SDMS US EPA Region V Imagery Insert Form Document ID: 239269 Some images in this document may be illegible or unavailable in SDMS. Please see reason(s) indicated below: Illegible due to bad source documents. Image(s) in SDMS is equivalent to hard copy. Specify Type of Document(s) / Comments: 239269 SOME ILLEGIBLE HANDWRITING ON SOME MANIFESTS Includes COLOR or RESOLUTION variations. Unless otherwise noted, these pages are available in monochrome. The source document page(s) is more legible than the images. The original document is available for viewing at the Superfund Records Center. Specify Type of Document(s) / Comments: n Confidential Business Information (CBI). This document contains highly sensitive information. Due to confidentiality, materials with such information are not available in SDMS. You may contact the EPA Superfund Records Manager if you wish to view this document. Specify Type of Document(s) / Comments: Unscannable Material: Oversized or Format. Due to certain scanning equipment capability limitations, the document page(s) is not available in SDMS. The original document is available for viewing at the Superfund Records center. Specify Type of Document(s) / Comments: Document is available at the EPA Region 5 Records Center. Specify Type of Document(s) / Comments: Page 1
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SDMS US EPA Region VImagery Insert Form
Document ID: 239269
Some images in this document may be illegible or unavailable in SDMS. Please seereason(s) indicated below:
I l legible due to bad source documents. Image(s) in SDMS is equivalent to hard copy.
Specify Type of Document(s) / Comments: 239269
SOME ILLEGIBLE HANDWRITING ON SOME MANIFESTS
Includes COLOR or RESOLUTION variations.Unless otherwise noted, these pages are available in monochrome. The source document page(s) is more legible than theimages. The original document is available for viewing at the Superfund Records Center.
Specify Type of Document(s) / Comments:
n Confidential Business Information (CBI).This document contains highly sensitive information. Due to confidentiality, materials with such information are not availablein SDMS. You may contact the EPA Superfund Records Manager if you wish to view this document.
Specify Type of Document(s) / Comments:
Unscannable Material:Oversized or Format.Due to certain scanning equipment capability limitations, the document page(s) is not available in SDMS. The originaldocument is available for viewing at the Superfund Records center.
Specify Type of Document(s) / Comments:
Document is available at the EPA Region 5 Records Center.
Specify Type of Document(s) / Comments:
Page 1
Final Report
Summary of RemovalActions at MilwaukeeSolvay Coke and GasCo. Site
Volume 2
Appendices F thru I
Prepared for
Water Street Holdings, LLC311 E. Greenfield AvenueMilwaukee, Wl 53207
Prepared by:
Earth Tech, Inc.1020 N. Broadway, Suite 400Milwaukee, Wl 53202
March 2005
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX F
Other Waste Disposal Documentation
• F-1: Onyx Environmental Services
• F-2: Tires and Belts
• F-3: Advanced Waste Services
EarthTechA Tyco International Ltd. Company
L:\work\72534\Admin\Reports\Rpttext.doc
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX F-1
Waste Stream Information fromOnyx Environmental Services
EarthTechA Tyco International Ltd. Company
L:\work\72534\Admin\Reports\Rpttext.doc
Environmental Services
Fax CoversheetTO:
COMPANY:
FAX NUMBER:
FROM:
DATE:
Bill Kralj
Earth Tech - 1020 North Broadway Suite 400, Milwaukee, Wl 53202
1.414.225.5111
Allan Kountz
02/14/05
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT ISADDRESSED. AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED OR CONFIDENTIAL.
If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering the message to the intendedrecipient, you are notified that any dissemination or distribution of this communication is strictly prohibited. If you have received thiscommunication in error, please notify us immediately by telephone, and return the original message to us by mail. Thank You.
RQ. WASTE POLYCHLORINATED BPHENYLS, SOLID,(BALLASTS). 9. UN2915. II
0 0 O N 0 0 9 5 1 K
d.
J, Addition^ Descrtpttons for Materials Listed Above ,, „'in
ino
I
KlHandBnoCodwfoiWaste* Listed AbovB
> i a:
15. Special Handling Instructions and Additional InformationPACKING SUPS ATTACHED FOR CLARIFICATION - EMERGENCY NUMBER-INFOTRAC: 1-800-535-5053PC165 W TECH SERVICES
o
hUJIt-Oj»
s|Ir-iiu,OD <
ll
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and arclassified, packed, marked, and labeled, and are In all respects In proper condition for transport by highway according to applicable International and national government regulationsIf I am a large quantity generator, I certify that I have a program In place to reduce the volume and toxlcity of waste generated to the degree I have determineto be economically practicable and that 1 have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes thpresent and future threat to human health and the environment; OH; H I am a small quantity generator, I have made a good faith effort to minimize my wastgeneration and select the best waste management method that Is available to me and lhatj can ar" ~ Date
17. Transporter 1 Acknowledgement of Receipt of MaterialsPrinted/Typed Name
rspo
Signature
18. Transporter 2 Acknowledgement of Receipt of Materials
Month Day Yea*
J7iO|</Date
Printed/Typed Name Signature Month Day Yea
19. Discrepancy Indication Space
20. Facility Owner or Operator. Certification of receipt of hazardous materials covered by this manifest except as noted inItem 19
DanPrinted/Typed Name Signature Month Day Yea
E i Form 8700-22 (**. 9/88)^ •• ; •••^&£&&. EQP5110
u £ £ o 4 u i i
ONYX ENVIRONMENTAL SERVICES
Pll
aENenATOR
•pe or print In block letters. (Form designed for use on elite (12-prtch) typewriter.)
SPECIAL WASTE 1 - Generator's US EPA ID No. nnJSSBSftioMANIFEST TICKET kw ,'LLIn In , « « - , !< * TTTT
SOLVAY COKE AND GAS COMPANY . '311 EAST GREENRELD AVENUE SAMEM(LWAUKEE?VVl S32tW
4. Generator's Phone A\A ft/itrwW5. Transporter 1 Company Name 8. US EPA ID Number
I I I I- IONYX ENVIRON MP^1"*1 RVf^R i ir l i ^ l l r j l n t j l n f t ' a ^ g l n g7. Transporter 2 Company Name . 8. US EPA ID Number
• . ' ' - I I I9. Designated Facility Name and Site Address 10. US EPA ID Number
ONYX SPECIAL SERMCESmc' 1 75 MINERAL SPFJNGS DRIVE
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) 1 2. Conn
15. Special HShdllng Instructions and Additional Information • . '
PACKJNG SUPS ATTACHED FOR CLARIFICATION - EMERGENCY NUMBERS NFOTRAD t-BOD-S35-5DS31 F 'IB5 , f-)i 1_ / • • i-
16. GENERATOR'S CERTIFICATION: I hereby declare mat the contents ol the consignment are Fully and accurately described above byproper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highwayaccording To applicable international and national government regulations.
,,: ' • . — • r-^
5N
P0
?
H
ACI
1
Y
Prii*M^Typed Name .• . Signafipfr ^^^ \, . — \ fi
' 1 J. \f* — sU«~ / / ^^\\ l\
17. Transported AeKrtovdedgemenVol Receipt of Matertals — J\ i f 'if}Prlrited^yped Name / ^^^ ^ Jigrjamis— — J/// t {Jr/*
rM^MJKj'.nlszK ' ^Ai**&l6JJyt~•* *^
^0^
Month Day Year
't
Month Day Year
18. Transpdner^Acl<no ledd>mem .of Receipt o* Materials . ^ /^\Printed/Typed Name ^ ' ' Signature ( / Month Day Year
t M 1 119. Discrepancy Indlcallon Space
20. Facility Owner or Operator Certification of receipt of materials covered by Ihis manifest except as noted In Item 19.PrlnleO/Typed Name • ->. / ^ / •" Signature /~\ . , ^— \ /I Month Day Year
2-TRANSPOBTER 1 COPYSIGNATURE AND INFORMATION MWST BE LEGIBLE ON ALL COPIES
(MX mJMNW&L &R/EES L.L.C
BFtEttE
1 1 RTFrfi1 1
fi( rA ICT\
(MX location NEMKNEE WIE EPOLTIYAiteEB OFFICE
^MIECTIY ST
|EE2 | 475 |
.£<> S Tfcfrnlagy rapESted j\C Yc L HA END. WMXTBOB2151.
311 GST OTHSFMD PM&LE
(Mb 9999 99939SbabeM SirtiylB ZIP 53204'
a-inrRGL6 Qdgin^ RimVOCS
2. VfestelEneKB3.
4.
lab or Vfeebe Acsa
, SUPLN2315IGII HQait l]b VfeBte: Y HH: N ffl: N OW. N P: N_
8. Is ttevfisbESbEanbeirginpited irto9. Edes t±E\«8sbEstiesncD±ainFCfe
PCS C£nH±isticn 500.0040OR?
10. Is the vastestcsn subject to the Nfenre RiMart11. Is the vasbstrean atjject to EenzETE KE9M3?
If i€s, is the vastestrean subject to NT1 fi rnt-lnVOrtual! GmErtraUm .00
12. Is the v\asbEStreana±rject to Rm aJbpart CT co±idls?
Lytical Nfettod?Q^eistcr
B. Is YesNDXNDX
14. Gtrtaoiner
Irijpirg : UrLtsHM
.00 EferYear CteTineEESTOHKN:
15. Jnfr.itifi .icn
I hereby certify that all infomBticn aimittad. in this ard. all attachal ctnnsts contains trie ard accurate cfescdpticns cf thisvaste. Ay sanple sJmtted is reptBsartatixe as ctfirFrt in 40 OR 261 - pardix I or by usirg an agjnalert nethoi ALL relaa±infcznBticn recportirg krvn or a^ected haaicfe in the pcsasasicn cf the cpneratcr has bean disdc^d. I aiiirrias sanplirg cf
JSarpjrpcss cf TFrprt~ifirHt'irn.
SLgrature
If aapra-od fer narEgaret, Q^KX hss all the iby this prcfile.
r/psmits and ILCHBS for the vaste that has been ch3za±erizHi ard
WIP^D.
UF l^Ufr O.
STATE OF WISCONSINChapter 291, Wis. Stats.Form4400-66P Rev. 1-99
ALL COPIES MUST BE LEGIBLE,PLEASE TYPE
State of WisconsinDepartment of Natural ResourcesBureau of Waste Management •Box 8094Madison, WI 53708
FOR DNR USE ONLY
Fon gned for use on elite (12-pitch) typewriter. Form Approved. OMB No. 2050-0039.Manifest
Document No.II I fl
Generator's US EPA ID No.UNIFORM HAZARDOUSWASTE MANIFEST
Information in the shaded areasis not required by Federal law.
