARRENTON, NC 27589-9110 WARRENTON,NC 27589-9110
CERTIFICATE OF DISPOSAL
Chemical Waste Management, Inc. (ALD000622464) has received PCB material from:
WARREN COUNTY PCB LANDFILL
described on Alabama Hazardous Waste Manifest Number CWMA 0000940193-1
Waste Management, Inc. hereby certifies that the above described material (exluding PCB liquids, if applicable) was
landfilled on the dates shown below, in compliance with State and Federal Regulations.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statements or
representation (18 U.S.C. 1001 and 15 U.S.C. 2615), I certify that the information contained in or accompanying this
document is true, accurate and complete. As to the identified section(s) of this document for which I cannot personally
verify truth and accuracy, I certify as the company official having supervisory responsibility for the persons who, acting
under my direct instructions, made the verification that this information is true, accurate and complete.
Supervisor
OSD Unique ID Cont. # Profile Disposed Description
I / 2 / 03 940193-01 CU9614 2 I 7 I 03 PCB LANDFILL SOIL AND DEBRIS
Page 1 of 1 Manifest 0000940193-1
.,.,, ,., . . .. .,,·. _ . ·;• { .~/S0 ,(J ;-:J i 3 _
~'-~[" ,;~itAJ.ia~!>9YWtl~M:!!f ESII
(Form ltiecf for UN on elite (12-pitch) typ#IWrit#.) Fofln AppnMd. 0MB No. 2050-003II. EllplNa 9-30-81
NC 27589-9111
25212S7-171'.3
-WASTE MANAGEMENT, INC.
Erne. acility
'fua His,ivwy 17 at Mile Marker 163
Emelle, Alabama 35459 A L 00062 2
11. US DOT Description (Including Proper Shipping Neme. Hazerd Cleu. end ID NumbMJ
No.
: 8RQ,POLYCHLORINATED BIPHEIIYLS,SOLID,9,Ul2315,III
: Disposal Approval, II JO O'I -~ S: CWM Profile, CU q ~ I 'I
II
A
T
0
11 l,.:D,::ispo!'.:.::sal=-.:Ap~pro::,::va::.1.:.#.=================:__:CW:.::.:::M:.:.Prof.:=i::le~#:....===================-.J--.L..l..-J,....l......jl-LL.L..l..-J.-~
C.
Disposal Approval# CWM Profile #
sal Approval #
Purchase Order# ______________ _
Work Order# EMERGENCY CONTACT:
16 GENERATOR ·s CERTIFICATION: I hereby declara that the contents of this consignmenl are fully and accurately described above by the proper shipping name, and are classified, packaged, miuked and labeled/placard, and are in all n,apects in proper condition for transport according to applicable international
and national governmental regulations.
If I am a large quantity generator, I certify that I have a program on place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have selectecfihe practicable method of treatment. storage. or disposal currently available to me which m1n1m,zes the present and
future threat to human health and the environment; OR, if I am a small quantity generator. I have made a good faith effort to minimize my waste generation 8".'d select
the best waste mana ement method that is available to me and that I can afford.
Month Dey YHI
T 1 Acknowledgement of R-ipt of Material•
II t-----,-,c-,...,.......,,.,.......,..~-----------------,r-=,----,-.------+-4---.....--------------------1 A
N = µ~.:....:::....:~!.;::~::.:::::..::::::.:::.:!::~--,,----....l..L..µ;&:::!::::::::....~~~::!::::::::::::... _____ ...J.~~:::::C::~:L.21 o 18.Tranaporter 2 ~ment of R-.,t of Materials ~ t--icr.=:;-,.yped=~N;:;1::-:me::-:----,...,.--------------,..,..,,---,-----------------------,M,-,onth-.,..-...,,Dey,---,.,----1
E II
F
A
C
.......
19.Diacrpnc:y lndicltior\ -~
I ~ ~~=-~-=~---=---~~~""""."-~-~-~----------------------------------1 \i T 20. ator: Certificltion of ipt of hazardous materi1la covwed by thia manifest except II noted In Item 19. vt--,;;r;;,;;;j'.;,r;:;.a""ir.;;;;;;----:-----:::-----,-=ar-,--:;::,---,,,;.::=::=:"""'.'.:::----:-------:::r--:---------..:-:-::-.:----::--:--1 ~ (h -a.
