NCD980602163_20040206_Warren County PCB Landfill_SERB C_PCB Waste Shipments - Port Arthur, TX-OCR

PCB Waste Shipments TX Manifest Estimated Corrected Document Generator Quantity Quantity Treatment Number Signature OSD (kg) (kg) Transporter Description Date 2760562 11/13/2003 11/14/2003 16,600 16,600 11/14/2003 PCB Liquid 12/19/2003 3096202 02/06/2004 02/06/2004 PCB Decon Water 02/22/2004 Total 16,600 kg No. of Shipments 2 Port Arthur
TEXAS COMMISSION ON
ENVIRONMENT AL QUALITY
P.O. Box 13087
Austin, Texas 78711-3087
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form approved. 0MB No. 2050-0039.
UNIFORM HAZARDOUS 11 . ~enerator'~ US EPA ID-~\ Manifest 2. Page 1
I
Information in the shaded areas
) ' WASTE MANIFEST .o .-, lrfocument No. of 1 is not required by Federal law. N .c -R-0 .u .o -1 -3 ./ •U ·-'-. d . il . 1 H
3. Generator's Name and Mailing Address A. State Manifest Document Number
· Wf\RREN CO PCS U\NDFlLL .3096202 ROUTE 4 BOX 426 SAME ' WARRENtON , NC 27589 B. State Generator's ID ,·
4. Generator's Phone ( 919 )733-,rn96 000 . 3,1'·. ., n
5. Transporter 1 Company Name 6. US EPA ID Number C. State•Tr~nsporter's ID • •!',
HOBBIE D. WOOD.INC IA · L -D -0 -6 . 7 -1 -3 -13 -8-9 -1 D. Transporter's Phone [phone] •
7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID • . 'i
I F. Transporter's Phone ( .
9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID ,,
ONYX HMROMMENTAL SERV, LLC
HIGHWAY 73 H. Facility's Phone 3 .5 Ml LES W. OF T AYLm~·s BAYOU IT .x .o .o .o .o .8 .3 .B .B .9 .6 ; PORT ARTHUR TX 77640 [phone]
11A. 11 . US DOT Description (including Proper Shipping Name, Hazard Class, ID 12. Containers 13. 14. I. Total Unit HM Number and Packing Group) No. Type Quantity WVVol Waste No.•
X a. E:NVlRONMENTALLY HAZARDOUS SUBST.ANCES. LIQUID, NONE . n.o.s., 9, UN3082, Ill ..
G o·o ·1 T.T K ()<)re,. lllil E N b. E R
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J. _Additional Description!l for Materials.Usted Above ··• K_. Handling Codes for Wastes Listed Above
A) U-DECON-WA1ER 'M TH PCB'S '
SR#572571 1 0~ of .'Se,r\/t'ce~ 2.(Co{O&\-, .
< ;\''
15. Special Handling Instructions and Additional Information
PACr;JNG SUPS ATTACHED FOR CLARIFICATION -EMERGENCY NUMBER-INFOH"<AC: 1-800-535-5053, CERTIFICATE OF
DESTRUCTION REQUIRED .
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, packaged, marked, and labelled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and
national government regulations, including applicable state 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. ,,
ISi~~~
-·-Printedffyped Name Ji;(_ zq_.. -J,.
Month Day Year
-Pc:t. t n' c..i Cl.. M. 80...cku..s lo.::: 1,, · r; I•)· '
T 17. Transporter 1 Acknowledgement of Receipt of Materials Date R Printedffyped Name I Signature A Month Day Year 1 N I ! ·.J_· .1 s p
0 18. Transporter 2 Acknowledgement of Receipt of Materials Date R Printedffyped Name I Signature Month Day Year T E I I I R
19. Discrepancy Indication Space
F
A
C
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L 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. I
T r Date y
Printedffyped Name I Signature Month Day Year
---L~-1 I
,r-cn rvJ-11 IDn11 na1n1 In?\
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.... ENVIRONMENTAL SERVIO~S, L.L.C.
. Federal EPA ID: TX0000838896 !\
State EPA ID: 50212"001 Ji
Highway 73 i1
Port Arthur, TX 77643 \t
[phone] f
i JO ~ ~
WARREN COUNTY Pee LANDFliL
ATTN: MANIFEST SECTION ~i NCR□D0137802 1i
RT 4 BOX 426 ~!
WARRENTON, NC 27589 }
Ji ..!i
ONYX ES
CERTIFIC'iE OF OEST.RUCTION
'i:
, !,l
Onyx Environmental Services, L.L.fi. has received waete meterial·'from
WARREN COUNTY PCB L.ANDFI*' on 2/9/2004 as described on [State Manifest
or Uniform) Hazardous Waste M.ln st nvmbl!lr 0003096202. Onyx Emirornnental
SecViees. LL..C, hereby certifies tt,/, the at:icve described material was incinerated,
and thereby destroyed, rn accordatt_e with the 40 CFR, ~rt 761, as tt pertains to
the lncineratkln of Poly.Cr,1orinated('3iphenyl contaminated materials. ~-~· 'i[
Sequence 1 l!
ti
Profile Number: 372777 ";! ,, ,:
OnyX Tracking ID: •J• 572479 ,,
·I 1,
?rocess oa~uniu~i !r:§iimerJt Date !lenemQi:,!
