ML19095A664
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{{#Wiki_filter:NON.HMARDOUS WASTE MANIFEST S*l{o K ffi ffi re m re ffi ffi m ffi re K x Gle lH lE lR lA IJ Inl* I lffi lffi ln lffi l* l* NON.HMARDOUS WASTE MANIFEST
- 1. Generato/s US EPA ID No.
NIA Manifest Doarment No. GE/UNC-17.01 2.Page 1 of 1
- 3. Genemtois Name and Mailing Address Cabrera Services for GE UNC 71 Shelton Ave.
New Haven, CT 0651 1
- 4. Generators Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I run A. State Transportefs lD N/A B.TransporterlPhone 2A3498-1427
- 7. Transporter2 Company Name
- 8.
US EPA lD Number CSXTRR I UN C. State Transporte/s lD N/A D. Transporter 2 Phone 800-232-01 44
- 9. Designated Facility Name and Site Address
- 10.
US EPA lD Numbel EnergySolutions, LLG Clive Disposal Site (BulkWaste Facility) lnteBtate 80, Exit 49 Clive, UT 84029 NA E. State Facility's lD F. Facility's Phone (,lit5)884-0155 HM 11, WASTE DESCRIPTION
- 12. Cantainerc No. I ryp.
- 13. Total Ouantitu
- 14. UnitWt.tuol.
X UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 32880 P G. Additional Descriptions for Materials Listed Above tM# GF1U002079 H. Handling Codes for Wastes Listed Above
- 15. Soecial Handlinq lnstructions and Additional lnformation For questions
Contact:
Wade Fillingame (865) 300-5789 EMERGENCY RESPONSE:800-424-4300 Chemtrec contract # CCN3584 ffire&ffiffiffiffiffimffiffi*trtrffiffi*ffi*ffiffi#ffiffiffiffiffis
- 16. GENERAToR'S CERTIFICATIoN: This is to certify that the above-named materials are properly classified, described, packaged, marked and labeled, and are in proper hazardous waste regulation.
Date Printed/Typed Name W Wade Fillingame, Jr Diqitalt 5isd byWade !illingade DNi cn=Wad. Fillingame, o, ou. emaiEdllinqame@.ab.rakwi(es{oh. eUS oate:20t76 r3 I0:30:27&m' Mofin 06 Irs lt I R A N S P o R T E R 1 7. Transporter 1 Acknolvledgement of Receipt of Materials Date Printed/TvDed Name /Ze !.d Srtsan' g Sionature/To-ff4-. Month Date ob I t't Yeat /'7 '18. Transporter 2 Acknowledgement of Receipt of Materials Date Printed/Typed Name Signabre Month Date Year F A c I L I T Y
- 19. Discrepancy lndication Soace
- 20. Facility owner or Ooerator, Ceililication of receipt of the waste materials covered by this manifest, except as noted in item 1 L Date Printed/Typed Name Signafure Monftt Date Year
NON.HMARDOUS WASTE MANIFEST ffi ffi re ffi ffi ffi ffi g ffi ffi ffi ffi ffi G E N E R A T o R ffi ffi tr ffi ffi m ffi NON.HAzARDOUS WASTE MANIFEST
- 1. Generatois US EPA lD No.
NIA Manifest Doorment No. GE/UNC-17.02 2.Pae 1 0f 1
- 3. Generatols Name and Mailing Address Cabrera Services for GE UNC 71 Shelton Ave.
New Haven, CT 06511
- 4. Generators Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I Nn A. State Transportefs lD N/A B. Transporter 1 Phone 203-498-1427
- 7. Transporter2 CompanyNare
- 8.
US EPA lD Number CSXTRR I ruN C. State Transporteis lD N/A D. Transporter 2 Phone 800-232-0144
- g. Designated Facility Name and Sib Address
- 10.
