Arizona Administrative Code › Title 18 - ENVIRONMENTAL QUALITY › Chapter 13 - DEPARTMENT OF ENVIRONMENTAL QUALITY - SOLID WASTE MANAGEMENT › Article 13 - SPECIAL WASTE › Appendix B - Special Waste Manifest

Current through Register Vol. 30, No. 28, July 12, 2024
ARIZONA DEPARTMENT OF ENVIRONMENTAL QUALITY
SPECIAL WASTE MANIFEST
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Instructions for the Completion of the ADEQ Special Waste
				  Manifest
1. Enter the generator's
				Arizona Identification Number in box 1.
2. Enter the Emergency Response Notification
				Phone Number in box 2.
3. Enter the
				generator's name and complete mailing address, including city, state, and zip
				code, along with the generator's phone number, including the area code, in box
				3.
4. Enter the transporter's name,
				transporter's Arizona identification number, and telephone number, including
				the area code, in box 4.
5.
				Complete this box if a second transporter is to be used to transport the
				special waste to the receiving facility, following the instructions outlined in
				number 4 in box 5.
6. Enter the
				name, address, and physical site location of the primary special waste
				receiving facility. In the appropriate spaces, include the facility's Arizona
				identification number and the telephone number, including the area code, in box
				6.
7. Enter the name, address, and
				physical site location of the alternate special waste receiving facility. In
				the appropriate spaces, include the facility's Arizona identification number
				and the telephone number, including the area code, in box 7.
8. Enter United States Department of
				Transportation description (Including proper shipping name, hazard class, and
				identification number, if applicable) (For all non-Department of
				Transportation-regulated materials, enter the proper name, physical state, and
				description of all contents of the waste).
Mark an "X" in this column if waste is classified as a
				  hazardous material.
Container Number
Enter the number of containers being shipped for each
				  waste.
Total Quantity
Numerical value representing the number of containers
				  multiplied by the container size. Answer will be listed in pounds, gallons, or
				  cubic yards.
Unit weight or volume
P - Pounds
G - Gallons
Y - Cubic Yards
9. Use this space to indicate special
				transportation, treatment, storage, or disposal information. Emergency response
				telephone numbers or similar information may be included here in box
				9.
10. Print or type the
				generator's name followed by their signature and date in box 10.
11. Print or type the primary transporter's
				name followed by their signature and date in box 11.
12. Print or type the secondary transporter's
				name followed by their signature and date in box 12.
13. Indicate significant discrepancies in
				this box. Significant manifest discrepancy is defined as "a difference of more
				than 10% by weight for bulk shipments, any variation in a piece count for batch
				deliveries, or an obvious difference in a special waste type is discovered by
				inspection or analysis between the type or amount of a special waste designated
				in a special waste manifest, and the type or amount received by a special waste
				receiving facility" in box 13.
14.
				Print or type the receiving facility's owner or operator name followed by their
				signature and date in box 14.