INOINEAATION 1 ~i ,Ji 212:2/2004 NIA
Under clvfl'and criminal pen~lties of'. for ttie maklng or submission or false or
fraudulent statements or represent*. ons (18 U.S.C. 1001 and 15 u.s.c. 2615),
I certify that the information contain in or aocompanyiny this document is true,
accurate, and complete. M to the : entified saotion(s.) of this document for
Whieh I cannot pdtsanally v~rify trutt=.•nd accuracy1 l certify as the company official 11avlng supervi.ory responsi lity for tt'le persons who. acting under my
direct Instructions, made tha veri . on that this information is true, accurate,
and complete. f ~: p ,,
f -~ -~~t-·-··-· --
PAGE 02/0:2
' I.,:
'T~;AS NA!UR~L RESOURCE
CONSER~TION COMMISSION
P.O,Box 13087
Austin, Texas 78711-3087
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form approved. 0MB No. 2050-0039.
UNIFORM HAZARDOUS Ii 1. Generator's US EPA ID No. Manifest 2. Page 1 I Information in the shaded areas
I) ' WASTE MANIFEST N ·C ·R ·D ·D ·D ·1 ~ q £ 0 ,, LDocu_ment No. of 1 is not required by Federal law. ,
3. Generator's Name and Mailing Address -A. State Manifest Document Number
WA.PREN CO PCB LJl..r.JDF'U_ 02760562 RO'JTE j BC'.<' J26 S.A.ME
'.N,'PD'.:•!T!')N NC ::?7 5':19 B. State Generator's ID
4. Generator's Phone ( om ) . 73·~-<l9fi6 Poon
.oiaworter 1 Company Name !!:ED~,~ ~f~ -~~~101~~4-] __ C. State Transporter's ID '-fO ~~
TP!-ST/t.F MOTOP TRAN!"'H re-, D. Transporter's Phone tAnm ">'lA_A7~A
7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID
I F. Transporter's Phone
9. Designated Facility Name and Site Address 10. US EPA ID Number G.State Facility's ID
C;Nyx: E"·.J\·~ P.i:)r-· .. '~'1•1FN1 At. SEF?"-/, LLC
H!C:J-IWf..V 7:"1 H. Facility's Phone
3 5 M!L.ESW or TA'!LOR'S 8AYOI.J h o,~·oT ,,n.-rl-;• 'D -r·; r7c:_ 1n ·x ·o ·o ·o ·o ·a ·3 ·s ·s ·g ·6 f,!f)! I\ 71R-?A?1
11A. 11 . US DOT Description (including Proper Shipping Name, Hazard Class, ID 12. Containers 13. 14. I. Total Unit HM Number and Packing Group) No. Type Quantity Wt/Vol Waste No.
X a. PO, H/1ZAf~OQUS \.VASTF. UOU!'J. no ,3, (0018. D 0 1 8
G 0027). 9. NA30Q7., Iii, (F'CS) O·D ·l 1 -~-f,-D-t> MS20DM-E T 'T K
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J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above
A) UE PCB LIQUIDS PTA372704, OUT
OF SER\ACE DATE 11/14/03 ~ ~v~t t: 5oq1q1 l
15. Special Handling Instructions and Additional Information
PAC!-<JNG SUPS ATTACHED FOP CLAR!FICAT!ON -EMERGENCY NUMBER INF"OTRAC
Cer\,~\~te Of D~trvchb" R.8l.Ui~.
1 800 535-5053
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, packaged, marked, and labelled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and
national government regulations, including applicable state 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.
" ~nted/Typed Name Is~~ ~-Month Day Year
l:ttri cl~ M . Ba__c_.kLL.5. ~ L / I L /. 3 LO,__ 3
T 17. Transporter 1 Acknowledgement of Receipt of Materials ..,, Date R l~ruJ ,fl~.~
A
Gr=perrr: rrF-1--tJuJ Month Day Year N I /. / I / .i./ I 0.--=? s p
18. Transpq/ter 2 Acknowledgement of Receipt of Materials f I 0 Date R Printed/Typed Name I Signature Month Day Year T
E I I I R
19. Discrepancy Indication Space
F
A
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L 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. I
T Date y
nntpdaytS~eM M~-,~ ~oh vi', lSi!n (h (/ lJfi ~~ j A;. .
re
Mrr D~ y~ QlUl I · I/. 10-
TNRCC-0311 (Rev. 07/01/97) :J White -original-Pink-TSD Facility Yellow-Transpo ~er Green-Generator's first copy
When using the Uniform Waste Manifest for rail or water (bulk shipment) or international shipments refer to the applicable TNRCC regulations.,
REPORT SIPILLS AND/OR DISCHARGES TO THE TEXAS SPILL RESPONSE CENTER AT 512/463-7727 (24 HOURS)
INSTRUCTIONS TO GENERATOR (Please Type or Print Clearlyi
--
(1) Enter the Generator's U.S. EPA twelve digit identification number and the unique five digit number assigned to this manifest by the generator if you are
shipping hazardous waste.