US EPA lD Number EnergySolutions, LLC Clive Disposal Site (Bulk Waste Facility) lnteEtab 80, Exit 49 Clive, UT 84029 NA E. State Facility's lD na F. Facilit/s Phone (435)88,1-0{55 HM 11, WASTE DESCRIPTION
- 12. Conbiners No. I rype
- 13. Total Ouanlitu
'14. UnitWt.lr'ol. X UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 27500 P G. Additional Descriptions for Materials Listed Above tM# GF1U001451 H. Handling Codes for wastes Listed Above
- 15. Soecial Handlinq lnstructions and Additional lnformation For questions
Contact:
Wade Fillingame (865) 300-5789 EMERGENCY RESPONSE: 800-424-4300 Chemtrec contract # CCN3584 reffiffiffiffi#ffiffiffiffi*ruffiffiffiffiffimffi*ffiKwffiffiffiffis
- 16. cENERATOR'S CERTIFICATION: This is to certify thatthe above-named materials are propedy classified, described, packaged, marked and labeled, and are in proper hazardous waste regulation.
i Date Pnnteo/lypeo Name W Wade Fillingame, Jr Dlihlly tod by W.& fi11i.9.ft DN:.n+de Fillingae, q o!, ttonth Date 06 lrs Year Ir Date:2017.6.13 10i2q3l 04@ I R A N S P 0 R T E R '1 7. Transporter 1 Acknolvledqement of Receipt of Materials Date Pflntedlyped Name A Jam*i finqr.,- Sionature -hnn t (22".2/ Month Date aG lts Yeari7 '18. Transporter 2 Acknowledgement of Receipt of Materials zy' Date Printed/Typed Name Signature Month Date Year F A c I L I T Y
- 19. Discrepancy lndicatlon Space 20, Facility owner or ooerator. Certilication of receiot of the waste materials covered by this manifest, exceot as noted in item '19, Date Printedffyped Name Signafure Month Dde Year
NON.HMARDOUS WASTE MANIFEST I ffi ffi re ffi ffi ffi ffi ffi ffi ffi ffi ffi lG lelrlelnlr t; l* lffi l* l* l* lx lffi ln NON.HMARDOUS I l. Generators US EPA lD No. WASTE MANIFEST I N/A Manifest Document No. GE/UNC-17.03
- 2. Page 1
0f I
- 3. GeneratoCs Name and Mailing Addres Gabrera Services for GE UNC 71 Shelton Ave.
New Haven, CT 06511
- 4. Generators Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I rule A. State Transportefs lD N/A B TransporiellPhone 203498-1427
- 7. Transporter2 CompanyName
- 8.
US EPA lD Number CSXTRR I XN C. State Transportefs ID N/A D.rransporter2Phone 800-232-0144 L Designatd Facility Name and Site Addres
- 10.
US EPA lD Number EnergySolutions, LLC Clive Disposal Site (BulkWaste Facility) lnterstab 80, Exit 49 Clive, UT 8i1029 I NA E. State Facility's lD na F. Facilityl Phone (,+:}5)884-0t55 HM
- 11. WASTE DESCRIPTION
- 12. Conhiners No. I rype
- 13. Total CJilantitu
- 14. UnitWllr'ol.
X UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 321 00 P G. Additional Descriptions for Materials Listed Above IM# BFLU()(}(}()1l H. Handling Codes for Wastes Listed Above 1 5. Special Handlinq lnstructions and Additional lnformation For questions
Contact:
Wade Fillingame (865)300-5789 EMERGENCY RESPONSE: 800-424-4300 Chemtrec contract # CCN3584 ffitrffireffiffieffi*ffiffireffixffiffi*ffireffiffiffiffiffiffiffim*
- 16. GENERATOR'S CERTIFICATION: TIis is to certiff trat fte abovenamed materials are properly classified, described, packaged, marked and labeled, and are in proper conditonforfansportationaccordinghheapplicableregulationsoffteDepartnentofTransporhtion. Thematerialsdescribedonhismanifustarenotsubjecttofederal hazardous waste regulation..