EPA Form 8700-22 (Pev. 9-86) Previous ecition is obsolale. _____ t , _______ _
en, DC. -£IIELLE
\
\ I
tllll lectipt' 414695 1111 1
Datt/Ti• In 2/r//13 8:44
Laid Typt Rolloff
Trl!llpOrter R088IE D IXID IE
'tt ffiGBT SlJIOfARt tt
DW>IITE
Trvck lulltr 2M
AL
Ftdtnl a>a ID ALDl67138891
Tniler/Contar 11 2123 13
~ 4'._ Groa 5.T/21.N
JJJ:. bt D "~ :: / t) qj Adj. let ::
Rcpt Doc Docll•t Profilt Profilt Generator
Lilt LIi .· llllllter Sales Inwlcing CutOlfr
1 1 1111941193 Ql9614 VAIIEI man PCB LA
IARIFJTOI IC
Doc Seq I 1 m: SIIAI EIYIIOIIIEITAL
>511 m ~11 DEBRIS (CIRCLE>
PREFILLED fAULT Y OR I (CIRCLE>
>511 fa <511 hC 111 IISPD:TI(I (CIRCLE>
8lU 01'.llAL cm.ta
Cat Cnt Total V DCS
I Code , Quan. Y Units PCI
--; ·;· ~~--~;~ .. --;
SUBCC falut -m
P.O. lua
SAIPLED/llSPECTED ______________ FIEE UIIJIJlS DETECTED!
SELECT IIATEIIWD-SEl.ECT IIATEIUL VllD DISP!ISAL IIATDIALt
Scbt!d Fldtnl EPA -11 lo~ i1
Cat tut. Statu f I
ADEii f
Pl.Fl) UndettrlinaUt
mum
YES / I)
1131M-tll5
COO hq'd
PHYSICAL DESCRJmtll Cf l~i ____________________ WPIJ.1/APPR01fAL ____ _
SPOT SAIPLE:_813-_____ I_PBYS. DESCIJ"1tll. ___________________ _
UD.SCRE!I Pm 116 ! ________________________ _
161,SCRED Pm IEG l 7•2ri
12111.. s , n,n AJ.r O.:'-M-2naJ
-_,_ 10 ID -&-35040 I h,
,._ llalllllilll"• -•w1 ___ -----------------------------pb <PAPER> ______ _._ ___________________________ _
CI_Stl!El_+_-_Slll11DE SCREEl_•_-_1 ________________________ _
JDDffl(IAL WLffiCAL IIBl'D!_Y_I ___________________________ _
DESCRIBE: _________________________________ _
PCB aJIC, CPPII) ____ SUllIDI <9131> ____ FCllf COO£ _________________ _
XR2t BY IF CJUJDI 19111) TAB VAST£ Y I PAm FJLTD 1EST/ P F SPEC. GbYJTY ll'Z aJIC._PPI _______________ _
COIIIIEITS: ------------------
aJIPAT. 1EST V/ ________ CJI_RD_
ADD'L SPOr SAIPLE ATTACIIED!_J_I ________________________ _
DISPOOAL IETlllh S SP ST-3 ST-3/PT P-ST-3 P·ST-3/PT ST-5 ST-5/PT P-ST-5 Sil-PTA B-PD OIIER. _____ _
P-ST-5/PT ST-8 ST-am JIIC QC cue IISPECT> F JIC SP-YS PCI-IIAC P-IAC
P-ST-8 P-ST-8/PT fS-3 YS-5 YS-8
IIDICAD PWIETD 11IU. II Cll'J.ED .
B-IIAC LOADS DJJIJl6 JISIUTIOI TIAT m FOOD TO Bl LE$ mu ' sff IUST
BE l!1IIIEI) TO LAB AID Pl.MD (II 111.D. _______________________ _
REIEASED Fm DISPUiAL BY: _________ .DATE: ___ _
. •.
r ,' /
.,.. ........ ,.,,,
WASTE MANAGEMENT GENERATOR'S WASTE PROFILE SHEET
PLEASE PRINT IN INK OR TYPE
Service Agreement on File? D YES X)NO
IXJ Hazardous O Non-Hazardous IX] TSCA
Profile Number: WM Cu-9 614
Renewal Date: / /
1.
3.
5.
7.
9.