3. Generator's Name and Mailing AddressSOLVAY COKE AMD GAS COMPANYJ11 I-AS F <3fveENFIBJp AVENUEMILWAUKEE, WI 53204
Site Location If Different
4. Generator's Phone6. US EPA ID Number
NJD080fl311flO5. Transporter 1 Company Name
ONYX F.NMRONfrlEN r,AI_ SVCS I I 08. US EPA ID Number7. Transporter 2 Company Name
9. Designated Facility Name and Site AddressONYX ENMRONMEN TAL SERVICESWt?4 NW451 BOUNDARY RO.
10. US EPA ID Number
W 00039871*18
TotalNo. Type Quantity11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
WAS TE AERO60UB. FLAMMABLE.(EACH NOT EXCEEDING 1L CAPACITY), 2 1ON1050
WASTE FI.AMMAW.E LJQWDS. n.o.s.. 3. UN19fl3.lli o n Q a
15. Special Handling Instructions and Additional Information
PACWNG SUPS ATTACHED FOR CLAHFICATION - EMERGENCY NUMBER-)NFOTRAC: 1 QOO-5;»-5053PC10S W TECH SERMCES
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by propershipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to ap-plicable international and national governmental regulations and according to the requirements of the Wisconsin Department of Natural Re-sources. If I am a large quantity generator, I also certify that I have a program in place to reduce the volume and toxicity of waste generated to thedegree I have determined to be economically practicable and I have selected the practicable method of treatment, storage, or disposal currentlyavailable 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 minimise my waste generation andselect the best waste management method that is available to me and that I can afford.
DatePrinte^Typed Name & Position Title Month Diy Year
17. TRANSPORTER 1 Acknowledgement of Receipt of Materials DatePrin yped & Position Title
18. TRANSPORTER 2 Acknowledgement of Receipt of Materials
Month Day Year
7 DatePrinteoVTyped Name & Position Title Signature Month Day Year
I I I I I I I19. Discrepancy Indication Space
[ 20. FACILITY OWNER OR OPERATOR: Certification of receipt of hazardous materials covered by this manifest except asnoted in Item 19.
i .intedyTyped Name & Position Title SignatureDate
Month Day Year
1 1 I I I
'iPA Form 8700-22 (Rev. 9-88) Previous editions are obsolete. Copy Distribution: 1 - Generator send to Wis. DNR_ „ . „ . . 2 — Generator retainEmergency 24 Hour Assistance 3 _ Facility gend to wig DNR
and Spill Reporting COPY 3 - Copies 1 & 3 mail to Wis. DNR at above address.Telephone Number (800)943-0003 iV\GUTY SEND TO WI DNR
A;jd lioral Descriptions for Materials Listed AboveA) SA 493575 CWDDPK3 B) Ul 888487 CWDFUELS C) S/E 493575 CWDDPK8 D007D008 D)L/C822578STB001912 E) S/C 493575 CWDOPKB A F) S/E 493575CWDSUPHG G) LA 822579 CWDFUELS H) LA 885849 CWDOZLNHL I )SA 493575CWDDPI-WR
PACMNG SUPS ATTACHED FOR CLARIRCATION - EMERGENCY NUMBE^NFOTRAC. 1-800-535-5053
Land Disposal Restriction Notification Form
Gowrator Name SOLVAY COKE AND GAS COMPANY Man Doc No 04001
EPA ID Number \MM000508215 Manifest WIK363294
This notice is being provided in accordance with 40 CFR 268.7 to inform you that this shipment contains wasterestricted from land disposal by the USEPA under the land disposal restriction program. Identified below foreach container is the designaticn of the waste as a wastewater or non-wastewater, the Clean Water Act (CWA)permit flatus associated with the treatment/disposal facility, applicable waste codes and any correspondingsubcategories, list of any FOOT -F005 solvent constituents that are present in the waste, and any underlyinghazardous constituents (UHC) that are present
493576 / CWDPROPANENon-Wastewater/ Non-CWAD001 (IGNITABLE CHARACTERISTIC WASTE, LIQUIDS >=10% TOC PER 261.2 1(a)(1))NoneNot ApplicableRestricted waste requires treatment to applicable standards.
888670/CWDFUELSNon-Wastewater/ Non-CWA0001 (IGNITABLE CHARACTERISTIC WASTE, LIQUIDS >=10% TOC PER 261.2 1(a)(1))NoneNot ApplicableRestricted waste requires treatment to applicable standards.
I hearby certify that all information in this and associated land disposal restriction documents is complete andaccurate to the beat of my knowledge and information.
Signature
Title Date ro^L
Page _3_ of _3_
ONYX ENVIRONMENTAL
RecertificfrtionONYX LOCATIONInvoice Address
WASTESTREAM INFORMATION
Disposal Cods
Manifest from - blank if direct
Generator EPA ID WIM0005Q8215
1. Generator Name SOLVAY COKE AND GAS COMPANY
Addrsn 311 EAST GREENFIELD AVENUE
CHy MILWAUKEE
SIC Cod* 9999
State Wattestream*
State Wl Country US Zip 53204
Source G11
IstNAICSCodt
Origin
2nd NAICS Code
Form W219
3rd NAICS Code
System Type
2. Waste Name UQ1JID WAX WITH PETROLEUM DISTILLATES Lab or Warts Area
3. Process Generating Waste UNUSED MATERIAL
4. Shipping Name FLAMMABLE LIQUIDS, n.o.s
Hazard Clan 3
RQ Desc 1.
UN/NA Number UN1993 Pack Group
2.
RQ Amount (Ib*.) 0
DOT Dae: 1. PETROLEUM DISTILLATES 2.
Waete Codec D001-IL
WastewatsrfY/N) N Sub-Category IL- IGNITABLE CHARACTERISTIC WASTE. LIQUIDS >= 10% TOC PER 261
6. Physical and chemical properties:
pH Lo 5 Specific Gravity Lo 0
pH HI 9 Spa
Solids:
Suspended Lo 0
Suspended Hi 0
Physical Stats:
Physical State 1
efflc Gravity Hi 0
Flash Point (F) Lo 100 Water Solubility
Flash Point (F) HI 140 Water Solubility
SetUeable {%) Lo 0 Dissolved (%) Lo 0 X Ash Lo
SetUeable (%) Hi 0 Dissolved (*) HI 0 % Ash HI
L - liquid
Physical State 2
Physical State 3
Halogen*:
Bromine (%) Lo
Bromine (*) Hi
'or Intensity
U ascription
Hazardous Characteristics:
Haz. Char. 1
Haz.Char.2
Haz. Char. 3
Chlorine (%) Lo Fluorine (%)Lo Iodine (*) Lo
Chlorine (% ) H 1 Fluorine (%) H 1 Iodine (%) H 1
Lo 0 BTU/lbLo 0
HI 0 BTU/lbHI 0
0 Free Liquid (H) Lo 95
0 Free Liquid (%) HI 100
Layers: B - Si-layered
Top C - low (water)
Middle
Bottom
Color 1 PNK
Color 2
Intensity
Contains Used Olr? No HOC < 1000 ppm HOC > 1000 ppm
1 Qf WIP NO. 888487
7. Chemical Composition;
Component
LIQUID WAXESPETROLEUM DISTILLATESWATER
.flier:
8. Is the vosteitream being imported into the U SA?
Low252510
Yas/No
No
High
757525
%/PPM/PPB
I
9. D oes the wattestream contain PCBs regulated by 40 CPR?
10. Is the wartestream subject to the Marine Pollutant Regulations?
11. Is the wattettream subject to Benzene NE5HAP?
If Yet, Is the WMtestream subject to Notification and Control Regs?
12. Is the waUettream subject to RCRA sutapart CC controls?
CC approved analytical method? General Knowledge?
13. Is the wattastream from a CERCLA or state mandated cleanup?
No PCB concentration:NoNo Benzene concentration:
No
No
Vol. Org. Cone., If known:
0.00 PPM
0.00 PPM
0.00 PPMW
U. Container Information (Identify UN container marking if known)
Packaging: Bulk Solid Type/Size: Bulk Liquid:
Other
Type/Size: Drum: Typa/Size:
Shipping Frequency: Units Per Month Quarter Year One Time Other
16. Additional Information:
'•* analytical or an MSDS available that describes the waste? Yes No If Yes. please attach.
AERATOR CERTIFICATION
I hereby certify that all information submitted in this and all attached documents contains true and accurate descriptions ofthis 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. Iauthorize sampling of any waste shipment for purposes of recertification.
NAME (Print or Type) PHONE DATE
—SIGNATURE TITLE
FACILITY NOTIFICATION
If approved for management, ONYX has all the necessary permits and licenses for the waste that has been characterizedand identified by this profile.
TSDF PROCESSING USE ONLY: PPE REQUIRED? DESCRIBE.
Page 1 of 2 WIP NO. 883487
ONYX ENVIRONMENTAL
WASTESTREAM INFORMATION} RecertificationONYX LOCATION D
Shipping Frequency. Units Per Month Quarter Year One Time Other
16. Additional Information:
Is analytical or an MSDS available that describes the waste? Yes _ No _ If Yes. please attach.
AERATOR CERTIFICATION
^ereby certify that all information submitted in this and all attached documents contains true and accurate descriptions ofthis 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. Iauthorize sampling of any waste shipment for purposes of recertification.
NAME (Print or Type) PHONE DATE
TITLE
FACILITY NOTIFICATION
If approved for management, ONYX has all the necessary permits and licenses for the waste that has been characterizedand identified by this profile.
TSDF PROCESSING USE ONLY: PPE REQUIRED? HO DESCRIBE:
Pago 2 uf 7. WIP NO. 888670
ONYX ENVIRONMENTAL^ ONYX
WASTESTREAM INFORMATION") Recartification
ONYX LOCATION Disposal Cod8Q Invoice Address " ADDRESS CITY ST
r~j Manifest from - blank if direct IONYX TSDF requested Technology requested Generator No. 518663
Hazard Clan NONE UN/NA Number NONE Pack Group RO Amount (Ib*.) Q_
RQOMC
DOT Dae
1.
1. TAR
2.
2.
Wart* Coda* NONE
Wwt*wat*r(Y/N) N Sub-Category
8. Physical and chemical properties:
pH Lo 5 Sp»
pH Ht 9 Spa
Solids:
Suspended Lo 0
Suspended Hi 0
Physical State:
Physical State 1
dflc Gravity Lo 1
cfflc GrawnV Hi 1
Flash Point (F) Lo 0 Water Solubility Lo 0
Flash Point (F) Hi 0 Water Solubility HI 0
BTU/lb Lo 0
BTU/lb HI 0
S«ttl*at>l* ft,) Lo 100 Dissolved (It) Lo 0 % Ash Lo 0 Fr«* Liquid {%) Lo 0
Settteable (X) HI 100 Dissolved {%) HI 0 % Ash HI 0 Fre* Liquid {%) HI 0
M - semi-solid
Physical State 2
Physical State 3
Halogens:
Bromine (%) Lo
Bromine (*) HI
*>dor Intensity
Description
Hazardous Characteristics: Layers: C - Single-Phase
Haz. Char. 1 Top A - high (syrup)
Haz. Char. 2 Middle
Haz. Char. 3 Bottom
Chlorine (X)Lo Fluorine (%)Lo Iodine (%)Lo
Chlorin*(%)HI Fluorin* (%) HI Iodine (%) HI
Color 1 BLK
Color 2
Intensity
Contains Used Oil? No HOC < 1000 ppm HOC > 1000 ppm
1 nf WtP NO. 388486
7. Chemical Composition:
Component
TAR
Low High %/PPM/PPB100 100 %
>er:
I* the wnteitrewn being Imported Into the USA?
9. 0 oat the wartsttream contain PCBs regulated by 40 CPR?
10. Is the wsBttftream subject to the Marine Pollutant Regulations?
11. Is the waitestream subject to Benzene NESHAP?
If Yn, hi the wartestream subject to Notification and Control Reqs?