lt. Printed/Typed Name W Wade Fillingame, Jr Month 06 Date I ts Yeu ltt I R A N S P o R T E R 1 7. Transporter 1 Acknowledqement of Receiot o rls ate 4a/."-tC Monfrt Date Yeu dL I tS lt1 1 8. Transporter 2 Acknowledgement of Receipt of Materials Date Printed/Typed Name Signature Month Date Yeil F A c I L I T Y
- 19. Discrepanry lndicaton Space
- 20. Facility Owner or 0perator, Certificaton of receipt of he waste materials covered by this manifest. exceDt as noted in item I I Date Printed/Typed Name Signafure Month Date Year
NON.HAZARDOUS WASTE MANIFEST OT I I I I I I I I I I I I I G E N E R A T o R I Ir I I I NON.HAZARDOUS WASTE MANIFEST '1. Generator's US EPA lD No. N/A Manifest Doorment No. GE/UNC.17.04 2.Paoe 1 0f 1
- 3. Generatods Name and Mailing Address Cabrera Services for GE UNG 71 Shelton Ave.
New Haven, CT 06511
- 4. Generators Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I run A. State Transporte/s lD N/A B. Transporter 1 Phone 203-498-1427 7, Transporter 2 Company Name
- 8.
US EPA lD Number CSXTRR I ruN C. State Transportels lD NiA D.Transporter2Phone 800-232-0144
- 9. Desagnated Facility Name and Site Address
- 10.
US EPA lD Number Energysolutions, LLC Clive Disposal Site (Bulk Waste Facility) lnterstate 80, Exit 49 Clive, UT 84029 I NA E. State Facility's lD na F. Facility's Phone (.85)8&r((55 HM
- 1. WASTE DESCRIPTION
- 12. Containers No I
Trne
- 13. Total C}rantitu 14, UnitM.ruol.
X UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 32200 P G. Addilional Descriptions for ltlaterials Lbted Above lM# GF1U002120 H. Handling Codes for Wastes Listed Abo/e Handlino lnstructions anr rmation For questions
Contact:
Ytlade Fillingame (865) 300-5789 EMERGENCY RESPONSE: 800424-4300 Chemtrec contract # CCN3584 IIIITIII:TIIITIII IIIIIIIIIII
- 16. GENERATOR'S CERTIFICATION: This is to certifo that he above-named materials are properly classifted, described, packaged, marked and labeled, and are in proper hazardous wasle regulation..
I Date Pnnted/ I yped Name W Wade Fillingame, Jr Si( Digiblrydgndbywa&Fillinsame ' /FF*;r"V 3##;f,lll:g:::;:,:';.* Date: 20r 7.6.1 3 10:?7:47 gm', Month eus 06 Date I rs Y(lr I R A N S P 0 R T E R 1 7. Transporter 1 Acknoivledqement of Receiot of t\\4a Date PrintedlJyped Name //r9 "-T lsn5l,.- I t/-W 4L -ltr lt7 1 8. Transporter 2 Acknovyledgement of Receipt of Materials Date Printed/Typed Name Signahrre Month Date Yeu F A c I L I T Y
- 19. Discrepancy lndication Space
- 20. Facility Owner or 0perabr, Certification of receipt of tre waste mahrials covered by tris manifesl, exceot as noted in item 1 9.
Date Printed/Typed Name Signature Month Date Year
NON.HAZARDOUS WASTE MANIFEST s 13"> ue s elite ffi ffi ffi ffi ffi ffi ffi tr ffi ffi ffi ffi ffi G E N E R A T o R I I I I I I I NON.HMARDOUS WASTE MANIFEST
- 1. Genemto/s US EPA lD No.
N/A Manifest Doclment No GE/UNC-17-05 1 0f 1
- 3. Generatols Name and Mailing Address Cabrera Services for GE UNG 71 Shelton Ave.
New Haven, CT 06511
- 4. Generators Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I run A. State Transportels lD NIA B. Transporter 1 Phone 203-498-1427
- 7. Transporter 2 Company Name
- 8.
US EPA lD Number CSXTRR I ruN
- c. State Transportefs lD N/A D. Transporter 2 Phone 800-232-0144
- 9. Designated Facility Name and Site Addrs
- 10.
US EPA lD Nurnber EnergySolutions, LLC Clive Disposal Site (Bulk Waste Facility) lnterstate 80, Exit 49 Clive, UT &$29 I NA E. State Facilitys lD na F. Facilitys Phone (435)884-0r55 HM
- 1. WASTE DESCRIPTION
- 12. Conhiners No. I Tyoe
- 13. Total Ouantitu
- 14. UnitWt.ruol.
X UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 31 580 P G. Additonal Descdptions for Materials Listed Above lM# GF1U002008 H. Handling Codes for Wastes Listed Above ll Handlinq ln rns and Additional Information For questions
Contact:
Wade Fillingame (865)300-5789 EMERGENCY RESPONSE: 800-424-$00 Chemtrec contract # CCN3584 ffiffireffiff#ffiffiffi*ffiffiffiffiffi*&ffiffiffiffiffiffiffi*ffiffim
- 16. GENERATOR'S This is to certify that the above-named materials are properly classified, described, packaged, marked and labeled, and are in proper
@nditionforfansporbtionaccordingtotheapplicableregulationsofUreDepartmentofTransporhtion. Themalerialsdescribedonftismaniftstarenotsubjecttofederal hazadouswasleregulation. E Printed/Typed Name W Wade Fillingame, Jr Month Date Y, 06 I rs 17 I R A N s P 0 R T E R ansDorter'1 A Iement c )t0 ate Printed/Typed EIg. " iArk.-l )('r7 5*a-:<! Moiln b6 /'/ I tz '18. Transporter 2 Ac*novtdedqement of Receipt of Materials Date Printed/Typed Name Signature Month Date Yeu F A c I L I T Y
- 19. Discreoancy lndication Soace
- 20. Facility Owner or O0erator, Certification of receipt of the waste materials covered by this manifest, except as noted in item 19 Date Printed/Typed Name Signature Month Dde Year
? Pfre
NON.HMARDOUS WASTE MANIFEST ffi ffi ffi ffi ffi ffi re ffi ffi ffi ffi m ffi G E N E R A T o R I I I I I I I NON.HAzARDOUS WASTE MANIFEST '1. Genemtor's US EPA lD No. N/A Manffest Doarmeni No. GE/UNC.17.06
- 2. Paqe 1
0f 1
- 3. GeneratoCs Name and Mailing Address Cabrera Services for GE UNC 71 Shelton Ave.
New Haven, CT 06511
- 4. Generators Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I Ule A. State Transportels lD NIA B. Transporter 1 Phone 203498-1427
- 7. Transporter2 Company Name
- 8.
US EPA lD Number CSXTRR I ruN C. State Transporhrs lD N/A D. Transporter 2 Phone 800-232-0144
- 9. Lresrgnarcd Faq[ty Name ano sfte Ad0res6
- 10.
us LPA ll] Nurnber Energysolutiong LLC Clive Disposal Site (Bulk Waste Facility) lnteEtate 80, Exit 49 Clive UT 84029 NA E. State l-asllty's lL) na
- h. haofity's Phone (43s)8&f-0155 HM
- 11. WASTE DESCRIPTION
- 12. C,onhines No. I troe
- 13. Total Ouantitu
- 14. UnitWt.lr'ol, X
UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 22080 P G. Additional Descriptions for Materials Listed Above rM# ERRU-00A226 H. Handling Codes for Wastes Listed Above 15, Special Handlino Insfuctions and Additional lnformation For questions
Contact:
Wade Fillingame (865) 300-5789 EMERGENCY RESPONSE:800.424-00 Chemtrec contract # CCN3584 x ffi x ffi x re ffi ffi ffi ffi ffi ffi ffi ffi ffi ffi ffi # ewffi
- 16. GENERATOR'S CERTIFICATION: This is to certify tirat the above-named materials are properly classified, described, packaged, marked and lrteled, and are in proper conditionfortansportationaccordingtotheapplicableregulationsoftheDepartmentofTransportation.