Generator Name:
Facility Street Address:
Facility City:
Zip/Postal Code:
County:
Warren Countv PCB Landfill 2. SIC Code:
Box 426 . Route 4 4. Phone: [phone]
Warrenton. NC 6. State/Province: North Carolina
27589 8. Generator USEPNFederal ID #: NCRQOOI 37802
Warren 10. State/Province ID Ii North Carolina
11 . Customer Name: NC Dent. of Nat. and Env. Resources 12. Customer Phone: [phone]
13. Customer Contact:
15. Billing Address:
Bill Galla2:her 14. Customer Fax: [phone]
Shaw E&I. 200 Horizon Center Blvd .. Trenton. NJ □Sc:1me as above
1. Description
a. Name of Waste: PCB landfill debris and thermal treatment waste oroducts
b. Process Generating Waste: PCB contaminated soil is excavated from a landfill. The excavated soil is
. _ _treated in a thermal desorber to remove the PCBs. The concentrated PCBs will either be treated
. on site or sent to off site incineration The treated sail is return ed ta the landfill
I C. Coior d. Strong odor e. Physical state @ 70°F f. Layers g. Free iiquid range
(describe): X ISolid □Liquid O Single Layer 0 to 0 %
Brown. black None □Gas □Sludge )[ Multi-layer
~ white, gray □Other h. pH: Range
4 to 10
i. Liquid Flash Point: □ <73°F □73-99°F □ 100-139°F □ 140-199°F □~ 200°F X Not applicable
j. Chemical Composition (List all constituents [including halogenated organics. debris. arid UHC'sJ present in any concentration and submit
representative analysis):
Constituents Concentration Range Constituents Concentration Range
TPH 0 to 15 % PCB 0 to 6 %
PAH 0 to 5 % Sand and Soil 0 to 80 %
Cement Kiln Dust 0 to 80 % Trash folastic. bottles. etc.) 0 to 25%
Crushed rock/Concrete 0 to 95 % LIST IS CONTINUED ON A TT ACHED SHEET
-ui f~1• .. IJ\l/l:.l,I J...'111(1h'■IIII I J...'11. 1: ,11,!111111 :•~ (9j::1::,1a11111,;1~
k. O Oxidizer D Pyrophoric D Explosive O Radioactive
D Carcinogen D Infectious D Shock Sensitive O Water Reactive
I. Does the waste represented by this profile contain any of the carcinogens which require OSHA
notification? (list in Section B.1 .j) ···············-··--···-··········-····--·--···········-····-·····--··-·--····-··-·---··--····•··----·-·-··.·······-··-············-·······
m. Does the waste represented by this profile contain dioxins? (list in Section B.1.JA.n ~J.Y.t~.q.\ . .AJ~~.<::ht::q)
n. Does the waste represented by this profile contain asbestos? ... •-··· .. ·········· ....... _ .. _._ .. _ ............. _ ....... -...... _ .... --............ _.
If yes ···-··············-···-········ ......... -················-···-··-·-·······-···-·· .. ·-······ ............... _ ....... __ .. _ .. _._ 0 friable D non-friable
o. Does the waste represented by this profile contain benzene? ......... ·-··--·-·-····---·-·-··--·--··--····-·····················-·--·-···-·-···-··
If yes, concentration . 0.00 16 ppm
Is the waste subject to the benzene waste operati ons NESHAP?·---·········•:-.............. __ .. _._ .. _ ........ -.-··-····---·-····--····-····
p. Is the waste subject to RCRA Subpart CC controls? ..................................... ·•··-··············-··-··· ............ _._ .. _ ......... ____ .,._ . .,
If no, does the waste meet the organic LOR Exemption? ..... _ ............ ·-·····-········ ........ -...................... ·-····· .... · .... -......... .
If no, does the waste co ntain <500 ppmw volatile organic (VO)? .. _ .. _ ................ -···············-·-···-·-· ····-··············· ........ _
Volatile organic conce ntrati on __________ ppmw
q. Does the waste contain any Class I or Class II ozone-depleting substances? .......... -··•·····-··· ............................... .
r. Does the waste contain debris ? (list in Ssection B.1.i). _ ----····-·· ·-··--·-..