12. Is me wasteBtream subject to RCRA subpart CC controls?
CC approved analytical method? General Knowledge?
13. Is the wattettream front a CERCLA or state mandated cleanup?
Yes/No
No
No PCB concentration:
No
No Benzene concentration:
No Vol. Org. Cone., if known:
No
0.00 PPM
0.00 PPM
0 00 PPMW
14. Container Information (Identify UN container marking if known)
Packaging: Bulk Solid Typa/Siza: Bulk Liquid:
Other
Typa/Siza: Drum: Typa/Slza:
Shipping Frequency: Units Par Month Quarter Year One Time Other
16. Additional Information:
Is analytical or an MSDS available that describes the waste? Yes No If Yes. please attach.
"•FNERATOR CERTIFICATION
ereby certify that all information submitted in this and all attached documents contains true and accurate descriptions ofthis 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. Iauthorize sampling of any waste shipment for purposes of recertification.
NAME (Print or Type) PHONE DATE
""SIGNATURE" TITLE
FACILITY NOTIFICATION
If approved for management, ONYX has all the necessary permits and licenses for the waste that has been characterizedand identified by this profile.
TSDF PROCESSING USE ONLY: PPE REQUIRED? _NO DESCRIBE:
Pagu 2 of 2 WIP NO. 888486
") RecertificationONYX LOCATION
Q Invoice Address
[~] Manifest from . blank if direct
ONYX ENVIRONMENTAL*r ONYX
WASTESTREAM INFORMATION
ADDRESSDisposal Code
Generator EPA ID WIMOOOS06215ONYX TSDF requested Technology requested
1. Generator Mama 50LVAY COKE AND GAS COMPANY
Address 311 EAST GREENFIELD AVENUE
CHy MILWAUKEE
SIC Code 9999
Source G32
lit NAICS Code
Origin
State Wl
2nd NAICS Code
Form W310
3rd NAICS Code
System Type
2. Warts Name OILY RAGS Lab or Watte Area
3. Process Generating Watte Clean up of oil spills.
4. Shipping Name NON-REGULATED MATERIAL. NON-RCRA.NON-DOT
Hazard Clan NONE UN/NA Number NONE Pack Group RQ Amount (Ibs.) 0_
RQ Dssc:
DOT Owe
1.
1. RAGS
2.
2. OIL
Waste Code* NONE
Wastswater (V/N) N Sub-Category
6. Physical and chemical properties:
pH Lo 5 Sp»
pH HI 9 Sp*
Solids:
Suspended Lo 0
Suspended HI 0
Physical State:
Physical Stale 1
cflfc Gravity Lo 1
chic Gravity HI 1
Flash Point (F) Lo 200 Water Solubility Lo 0
Flash Point (F) Hi 200 Water Solubility HI 0
BTU/lb Lo 5000
BTU/lb HI 10000
S*W«able ft) Lo 95 Dissolved ft) Lo 0 % Ash Lo 0 Fr»* Liquid (*) Lo 0
SeWeableW) Hi 100 Dissolved (%) Hi 0 % Ash Hi 0 Free Liquid (%) HI S
S - solid
Physical State 2
Physical State 3
Halogens:
Bromine ft) Lo
Bromine ft) HI
Odor Intensity B - mild
Jescrlptlon OILY
Hazardous Characteristics: Layers: C - Singja-Phase
Haz. Char. 1 Top D - solid
Haz. Char. 2 Middle
Haz. Char. 3 Bottom
Chlorine ft J Lo Fluorine (%) Lo Iodine ft) Lo
Chlorine ft) Hi Fluorine ft) HI Iodine ft) Hi
Color 1 VAR
Color 2
Intensity
Contains Used Oil? No HOC < 1000 ppm HOC > 1000 ppm
1 >'f WIP NO. 885651
7. Chemical Composition:
Component
OIL, LUBRICATINGOIL SOAKED RAGS
Low
095
High
5100
%/PPM/PPB
%%
or:
-. hi the waiteitream being Imported Into the USA?
9. Does the wartettream contain PCBs regulated by 40 CPR?
10. d the waiteitream lubject to the Marine Pollutant Regulation!?
11. Is the warteetream subject to Benzene NESHAP?
If Yet, hi the waiteitream subject to Notification and Control Reqs?
12. It the wattattream subject to RCRA subpart CC controls?
CC approved analytical method? General Knowledge?
13. Is the wacteitream from a CERCLA or state mandated cleanup?
Yw/No
NoNo PCB concentration: 0 00 PPM
No
No Benzene concentration: 0.00 PPM
No Vol. Org. Cone., If known: 0.00 PPMW
No
U. Container Information (Identity UN container marking if known)
Packaging: Bulk Solid Typa/Size: Bulk Liquid:
Other.
Type/Size: Drum: Typa/Size:
Shipping Frequency. Units Per Month Quarter Year Ona Time Other
15. Additional Information:
Is analytical or an MSDS available thai describes the waste? Yes No If Yes. please attach.
-NERATOR CERTIFICATION
,ereby certify that all information submitted in this and all attached documents contains true and accurate descriptions ofthis 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. Iauthorize sampling of any waste shipment for purposes of recertification.
NAME (Print or Type) PHONE DATE
v-SrGNATURE TITLE
FACILITY NOTIFICATION
If approved for management ONYX has all the necessary permits and licenses for the waste that has been characterizedand identified by this profile.
TSDF PROCESSING USE ONLY: PPE REQUIRED? _NO DESCRIBE:
Shipping Frequency: Units Per Month Quarter Year One Time Other
16. Additional Information:
Is analytical or an MSDS available that describes the waste? Yes No If Yes. please attach.
GENERATOR CERTIFICATION
jereby certify that all information submitted in this and aH attached documents contains true and accurate descriptions ofthis waste. Any sample submitted is representative as defined in 40 CFR 291 -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. Iauthorize sampling of any waste shipment for purposes of recertification.
NAME (Print or Type) PHONE ATE
TITLE
FACILITY NOTIFICATION
If approved for management, ONYX has all the necessary permits and licenses for the waste that has been characterizedand identified by this profile.
TSDF PROCESSING USE ONLY: PPE REQUIRED? _N° DESCRIBE:
2 ot 2 WIP NO. 885649
* RecsrtificationONYX LOCATIONInvoice Address
ONYX ENVIRONMENTAL*T ONYX
WASTESTREAM INFORMATION
ADDRESSDisposal Coda
(~1 Manifest from - blank if direct
Generator EPA ID WIMOQQ5Q821SONYX TSDF requested Technology requested
1. Generator Name SOLVAY COKE AND GAS COMPANY
Addren 311 EAST GREENFIELD AVENUE
CHy MILWAUKEE
SIC Code 9999
Source G09
1st NAICS Code
Origin
Stale Wl
2nd NAICS Code
Form W307
3rd NAICS Code
System Type
2. Watte Name EMPTY DRUMS
3. Proem Generating Waste EMPTY DRUMS
4. Shipping Name EMPTY DRUMS
Hazard Clan NONE
RQDssc: 1.
Lab or Waste Area
UN/MA Number NONE Pack Group
2.
RQ Amount (Ibs.) 0
DOT Owe: 1.
Waste Codes NONE
Wastewatsr(WN) N Sub-Category
6. Physical and chemical properties:
pH Lo 0 Sp*
pH HI 0 Sp*
Solids:
Suspended Lo 0
Suspended Hi 0
Physical State:
Physical State t
Physical State 2
cffie Gravity Lo 0
dffc Gravity HI 0
Flash Point (F) Lo 0 Water Solubility Lo 0
Flash Point (F) Hi 0 Water Solubility HI 0
BTU/lb Lo 0
BTU/lb HI 0
Sefflaable ft) Lo 0 Dissolved ft) Lo 0 % Ash Lo 0 Free LInuld ft) Lo 0
Settteable ft) Hi 0 Dissolved ft) HI 0 X Ash HI 0 Free Liquid ft) HI 0
S - solid
Physical State 3
Halogens:
Bromine ft) Lo
Bromine ft) HI
~*<or Intensity
Ascription
Hazardous Characteristics: Layers: C - Single-Phase
Haz. Char, t Top
Haz. Char. 2 Middle
Haz. Char. 3 Bottom
Chlorine ft) Lo Fluorine ft) Lo Iodine ft) Lo
Chlorine ft ) HI Fluorine ft) HI Iodine ft) HI
Color 1 BLK
Color 2
Intensity
Contains Used Oil? No HOC < 1000 ppm HOC > 1000 ppm
Paao 1 of WIP NO. 885650
7. Chemical Competition;
Component
EMPTY METAL DRUM
Low
100
High
100%/PPM/PPB
%
. to the wartestreant being Imported Into the USA?
9. Oo« the wastestream contain PCB* regulated by 40 CPR?
10. r* the wwrtntrewn subject to the Marine Pollutant Regulations?
11. Is the waBtatream subject to Benzene NESHAP?
If Yn, ts the wwtestream subject to Notification and Control Reqs?
12. hi the wattattream subject to RCRA subpart CC controls?
CC approved analytical method? General Knowledge?
13. Is the wastettraam from a CERCLA or state mandated cleanup?
Yw/No
No
No PCB concentration:
No
No Benzene concentration:
No
No
Vol. Org. Cone., If known:
0.00 PPM
0.00 PPM
0.00 PPMW
14. Container Information (Identity UN container marking if known)
Packaging: Bulk Solid Type/Size: Bulk Liquid:
Other
Type/Siza: Drum: Typa/Size:
Shipping Frequency: Units Par Month Quarter Year One Time Other
16. Additional Information:
Is analytical or an MSDS available that describes the waste? Yes No If Yes. please attach.GENERATOR CERTIFICATION
nereby certify that all information submitted in this and all attached documents contains true and accurate descriptions ofthis 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. Iauthorize sampling of any waste shipment for purposes of recertification.
NAME (Print or Type) PHONE DAT
SIGNATURE TITLE
FACILITY NOTIFICATION
If approved for management ONYX has all the necessary permits and licenses for the waste that has been characterizedand identified by this profile.
TSDF PROCESSING USE ONLY: PPE REQUIRED? .NO DESCRIBE:
J ISULflKIC K3D I 50.001 90.00|J IWKIER | io.oo| so.ool
Otter:8. Is the vastestream being imported into the USA? Yes Nb9. Eces the vastestream rrntain PCBs regulated by 40CFR? Yes tb
PCB Concentration .00 ppm10. Is the vastestream subject to the Nferine Pollutant Regulations? Yes Nb11. Is the vastestream subject to Baizene NE35VP? Yes Nb
If yes, is the vastestream subject to ^bti±icatdorv'a3ntrol Regjiremants? Yes NoBenzene Ctncentraticn .00 ppm
12. Is the vastestream subject to RCRA. subpart CC ccntrols? Yes tto^Ailatile Organic Concentration .00 ppnw
CC proved Analytical Ntethod? Yes MD_Geoerator Micwledge? Yes No
13. Is the vastestream from a CERCtA or state mandated clean-p? Yes Kb
14. ttTtrri
ft^kaging: Type/Size:
EtetjMry: thits .00 Per Day _ Per Week _ Per Nfcnth _ Per Qtr _ Per Year _ Cne Tiire _CEM EESCRIPITCN:
15.
