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pdfForm Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
Please print or type.
2. Page 1 of 3. Emergency Response Phoyyyy
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UNIFORM HAZARDOUS 1. Generator ID Number
WASTE MANIFEST
5. Generator's Name and Mailing Address
4. Manifest Tracking Number
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9a.
HM
10. Containers
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
and Packing Group (if any))
No.
Type
11. Total
Quantity
12. Unit
Wt./Vol.
13. Waste Codes
GENERATOR
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
TRANSPORTER INT'L
15. GENERATOR’S/OFFEROR’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 export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Port of entry/exit: _________________________________________________________
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Full Rejection
Partial Rejection
DESIGNATED FACILITY
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
Month
Day
Year
1.
19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
4.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
Form Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
Please print or type.
UNIFORM HAZARDOUS 1. Generator ID Number
WASTE MANIFEST
2. Page 1 of 3. Emergency Response Phone
5. Generator's Name and Mailing Address
4. Manifest Tracking Number
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9a.
HM
10. Containers
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
and Packing Group (if any))
No.
Type
11. Total
Quantity
12. Unit
Wt./Vol.
13. Waste Codes
GENERATOR
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
TRANSPORTER INT'L
15. GENERATOR’S/OFFEROR’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 export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Port of entry/exit: _________________________________________________________
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Full Rejection
Partial Rejection
DESIGNATED FACILITY
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
Month
Day
Year
1.
19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
4.
DESIGNATED FACILITY TO GENERATOR
Form Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
Please print or type.
UNIFORM HAZARDOUS 1. Generator ID Number
WASTE MANIFEST
2. Page 1 of 3. Emergency Response Phone
5. Generator's Name and Mailing Address
4. Manifest Tracking Number
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9a.
HM
10. Containers
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
and Packing Group (if any))
No.
Type
11. Total
Quantity
12. Unit
Wt./Vol.
13. Waste Codes
GENERATOR
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
TRANSPORTER INT'L
15. GENERATOR’S/OFFEROR’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 export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Port of entry/exit: _________________________________________________________
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Full Rejection
Partial Rejection
DESIGNATED FACILITY
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
Month
Day
Year
1.
19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
4.
DESIGNATED FACILITY COPY
IF YOU RECEIVED THIS MANIFEST, YOU HAVE RESPONSIBILITIES UNDER THE e-MANIFEST ACT. SEE INSTRUCTIONS ON REVERSE SIDE.
Form Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
IV. Instructions for Owners and Operators of Receiving Facilities Designated on the Manifest
Item 18. Discrepancy
Item 18a. Discrepancy Indication Space
1. The authorized representative of the designated (or alternate) facility’s owner or operator must note in this space any discrepancies between the waste
described on the manifest and the waste actually received at the facility. Manifest discrepancies are: significant differences (as defined by §§ 264.72(b)
and 265.72(b)) between the quantity or type of hazardous waste designated on the manifest or shipping paper, and the quantity and type of hazardous
waste a facility actually receives, rejected wastes, which may be a full or partial shipment of hazardous waste that the facility cannot accept, or container
residues, which are residues that exceed the quantity limits for “empty” containers set forth in 40 CFR 261.7(b).
2. For rejected loads and residues (40 CFR 264.72(d), (e), and (f), or 40 CFR 265.72(d), (e), or (f)), check the appropriate box if the shipment is a rejected
load (i.e., rejected by the designated and/or alternate facility and is sent to an alternate facility or returned to the generator) or a regulated residue that
cannot be removed from a container. Enter the reason for the rejection or the inability to remove the residue and a description of the waste. Also,
reference the manifest tracking number for any additional manifests being used to track the rejected waste or residue shipment on the original manifest.
Indicate the original manifest tracking number in Item 14, the Special Handling Block and Additional Information Block of the additional manifests.
3. Owners or operators of facilities located in unauthorized states (i.e., states in which the U.S. EPA administers the hazardous waste management
program) who cannot resolve significant differences in quantity or type within 15 days of receiving the waste must submit to their Regional Administrator
a letter with a copy of the manifest at issue describing the discrepancy and attempts to reconcile it (40 CFR 264.72(c) and 265.72(c)).
4. Owners or operators of facilities located in authorized states (i.e., those states that have received authorization from the U.S. EPA to administer the
hazardous waste management program) should contact their state agency for information on where to report discrepancies involving “significant
differences” to state officials.