(2) Enter the total number of pages used to complete this manifest.
(3) Enter the company name and mailing address of the generator of the waste.
(4) Provide a phone number where an authorized agent of your firm may be reached in the event of an emergency.
(5) Enter the company name of the first transporter and their U.S. EPA ID Number.
(6) If applicable, enter the company name of the second transporter and their U.S. EPA ID Number. If more than two transporters are used, enter each additional
transporter's information on the Continuation Sheet (EPA form 8700-22A) or in box 15 of this form.
(7) Enter the company name, site address, and U.S. EPA ID Number of the facility designated to receive the waste listed on this manifest.
(8) COMPLETE ALL STATE OF TEXAS INFORMATION A. THROUGH H. IN THE SHADED AREAS.
(9) Complete the waste description table as follows:
(A) ITEM 11 A -When shipping an EPA/DOT regulated hazardous waste or material in conjunction with solely state regulated waste enter an "x" in the
HM box before each EPA/DOT regulated waste/material description.
(B) ITEM 11 -Enter the U.S. DOT Proper Shipping Name, Hazard Class or Division, and ID Number (UN/NA) for each waste identified. If it is a Class I
nonhazardous waste use the Texas Waste Code description.
(C) ITEM 12 -Enter the number of containers for each waste and the appropriate abbreviation for type located in Subchapter A of the TNRCC Industrial
Solid Waste Rules.
(D) ITEM 13 -Enter the total quantity of waste described on each line.
(E) ITEM 14 -Enter the appropriate letter from the table below !or the unit of measure.
G = Gallons (liquids only)
P = Pounds
T = Tons (2000 lbs.)
Y = Cubic Yards
L = Liter (Liquids Only)
K ~ Kilograms
(F) ITEM I -Enter the appropriate TNRCC State Waste Code for each waste you are shipping.
M = Metric Tons (1000 kg.)
N = Cubic Meters
(10) The Generator must read, sign (by hand). and date the certification statement. If a mode other than highway is used, the word "highway" should be lined
out and the appropriate mode (rail, water or air) inserted in the space below. In signing the waste minimization certification statement, those generators
shipping hazardous waste who have not been exempted by statute or regulation from the duty to make a waste minimization certification are also certifying
that they have complied with the waste minimization requi rements.
(11) The manifest must be signed and dated by the first transporter in the presence of the Generator. If more than one transporter is to be used, the Generator
must provide additional copies lo, their use.
* (12) Generator retains green copy, sending remaining copies with the driver.
INSTRUCTIONS FOR THE TRANSPORTER (Please Type or Print clearly)
(1) As driver of the transport vehicle, you are responsible for ensuring that all waste received by you arrives at the specified destination.
(2) Sign and date the space provided, certifying the waste amounts in PART I were received for transport. NOTE: If you are unable to carry out the delivery
of the shipment as specified, dial the emergency phone numbers given in PART I notifying the GENERATOR.
(3) Upon delivery of the shipment, the TSD Facility Owner/Operator is to sign for the shipment in your presence and fill in "date received".
' • *(4) S~parate,the yellow copy.and retain fiiryour records. Leav.e the ·remaining ?Opies with the TSD Facility_Owner/Operator.
INSTRUCTIONS TO TREATMENT, STORAGE AND DISPOSAL (TSO) FACILITY OWNER/OPERATOR (Please Type or Print Clearly)
(1) The authorized representative of the designated (or alternate) facility's owner or operator must note in ITEM 19 any significant discrepancy between the
waste described on the manifest and the waste actually received at the facility.
(2) Enter date received and sign in the presence of the driver declaring receipt of the wastes and verifying the quantities in _the table in PART I.
(3) Retain the pink copy for your records and return the completed original (white) copy to the GENERATOR.
t
• U.S. EPA and TNRCC regulations require that copies of this Uniform Hazardous Waste Manifest be retained for a period of three (3) years in your company records. Do not send to TNRCC unless otherwise notified by these departments.