I hereby certify that all infontBticn siinrLtted in this and all attached dfcamants contains true and accurate descripticns of thisveste. Any sanple submitted is rqccesaftative as defined in 40 CFR 261 - ^pendix I car by using an eqjivalent method. All relevantinfomaticn regarding kncvn or su^ected hazards in the poesessicn of the gensrator has been disclosed. I authorize sanplirg ofany vaste shipnant for purposes of recertificaticn.
^ns (Print or Type) Hrae E&te
Sicpature on EHe/_Title
:f approvBd for managanaTt, CNYX has all the necessary permits and licenses for the waste that has been characterized andidentified by this profile.
Otter:8 . Is the vestestream being inported into the LEA? Yes _ Mb9 . Eces the wastestrean cmtain PCBs regulated by 40CTR? Yes _ tb
KB CriXHiLratim _ .00 ppm10. Is the wBStestrean subject to the Iterine Pollutant Regulations? Yes _ tfc>11. Is the vestestrean subject to Benzene NE3ffiP? Yes _ Ifo
If yes, is the vestestr^am subject to Not" if i ratlrn/Cbntrol IteqjirertBrts? Yes _ tfc>BerEene Ctnoentraticn _ .00
12 . Is the wastestrean subject to RCRA subpart CE cmtcols? Yes _ Na _VTlafile Organic Ctnoaitraticn _ .00 pptw
13 . Is the wastestresm frcm a CEROA or state itHndated cleanup? Yes _ Kb
14. <">«d .-filler Ti iFt rnnt-i<-n ;
Efedcaging: _ Typa/Size: _ __ Type/Size: _ _
Ftetjjancy: thits .00 Iter Eey _ Bar Vfeek _ Ffer Mnth _ Efer Qtr _ R=or Year _ CneUCM EESCRIPnCN:
GEtERMCR CHZHFICKHKN
I hereby certify that all information submitted in this and all attached docuvaits contains true and accurate descripticns of thiswaste. Pry sarrple sutrtitted is representative as defined in 40 O?R 261 - .Pppaxiix I or by using an eqjivalent method. All relevantinformation regarding knew or suspected hazards in the possession of the generator has been disclosed. I mftT-nriTF- sampling ofany v«ste shipnnant for purposes of recertificaticn.
& E(Pri t or Type) Fhcne Date
Sicpature en File jTitle
approved for rranagerrent, CNYX has all the necessary permits and licenses for the waste that has been characterized and. df=ntified by this profile.
Qhar.Is t±eveste3b£ern being impacted irto tie IS?EtES the vastesttBsn cn±ainECfe iBgjMsd ty 40OR?RB Ctrrattatim .
8.9.
1Q11.
_12. Is t±B vasbestrEsm a±r|ect: to Ftm sdp^rt GC ca±icils?
\£ilduls Ct iic QjrHtrstiaiGC /£pOv6d Asl ticaL NfettacJ?Gtoerator Itewla^?
D . Is t±E vastesteem frcm a CEKIA or state narkted deaop?
TH t-h-* \Aflcj-ppJ-rmm .qhrp-f In thp Nfrrinp RSllitTTt-.Is the vastesdsan abject tn BSEHE ISE3*P?If >es, is ths \Aastestean atrject
CtrEHtriicn .00
YesYes
YesYes~lSbC
Yes
Ys _ ND_XYes IStTxYes ~~ ND~X
14 .
Ebagpary: LtiitsUCM
.00 EerNbfh EferCtr EerYear CteTine
15.
GHsEFFQER LfcKllt-lUUJU'lI hecety cgt-ify ttd; all irfatnaticn siimtted in this and all attadisd ctELments certains true and accurate cfescriptiaB cf thisv^te. Ay saqie aimtted is rgie3a±ati\e as cfeEined in 40 OR 261 - ^pardix I cr ty usirg an agji\alflt nethod. All tElaant•irrfrrrmMrn receding kr>n or suspected hazaids in ths pm-mim cf ths cpneratrrr has beai ctisdcffld. I authcri^e ssnplirg cfany \A8Ete shipiet ftarpurpcBes of reaa±±Ei£3ticn.
or T^pe) Hxne Efete
Title
BOLHYIf ajpccxed farnHB^tet, OSKCltSdll UTS recE^arypetnits ard LLCHBES for t±ev£6te that hasiifHiciHracterisdardxfatified iy this ptcfile.
;2 WIPID. 4SS576
OKX HMKNOIIZL SERflCE KL.C.
MQMSOCNBEETLE
I I
I I fiioceMiEffiCKKXIazticn E DCNEE EPOUIY
OEFKENEMMMEEPHK WE
CTIY ST|552 476
QttX T3F invested QEna7trT-Mx5LS6S3
3XL EPST OTENFTHD A\£KLE
toaster EBV ID tt>.: State It>.
WMXXE03215
CJiyMELWUEE StateWCtlfe9999 999S9
State VtetesttEHTiNb.QurfaylB ZIP 53204'
Qdgjnl^ RnnWB20
2. VfeBbsN&reHIBB3. EtaGEEBGtaaatirgVeste
4. Ehmirgl)BielMVERffiLWPSIE-MyESIfiratdClasMlElK^ND. 1SCNE RJ RQait 0 Tb Vtete: N Pffl: N Hi N DW: N P: N
IQD3S: I. 2.DQTE6S: 1.HIES 2.5. VteteCfttetQE
Vtebafiba: NH Wastoeter X StbCSEtpy Mix: N StiL: N
6 ft^fiifTll rff\ <}MIliml |TI JI-Tl IRRr
fH Specific Gkaoty Ela^i Rart(F) Sa < 2 a < . 8 a < 8 0 0'-, 2 - 5 b .8 - 1.0 b 80 - 100 100j X 5 - 9 c X 1.0 c 101 - 140 0d 9-02.5 d 1.0-1.2 d 141-200e >12.5 e > 1.2 e > 200
aect - aect f X rofladi - sect
BiskaLStEte Kv<qrrtlp! aTn-ytTyicj-irc,s X gnliri a air rea±i\e r ladkBctive cr ISFC rm FRTJ-Fnlid w vefcer reacti\e s dxck ^nsLti\e1 ligrid c Qaroda iEacti\e t tsrp satiiti^ep pjipable aari-siid f ajlfida reecti e m pclyrenstioyhiranf flrwiTlp prvdgr e eplcsi\e n OftcarciirEpiq c^ o oddizing acdd i infecticLBa geirfol p paocids ftrrrer h irfralatiaa hazardr prppRTrlTPd lirjrid 7mp:d cMris per 40 OR 268.45h ^^
I herety oertify tiEt all inforiBticn submitted in this and all attacbai ctnnets crrtains true and accurate cfegcrjpticns cf ttrisvaste. Pn/ sanpOs ainitted is rep: BtHti\e as dsfirei in 40 CTR 261 - ^perriix I or by ising an eqjimlert nethoi. All relaa±infctndiiai le irdiig kr>n or sj sdad hazards in the pc^FFHirn cf the genR-alrr has beai dJaJcmd. I a±hal2e sanpling cfaryveste shipint fiarpaipcss cf iBG6a±ificaticn.
J^ne(Rrirt c^T^e^^ Ehzne ESte
IJU* rn iT t i Ju . < )^litle
EPOLDY MMEKHEKNIf a^m^d for nutyaiul, QSKX has all the raueaaay permits and lioa'BES for the vaste that has beai charBCteriaad and
I by thisptrfile.VHP tO. 4SS577
INCOMING PACKING SUMMARY
Generator Number 518663
SOLVAY COKE AND GAS COMPANY
311 EAST GREENFIELD AVENUE
MILWAUKEE, Wl 53204
Attn: TOMJACOBSON
EPA ID: WIM000508215
Manifest Number WIK363294Field System ID: WO
Work Order Number 0487045000
Date Shipped: 08/27/2004
Document Number 04001
PHY State: S
Container* WO-0487045000-002 Waste Area:
WIP: 493576 DisposalCodr. CWDLEADACID
Date Accumulated: 08/13/2004 Special Handling: Gen Drum ID:
Itenlfest Number WIK363294 Work Order Number. 0487045000 Page 8 of 6
ONYX ENVIRONMENTAL SERVICES
Pie- 'pe or print In block letters. (Form designed for use on elite (12-pltch) typewriter.)
SPECIAL WASTEMANIFESTTICKET
1. Generator's US EPA ID No. Manifest,i ,1 A ,i .u ;U u i yuren: 2. Page 1of
3. Generator's Name and Mailing Address
bU.VAY COKE AND GAS COMHANY311 EAS r O^ENFTELD AVENUEMILWAUKEE. V* S&tM
' A. Manifest Document Number
0041595B. State Generator's ID
4. Generator's Phone 414 345-06355. Transporter 1 Company Name US EPA ID Number
J it * * * 4 H J» J>C. State Trans. ID 16139
|D. Transporter's Phone (Q73) 347-71117. Transporter 2 Company Name 8. US EPA ID Number
1
E. State Trans. ID
F. Transporter's Phone
9. Designated Facility Name and Site AddressONYX SPECIAL SERWCES,INC1275 MINERAL SPRINGS DRIVE
PORT WASHINGTON. VW 33074
10. US EPA ID Number G. State Facilty's ID
N/A
j v j r M * * * * * * * *
H: Facility's Phone
(282) 284-686511. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
HM
12. Containers
NO; Tyrw
13.Total
Quantity
14Unit
WWolWaste No.
UNIVERSAL WASTE-LAMPS. (BULBS), NONE. NONEN O N E
P
i i
J. Additional Descriptions for Materials Listed AboveA) SA 493577 SUP8ULB 40 X 8 FOOT;245X4 FOOT; 432XINCAND
K. Handling Codes for Wastes Listed Above
15. Special Handling Instructions and Additional Information
PACKING SUPS ATTACHED FOR CLARIFICATION - F.MERGENCY NUMBER-) NFOTRAC: 1-800-535-5053PC 1 H5 V* TECH SERM CES
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above byproper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highwayaccording to applicable international and national government regulations.
Printed/Typed Name Month Day Year
/^l Y17. Transporter 1 Acknowledgement of Receipt of Materials
Printed/Typed Name Signature Month Day Year
18. Transporter 2 Acknowledgement of Receipt of Materials
PrinteoTTyped Name Signature Month Day Year
19. Discrepancy Indication Space
20. Facility Owner or Operator. Certification of receipt of materials covered by this manifest except as noted in item 19.
PrinteoTTyped Name Signature Month Day Year
1 LSIGNATURE AND INFORMATION MUST BE LEGIBLE ON ALL COPIES
9-TRANSPORTFR 1 COPY
SEE INSTRUCTIONS ON REVERSE SIDE OF COPY 6.STATE OF WISCONSINChapter 291, Wis. Stats.Form 4400-66P Rev. 1-99
ALL COPIES MUST BE LEGIBLE,PLEASE TYPE
igned for use on elite (12-pitch) typewriter.
State of WisconsinDepartment of Natural ResourcesBureau of Waste Management •Box 8094Madison, WI 53708
FOR DNR USE ONLY
Form Approved. OMB No. 2050^^0039.
ManifestDocument No.
I .1 I I
Generator's US EPA ID No.UNIFORM HAZARDOUSWASTE MANIFEST
Information in the shaded areasis not required by Federal law.