Item 18b. Alternate Facility (or Generator) for Receipt of Full Load Rejections
Enter the name, address, phone number, and EPA Identification Number of the Alternate Facility which the rejecting facility has designated, after consulting
with the generator, to receive a fully rejected waste shipment. In the event that a fully rejected shipment is being returned to the generator, the rejecting
facility may enter the generator’s site information in this space. This field is not to be used to forward partially rejected loads or residue waste shipments.
Item 18c. Alternate Facility (or Generator) Signature
The authorized representative of the alternate facility (or the generator in the event of a returned shipment) must sign and date this field of the form to
acknowledge receipt of the fully rejected wastes or residues identified by the initial facility.
Item 19. Hazardous Waste Report Management Method Codes
Enter the most appropriate Hazardous Waste Report Management Method code for each waste listed in Item 9. The Hazardous Waste Report Management
Method code is to be entered by the first facility that receives the waste and is the code that best describes the way in which the waste is to be managed
when received by the facility.
Item 20. Designated Facility Owner or Operator Certification of Receipt (Except As Noted in Item 18a)
Enter the name of the person receiving the waste on behalf of the owner or operator of the facility. That person must acknowledge receipt or rejection of
the waste described on the manifest by signing and entering the date of receipt or rejection where indicated. Since the Facility Certification acknowledges
receipt of the waste except as noted in the Discrepancy Space in Item 18a, the certification should be signed for both waste receipt and waste rejection,
with the rejection being noted and described in the space provided in Item 18a. Fully rejected wastes may be forwarded or returned using Item 18b after
consultation with the generator. Enter the name of the person accepting the waste on behalf of the owner or operator of the alternate facility or the original
generator. That person must acknowledge receipt or rejection of the waste described on the manifest by signing and entering the date they received or
rejected the waste in Item 18c. Partially rejected wastes and residues must be re-shipped under a new manifest, to be initiated and signed by the rejecting
facility as offeror of the shipment.
Note: The e-Manifest Act mandates several changes to the federal manifest program. Beginning on June 30, 2018:
• This manifest (Revision 12-17) must be used and all previous editions are prohibited.
• Any facility (e.g., a RCRA-permitted facility, Subtitle D facility) that receives a manifest accompanying a state-only regulated waste must comply with 40
CFR 264.71 or 265.71 (use of the manifest) and 40 CFR 264.72 or 265.72 (manifest discrepancies).
• Any facility that receives a paper manifest accompanying a federally regulated waste or state-only regulated waste must submit the top copy (Page 1)
of the manifest and any continuation sheets to the U.S. EPA’s e-Manifest system within 30 days. The copies must be submitted in an acceptable format.
Submissions must be made at the mailing address or electronic mail/submission address specified at the e-Manifest program website’s directory of
services (see www.epa.gov/e-manifest).
• The facility will be assessed a fee for each manifest copy submitted.
• Go to www.epa.gov/e-manifest for the directory of services and additional information.
PRA Burden Statement:
The public burden related to the Uniform Hazardous Waste Manifest, which is approved under OMB 2050-0039, is estimated to average (per manifest) 60
minutes for generators; 20 minutes for transporters; and 30 minutes for owners and operators of receiving facilities designated on the manifest. This is a
mandatory collection under 40 CFR Part 262, Subpart B, 40 CFR Part 263, Subpart B, and 40 CFR Parts 264 and 265, Subpart E. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The
completed form should be submitted in accordance with the instructions accompanying the form, or as specified in the corresponding regulation. Send
comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing
respondent burden, including through the use of e-Manifest, to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T),
1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Please include the OMB control number in any correspondence. Do NOT send the completed
manifest forms to this address. Privacy Act Statement - None of the information collected under the Manifest Program is considered Personally Identifiable
Information (PII) or Confidential Business Information (CBI).
Form Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
Please print or type.
UNIFORM HAZARDOUS 1. Generator ID Number
WASTE MANIFEST
2. Page 1 of 3. Emergency Response Phone
5. Generator's Name and Mailing Address
4. Manifest Tracking Number
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9a.
HM
10. Containers
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
and Packing Group (if any))
No.
Type
11. Total
Quantity
12. Unit
Wt./Vol.