BURDEN STATEMENT
The public reporting burden for this collection of information is estimated to average 31 minutes for generators, 16 minutes for transporters, and 16 minutes for treatment, storage and disposal facilities. The recordkeeping burden
per response for this collection of information is estimated to average 6 minutes for generators, 6 minutes for transporters, and 6 minutes for treatment, storage and disposal facilities. The burden associated with reading the regulations
is estimated at 1 hour and 15 minutes annually. Burden means the total time, effort. or financial resources expended by persons to generate, maintain, retain, or disclose or provide information to or for a Federal agency. An agency may not conduct or sponsor, and a person is r.ot required to respond to, a collection of inforr.,ation unless it displays a currently valid 0MB control number. The 0MB numbers for EPA's regulations are listed in 40
CFR Part 9 and 48 CFR Chapter 15. Send comments regarding \hose burden statements er any olhe, aspect cf this collection, ir.ctuding suggestions for reducing the burden, including through the use of automated collection tech-
niques to the Director, OPPE Regulatory lnformahoc Divis,o:i. U.S. E,wircnmentat Proleclloc Agency 12137/. 401 M St, S.W., Washington, D.C., 20460 and to the Office of Information and Regulatory Attairs, Office of Management
and Budget, Attention: Desk Officer for EPA, 725 17tn Sueet. N.N. Wash111gto:1, D.,~. 2C503. include tne ot.:8 control number in any correspondence
ONYX ENVIRONMENTAL SERVICES, L.L.C.
Onyx Environmental
P.O. Box..2563
4'0NYX
Port Arthur, Texas 77643-2563
Date: l \I \J ( 0 6
lDJai°f~V\ ~ o ~~b u ndh\ \
\
Regarding Texas Manifest (s):
TX __,,._O :If---"!--=-~ O"---"<.S-=---(_p~--'----
TX-------------
TX ____________ _
TX
TX
TX
The following corrections should be made to the above manifest (s). Please note these corrections for your next shipment.
Item 1. Should be
Item 6. Should be
Item 8. Should be
Item 10. Should be TXD000838896
Item 14. Should be
Item B. Should be
Item C. Should be
Item D. Should be
Item E. Should be
Item F. Should be
Item G. Should be 50212
Item H. Should be
Item I. Should be
Item K. Should be t\040
Item R. Should be
Item T. Should be
If you have any questions, please call us.
Sincerely,
Receiving
CC: File Printed on recycled paper
' TEXAS NATYRAt.l REi ou\cE • }
CONSER\AtTION COMMISSION ~ P.O.mox 13087
Austin, Texas 78711-3087
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form approved. 0MB No. 2050-0039.
UNIFORM HAZARDOUS 11. Generator's US EPA ID No. Manifest 2. Page 1 I Information in the shaded areas
' WASTE MANIFEST IN ·r ·c ·n ·n ·n ·1 -~ ·7 'Rn ., I Docu_ment No. of 1 is not required by Federal law.
3. Generator's Name and Mailing Address V ~ V V ' A. State Manifest Document Number
WARREN CO PCB LAN DR LL SAME 02760562 ROUTE 4 BOX 426 WARRENTON, NC 27569 B. State Generator's ID
4. Generator's Phone ( Q10 ) 7'l~_,.nno Doo3, bJ6~orter 1 Company Name E£:?D P-Kf<:.-t, .(-t, 1."12 -~ .Ys8t/~'5offr3..47 ·-
C. State Transporter's ID '4-r'J ~"'--
'(CI_CTATa:; •~AT/"\D TCA~''"'T r-r, D. Transporter's Phone ·-'-... .c.. ... ----
7. Transporter 2 Company Name 8. US EPA ID-Number --E. State Transporter's ID •-.. -
I F. Transporter's Phone
9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID
ONYX EN'v1RONMENTAL SERV, LLC
HIGHWAY73 H. Facility's Phone .
3 5 Ml LES W OF TAYLOR'S BAYOU IT ·y ·n ·n ·n ·n ·A -~ ·A 'A ·a 'R ,~-· ------· _,,,, ___ ... --· ... ,... _., _, __ ·-
11. us D0Y ciescriptio1n'i1ncluding Proper Shipping Name, Hazard Class, ID 13. 1'4. ...,,. ... ---·•· 11A. 12. Containers I. Total Unit HM Number and Packing Group) No. Type Quantity Wt/Vol Waste No.
X a. RO. HAZARDOUS WASTE. LIQUID, n.o.s .. (0018, 00 1 8
G 0027), 9, NA30B2, Ill. (PCB) 10'/YI IT ·r t-~-~-D·l> I(' It)\ \.t <! .,.I\ l...ll E
N b. E
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J. Additional Descriptions for Materials Listed Above I K. Handling Codes for Wastes Listed Above
A) llE Pt$ UQUIOS.PTA.372184,0UT
OF SS'oMCe OATE U/14/03 Sen,,ce ~~qJ;e~t it: 9or,1q J .
15. Special Handling Instructions and Additional Information
PACl<ING SUPS ATTACHED FOR CLARIFICATION -EMERGENCY NUMBER-INFOTRAC: 1-800-535-5053
C.e--t, Cad f' O( DP'"_,itvd 10n Rf1lJUlvt'c1.
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, packaged, marked, and labelled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and
national government regulations, including applicable state 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.