Thematerialsdescribedonthismanifestarenotsubjecttofederal hazardous waste regulation. I Date Printed/Typed Name W Wade Fillingame, Jr Diqit.lly {0nedby Wade Fillinqam DN:.n=Wd Fillingamc o, o!, em.il=wf llirg.m@hera*ril<a..om, GUs Date20l76.ll t0:25:51 04m ttonth 06 Date Yrlt I rs I R A N S Po R T Ep
- 17. Transporter 1 Acknowledgement of Receipt of Materials Date Prilted/Typed Name S', p, z; Elr.,-,re-*--
SignahJre -Uz-- (2*zz-- Month Date 0d I rs Year li> 1 8. Tmnsporter 2 Ac*nowledgementtf Receipt of Maierialty'- Date Printed/Typed Name Signafure Month Date Yeil F A c I L I T Y '19. Discrepancy lndicaton Space
- 20. Facility Owner or Operator, Certification of reelpt oJ the waste materials covered by this manifest, except as noied in itenr 19 Date Printed/Typed Name Signafure Month Date Year
NON.HAZARDOUS WASTE MANIFEST '1. Generator's US EPA lD No. N/A Nlanibt Do$mnt No. cE/uNc-17-07 rl TIrl I F n Ir I I I I G E N E R A T o R il I I I I I NON.HAZARDOUS WASTE MANIFEST 1 0f 1
- 3. GeneraMs Name and ilafllg Addrcss Cabrera SeMcee for GE UNC 7t Shelton Ave.
New Haven, CT 06511
- 4. Generators Phofle Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental l rule A. StateTrasporter's ID N/A B.TransporterlPhone 203498-1427 7i transporter2 Corpany Name
- 8.
US EPA lD Number CSXTRR I ruN C. StateTrilsporte/s lD N/A D. Trasporter 2 Phone 800-232-0144
- l. Desig-natedFa-cility Name aod Site Address
- 10.
US EPA ID Nuder EnergySolutlons, LLC Clive Dispoeal Site (BulkWGte Facility) lnteBtate 80, Exit ilg Clive, UT&$29 NA E. Sbte FaciliVs lD F. Facility's Phsie ('85)88'f'0t55 Hit
- 1. WASTE DESCRIPTION
- 12. ConhineG No. I rvpe
- 13. Total Ouantitv
- 14. UnitWt.rVol.
X UN 3077, Environmentally hazardous substance,solid, n.o.s. (RQ - Asbestos) 1 IM 23024 P G. Additional Descriptions for tvhteriats Lbted Above tM# BFLU 000074 H. Handling Codes for Wastes Lisled Abae
- 15. Soecial Handlino lnstruc{ions and Additional lnfurmation For questions
Contact:
Wade Fillingame {865) 300-5789 i &rlt.84e'ryilc "t P7rd){r-\\{ $(* t-{tvr<i J** t flEa* aA td ( CUr64.r.2--,ff{1N St l I-TI I I I I I I I T ,6. GENERATOR'S CERTIFICATIOi'I: I hereby cerlify fiat fre conbnb of tris shipment are fully and acdJrately described and are in all respecb in proper conditon for bansport. The materials described on his manifest are not subjec{ to federal hazardous waste regulation. I Date Prhted/Iyped NarrE W Wade Fillingame, Jr l$ffi#'ffi{f,: Month Date .{s 06 I ts Y(ltt Drabr761l6g:ll.gW I R A N s Po R T E P
- 17. Tansporter 1 Acknodedqement of Receiot ol ttilateriats Date Pnhtedffyped NarE 4ame) /?nq u,-
Sionafure -ha.*-'" Ok*,---- Manth Data Year tt b I l:7 I t )
- 18. Transoorter 2 AcknorlledqfiEnt of Receiot o{ fuhbrials-/
Date Printedlfyped Narne SInature Month Date Yeu F A c I L I T Y
- 19. Discrepancy lndication Space
- 20. Facili$ Orner or Operabr, Certification of receht of he waste materials @vered by his manifest, except as noted in item 19 Date Printed/typed Narne Signatrre Month Date Year ma
t-Generabds US EPA lD No. N/A Manifest Oocilment No. GEIUNC-17.08
- 2. Page K
H n ffi m m K g ffi m lr n K IG leIr lE lR IAlrlo l-H t E ffi t m x NON.HAZARDOUI' Y{ASTE i,IANIFEST 1 of 1
- 3. Gslemt0/s Name antMailing Address Cabrcra Services for GE UNC 7{ Shelton Ave.