3. Generator's Name and Mailing AddressSOC. AY COKE ,'\HD '.!AS ":f'F.|!''A,'
Site Location If Different
4. Generator's Phone (6. US EPA ID Number
w5. Transporter 1 Company Name
8. US EPA ID Number7. Transporter 2 Company Name
10. US EPA ID Number9. Designated Facility Name and Site Address
GtvY/C
13.Total
Quantity wt/Voi12. Containers
No. Type11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number)
FLAMMABLE SOLIDS ORGANIC n (•.; . (AC HVATEO CARBON. F'lU'EFt .1.UN132S II
15. Special Handling Instructions and Additional Information
PACKING SLIPS ATTACHED FOP CLARIFICATION - EMERGENCY NUMBER-INFOTRAC: 1-800-535.5053 PC »65 >..M FIELD SERV
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by propershipping name and are classified, packed, marked, and labeled, and are in aU respects in proper condition for transport by highway according to ap-plicable international and national governmental regulations and according to the requirements of the Wisconsin Department of Natural Re-sources. If I am a large quantity generator, I also certify that I have a program in place to reduce the volume and toxicity of waste generated to thedegree I have determined to be economically practicable and I have selected the practicable method of treatment, storage, or disposal currentlyavailable 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 andselect the best waste management method that is available to me and that I can afford.
DatePrinted/Typed Name & Position Title
- •Signature / T'
a^f JJuMonth Day Year
17. TRANSPORTER 1 Acknowledgement of Receipt 6f Materials 'LJ Datented/Typed Name & Position Signature
. —^' jfMonth Day Year
18. TRANSPORTER 2 Acknowledgement of Receipt of Materials & DatePrinted/Typed Name & Position Title Signature Month Day Year
I I I I I I I
19. Discrepancy Indication SpaceFAc£ I 90. FACILITY OWNER OR OPERATOR: Certification of receipt of hazardous materials covered by this manifest except asI noted in Item 19. DateY r tinted/Typed Name & Position Title
EPA Form 8700-22 (Rev. 9-88) Previous editions are obsolete.
i'.otice "..', be:n5 provided -:". 5ccordsi;^5 ''"ith 40 3F3-- 25?.'" tc irifcir:: ycu that Lri:- sh:p;rw;:t crm^iriS y;iit.c'a^d 1} cs7i ^and !±3posii by rJ"<e USE3A linear che )i:d c^pcs^J rtj^a-ictjcsi p/o^'arij. laaitJil&d bs.'o'p fcr
n of ihev-afie as awaEtsvi'ater •crnan-v.raH.e'wat-^r t';5C.";9Hn'?'':?t=r Act 'C>*'?X'ir. siaiiLiE, iiscdated with tha^rea'jr.e'.L'tispczal fdcl:;"/, ip^iicib'^^i^Li cxisj, a^d av.' :on--;:v:cr..±::
s, iist of 3ny?00}-?OCo iOii'Sji cc^siiiusuj mat ore v-estra :;; Lae w.sst^, ^i<i s\ :jncsrlv:r-
rs: r i r f ••! •- :-'-'- e r V\A' -C'32^959939 -00 1822580 / CWDSHMHAZ
Other:8. Is the wastestream being irrported into the IBV?9. Does the wastestream contain ECEs regulated by 40CFR?
ECB Ccncentraticn .00 ppn10. Is the wastestream subject to the lYarine Ebllutant Regulaticns?11. Is the wastestream subject to Benzene NE3KP?
If yes, is the wastestream subject to tfatificati m/Qntrol Regjirenents?Benzene Qcncentraticn .00 gm
ccntxols?Is the wastestream subject to RCEA. subpart'\folatile Cttganic Ctncentraticn
CC ^proved Aalytical Nfethcd?C3enerator Kicwledgs?
13. Is the wastestream frcm a CEFOA or state irancfeted cleanLp?
YesYes
YesYesYes
Yes
. Nb
_Nb
Nb
.00
YesYesYes MD
14 . O i *-nf IMT' TfifiifilMl irn
E^daging:
Vrrrjm-y- Units
UCM
Type/Size:Type/Size:
.00 Per Eay_EESCRIPnCN:
Eer Meek Eer Fer Qtr Eer Year Cte
I hereby certify that all infarrraticn submitted in this and all attached docutEnts contains true and accurate descriptions of thisveste. ffy sanple submitted is representative as defined in 40 CFR 261 - Appendix I or by using an eqjivalent method. All relevat:infarnaticn regarding knovxi or suspected hazards in the possession of the generator has teen disclosed. I ^iiH-r-iH•*? sanpling ofany waste shipment forurposes of recertificaticn.
n 414 1M72I7.bfene (Print on Type)
Sicyature en File
Ehone / Eate
Signature
£-71 V
rarrr.TTVpproved for rranagerrent, CNYX has all the necessary permits and licenses for the waste that has been characterized and
by this profile.
2 VCP ND. 622580
OCX ENVHOMNffiL SERVICES L.L.C.
Wt>UKiLb*?M HtFUE
| | tteoerH fi ratn'm
Onuoiae AHtEBS
OKX location MEIOtME FRLLS FSCLUIY
CTFTCE
NBOOSEE FKLLS WI
CTIY ST476
CNBC TED* iBCfjestBd1. Generator Name 3XV7W CCKE
^technology WIMD00508215(XMEENY O-l IMT^I I It).
Address 311 ERST Q3EENFIELD AVEMJE
CLty MILtMJKEE
NftKBtSKJ Gbtte 9999
State WESburoe G09 Cfcdgin I
State *fastestrean ffc>.
US ZIP 53204Rxm
2. tfesbe tfene FIUtR WTIH A^TIVSJHJ CBRBCN3. Process Gtaeraticg Hbste
used filter wit± activated rarhm
l£b or Vbste Area
4. admirer Itene FU*Mffl[£ SCtJDS, CR3*HC, n.o.s.Kazzard Class 4.1 W/fR. tb. USI1325 EG II HQ ant 0 3b
BQOes: 1.EOT DEB: 1.
Waste: Y Pffl: N2.2.
3H: N EJW: N P: N
5. Vfeste Gbdes D001Vfe Men tfastaefaer X Stto Gabegay IS Mix: N 9d: N
e. aIHabc Xde
s Xm1
Pf
gardh
y*=qra1 mA rH=nriral j»
2 a2 -5 b5-9 c9 - 12.5 d> 12.5 e
exact
Hiysical State
solidsemi-solid
purpable semi-solidflowable powder
gasaerosol]TjT=f3,ea iH 7fr\ Tirpi iH
debris per 40 OFR 268
sharps
1 • l-U |— IfiR-
yv1^ 'j^fHr* cias/ity
<.8.8 - 1.01.0
1.0 - 1.2> 1.2
exact
Haza
a air- reactivew water reactivec cyanide! reactivef sulfide reactivee explosiveo oxidizing acidp peroxide formsr
J 1/CnVKIED CARECN LEED AS A FELTER | 100.00 | 100.001
Other:8. Is the vestestream being inported into the U3V? Yes Its9. Doss the vastestream contain ECBs regulated by 40CTR? Yes No
PCS Ctncentratim .00 ppn10. Is the vestestrean subject to the Iferine Pollutant Regulations? Yes No11. Is the wastestream subject to Benzene NEEHAP? Yes No
If yes, is the wastestream subject to Notificatim/CtntDol ReqjiretTEnts? Yes NoBenzene Ctnosntratkn .00 ppn
12. Is the ^^BStestrBatn subject to RCRA subpart CC ccnttnls? Yes No'WDlatile Organic Ctncentraticn .QQ
CC ^pproued Analytical ^fethod? Yes NoGenerator Hxwlectjs? Yes No
13. Is the VBStestteam fron a CEKdA or state unrelated cleanup? Yes No
14 . ri i J firrrTf*r Ti ifi wiiRt~inn :
E&ckaging: lyps/Size:Type/Size:
Etegpetxy: Lhits _ .00 Par Cay _ Per Week _ Per Mnth _ Par Qtr _ Par Year _ Che TineUCM ~
15. Z^Hil-irral ItltoUlblLdCQ
I hereby certify that all inforrraticn submitted in this and all attached documents contains true and accurate descriptions of thiswaste. Pny sample submitted is r^resenfcative as defined in 40 CTR 261 - .Appendix I or by using an equivalent method. All relevantinforttBticn regarding known or suspected hazards in the possession of the generator has been disclosed. I authorize satpling ofany i*aste shipnsnt for purposes of reoertificaticn.
Signature
approved for rranagemait, OtfOC has all the necessary permits and licenses for the v«ste that has beai characterized and
identified by this profile.page 2 mPVD. 622583
INCOMING PACKING SUMMARY
'jenarjitcr Number: *513SS3SOLVAY COKE AND GAS COMPANY
311 EASTG.R£ENRELOAVEN!..E
MILWAUKEE. -A?! 53204
Attn: TOM JA COBoONEPA ID: WMBOQ503215
Marlfe;t N'j.mUr. WlK2j3250
Held Systap; !D: VTf
Work Order Nuroc-5" 0?2SS5iS9y3
Date Shipped: 03/02SC04
Docurvi ent NUR oe'"' 5S2fO
:ir.er3: WY3323959999-002 Wasted
WiP: 622533 DispesaiCcde: 3RRCAReON-HAZ PHY State: S
SOLVAY COKE AND GAS COMPANY311 EAST GREENFIELD AVENUEMILWAUKEE
Recert Due Status Approval Code
8/10/09 G SUPBALLAST8/10/09 A MIC4935756/08/08 G CWDAEROSOL6/08/08 G CWDSUPHG6/08/08 G CWDLEADACID6/08/08 G CWDDPK36/08/08 G CWDDPK8IA6/08/08 G CWDDPK66/08/08 G CWDDPKNR6/08/08 G CWDPROPANE8/10/09 G SUPBULB
I8/26/09 G STB0019128/26/09 G CWDFUELS8/26/09 G CWDSHMHAZ8/26/09 G SUPBALLAST8/26/09 G SUPBALLAST8/26/09 G SRRCARBON-HAZ8/27/09 G CWDOZLNHL8/27/09 G CWDORCEMPTY8/27/09 G CWDWTENHS8/28/09 G SRRB078288/27/09 G CWDFUELS8/27/09 G CWDFUELS
DOCK RECEIPT P A C E I1. EXPORTERScflLtnes Internationalfor Jjxz Amad3f» E. Main Street
yville, N.C.
5. DOCUMENT NUMBERchs045032
0. EXPORT REFERENCES
SE ALINES REF #9111
2. CONSIGNED TO
MSCC/OCSXRR
BEDFORD PARK TERMINAL
7000 71RST ST
CHICAGO, IL
3. NOTIFY PARTY/INTERMEDIATE CONSIGNEE
7. FORWARDING AGENT
S. POINT (STATE) OF ORIGIN OR FTZ NUMBERMILWAUKEE WI
9. DOMESTIC ROUTING/EXPORT INSTRUCTIONSCHEETAH TO HANDLE US INLANDMSCTO HANDLE OCEAN
Loading 8/3
I2,PRE-CARRIAG6BYCHEETAH14. EXPORTING CARRIERMSC CHINA VJ20R
13. PLACE OF RECEIPTMILWAUKEE WI1 S. PORT OF LOADINGNEW YORK
10. LOADING JTER /TERMINALMSC MAKER TERMINAL/NY
16. FOREIGN PORT OF UNLOADINGPORT QASIM PAKISTAN
17. CLACEOFDELIVERV 11. TYPEOFIrfOVEOCEAN
1 li. CONTAINERIZED
YESX NO
MARKS AND NUMBERS NUMBER
OFPACKAGES(19)
DESCRIPTION OF COMMODITIES
(20)
GROSS WEIGHT MEASUREMENT
(21) (22)CONTAINER*:. 1 X 20 OT USED BELTING
PCS: /
.TOTAL VALUE:
ACCORDING TO APFL1CABU INTERNATIONA], AND NATIONAL GOVERNMENTAL K£GULAT>ON$.