□YES X NO
XYES □No
□YES Xl NO
XYES □No
□YES X NO
□YES X NO
X YES □NO
XYES ONO
□Y ES X NO
XYES □NO
2. Quantity of Waste
Estimated An nual Volume 200 X Tons □Yards □Drums 00ther (specify)
3. Shipping Information
a. Packaging:
X: Bulk Soli d; Type/Size: 20 yard ro ll off O Bulk Liquid; Type/Size:
□Drum; Type; Size: __ □Other:
b. Shipping Frequency: Units 2 Per:XMonth Oauarter □Year D one time Cl Other.·
c. Is this a U.S. Department of Transportation (US DOT) Hazardous Material? (If no, skip d, e, and f) .. □YES X NO
999·2117
\Al1!_;:J
WASTE MANAGEMENT GENERA TOR'S WASTE PROFILE SHEET
PLEASE PRINT IN INK OR TYPE
d. Reportable Quantity (lbs.; kgs.): e. Hazard Class/ID#:
f. USDOT Shipping.Name: ---~~.7.---~-~---------------------
g. Personal Protective Equipment Requirements:
h. Transporterffransfer Station:
:.cl Generator'sCertification. Please 'checka ro riateres onses;si n;·and·datebelow.~"" :·•:· .. • .. ,·: ·· ·.· ··::·. · ·:Y .,;_
1. Is this a US EPA hazardous waste (40 CFR Part 261 )? If the answer is no. skip to 2 ............................................. ·--·····--······---□YES XNO
a. If yes. identify ALL USEPA listed and characteristic waste code numbers (D. F. K. P. U)
b. If a characteristic hazardous waste. do underlying hazardous constituents
(UHCs) apply? (if yes. list in Section B.1.j) ....................................................................................... . □YES ONO
c. Does this waste contain debris? (if yes, list size and type in Chemical
Composition• 8.1.) ............................................................................................................................. . □YES □NO
2. Is this a state hazardous waste? .................................................................................... .,................................................................. 0 YES X NO
identify ALL state hazardous waste codes
3. Is the waste from a CERCLA (40 CFR 300, Appendix B) or state mandated clean-up?............................................................. X YES D NO
If yes, attach Record of Decision (ROD), 104/106 or 122 order or court order that governs site clean·up
activity. For state mandated clean-up, provide relevant documentation.
4. Does the waste represented by this waste profile sheet contain radioactive material, or is disposal
regulated by the Nuclear Regulatory Commission?........................................................................................................................ DYES XI NO
5. Does the waste represented by this waste profile sheet contain concentrations of Polychlorinated
Biphenyls (PCBs) regulated by 40 CFR 761? (if yes, list in Chemical Composition • B.1.j) ........................................................ X YES ONO
a. If yes. were the PCBs imported into the U.S.?..................................................................................... □YES X NO
6. Do the waste profile sheet and all attachments contain true and accurate descriptions of the waste
material, and has all relevant information within the possession of the Generator regarding known or
suspected hazards pertaining to the waste been disclosed to the Contractor.? ......................................................................... :... X YES D NO
7. Will all changes which occur in the character of the waste be identified by the Generator and disclosed
to the Contractor prior to providing the waste to the Contractor?................................................................................................... X YES ONO
X Check here if a Certificate of Destruction or Disposal is ~equired.
Any sample submitted is representative as defined in 40 CFR 261 • Appendix I or by using an equivalent method. I authorize WM to obtain a
sample from any waste shipment for purposes of recertification. If this certification is made by a broker. the undersigned signs as authorized
agent of the generator and has confirmed the information contained in this Profile Sheet from information provided by the generator and additional
information as it has determined to be reasonably necessary. If approved for management, Contractor has all the necessary permits and
licenses for the waste that has been characterized and identified by this approved pr file.
Certification Signature: ~a:t;r;;._~ .a;-.•·_!_~~~~~'.'.:._---Title: PCB Landfill Project Manager
Name (Type or Print): Patricia M. Backus Company Name: NCDENR Date: IO/B/02.
X Check if additional information is attached. Indicate the number of attached pages 7' 7
1. Management Method D Landfill D Non-hazardous Solidification D Bioremediation D Incineration
D Hazardous Stabilization D Other (Specify)
Proposed Ultimate Management Facility: 2.
3. Precautions, Special Handling Procedures. or Limitation on Approval:
4. Waste Form 5. Source ________ 6.
Special Waste Decision ..................................... .