New Haven, CT 06511
- 4. Generators Phone Billto: NA ATTN: NA 6,
USEPAIDNUI$g McVac Environmental I hln A.&ateTrarsportefslD N/A elT*-p"'t"tPh* 203498-1427
- 8.
US EPA DNUn$er csrr RR I un
- c. st3te Transporteis lD N/A D.Transporter2Phone 800-232-0144
- 10.
usEPAloNwBer EnergySolutione. LLC Glive Dlepocat Site (BulkYllaeb Facill$ InteFtab 8l), ExB 49 Clive, UT 8/$29 NA T.stateFaliiilEid F. Faeility's Phone {'l3s)88'i{155 Hlt t1. WASTE DESCRIPTION 12, ConhinelE No. I rvpe
- 13. Tolal
&ranlitv
- 14. UnitM.ruol.
X U N 3077, Environmentally hazardous substance,solid, n,o.s. (RQ - Asbestos) 1 IM 23060 P G. Additioflal Descriptions for lvlaterials Listed Above rM# GF1U002198 H. Handling Codes for Wastes LiSed Above For questions
Contact:
Wade Fillingame (865)300'5789 g;*;;(( ft{r* {*t" &$* *f Z*_{"^ {r-."*{;*ts{ ', 5-t ' i {(L is; r{ i i {/+ 31 tIrtrilf,ilxf,nDfxtEt snipmeniire trtty and acorrady describd and are in all respects in proper conditbn ior tansport. The materials described on his manilest are not subject to fedetal hazadous waste regulation. I Date Printed/Typed Name W Wade Fillingane, Jr qoblU#Bw*Fli@ft O+.n=W* Filinry, o, @, otl#llinr&ktd.6 @6, eul &:20l7stl(M:51 04&' l&,nh 06 Date Year I rg ltr I R A N S P o R T Ee
- 17. Transporter 1 Acknowledgement of Receipt of t,taterials Date Prinbd/TYled Name
/{"!;.-T S<qSu* <
- Wflt***a tortrl Dde Yeu et, I t3 I t7
- 18. Transoorter 2 Acknorledaement of Receiot of i.,laierials Dab Printed/Typed Nane Signaftrre Month Date Yea F
A c It I T Y
- 19. Discreoancv lndicatim Soace
- 20. Facilrty owner or operator, Certification of receht of tre waste materials mvered by his manifest, except as noted in item 19.
Date Printed/Typed Name Signature Motth Date Year NON.HAZARDOUS WASTE MANIFEST
- "d
NON-HMARDOUS WASTE MANIFEST ffi ffi ffi ffi ffi ffi ffi re ffi m ffi ffi ffi G E N E R A T o R re x ffi ffi ffi ffi ffi NON.HMARDOUS WASTE MANIFEST
- 1. Generato/s US EPA lD No.
NIA Manifest Doflment No. GE/UNC-17-09
- 2. Paqe 1
0f I
- 3. Generatois Name and Mailing Address Cabrera Services for GE UNC 71 Shelton Ave.
New Haven, CT 065'll
- 4. Genemtors Phone Billto: NA ATTN: NA
- 5. Transporter 1 Company Name
- 6.
US EPA lD Number McVac Environmental I Un A. State Transporter's lD NIA B. Transporter 1 Phone 203498-1427
- 7. Transporter 2 Company Name
- 8.
US EPA lD Number CSXT RR I ItN C. StateTransporteds lD NIA D. rransporter 2 Phone 800-232-0144
- 9. Desfunated FaciliU Name and Sib Address
- 10.