13. Waste Codes
GENERATOR
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
TRANSPORTER INT'L
15. GENERATOR’S/OFFEROR’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 export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Port of entry/exit: _________________________________________________________
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Full Rejection
Partial Rejection
DESIGNATED FACILITY
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
Month
Day
Year
1.
19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
4.
TRANSPORTER COPY
Form Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
II. Instructions for International Shipment Block
Item 16. International Shipments
For export shipments, the primary exporter must check the export box, and enter the point of exit (city and state) from the United States. For import
shipments, the importer must check the import box and enter the point of entry (city and state) into the United States. For exports, the transporter must sign
and date the manifest to indicate the day the shipment left the United States.
III. Instructions for Transporters
Item 17. Transporters’ Acknowledgments of Receipt
Enter the name of the person accepting the waste on behalf of the first transporter. That person must acknowledge acceptance of the waste described on
the manifest by signing and entering the date of receipt. Only one signature per transportation company is required. Signatures are not required to track the
movement of wastes in and out of transfer facilities, unless there is a change of custody between transporters.
If applicable, enter the name of the person accepting the waste on behalf of the second transporter. That person must acknowledge acceptance of the
waste described on the manifest by signing and entering the date of receipt.
Note: Transporters carrying imports, who are acting as importers, may have responsibilities to enter information in the International Shipments Block.
Transporters carrying exports may also have responsibilities to enter information in the International Shipments Block. See above instructions for Item 16.
This manifest reflects formatting changes made by U.S. EPA in December 2017. Beginning on June 30, 2018, this manifest (Revision 12-17) must
be used and all previous editions are prohibited. Go to www.epa.gov/e-manifest for additional information.
PRA Burden Statement:
The public burden related to the Uniform Hazardous Waste Manifest, which is approved under OMB 2050-0039, is estimated to average (per manifest) 60
minutes for generators; 20 minutes for transporters; and 30 minutes for owners and operators of receiving facilities designated on the manifest. This is a
mandatory collection under 40 CFR Part 262, Subpart B, 40 CFR Part 263, Subpart B, and 40 CFR Parts 264 and 265, Subpart E. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The
completed form should be submitted in accordance with the instructions accompanying the form, or as specified in the corresponding regulation. Send
comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing
respondent burden, including through the use of e-Manifest, to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T),
1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Please include the OMB control number in any correspondence. Do NOT send the completed
manifest forms to this address. Privacy Act Statement - None of the information collected under the Manifest Program is considered Personally Identifiable
Information (PII) or Confidential Business Information (CBI).
Form Approved. OMB No. 2050-0039
Expiration Date: mm/dd/yyyy
Please print or type.
UNIFORM HAZARDOUS 1. Generator ID Number
WASTE MANIFEST
2. Page 1 of 3. Emergency Response Phone
5. Generator's Name and Mailing Address
4. Manifest Tracking Number
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9a.
HM
10. Containers
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
and Packing Group (if any))
No.
Type
11. Total
Quantity
12. Unit
Wt./Vol.
13. Waste Codes
GENERATOR
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
TRANSPORTER INT'L
15. GENERATOR’S/OFFEROR’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 export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Port of entry/exit: _________________________________________________________
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Full Rejection
Partial Rejection
DESIGNATED FACILITY
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
Month
Day
Year
1.
19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
4.
GENERATOR’S INITIAL COPY
U.S. EPA Form 8700-22
Read all instructions before completing this form.
1. Federal regulations require generators and transporters of hazardous waste and owners or
operators of receiving facilities designated on the manifest to complete this form (EPA Form
8700–22) and, if necessary, the continuation sheet (EPA Form 8700–22A) for both interand intrastate transportation of hazardous waste.
2. This manifest reflects formatting changes made by U.S. EPA in December 2017.
Beginning on June 30, 2018, this manifest (Revision 12-17) must be used and all
previous editions are prohibited. Go to www.epa.gov/e-manifest for additional
information.
3. This form must be purchased from a registered printer
(https://www.epa.gov/hwgenerators/approved-registered-printers-epas-manifestregistry#how) and has been designed to be filled out using standard computer printers; a
firm point pen may also be used—press down hard. After June 30, 2018, this form can also
be completed electronically in EPA’s e-Manifest system.