Salesperson's Signature: ___________________________ _
Division Approval Signature (Optional}:
Special Waste Approvals Person Signature:
999-2117
System Type
□Approved
Date:
Date:
Date:
D Disapproved
l
Continuation of part B.1.j of the Generator's Waste Profile Sheet
Profile Number WM CU 9614
Constituents Concentration Range
Filter Fabric 0 to 100%
Dioxin/Furan TEQ 0 to 238 ng/Kg (ppt)
Granular Carbon 0 to 75%
HEP A and Cartridge Filters 0 to 30%
'
North Carolina
Department of Envirom11ent and Natural Resources
Division of Waste Management
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Dexter R. Matthews, Director
August 23, 2002
Mr. Steve Miller
Waste Management
1675 Allen's Crossroads Rd,
Four Oaks, NC 27524
Dear Mr. Miller:
. ,-·.
, . . .,,
·.'. · .... ,..._.___•i .. '. ,
NCDEMR
Thank you for including me in your meeting with Shaw Environment and Infrastrncture, our contractor
for the PCB Landfill Detoxification Project, concerning the disposal of material from the project at your
Emelle, Alabama, facility.
You requested that I supply information concerning the history of the landfill and the state mandate for
the remediation project.
History of the Landfill
In 1982 the State of North Carolina constructed a landfill permitted under the Toxic Substances Control
Act (TSCA) in Warren County. The purpose of the landfill was to contain soil that had been
contaminated by the illegal spraying of liquids containing polychlorinated biphenyls (PCBs) along over
210 miles of road in North Carolina. The contaminated roadsides, designated as the PCB Spills, were
listed on the National Priorities List and the removal of the contaminated soil and placement in the
landfill was the remedial action approved by the U. S. Environmental Protection Agency (EPA) under the
Superfimd program.
Before soil removal, the ro adsides were sampled to determine the extent of contamination. Based on the
analyses, the shoulders of the roads were trenched to a width of approximately 24"-30" from the edge of
pavement, and approximately 3" deep. This plan was designed to remove all of the contarninated soil
along with a small amount of uncontaminated soil. Sampling also identified the contaminant as a mixture
similar to Aroclor 1260.
Construction of the landfill began on June 21, 1982. Placement of contaminated soil into the landfill
commenced on September 15, 1982 and was completed on November 17, 1982. The soil was excavated
from the roadsides and transported directly to the landfill by the North Carolina Department of
Transportation. Trnck identification and weigh was closely monitored. The North Carolina Department
of Public Safety provided around the clock security. The total volume of contaminated soil was estimated
to be 40,000 cubic yards. The only additional materials placed in the landfill were 50 truckloads of
cement kiln dust purchased from a vendor in New Hanover County. The kiln dust was placed in the
northeast corner of the landfiJI to absorb excess moisture due to extremely heavy rains during the
construction. After all the roadside material was received, the landfill was closed. Construction was
completed on July 14, 1983.
1646 Mail Service Center, Raleigh, North Carolina 27699-1646
Phone: 9 I 9-733-4996 \ FAX: [phone] \ Internet: www.enr state.nc.us
AN EQUAL OPPORTUNITY \ AFFIRMATIVE ACTION EMPLOYER -50% RECYCLED / I 0% POST CONSUMER PAPER
t Mr. Steve Miller
August 23, _2002 ____________ ····---·---··-_. ___ ,. ______________________________ _ -------
Mandate for Remediation
Over 90 sites in 20 counties were evaluated as possible landfill locations with six sites chosen for
extensive investigation. The Warren County site was selected as the location for the new landfill because
it "demonstrated the least restrictions and the greatest degree of protection of the public health and
environment." However, many in the community felt the county was the selected because it had a
predominantly minority population and was one of the poorer counties in the state. Residents and civil
rights leaders vehemently protested the construction of the landfill with over 400 arrested. That
community activism is considered the "watershed event" that brought the environmental justice
movement to the national level.,;
The Governor of North Carolina at the time, James B. Hunt, Jr., wrote a letter to the citizens of Warren
County promising that the state would "push as bard as it can for detoxification of the landfill when and if
the appropriate and feasible technology is developed." Landfilling was the only TSCA-approved disposal
method for contaminated soil at that time of the spills. A study conducted in the mid-l 980s concluded
that no detoxification technology was available and that the landfill was "state-of-the-art."
Despite assurances that the landfill was well-constructed and approved for construction by EPA and that
monitoring has not indicated the movement of contaminants beyond the landfill, the citiz.ens living nearby
remain concerned about the possible health impacts now and in the future.