US EPA lD Number EnergySolutions, LLG Clive Disposal Site (BulkWaste Facility) lnterstaG 80, Exit 49 Clive UT 84029 NA E. State Facility's lD na F. Facility's Phone (435)884-0{55 HM 1 1. WASTE DESCRIPTION
- 12. Conbiners No. I tvpe
- 13. Total Quantity
'14. UnitM.f/ol X UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos) 1 IM 33260 P G. Additional Descriptions for Materials Listed Above lM# GF1U001483 H. Handling Codes for Wastes Listed Above
- 15. Special Handling lnstructions and Additional lnformation For questions
Contact:
Wade Fillingame (865)300-5789 EMERGENCY RESPONSE:800-424-4300 Chemkec contract # CCN3584 xffiffiffiffiffiffireffixffiffiffiffiffiffiffireffiffiffiffi*ffiffiffiffix
- 16. GENERATOR'S CERTIFICATION: This is h certify trat he above.named matedals are properly dassified, described, packaged, ma*d and labeled, and are in proper hazardous waste rcgulation.
m I Printed/Typd Name W Wade Fillingame, Jr 'is ffEfur.r,/ Digitally5igned by Wa& Fillingame DM.n=wde FillinSam, o, ou, em.il=SllinFm@bdaFrvi.ei{om,.=US Date: 20J7.ffi.1 3 t0:24:56&m' Month Date Yea Ir ln 06 I R A N S P o R T E R
- 7. Transoorter 1 Actnowledoement of Receiot of Materials Date intedi IvDed Name i42<q-.*en*.a*t
'"rr-#;'*'{* MOmn a6 ts I n7 'l 8. Transporter 2 Acknowledoemeflt of Receipt of Materials Date Printed/Typed Name Signature Month Date Yeat F A c I L I T Y
- 19. Discrepancv lndication Soace
- 20. Facility Owner or Operator, Certification of receipt of the waste materials covered by this manifest, except as noted in item 1 I Date Printed/Typed Name Signature Month Date Yeat
NON.HAZARDOUS WASTE MANIFEST I I I I I I I I I I I G E N E R A T o R I I I I I I I Manifest Doorment No. GE/UNC-17-12 Cabrera Services for GE UNC 71 Shelton Ave. New Haven, CT 06511
- 4. Generators Phone A. SbteTransporteds lD N/A
- 5. Transporter 1 Company Narne
- 6.
US EPA lD Number McVac Environmental I N/A B. Transportell Phone 203498-1427 C. State Transporter's lD N/A CSXT RR I N/A D.rransporter2Phone 800-232-01M . Designated Facility Name and Site Address '10. US EPA lD Number EnergySolutions, LLC Clive Dlsposal Site (Bulk Waste Faclllty) lnteretate 80, Exit rl9 Clive, UT 84029 F, Facility's Phone (435)884{155 UN 3077, Environmentally hazardous substance, solid, n.o.s. (RQ - Asbestos Additional Desuiptions for ilaterials Lbted Above H. Handling Codes for Wastes Listed Above For questions
Contact:
I'Uade Fillingame (865) 300-5789 EMERGENCY RESPONSE: 800-42&4300 IIIIII is to ceffry hat the above-named materials are properly classified, described, packaged, marked and labeled, and are in proper condition for banEortation according b fie applicable regulations of he Departnent of Transportation. lle materials described on fis manifest are not subject to federal hazardous waste regulation.. W Wade Fillingame, Jr Diqtalv iqmd bywa* Fillinqame ON: cn=Wide tillinsame o, ou, emiEdliingahe@<abrera*ri.es.com, eUs tute: 20176-13 124120q'm' Date 13 Yaar 17 J. of he waste materials covered by this manifest, exceot as noted in NON.HAZARDOUS WASTE MANIFEST
- 1. Generator',s Uli EPA lU N0.
N/A ? PeAe 1 of 1 Billto: NA ATTN: NA E. State Facility's lD HM 11, WASTE DESCRIPTION
- 12. Containers No I
Tvoe
- 13. Total Ouantitv
'14. UnitWt.A/ol. X 1 IM 30700 P
- 15. Special Handlino lnstructions and Additional lnformation r
M0mn 06 I R A N S P o R T E R 1 /. I ransporter 1 Acknoryledgement of ReceiDt 0f Materials Date PnltedTyped NarrE A Sq.nc-r {-l*-qa.r* Date Printed/Typed Name ,? SignaUre Month DAE Yeat F A c I L I T Y
- 19. Discrepancy lndication soace Date Printed/Typed Name Month Date Yeu tt tt Signature}}