The public burden related to the Uniform Hazardous Waste Manifest, which is approved under OMB 2050-0039, is estimated to average (per manifest) 60
minutes for generators; 20 minutes for transporters; and 30 minutes for owners and operators of receiving facilities designated on the manifest. This is a
mandatory collection under 40 CFR Part 262, Subpart B, 40 CFR Part 263, Subpart B, and 40 CFR Parts 264 and 265, Subpart E. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The
completed form should be submitted in accordance with the instructions accompanying the form, or as specified in the corresponding regulation. Send
comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent
burden, including through the use of e-Manifest, to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200
Pennsylvania Ave., NW, Washington, D.C. 20460. Please include the OMB control number in any correspondence. Do NOT send the completed manifest
forms to this address. Privacy Act Statement - None of the information collected under the Manifest Program is considered Personally Identifiable
Information (PII) or Confidential Business Information (CBI).
I. Instructions for Generators
Item 1. Generator’s U.S. EPA Identification Number
Enter the generator’s U.S. EPA twelve-digit identification number, or the state generator
identification number if the generator site does not have an EPA identification number.
Item 2. Page 1 of ___
Enter the total number of pages used to complete this manifest (i.e., the first page (EPA Form
8700-22) plus the number of continuation sheets (EPA Form 8700-22A), if any).
Item 3. Emergency Response Phone Number
Enter a phone number for which emergency response information can be obtained in the event
of an incident during transportation. The emergency response phone number must:
1. Be the number of the generator or the number of an agency or organization who is
capable of and accepts responsibility for providing detailed information about the
shipment;
2. Reach a phone that is monitored 24 hours a day at all times the waste is in transportation
(including transportation related storage); and
3. Reach someone who is either knowledgeable of the hazardous waste being shipped and
has comprehensive emergency response and spill cleanup/incident mitigation information
for the material being shipped or has immediate access to a person who has that knowledge
and information about the shipment.
Note: Emergency Response phone number information should only be entered in Item 3 when
there is one phone number that applies to all the waste materials described in Item 9b. If a
situation (e.g., consolidated shipments) arises where more than one Emergency Response
phone number applies to the various wastes listed on the manifest, the phone numbers
associated with each specific material should be entered after its description in Item 9b.
Item 4. Manifest Tracking Number
This unique tracking number must be pre-printed on the manifest by the forms printer.
Item 5. Generator’s Mailing Address, Phone Number and Site Address
Enter the name of the generator, the mailing address to which the completed manifest signed
by the designated facility should be mailed, and the generator’s telephone number. Note, the
telephone number (including area code) should be the normal business number for the
generator, or the number where the generator or his authorized agent may be reached to
provide instructions in the event the designated and/or alternate (if any) facility rejects some or
all of the shipment. Also enter the physical site address from which the shipment originates
only if this address is different than the mailing address.
Item 6. Transporter 1 Company Name, and U.S. EPA ID Number
Enter the company name and U.S. EPA ID number of the first transporter who will transport the
waste. Vehicle or driver information may not be entered here.
Item 7. Transporter 2 Company Name and U.S. EPA ID Number
If applicable, enter the company name and U.S. EPA ID number of the second transporter
who will transport the waste. Vehicle or driver information may not be entered here.
If more than two transporters are needed, use a continuation sheet(s) (EPA Form 8700-22A).
Item 8. Designated Facility Name, Site Address, and U.S. EPA ID Number
Enter the company name and site address of the facility designated to receive the waste listed
on this manifest. Also enter the facility’s phone number and the U.S. EPA twelve-digit
identification number of the facility.
Item 9. U.S. DOT Description (Including Proper Shipping Name, Hazard Class or Division,
Identification Number, and Packing Group)
Item 9a. If the wastes identified in Item 9b consist of both hazardous and nonhazardous
materials, then identify the hazardous materials by entering an “X” in this Item next to the
corresponding hazardous material identified in Item 9b.
Item 9b. Enter the U.S. DOT Proper Shipping Name, Hazard Class or Division, Identification
Number (UN/NA) and Packing Group for each waste as identified in 49 CFR part 172. Include
technical name(s) and reportable quantity references, if applicable.
Note: If additional space is needed for waste descriptions, enter these additional
descriptions in Item 27 on the continuation sheet (EPA Form 8700-22A). Also, if more than
one Emergency Response phone number applies to the various wastes described in either
Item 9b or Item 27, enter applicable Emergency Response phone numbers immediately
following the shipping descriptions for those Items.