IH Printed/Typed Name I Sign;:i.ture Month Day Year R,f v-, CI,-;\< p '1. ,... I< ii ".. ''-$) /-,/ ~--k,:.: , .:,1,,_J I. 1.1 1.l -.3Lo-· (. :-j ~\. /,) . . ... ~
T 17. Transporter 1 Acknowledgement of Receipt of Materials ~ Date A I~; A a rinted/Type{Name Month Day Year N .,.. ,A{l'-J '.l) I r,,-f MUJ I /. I I , .I.J 1-/').=1 s '.J. ,. I "j). ~ ,,,, ~ p
18. TranspoJ er 2 Acknowledgement of Receipt of Materials , --, Date 0 i J A Printed/Typed Name I Signature Month Day Year T
E I I I A
19. Discrepancy Indication Space
F
A
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L 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. I
T Date y I Signature Printed/Typed Name Month Day Year
I I · I
TNRCC-0311 (Rev. 07/01/97) White -original Pink-TSO Facility Yellow-Transporter Green-Generator's first copy
TE~AS NATURAL RESOURCE
CONSER'f ATION COMMISSION
P.O Box '13087
PA T
l ,
Austin, Texas 78711-3087
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form approved. 0MB No. 2050-0039.
UNIFORM HAZARDOUS 1. Generator's US EPA ID No.
WASTE MANIFEST
3. Generator's Name and Mailing Address
WARREN CO PCB LANDFILL ROUTE 4 BOX 426 WARRENTON, NC 27589
T -STA
S.A.ME
0 2
Manifest
Document No. . . .
7. Transporter 2 Company Name 8. US EPA ID Number
9. Designated Facility Name and Site Address
ONYX EN\1RONMENTAL SERV., LLC
HIGHWAY 73
3 .5 Ml LES W. OF TAYLOR'S BAYOU
10. US EPA ID Num_ber
T ·x ·o ·o ·o ·o ·B ·3 ·B ~ ~ ·
11A. HM
11. US DOT Description (including Proper Shipping Name, Hazard Class, ID
Number and Packing Group)
X a. RO, HAZARDOUS WASTE, UQUID, n.o s., (D018,
formation in .the shaded areas . .
0027)., 9, NA3082, Ill . (PCB) 1 I L D -1\
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15. Special Handling Instructions and Additional Information
PACl<JNG SUPS ATTACHED FOR CLARIFICATI ON -EMERGENCY NUMBER-INFOTRAC: 1-800-535-5053
C.erii'f\~~ of D6trvch'o" R~ui~.
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, packaged, marked, and labelled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and
national government regulations, including applicable state 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.
~nted/Typed Name
f-·fLtr,· ci-~ M.
19. Discrepancy Indication Space
~ 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
T D~e Yl--------=------'--------------....,,..------------------------'----------1 Printed/Typed Name Signature Month Day Year
TNRCC-0311 (Rev. 07/01/97) White O original Pink-TSO Facility Yellow-Transporter Green-Generator's first copy
,. TEXAS NATURAL RESOURCE
CONSE~W\TION COMMISSION
, P.O.·Box 1301,17
Austin, Texas 78711 -3087
Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form approved. 0MB No. 2050-0039.
UNIFORM HAZARDOUS 1.1, ._G __ en __ era_ t_or's u_s EPA 1_0 No. Manifest 2. Page 1 I Information in .the shaded areas
1,,1-___ W.;.;..A_S_T_E_M_A_N_IF_E_S_T ___ ..._ ______________ ~l.~q-oc_u __ m~e-n_tN_o __ ·+--of_, _ __. __ is_no_t_re_q_u_ir_e_d_b_y_F_e_d_e_r-al_l_a_w_.~
3. Generator's Name and Mailing Address A. State Manifest Document Number
02760562 _..,,. •_! T?1J··-! ·.·c
,· ,r··; . ·re "-,··
8. State Generator's ID
4. Generator's Phone ( ,-1r; ) •,.-·, ·;:vw Poo.3, ,, -~..;.;_-"-'-----------------------+.,,--.,,---=-----=.A.------------1 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID
I . . . . , . ,· " . , . , . . .,., D. Transporter's Phone rnnm ?'IA .. C!"t,1i:i
7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID
I F. Transporter's Phone
9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID
;·_:r-· T.'· .. _-; .'.··,,·-, .. ,:: r; ·;-,( H. Facility's Phone
.... ,.. ·, ... ;
11A. 11. US DOT Description (including Proper Shipping Name, Hazard Class, ID 12. Containers 13.
Total
Quantity
14.
Unit
Wt/Vol HM Number and Packing Group) No. Type
d.
.
7'.lfi-13?1
I.
Waste No.
J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above
1l.) LJE PCB UOUiDS PTA3727U( OUT :
OF SERVI CE DATE 11/14/03
Sen,~~ ~etf.J}~t t: 9oq1q1
15. Special Handling Instructions and Additional Information
,. ·· ... ~-~ r,: .--.. :: :--~-•\ 1 T ~-.!: H[C1 FC·fJ CLAf{! r! C./\--(/·.J r:r,: 1:-:·-=-~--r -~~ -~ '·/ ; l'. s"J '1f" f .~ i; . ·r ~};
Certt'f\-coJe of D6trvchol'\ R.equi'~.