THESE COMMODmeS LICENSED BY THE U.S. COR ULTIMATE DESTINATION PAXISTAN.
DELIVERED BY:LIGHTERTRUCKARETVED-DATE __CHECKED BY
TIME
PLACED IN SHIP LOCATIONON DOCK FOR THE MASTER
BY DATE
RECEIVED THE ABOVE DESCRIBED GOODS OR PACKAGES SUBJECTTO AH, THE TERMS OF THE UNDERSIGNED'S REGUI,AR FOR OF
TRUCK RECEIPT AND BILL, OF LADING WHICH SHALL CONSTITUTETHE CONTRACT UNDER waSttl THE GOODS ARE RECEIVED. COPIES UNLOADED-OT WHICH ARE AVAILABU! FROM THE CARRIER ON REQUEST ANDMAY B£ INSPECTED.A/^NY OF ITS OFFICES
SIdNEDi
SH; MUST SIGN HERE
Auburndaie Recycling Center, Inc.10453 S. George AveAutmrntiaie, VI 54412Telepnone : 715.652.3622
State or Wisconsin'Department of Natural ResourcesBureau of Waste ManagementBox 8094Madison, WI 53708
UNIFORM HAZARDOUS•:'••'-• WASTE MANIFEST
1. Generator's US EPA ID No
Form Approved. OMB No. 205OO089. Expire* 9-3
Information in the ahaded areis not raqulrod by Federal la*
Si'
3:_ti%tt*rmtor's Name and Mailing AddressMarina Cr.a.-<eway
r'» Phone (
Six Location II
6^ TraniporUr 1 Compuiy NameAdvancccf. Wosta
7. T
Facility Name and Sita Ad.draMControl Tn<fusts:\es.
4343 '(Cennt'fly *v«.East Chicago. ItJ 46312
«. US BPA ID Nwabw
WI0000815381S EPA ID Numbar
10. US BPA ID Number
1NDOOG646943
11. US DOT Description (Including Pnpir Shipping Nom« Hazard OM« and ID ttumbtr)
waste.133
? W*s*#&> -'ft
16. Special Handling Inatructioaa Information
24 iiovu' ptier^ency C6;-;u.^cV. i^-00-342-9792 Eraergency Espouse C-r* lioardIS. GENERATOR'S CERTIFICATION: I hereby declare that the conttnu of thia consignment an ft
•hipp<"g nmm^maA •«n-U«atfU^, fia.-lj.ri, marfcaJ. mnA.lmhflmA, maA M»hiMHramaetainpropar enndiplicabla intarnaUonal and national governmental regulattau tod according to the requvemeatc <
1 fully and accurately described above bf properr condition for transport by highwrny tccar&aLfto'mp-
r_ ^ ^ m ntnt* of the Wlaconaln Department of Natural Ra>sourcea. If I am a large quantity generator. 1 also cer3ry that I have • program in place to reduce thavohme and tozicity of waste generated to thedegraa I have determined to be acoaomicalry practicable and I bav« aelected the practicable method of treatment, storage, or diepoaal currentlyavailable to me which minimises the preeent and fntura throat to human health and the environment;
OB, if I am a amail qumnUty generator. I have made a good faith effort to minimise my waate generation andselect the beat wute management method that ia available to me and that I can afford.
Dated Name & Position Title
17. TRANSPORTER 1 Acknowledgement of
tyV £jM.r,
Date
5at»18. TRANSPORTER 9 Acknowledgement of Receint of MaterialiPrmUoVTypod Name & PoaiUoaJltUtt#/?& &b kfOBCk Y<
19. Discrepancy Indication Space
20. FACILITY OWNER OR OPERATOR: Certification of receipt of hasardcnoted is Item 19.
i materiaJe cevend by thia a it except aa
Printed/Typed Name Signature
EPA Form 8700-32 (Rev. 948) Previoua editiana are obaolata. OBDJ Diitribuckni
The p^ges accompanying this facsimile.transmission contain information from trie firm of GreatUkes Analytical. The pages are confidential or privileged. Th» information Is Intended for the use ofthe Individual or entity name on mis covar sheet. If you are not the Intended recipient, be aware thatany disclosure, copying, distribution or us* of the contents of this information is prohibited. If youhave received the facsimile In error, please notify us by telephone immediately so that we canarrange for the retrieval of me original documents at B^oost toj
A COPY OF THIS FACSIMILE WILLV WILLNOTv BE MAILED.
i2,iil/200;: 14:37 14146450645 LAKE STATES INDUSTRI PAGE 02
12/01/2003 m 0:39 FA1 4145709481 Great Lakes Analytical ®002/016
ANALYTICAL Oak Creek. Wisconsin 53154 (414) 570-«4eO FAX (414) 570-9461
01 December 2003
Tom JacobsonLake States industrial Service311 E. Greenfield Ave.Milwaukee, Wl 53204RE: Milwaukee Solvay Coke Site
Enclosed are the results of analyses for samples received by the laboratory on 11/14/03. Ifyou have any questions concerning this report, please feel free to contact me.
Sincerely,
Great Lakes Analytical
Andrea StathasProject Manager
19/01/2003 14:37 14146450645 LAKE STATES INDUSTRI
12/01/2003 ION 0:40 FAI 4145709461 Great Lakes AnalyticalPAGE 03
Great Lakes Anoly&ml-Oak Creek The nulti In OOt rtport afffy to Hit tampia aufyrti in accordance *iik «*r tkdn ofcattoiy Jeeumtxt TUiattUytleolnfortnaathenpnitttcaSln la entinty.
Andrea Stathic, Project Manager Page 1 of12
12/01.0303 14:37 14146450645 LAKE STATES INDUSTRI PAGE 04
12/01/2003 MON 0:40 FAI 4U5709461 Great Lakes Analytical
Tilt rtsula lit Aii'npan tppfy to the tOOfltt analyse* In aeeor4ana *U» tfit chain ofaaatfioeumtal. Tkii auifytoi rlpon mat be nproJvctJ to ta cnti^ly.
Page 7 of 12
1-01/2003 14:37 14146450645 LAKE STATES INDUSTRI
12/01/2003 flUN 0:42 FAI4145709461 Great Lakes AnalyticalPAGE 10
GREATLAKESANALYTICAL
140 East Ryan RoadOtt Creak. Wisconsin 53154
Emalli(414)570-0460 FAX (414) 57 -9461
Uke Sana InduatruU Service
3 HE. Greenfield Ave.Milwaukee WI, 53204
Project Milwaukee Sotay Coke SitePro/act Number [none]Project Mmgo: TomJicotoon
fepwto*12/01/03 12:35
PotydilQrmated BIpheayls by EPA Metfrod 8082Great Lake* Analytical-Buffalo Grove
Great Lakes Analytical-Oik Creek Tht nent/cr In Alt nperl apffy H itt lamfltx tMfyttt In aeeonlanet wifA Ik* duiii ofOOttiy document UU> tamfyHfal repan MUM b» npntaeei lit to tnlinlr.
Andrea Staihai, Project Manager Page 9 of 12
:?/01/2083 14:37 14145450645 LAKE STATES INDUSTRI PAGE 12
12/01/2003 ION 0:42 FAI 4145709461 Great Lakes Analytical
Great Lakes Anfllytical-O«k Creek ninatliMt* Ait m*n apply* riutompta amtfyirt l«aceer<danee wM At ota/i t>fneledf torment, 'ftiii tnofyOeal report mtul be rtfrvjtteal in it*
Andrei Stitbas, Project Manager P««elOofl2
•01/2003 14:37 14146450645 LAKE STATES INDUSTRI
12/01/2003 M 0:43 FAI 4145709461 Great Lakes Analytical
Great Late Anatytlcftl-Buffiilo Grove NELAPPlinuiyAeereditttian:lIltnoi« #100261
Great Lakes An4ytical-Bu£WoQroveNELAP Secondary Accreditation: New Jeoey ML001
Great Lakes Analytical-Oak CrecX WI Winconnn DNR Cwtificatioa Lab ED: 341000330
Grart liKe* Analytiul-Oak Creek, WI NELAP Primary Accreditulon: niinoi* #1 00307
Note: For analyses that require NELAP •corcdjtation, all aiulyteg, by matrix and method, are accredited following current NELAPstandards wnl*s» specifically noted by M«y of a qualifier lined above.
Great Lakes Analytical-Oak Creekoandy donoiou. niionafytttal report mat At mpnJaetfi* IB tHfrey.
Andre* Stathan, Project Manager Page 12 of 12
GREATLAKESANALYTICAL
CHAIN OF CUSTODY REPORT
1380 Buacti Partway 140 E. Ryan RoadBuffalo Grow. IL 600694505 Oak Creek, Wl 53154
(847)806-7786 (414)570-9460 :
FAX (847) 808-7772 FAX (414) 57O9461
Hapon to: T<*» ->flLA acitoil a Shtenad G Ccurf.rO
HofBottbePmservatim Used
Protect it/POt:
LABORATORYID NUMBER
PIO;
PICK
HOf 'It- -ol
cs
k—• [.-.,•••-= CS
« °JS LO
£?CB
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GREATLAKESANALYTICAL
CHAIN OF CUSTODY REPORT
1380 Busch Partway 140 E. Rya/» RoadBufiaJo Grove. !L 6M69-45C5 Oak Cree k, Wl 53154
OiAwabto ftctafltt I DeAwy iWsWrod.D STO DOU.I> IGLA M qi«rt_g SHOP* Q i
cnaui
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en
12/16/2003 TUE 22:19 FAI 4145709461 Great Lakes Analytical iOOl/006
GREAT " > : i uLAKES 140 East Ryan Road Email: [email protected] oak creek. Wisconsin 53154 (414)570-9460 FAX (414)570-9451
17 December 2003
Tom JacobsonLake States Industrial Service311 E. Greenfield Ave.Milwaukee, Wl 53204RE: MSCG Pre Treatment List
Enclosed are the results of analyses for samples received by the laboratory on 12/10/03. Ifyou have any questions concerning this report, please feel free to contact me.
Sincerely,Great Lakes .Analytical
Andrea StathasProject Manager
12/16/2003 TUE 22:19 FAX 4145709461 Great Lakes Analytical
SanptelD Laboratory ID Matrix Dxt* San^dod Date Received
T032
T038
W312132-01
W312132-02
Waste (L)
Waste (L)
12/10/03 16:30
12/10/03 16:30
12/10/03 17:00
12/10/03 17:00
Great Lakes Analytical-Oak Creek Thf naulu in thti report apply to tilt samples arufyud in accordance wick tke chain ofcustody document. This analytical report mat bt npnductd in ia intirtty.
Andrea Stathas, Project Manager Page 1 of 4
12/16/2003 THE 22:19 FAX 4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek The nsula in this report apply to At samplti anatjnid in accordance with the chain ofcustody documtnt. This analytical report mint b* reproduced la la entirety.