Item 10. Containers (Number and Type)
Enter the number of containers for each waste and the appropriate abbreviation from Table I
(below) for the type of container.
TABLE I.--TYPES OF CONTAINERS
BA = Burlap, cloth, paper, or plastic bags.
DT = Dump truck.
CF = Fiber or plastic boxes, cartons, cases.
DW = Wooden drums, barrels, kegs.
CM = Metal boxes, cartons, cases (including rollHG = Hopper or gondola cars.
offs).
CW = Wooden boxes, cartons, cases.
TC = Tank cars.
CY = Cylinders.
TP = Portable tanks.
DF = Fiberboard or plastic drums, barrels, kegs.
TT = Cargo tanks (tank trucks).
DM = Metal drums, barrels, kegs.
Item 11. Total Quantity
Enter, in designated boxes, the total quantity of waste. Round partial units to the nearest
whole unit, and do not enter decimals or fractions. To the extent practical, report quantities
using appropriate units of measure that will allow you to report quantities with precision.
Waste quantities entered should be based on actual measurements or reasonably accurate
estimates of actual quantities shipped. Container capacities are not acceptable as estimates.
Item 12. Units of Measure (Weight/Volume)
Enter, in designated boxes, the appropriate abbreviation from Table II (below) for the unit of
measure.
TABLE II.--UNITS OF MEASURE
G = Gallons (liquids only).
N = Cubic Meters.
K = Kilograms.
P = Pounds.
L = Liters (liquids only).
T = Tons (2000 Pounds).
M = Metric Tons (1000 kilograms).
Y = Cubic Yards.
Note: Tons, Metric Tons, Cubic Meters, and Cubic Yards should only be reported for very
large bulk shipments, such as rail cars, tank trucks, or barges.
Item 13. Waste Codes
Enter up to six federal and state waste codes to describe each waste stream identified in Item
9b. State waste codes that are not redundant with federal codes must be entered here, in
addition to the federal waste codes which are most representative of the properties of the
waste.
Item 14. Special Handling Instructions and Additional Information
1. Generators may enter any special handling or shipment-specific information necessary
for the proper management or tracking of the materials under the generator’s or other
handler’s business processes, such as waste profile numbers, container codes, bar
codes, or response guide numbers. Generators also may use this space to enter
additional descriptive information about their shipped materials, such as chemical
names, constituent percentages, physical state, or specific gravity of wastes identified
with volume units in Item 12.
2. This space may be used to record limited types of federally required information for which
there is no specific space provided on the manifest, including any alternate facility
designations; the manifest tracking number of the original manifest for rejected wastes
and residues that are re-shipped under a second manifest; and the specification of
polychlorinated biphenyl (PCB) waste descriptions and PCB out-of-service dates required
under 40 CFR 761.207. Generators, however, cannot be required to enter information in
this space to meet state regulatory requirements.
Item 15. Generator’s/Offeror’s Certifications
1. The generator must read, sign, and date the waste minimization certification statement. In
signing the waste minimization certification statement, those generators who have not
been exempted by statute or regulation from the duty to make a waste minimization
certification under section 3002(b) of RCRA are also certifying that they have complied
with the waste minimization requirements. The Generator’s Certification also contains the
required attestation that the shipment has been properly prepared and is in proper
condition for transportation (the shipper’s certification). The content of the shipper’s
certification statement is as follows: “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 export shipment and I am the Primary Exporter, I certify that the contents of
this consignment conform to the terms of the attached EPA Acknowledgment of Consent.”
When a party other than the generator prepares the shipment for transportation, this party
may also sign the shipper’s certification statement as the offeror of the shipment.
2. Generator or Offeror personnel may preprint the words, “On behalf of” in the signature
block or may hand write this statement in the signature block prior to signing the
generator/offeror certification, to indicate that the individual signs as the employee or
agent of the named principal.
Note: All of the above information except the handwritten signature required in Item 15 may be
pre-printed. (Handwritten signatures are not applicable if the generator is preparing and signing
an electronic manifest using EPA’s e-Manifest system.)
| File Type | application/pdf |
| File Title | Manifest.ai |
| Author | prepress |
| File Modified | 2020-12-23 |
| File Created | 2006-05-08 |