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, packaged, marked, and labelled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and
national government regulations, including applicable state 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.
J;!!;inted/Typed Name
~a±n· ct'~ M . B°'-Gk~ Month Day Year
I. I 1lJ -.3L 0 __ 3
~ 17. Transporter 1 Acknowledgement of Receipt of Materials Date
A Printed/Typed Name I Signature Month Day Year ~ I I I Pl------------------------....1..----------------------.j,,,>, ......... ~__,~,,...~ o 18. Transporter 2 Acknowledgement of Receipt of Materials Date Rl-----"-------"------'----------,,------------------------'---------1 r Printed/Typed Name I Signature Month Day Year
-~--~-------------------------~-------~~,~=-====-~~~~,L:=L~ 19. Discrepancy Indication Space
~----------------------------------------~------·---~ ! ~ 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by ihis manifest exciii.Tt as notecl in Item 19. -. ----~ ·. -· .• ~··
~ . ___ .,_ ··----·-_J_ Date _
.__..._ __ Printed/Typed Name . I Signature ·----------····--... ···-~-----_ .ton~~L~~~: _L~~~~'
TNACC-03; 1 (Rev. 07/0 1/97)
!J{NYX IENVlillONMENTAL SERVICES -~
"
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N~D0J'5_ f)~. LF~ Jnru ---
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\ 01 /19/2004 16:07
01i19/2004 15:07
9195284020
4097351636
411M ENVIRONMENTAL SERVICES, L.L.C.
Federal EPA ID: TX0000838898
state EPA ID: 50212-001
Highway73
Port Arthur, TX 77643
[phone]
WARREN COUNTY PCB LANDFILL
ATTN: MANIFEST SECTJON
NCROO01378O2
RT 4 BOX426
WARRENTON, NC 27569
ONYX ES
CERTIFICATE OF Dt;STBUCllO,N
Onyx Environmental Services, L.L,C. has received waste material fmm
WARREN COUNTY pea l.ANDFILL on 11/17/2003 as described on [State
Manifest or Uniform] Ha;z:ardous Waste Manif'est number 0002780562. Onyx
Environmental Services, L.L.C. hereby certifies that the abOve descfibed material
was incinerated, and thereby destroyed, in accordance with the 40 CFR, part 761,
as it pertains to the Incineration of Poly-Chlorinated Biphenyl contaminated
materials.
Sequence 1
Profile Number:
Onyx Trackifig ID:
Process
INCINERATION
372704
571255
Onyx Unit ID Treatment Date
1 12119/2003
Generator#
NIA
uncier civil and criminal penalties of law for the making or submission of false
or fraudulent statements Qr representations (18 U,S,C. 1001 and 15 U.S.C.
2615), I certify that the information contained In or accompanying this
dooument is true, accurate, and complete. As to the Identified sectlon(s) of
this document forwh\oh I cannot personally verify truth and accuracy, I certify
as the company offi~al having supervisory responsibility for the persons who,
aCling under my di1'9ct instructions, made the verlflC8tion that this information
is tl\le, accurate, and complete.
PAGE 02/02
PAGE 02/02
ONYX ENVIRONMENTAL SERVICES, L.L.C.
WASTESTREAM INFORMATION PROFILE
□Recertification
ONYX LOCATION
0 Invoice Address
D Manifest from -blank if direct
ADDRESS
ONYX TSDF requested PTA Technology requested __
I. Generator Name Warren County PCB Landfill
Address Route 4. Box 426
Disposal Code
CITY ST
Generator No. __ Generator EPA ID No. NCR000137802
Generator State No. NC ___ _
State Wastestream No. __ _
City Warrenton State~ Country USA ZIP~
NAlCS (SIC) Code __ Source Origin __ Form System Type __
2. Waste Name PCB Liquids Lab or Waste Area __ _
3. Process Generating Waste Site Cleanup
4. Shipping Name RO. HAZARDOUS WASTE LIQUID, NOS
Hazard Class2 UN/NA No.NA3082 PGID RQ amtl00lb
RQ Do,o, I '-
DOT Desc:
5. Waste Codes 0027 D018
Wastewater O Non Wastewater [8:1 Sub Category
6. Physical and chemical pro erties (check all that apply)
pH Specific Gravity Flash Point (F) Solids
a O < 2 a O < .8 a O < 80 __ %suspended i %ash
b O 2 -5 b O .8 -1.0 b O 80 -100 % settleable
C [8:1 5 -9 C □ 1.0 C □ 101 • 140 % dissolved 17200
water solubility
BTU/lb
d O 9 -12.5 d [8:I 1.0 -1.2 d [8:1141 -200
e O > 12.5 e O > 1.2 e O > 200
exact exact f O no flash __ exact Free Liquid Range _to 100%
Physical State Hazardous Characteristics Odor
s O solid a 0 air reactive r D radioactive or NRC regulated a none □
m O semi-solid w 0 water reactive s D shock sensitive b mild ~
I [8:I Iiquid C 0 cyanide reactive t D temp sensitive c strong □
p O pumpable semi-solid f 0 sulfide reactive m O polymerization/monomer describeoil
f O flowable powder e 0 explosive n D OSHA carcinogen
g Ogas 0 0 oxidizing acid I D infectious Halogens
a O aerosol p D peroxide former h D inhalation hazard Zone: Br --%Bromine -
r O pressurized liquid Cl 5-10 % Chlorine
d O debris per 40 CFR 268.45 F --%Fluorine
h O shams I %Iodine
Layers: a Dmultilavered: b D bi-layered: c [8:1 sinele phase:
Top Laver Second Layer Bottom Laver Color
Viscosity D high (syrup) 0 high (syrup) 0 high (syrup) black
by [8:1 medium ( oil) 0 medium ( oil) 0 med ium ( oil) --
Layer: D low (water) 0 low (water) 0 low (water) --
Dsolid Osolid 0 solid
Used oil y/n _ HOC <1000 ppmOor > 1000 ppm[8:I page I of2
WIPNo.