Following Governor Hunt's return to office in 1993, a Joint Warren County/State PCB Landfill Working
Group (Working Group) consisting of community members, environmental activists, and representatives
from the Department of Environment and Natural Resources (DENR) was established. The Working
Group with the assistance of independent science advisors selected Base Catalyzed Decomposition as the
best and safest process for the site.
The General Assembly of North Carolina supported their decision by mandating the use of Base
Catalyred Decomposition for the remediation in Session Law 1998-212, Senate Bill 1366 and directed
DENR to oversee the project.
If you require additional information or have questions, please call me at [phone] ext 308.
Sincerely,
Patricia M. Backus, P .E.
PCB Landfill Project Manager
cc: Mike Kelly, DENR
Gary Duke, Shaw E&I
Bill Gallagher, Shaw E&I
Jim Cloonan, Earth Tech
Analytical Data on Material in the Landfill
Table 4-2 .......................................... PCB Data Summary-Raw Soil
Table 4-3 .......................................... PCDDs/PCDFs Data Summary -Raw Soil
Table 4-4 ........................................... VOC Data Summary-Raw Soil
,4 .
•\
' I TABLE 4-2
WARREN COUNTY PCB LANDFILL TREA TABILITY STUDY
PCB DATA SUMMARY -RAW SOIL
I WC1-3 WC1-4 WC2-3 WC2-4 Soil Blank
I Analytes ug/kg (ppb) ug/kg (ppb) ug/kg (ppb) ug/kg (ppb) ug/kg {ppb)
Total MonoCB 28 44 6 3 ND (0.09)
I Total DiCB 2,900 3,100 205 118 ND (0.09)
Total TriCB 19,940 20,850 2,060 764 ND (0.1)
I Total TetraCB 19,590 25,090 4,260 1,970 ND (0.1)
Total PentaCB 60,880 71,890 30,600 20,010 ND (0.2)
Total HexaCB 256,250 419,610 189,500 129,450 ND(0.1)
I Total OctraCB 155,970 261,390 121,220 87,770 ND (0.1)
Total NonaCB 30,050 49,050 23,400 18,080 ND (0.1)
Deca CB 1,400 2,260 1,030 768 ND (0.1)
19 32 26 21 ND(0.2)
Total PCB 547,027 853,316 372,307 258,954 ND
*Data analyzed by Triangle Laboratories, Inc.
,.
,_ .
I TABLE 4-3
WARREN COUNTY PCB LANDFILL TREA TABILITY STUDY
I PCDDs/PCDFs DATA SUMMARY-RAW SOIL
f
WC1-3 WC1-4 WC2-3 WC2-4 Soll
Analytes ng/Kg {ppt) ng/Kg {ppt) ng/Kg (ppt) ng/Kg (ppt) Blank
2378-TCDD ND ND ND ND ND (0.3)
12378-PeCDD ND ND ND ND ND (0.6)
123478-HxCDD ND ND ND ND ND (0.5)
123678-HxCDD 2.2 2.3 4.5 ND ND (0.4)
123789-HxCDD 1.8 1.6 2.1 ND ND (0.5)
1234678-HpCDD 14.8 18.1 145 32.8 ND (0.8)
OCDD 506 515 2,710 1,300 ND (1.5)
2378-TCDF 108 125 46.1 49.7 ND (0.3)
12378-PeCDF 29.7 33.8 12.7 14.4 ND (0.5)
23478-PeCDF 114 123 53.5 58 ND (0.5)
123478-HxCDF 1120 1230 826 923 ND (0.5)
123678-HxCDF 126 136 111 135 ND (0.4)
234678-HxCDF 50.9 48.8 31.6 34 ND (0.6)
123789-HxCDF 6.3 5.9 3.6 2.8 ND(0.6)