Andrea Stadias, Project Manager Page 2 of4
12/16/2003 TUE 22:20 FAX 4145709461 Great Lakes Analytical
T)it TON/tt In Ih'a report apply to At naaiplu anafyied In accordance with the chain cfcustody document. This analytical report mat bt rtproductd in iti entirety,
Page 3 of4
12/1(5/2003 THE 22:20 FAX 4145709481 Great Lakes Analytical P05/006
jgSBGREATSil| LAKESKBM ANALYTICAL
Lake States Industrial Service311 E. Greenfield Avc.Milwaukee, WI 53204
140 East Ryan RoadOak Creek, Wisconsin 53154
Project: MSCOPre Treatment ListProject Number [none]
H This quality control m*Muremenl in above the liboratmy cnxbliihcd limit.
Great Lakes Analytical-Buf&lo Grove Wisconsin DNR Certification Lab ID: 999917160
Great Lakes Anatytical-Buf&lo Grove NELAP Primary Accreditation; Illinois # 100261
Gnat Lakes Analytical-Buffiilo Grave NELAP Secondary Accreditation: New Jersey #ILQO I
Great Lakes Analytical-Oak Creek, WI Wisconsin DNR Certification Lab ID: 341000330
Great Lakes Analytical-Oak Creek, WI NELAP Primary Accreditation: Illinois #100307
Note: For analyse* that require NELAP accreditation, all analytes, by matrix and method, are accredited following current NELAPstandards unless specifically noted by way of a qualifier listed above.
Great Lakes Analytical-Oak Creek The results In this report appfy to the sampla anafyxtd in accordant with tke chain ofcustody document, TMs analytical report must ht reproduced In Us entirely.
Andrea Stathas, Project Manager Page 4 of 4
| GREATj| LAKES(•ANALYTICAL
CHAIN OF CUSTODY REPORT
1380 Busch Parkway 140 E. Ryan RoadBuffalo Grove. IL 60089-4505 Oak Creek, Wl 53154
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX G-2
Analytical Test DataRelating to Liquid Discharges to
Milwaukee Metropolitan Sewerage District
EarthTechA Tyco International Ltd Company
L:\work\72534\Adrnin\Reports\Rpttext.doc
Preserving The Environment <Improving Water Quality
December 4, 2003
Mr. Tom JacobsonLake States Industrial Services311 East Greenfield AvenueMilwaukee, WI 53204
Subject: Notice of Intent 2003.037
Dear Mr. Jacobson:
The Milwaukee Metropolitan Sewerage District (MMSD or District) has received a Notice ofIntent submitted by Environmental Associates, Inc., for the discharge of water from the formerSolvay Coke and Gas site, located at 311 East Greenfield Avenue, Milwaukee. The District isapproving the discharge of water from this site subject to the following conditions:
1. The former Solvay Coke and Gas site must be in compliance with the general and specificlimits set forth in Chapter 11, MMSD Rules. The pH discharge must be greater than 5.0standard units.
2. In the water discharged to the sewer system, the following pollutant levels may not beexceeded.
Cadmium 1.5 mg/1Chromium, Total 8.0 mg/1Copper 6.0 mg/1Cyanide, Total 5.0 mg/1Lead 2.0 mg/1Mercury, Total 0.0026 mg/1Nickel 4.0 mg/1Oil and Grease 300 mg/1Zinc 8.0 mg/1Total Suspended Solids 100 mg/1Total VOC Scan <5 mg/1
3. At least one sample must be taken and analyzed for the above pollutants during discharge.
4. No discharge may occur during periods of at least 0.5 inches of rain. If it does rain, alldischarge from the former Solvay Coke and Gas site must cease to the sewer system.Commencement of the discharge cannot occur until 12 hours after the rain has stopped.
miiwaukee metropolitan sewerage District260 W. Seeboth Street, Milwaukee. Wl 53204-1446
414-272-5100 • www.mmsd.com Q£>
Mr. Tom JacobsonLake States Industrial ServicesDecember 4, 2003Page 2
5. The total volume of water discharged should be reported to Mr. Harvey Matyas, DistrictSenior Industrial Waste Engineer, when the pumping is completed. At that time, the theformer Solvay Coke and Gas site will be billed by the District at the rate of $1.05 per 1.000gallons discharged.
The policies and procedures for these types of discharges to the sewer system are currently beingstudied by the District. You should be aware that this approval may be rescinded at any time orchanges to your conditions may occur.
If the former Solvay Coke and Gas site is in violation of this letter of approval at any time, theDistrict may take enforcement actions which may include, but are not limited to, issuing a Noticeof Noncompliance, a Notice of Violation or seeking injunctive or civil penalties up to $10,000 perday per violation.
If you have any questions concerning this matter, please contact Mr. Harvey Matyas, SeniorIndustrial Waste Engineer, at 225-2164.
Sincerely,
Peter R. TopczewskiWater Quality Protection Manager
Cc: Mr. Joe Michaelchuck, P.E.Environmental Associates, Inc.
Re: Notice of Intent to Discharge Non-Domestic Wastewater, Former Solvay Coke and GasSite, 311 E. Greenfield Avenue, Milwaukee, Wisconsin
Dear Mr. Matyas:
The purpose of this correspondence is to provide a letter of understanding regarding the proposedwastewater discharge at the Former Solvay Coke and Gas Site. This letter will describe theprocess, operations, activities, and circumstances that will produce wastewater at this site as wellas plans for discharge. The Notice of Intent to discharge non-domestic wastewater, as requiredby Section 11.401 of the MMSD rules, is provided in Attachment A.
Site Background
The Former Solvay Coke and Gas Site is being deconstructed in phases by Lake States IndustrialServices. Various sized aboveground storage tanks (ASTs) associated with the Former SolvayCoke and Gas Production Facility are located throughout the site. The ASTs have deterioratedover time and currently contain residual coal tar and storm water. As a part of Phase I ofdeconstruction these ASTs will be emptied, cut open, cleaned, and removed from the site.
Proposed Discharges
Non-domestic wastewater is generated in one of two ways:
(1) Contaminated Water that has Accumulated in each AST as a Result of Rain Infiltration
As part of the deconstruction of the site, the ASTs will be emptied, cleaned and cut up for scrap.The first step in the AST removal process is to drain the water that has accumulated in the tanksas a result of rain water infiltration. It is proposed that the water that has accumulated in thetanks as a result of rain infiltration be drained from each AST and disposed of through thesanitary sewer. Because this water has been held in these tanks for a number of years, in directcontact with residuals within the tanks, and because cyanide has been detected in this water, thisdischarge would not be considered "unpolluted water" that could otherwise be routed directly tothe waters of the state under a WDNR permit.
ENVIRONMENTAL ASSOCIATES, INC.
The total volume of water that will be discharged from the draining of contaminated water thathas accumulated in each AST is expected to be approximately 25,000. Water will be dischargedin five batch discharges of 5,000 gallons each over a four week period of time. It is anticipatedthat all five discharges will be completed within four weeks of receiving discharge approval fromMMSD. The proposed discharge location is a toilet (4-inch line) located in Building #11 (Figure1, Attachment D).
A representative sample of water that has accumulated in the tanks as a result of rain infiltrationwas collected on November 19, 2003 and submitted to Great Lakes Analytical in Oak Creek,Wisconsin. The sample was analyzed for the compounds listed in MMSD section 11.202 and11.203(l)(a). No compounds were detected, above laboratory method of detection limits, withthe exception of cyanide (0.0736 mg/L), which was detected below the MMSD limit of 5.0mg/L. Wastewater analytical results are summarized in Table 1, Attachment B, and presented inAttachment C of this submittal.
(2) AST Wash Water
After the contaminated water in each tank is emptied, coal tar residuals will be removed andproperly disposed. The empty tank will then be thoroughly cleaned using high pressure washingequipment. It is proposed that this AST wash water also be discharged into the sanitary sewer.
It should be noted that AST wash water has not yet been generated and, therefore, has not yetbeen tested at the site for the pre-treatment parameters listed in MMSD Chapter 11.203. It isanticipated that this wash water will require pre-treatment prior to being discharge into theMMSD sanitary sewer to meet Chapter 11.203 limits. Treatment of this water will consist of aclarifier cell (frac tank) and liquid carbon canisters.
In order to gain approval for discharge, it is proposed that prior to each batch discharge a sampleof the treated water be collected for Chapter 11.203 parameters, pH and TSS. These results willbe compared to Chapter 11.203 limits prior to discharge and, if they fall below these limits,discharge will proceed. If any of the Chapter 11.203 limits are exceeded, additional treatmentwill be conducted and the effluent will be retested prior to discharge. All testing results will bemade available to MMSD at their request.
The total volume of AST wash water that will be discharged to the sanitary sewer is expected tobe approximately 25,000. AST wash water will be discharged in batches. It is anticipated thatthe discharging of AST wash water will be completed within four weeks of receiving approvalfrom MMSD. The proposed discharge location is a toilet (4-inch line) located in Building #11(Figure 1, Attachment D).
Lake States Industrial Services is requesting written permission to discharge the above describednon-domestic wastewater at the Former Solvay Coke and Gas Site. As Lake States IndustrialServices would like to commence discharge before freezing occurs, your prompt review wouldbe greatly appreciated. If you have any questions or concerns, please feel free to contact us.
Sincerely,
Environmental Associates, Inc. Lake States Industrial Services
Joe Michaelchuck, P.E. Bert SneadSenior Engineer President
Notice of IntentTo Discharge Non-domestic Wastewater,As Required by sec. 11.401, MMSD Rules
L Facility Information
(a) Facility name Former Solvay Coke & Gas Site
(b) Facility address311 E. Greenfield Ave.
Milwaukee, WI 53204
(c) Mailing address311 E. Greenfield Ave,
Milwaukee, WI 53204
(d) Contact person Tom JacobsonNameV.P. (Lake States Industrial Services)
Tide
414-645-0635 (office)Telephone
(e) Business description
The Former Solvay Coke and Gas Site is being deconstructed
by Lake States Industrial Services. Various above ground
storage tanks (ASTs) associated with the Former Solvay Coke
and Gas Production Facility are located throughout the site.
The ASTs have deteriorated over time and currently containresidual coal tar and water. As part of Phase I of deconstruction
these ASTs will be cut open, cleaned and removed from the site.
(f) Five digit NAICS code or four digit SIC code N/A
IL Discharge information
(a) Reason for submitting this notice of intent:
Constructing a new facility that will discharge process wastewater to the sewerage system
Taking possession or control of an existing facility that discharges process wastewater
Changing the physical size or operations at an existing facility to the extent that wastewatervolume or content will be substantially changed, including, but not limited to, a change inthe annual average daily discharge flow rate of 20% or more
Proposing to discharge contaminated groundwater
Commencing or modifying a discharge of hazardous waste that requires reporting accordingto sec. 11.411, MMSD Rules
Proposing to discharge non-domestic_JL_ Other. Explain on an attached page wastewater not previously reported
to the District.(b) Proposed date for the commencement of discharge as soon as possible (12 / 0 5 / 0 3)
(c) Describe the processes, operations, activities, and circumstances that will produce the non-domestic wastewater covered by this Notice of Intent
see cover letter
(d) Wastewater discharge rates for the facility as a whole. Complete this section if the dischargeis not a one-time discharge
Flow rates (gallons per day)Existing Proposed
Domestic
Non-domesticProcess
Non-contactcooling approximately 1,785 gallons per day
(see cover letter)Other
(e) Discharge type (fill in the spaces that apply)
1. Continuous discharge: hours per day days per week
2. Batch discharge: 1 0 , OOOgallons discharged per batch par ( 5 hai-nbas total)Frequency Time
3. One time discharge: gallons discharged over days
4. Other (explain the timing and type of discharge)
(f) List the pollutants potentially present in the wastewater covered by this Notice of Intent
See attached analytics.