WIP2001
7. Chemical Composition [M = Marine Pollutant, S • Severe Marine Pollutant, 0 = Ozone Depleting Substance, U = Underlying Hazardous Constituent,
B = Benzene NESHAP, T = TRI Chemical, C = OSHA Carcinogen]
Constituents
oil
PCB's
.. Total Compos1tron Must Equal or Exceed I 00"/o
Other:
8. Is the wastestream being imported into the USA?
9. Does the wastestream contain PCBs regulated by 40CFR?
PCB concentration 160.000ppm
Ranee
98-100
5-10
I 0. Is the wastestream subject to the Marine Pollutant Regulations?
11. Is the wastestream subject to Benzene NESHAP?
Units
%
%
If yes, is the wastestream subject to Notification and Control Requirements?
Benzene concentration __ ppm
Constituents
YesO
Yes[8]
Yes[8]
Yes□
YesO
Nol:8]
No □
No □
No [8]
No □
12. Is the wastestream subject to RCRA subpart CC controls? Yesl:8] No D
Volatile organic concentration, if known __ ppmw
CC approved analytical method [8] Generator Knowledge 0
13. Is the wastestream from a CERCLA or state mandated cleanup? YesO NoO
14. Container Information (Identify UN container marking if known)
Packaging: Bulk Solid O Type/Size: __ Bulk Liquid [8] Type/Size: __ Drum 0Type/Size: __
Other
Shipping Frequency: Units 5K gals
15. Additional Information: Bill to:
Shaw Environmental. Inc.
200 Horizon Center Blvd
Trenton. NJ 08691-1904
ATTN: Gary Duke, Project Manager
Per Month D Quarter 0
Is analytical or an MSDS available that describes the waste? Yes IZ! No0
GENERA TOR CERTIFICATION
Year O One Time~
If yes, please attach.
Ranee Units
I hereby certify that all information submitted in this and all attached documents contains true and accurate descriptions of this waste. Any sample submitted
is representative as defined in 40 CFR 261 -Appendix I or by using an equivalent method. All relevant information regarding known or suspected hazards in
the possession of the generator has been disclosed. I authorize sampling of any waste shipment for purposes of recertification.
-P~ t:,,..; c..i'q_ M . '?>Qc ku_s 'I I 9-733-4 9 cu;) X3o~
NAME (PRINT OR TYPE) PHONE DATE
\'-·-l?(MC-~l--<-~ ~ ~~-+=-·..-// -:PCB Lo.."'d+.· I I
SIGNATlJRE TITLE
FACILITY NOTIFICATION
If approved for management, ONYX has all the necessary permits and licenses for the waste that has been characterized and identified by this profile.
I TSDF PROCESSING USE ONLY: PPE REQUIRED No Yes Describe
PAGE 2 OF2
Wl!P No. _______ __
WIP2001
-
WASTE MANAGEMENT
February 17, 2003
Mrs. Patricia M. Backus
NC Dept. of Environmental & Natural Resources
Division of Waste Management
401 Oberlin Rd., Suite 150
Raleigh, NC 27605
Mrs. Backus:
Waste Management is pleased to provide you with pricing for the waste streams listed below. The prices
presented herein are estimates, pending profile review and approval.
Based on the information available, the following summarizes our quotation:
WASTE DESCRIPTION
Bullc PCB Oil (TSCA regulated)
WM FACILITY
Waste Management-Emelle Treatment Facility
Hwy. 17 North, Mile Marker 163
Emelle, AL 35459
DISPOSAL CHARGES
$0.66/pound
TRANSPORTATION CHARGES
$2,400/Trip
$85/Demurrage
Warrenton, NC
TSCA Incineration
Priority Load Rate (Warrenton to Emelle)
After 2-Hours Free Loading
All pricing is contingent upon the review of the Generator's Waste Profile Sheet and subject to the
conditions set forth in Attachment 1. Necessary documents will be forwarded to you and must be
completed and signed by an authorizing signatory of the generator. Upon acceptance of this proposal,
please contact me at your earliest convenience for the paperwork required to begin the approval process.