1234678-HpCDF 821 864 648 704 ND (0.6)
1234 789-HpCDF 547 584 354 337 ND (0.9)
OCDF 4050 5050 2930 2910 ND (1.2)
2378-TEQ 218 238 147 159 0
Total TCDD 12.3 1.3 0.95 1.4 ND (0.3)
Total PeCDD 31.3 35.4 16.8 17.5 ND (0.6)
Total HxCDD 9.2 7.7 13.5 4.9 ND (0.5)
Total HpCDD 14.9 35 323 78.3 ND (0.8)
OCDD 506 515 2,710 1,300 ND (1.5)
Total TCDF 465 459 171 189 ND (0.3)
Total PeCDF 763 844 470 504 ND (0.5)
Totai HxCDF 1990 2180 1510 1720 ND (0.5)
Total HpCDF 2350 2600 1680 1680 ND (0.7)
OCDF 4050 5050 2930 2910 ND (1 .2)
Total PCDD/F 10,192 11,727 9,825 8,405 0
' ,
TABLE4-4
WARREN COUNTY PCB LANDFILL TREA TABILITY STUDY
voe DATA SUMMARY-RAW SOIL
WC1-3 WC1-4 WC2-3 WC2-4 UTS Non-WW
Analytes ug/Kg ug/Kg ug/Kg ug/Kg ug/Kg
Chloromethane ND(0.3} ND(0.24} 6.04 ND(0.24} 30,000
Vinyl Chloride ND(0.28} NO(0.22) ND(0.21) ND(0.22)
Bromomethane ND(0.31) NO(0.25} ND(0.24) ND(0.25)
Chloroethane ND(0.33) ND(0.26) ND(0.25} ND(0.26)
Trichlorofluoromethane ND(0.11} ND(0.09) ND(0.08} ND(0.09}
1, 1-Dichloroethene ND(0.22} ND(0.18) ND(0.17) ND(0.18)
Carbon disulfide 0.37 ND(0.05} ND(0.05) ND(0.05) 4,800
Acetone 17.42 ND(0.18) 4.1 ND(0.18) 160,000
Methylene chloride 3.53 2.6 · 2.55 2.45 30,000
trans-1,2-Dichloroethene ND(0.16) ND(0.13) ND(0.12) ND(0.13)
1, 1-Dichloroethane ND(0.1) ND(0.08) ND(0.07) ND(0.08)
cis-1,2-Dichloroethane ND(0.16) ND(0.13) ND(0.12) ND(0.13)
Chloroform 0.31 ND(0.06) ND(0.06) ND(0.06) 6,000
1,2-Dichloroethane ND(0.12) ND(0.1) ND(0.09) ND(0.1}
Vinyl acetate ND(0.09) ND(0.06) ND(0.06) ND(0.06)
2-Butanone 64.43 ND(0.79} ND(0.75) ND(0.79)
1, 1, 1-Trichloroethane ND(0.12) ND(0.09) ND(0.08) ND(0.09)
Carbon tetrachloride 5.76 ND(0.13) 2.59 3.5 6,000
Benzene 1.47 1.47 1.6 1.18 10,000
Trichloroethene ND(0.37} ND(0.26) ND(0.25) ND(0.27}
1,2-Dichloropropane ND(0.22) ND(0.16) ND(0.15) ND(0.16}
Bromodichloromethane ND(0.12) ND(0.08) ND(0.08} ND(0.08)
cis-1 , 3-Dichloropropene ND(0.13) ND(0.09) ND(0.09) ND(0.09)
trans-1 , 3-Dichloropropene ND(0.15) ND(0.11) ND(0.1) ND(0.11)
1, 1,2-Trichloroethane ND(0.18) 0ND(.13) ND(0.12) ND(0.13)
Dibromochloromethane ND(0.27) ND(0.19) ND(0.18) ND(0.19)
Bromoform ND(0.35) ND(0.25) ND(0.24) ND(0.25)
4-Methyl-2-pentanone ND(0.12) ND(0.09) ND(0.09) ND(0.09)
Toluene 2.63 ND(0.06} 2.3 2.13 10,000
Tetrachloroethene 1.75 ND(0.25) 1.21 ND(0.26) 6,000
2-Hexanone ND(0.16) ND(0.11} ND(0.11) ND(0.12}
Chlcrobenzene 27.64 28.29 2.02 2.55 5,000
Ethylbenzene ND(0.17} ND(0.12) ND(0.12) ND(0.13}
m-/p-Xylene 0.77 ND(.09) 0.33 ND(0.09)
a-Xylene ND(0.14) ND(0.1) ND(0.1) ND(0.1} · 30,000
Styrene ND(0.08) ND(0.05) ND(0.05) ND(0.06)
1, 1,2,2-Tetrachloroethane ND(0.09) ND(0.06) ND(0.06) ND(0.06)