Upon review of the completed waste profile and review of available analytical data (if requested), the final
extended price will be good for sixty (60) days. lfnot accepted in the allotted time, all pricing will expire.
Waste Management appreciates this opportunity to serve the NC Dept. Of Environment and Natural
Resources. Should you have any questions or need additional information, do not hesitate to call me direct
at 919-207-2166 orour Customer Service Center in Emelle, AL at 800-652-5755.
Sincerely,
WASTE MANAGEMENT, INC.
Steven E. Miller
Account Manager
attachments
..
WASTE MANAGEMENT
February 17, 2003
Mrs. Patricia M. Backus
NC Dept. of Environmental & Natural Resources
Division of Waste Management
401 Oberlin Rd., Suite 150
Raleigh, NC 27605
Mrs. Backus:
Waste Management is pleased to provide you with pricing for the waste streams listed below. The prices
presented herein are estimates, pending profile review and approval.
Based on the information available, the following summarizes our quotation:
WASTE DESCRIPTION
Bulk PCB Oil (TSCA regulated)
WM FACILITY
Waste Management -Emelle Treatment Facility
Hwy. 17 North, Mile Marker 163
Emelle, AL 35459
DISPOSAL CHARGES
$0.66/pound
TRANSPORTATION CHARGES
$2,400/Trip
$85/Demurrage
Warrenton, NC
TSCA lncineration
Priority Load Rate (Warrenton to Emelle)
After 2-Hours Free Loading
All pricing is contingent upon the review of the Generator's Waste Profile Sheet and subject to the
conditions set forth in Attachment I. Necessary documents will be forwarded to you and must be
completed and signed by an authorizing signatory of the generator. Upon acceptance of this proposal,
please contact me at your earliest convenience for the paperwork required to begin the approval process.
Upon review of the completed waste profile and review of available analytical data (ifrequested), the final
extended price will be good for sixty (60) days. Ifnot accepted in the allotted time, all pricing will expire.
Waste Management appreciates this opportunity to serve the NC Dept. Of Environment and Natural
Resources. Should you have any questions or need additional information, do not hesitate to call me
direct at 919-207-2 I 66 or our Customer Service Center in Emelle, AL at 800-652-5755.
Sincerely,
WASTE MANAGEMENT, INC.
Steven E. Miller
Account Manager
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
ATTACHMENT 1.
STANDARD SURCHARGES
(If Applicable)
DRUM SURCHARGES AND MINIMUMS
Drums 2reater than 55 2allons will be charged at 1.5 times the drum price.
Drums less than 55 gallons will be char2ed . 75 times the drum price.
Drum solids for direct landfill less than 90% full will be char2ed an additional $25.00/drum.
Drums requirin2 overpackin2 will be char2ed an additional $100.00/drum.
Transship fee $125/drum (as required)
Drums or small containers on pallets will be charged at 4 times the 55-gallon drum price. (i.e. one gallon
containers, 5 2allon pails, small boxes, etc.)
Drum shreddin2 char2e prior to treatment -$100.00/drum.
Pallet price is based on a 4x4x4 size container; larger containers price @ actual measurement of container
received times cubic yard price.
BULK SURCHARGES AND MINIMUMS
Bulk solid density assumes 2,000 pounds= one cubic yard. (Direct landfill/stabilization waste streams only.)
Cubic yard price for box or ba2 based on actual measurement of container received.
Direct landfill bulk minimum -$1,000/load. (Excludes tax)
Treatment -bulk minimum -10 times bulk rate (i.e. stabilization, microencapsulation) (Excludes Tax)
Incidental liquids in bulk solid loads for direct landfill (requires solidification) -$800/load.
Leakin2 bulk loads -$200/load.
Macroencapsulation minimum char2e is 20 times the contracted price.
Incineration bulk solid minimum = $3,000/load.
Incineration bulk liquid minimum = $2,000/load.
Incineration direct inject bulk liquid minimum = $4,500/load.
Incineration direct in_ject bulk liquid (hard to handle) minimum= $8,000/load.
Incineration Bulk Liquid Tanker Rinse Out= $1,100 minimum charge.
WM MONTHLY FUEL SURCHARGE -WILL VARY BASED ON CURRENT FUEL PRICES.
MISCELLANEOUS FEES
ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT (ADEM) APPROVAL FEE
-New Waste Stream (2 year aooroval) I $125.00
-Recertification (2 year aooroval) I $ 75.00
WM ARRANGED TRANSPORTATION -DEMURRAGE AT CWM-EMELLE
WM assumes no responsibility for demurrage incurred for unloading as a result of error in manifesting or other required
paperwork.
WASTE STREAM EVALUATION FEES
NOTE: Waste Stream Evaluation Fees will no longer be billed unless a sample has to be sent by the Emelle Facility to an
outside lab for analysis.
Waste Stream Evaluation Fee (Outside Lab Fee)-Cost plus 10%