(g) Sample results. If you are able to sample the wastewater covered by this Notice of Intent, thenattach sample results according to the instructions.
(h) Would the wastewater covered by this Notice of Intent be regulated as hazardous wasteaccording to sec 40 CFR 261 if it was not discharged to the sewerage system?
Yes x NO
If yes, contact the District for additional reporting requirements.
(i) Describe any proposed treatment procedures or equipment
None.
(j) Enclose a drawing of the site where the discharge will occur, This drawing must identify allconnections to the sewerage system; the processes, operations, or activities generatingwastewater; treatment facilities, and potential sampling locations.See Figure 1 .
DJL Certification and signature
/ certify under penalty of law that this document and all attachments wereprepared under my direction or supervision in accordance with a systemdesigned to assure that qualified personnel properly gather and evaluate theinformation submitted. Based on my inquiry of the person or persons whomanage the system or those persons directly responsible for gathering theinformation, the information submitted is to the best of my knowledge and belieftrue, accurate, and complete. I am aware that there are significant penalties forsubmitting false information, intruding the possibility of fine and imprisonment
violations^
Signature ' £ Date
Primed name and title
Notice of Intent
ATTACHMENT B
Table 1: Non-domestic Wastewater Evaluation, November 19,2003,Solvay Coke and Gas Site, Lake States Industrial Services, 311 E. Greenfield Ave., Milwaukee, Wisconsin
Foooiocea:1 MMSD discharge liinti bated on MMSD Chapler 11.202 and 11.203(IX«) local limits1 TTie MMSD disdurge limit fat Endomlfrn is 1.3 ug/L1 The MMSD discharge limit for Polychlorinated Biphenyl's is 1.3 ug/L. This applies to each specie
polychlorinMed biphenyl.
NT-Not Tested
- = No discharge standard
of
Environmental Associate*, Inc.855mnwill-03
ATTACHMENT C
12/U2/2U03 1UK 5:07 FAI 4145709461 Great Lakes Analytical IP 1)3/032
Lake States Industrial Service311 E. Greenfield Ave.Milwaukee WI, 53204
Project: MSCC3 Pre Treatment ListProject Number [none]
Project Manager: Tom JscobsonReported:
12/02/03 17:03
ANALYTICAL, REPORT FOR SAMPLES
Sample ID Laboratory ID Matrix Dale Sampled Date Received
Tank 13 Spill W3II185-01 Water 11/19/0313:30 11/19/0314:40
Great Lakes Analytical-Oak Creek
indrea Stathas, Project Manager
Tht raula in this report apply la the lamples analyzed In accon/uncr with the chzincustody dncunieni. This analytical rtpnrt must be reproduced in ill tntirety.
Page 1 of l -
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TIE 5:08 4145709461 Great Lakes Analytical
Great Lakes Analytical—Oak Creek Tht nsulu In this report apply la the samples analyxd in accordance witli 111:: chaincustody document, Uiis analytical report must be reprvtiuced in la entirety.
Great Lakes Analytical-Oak Creek 77i* mulu In this report apply In the samples analyzed in accnrdance with Ihv r:ha:ncustody document. This analytical report must bv rrprvduetct in its enllrvly.
Great Lakes Analytical—Oak Creek The results in this rtporl apply to th<t samples analyzed in accordance with the '.-hnin nfcustody document. This analytical report miat h* reproduced In Its tHIirvly.
Hit rtxultt in this report apply to thr xampltt analysed In accordance with the di~-custody document. This analytical i*ifi:r: mat be reproduced in ill entirety.
Great Lakes Analytical-Oak Creek 77i« results in this report apply to tit* samples analysed In atlconlanet with thecu.itn<fy document. This analytical rtport must be rtproducitJ in Its tntirtcy.
Great Lakes Analytical—Oak Creek The results In this report apply la tht samples analyzed in accordance with Ihv chsir.custody document. This analytical rtpn>t rnusl be reproduced In Us entirely.
Great Lakes Analytical—Oak Creek Tlit results In this report apply to the latrjiis analyzed in accordance with ll«.- chaincustody document. Hiii analytical rtpo"! mai be rtpmductd In Its enlirtly.
.idrca Stadias, Project Monager Page X of 2^
12/02/2003 TIT 17 : r , [TX/RX NO 5084] @]OH>
12/uz/zuu,} TUB a;ub FAA weai Lanes Analytical I f l U l i / U J Z
Great Lakes Analytical-Oak Creek The remit* In this report apply to the tamplts anatymd III accunlanc* wit/1 the cl'-i.r. : •'custody dncumtlril. 77//J analytical report must he reproduced in Its entirety.
.ndrea Scathas, Project Manager Page 9 of:9
12/02/2003 TUE 17:04 [TX/RX NO 5084] 0J 011
1 2 / u z / z u u j rut o ; u a MA tanes Analytical
Great Lakes Analytical— Oak Creek The rfsutts In this report apply la the samples analyzed in accnrdanee with //';•_• chain •eiutody document. Th'u analyticalrrport must be rupruduftd in its entirely.
Great Lakes Ajvalytical—Oak Creek 77ir results in this report apply lt> the lamplis analyzed In accordance with Hie chaincustody document. Thin analytical report must be rrprvduetd In Its enllrvty.
rea Stathas, Projecc Manager Page 11 of 29
12/02/2003 TUB 17:04 [TX/RX NO 50841
12/02/2003 TUE 5:10 FAI 4145709461 Great Lakes Analytical 0014/032
Great Lakes Analytical—Oak Creek Tlie rrsulti in tHlt report apply In the samples onatyztd in accordance *iilh th* ehacustody document. This analytical report must Ixt reproduced in Its entirely.
ndrea Stathas, Project Manager Page 12
12/02/2003 TCE 1 7 : 0 4 [TX/Ri NO 5084]
12/02/2003 TUE 5:10 FAX 4145709461 Great Lakes Analytical 10015/032
Great Lakes Analytical—Ook Creek TItt: ri'sula In this report apply ta the samples unotystd in accordane* with the chain icustody document, Thli analytical report must be reproduced In Its entirety.
.drea Statbas, Project Manager Page 13 ol'2S
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TUE 5:11 FAX 4145709461 Great Lakes Analytical P16/032
fiThe resullj In thLi report apply la the xampltj analyzed In accordane* with the chaincustody document. Tl\lx analytical rtpnri must be reproduced in iLi tntircty.
The rvsults in this report apply to the samples analyzed In avcorjance with the chain "/custody tlccunierit. This analytical rcporl must he reproduced in I'M entirety.
Page 16 of 25
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TUE 5:11 FAI 4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek Tlit results In Ihis report apply to the samples analyzed in accordant* viitli Ihv ehair. ofcustody document. This analytical tvport must be reproduced in Its entirety.
Project: MSCG Pre Treatment ListProject Number, [none]
Project Manager. Tom JucobsonReported:
12/02/03 17:03
Base/Neutrals and Acids by EPA Method 625 - Quality ControlGreat Lakes Analytical—Buffalo Grove
AnalyteReporting Splice Source V.REC RPD
Rault Uinit Unit* Level Result VoREC Limits RPD Limit Notts
Batch 3110424 - EPA 3510C
Blank (31 10424-BLK1)Acenuphthcne
Accnnphthylenc
Anthracene
Bcn7.idinc
Bcnz (u) anthracene
Dcnzo (a) pyrcnc
Beozo (b) fluuranthcne
Bcnzo (glii) peiylene
Ben 70 (k) ttuorauthaie
Bi.s(2-chlorocthoxy)m«thaixe
Eis(2-chlorocthyl)etha-
Bi3(2-chloroisopropyl)«hcr
Bi5(2-cthylhcxyl)phlhalatc
T phcnyl phcnyl ether
L Benzyl phth*latc
4-Chloru-3-methyrphenol
?.-Chloro naphthalene
2-Chlorophcnol
4-Chlorophcnyl pheuyl ellier
Chrysenc
Diboxt (u.h) unthmccnc
1 .1-Dichloroboiztaic
1 ,.^-Dichlorobenzeue
l ,4-Dichlorobcnzeiie
j,3 '-Dichlorobcnzidine
2.4-Dichlarophcnol
Di fUiy l phlhubte
2,4-DiinediyIphenol
Dimctliyl phthalate
Di-n-buryl phihalate
•»,ft-DiniTn-2-mcthylphenol
2,4-Dinicrr)phenol
2s4-Duutrolo!ucnc
2,&-Dinitrololuene
Di-n-octyl phthalate
ND
ND
ND
ND
ND
ND
ND
ND
NDND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
Prepared: 11/19/03 Analysed: 11/21/0310.0 up/1
10.0 "
10.0
50.0
10.0
10.0
10.0
•w l
10.0
10.0
10.0
10.0
10.0
iy.o10.0
10.0
10.0
10.0 "
10.0
1U.O
10.0
10.0
10.0
10.0 "
20.010.0
10.0
10.0
10.0
10.0 "
50.050.0
10.0
10.0
10.0
Great Lakes Analytical—Oak Creek The i-e.tults In this rrpari apply to the samples analyzed In accordance wllfi the cli'iindocument. Thii analytical report must bv reproduced in its entirely.
Great Lakes Analytical—Oak Creek TTir rcxulu in ihii report apply to III* samples analyzed in accordance with the chicustody document This analytical rtfnrl must t>f reproduced in its entirety.
jdrca Stathas, Project Manager Page 20 of2;
12/02/2003 TUE 17:04 [TX/RX NO 5084] ®022
12/02/201)3 TUK 5:13 FAX 4145709461 Great Lakes Analytical 10023/032
Project: MSCG Pre Treatment ListProject Number (none]
Project Manager: Tom JucobjonReported:
12/02/0317:03
Base/Neutrals and Acids by EPA Method 625 - Quality ControlGreat Lakes Analytical—Buffalo Grove
AnulytcReporting
Result Limil UnicsSpike SourceLevel RejulL %REC
%REC RPDLimits RPD Limit Notes
Batch 3110424 - EPA 3510C
LCS(3tl0424-BSl)AccnnphthcneAcenaphthylene
AnthraceneBcnzidiiwBcn7 (a) anthracene
Bcnzo (») pyrcnc
Bcnzo (b) flunranthcnc
Benzo (fihi) perylcncBcnzo 00 fluonmUieoe
Bi.i(2-chloroctho*y)melnaneBis(2-ch loro ethyl Jcthcr
Bis(2-ch lonjisopropyl)ethCT
B is(2-elliylliexy\)phlhiiliitEimopkenyl plienyl eiher
bciiTyl plithal.Me
4-Chloro-3-mcthylphcnol
2 -Chloronaphthalcne
2-Chlorophenol
•4-Chlorophenyl phenyl etherChryscnc
Dibcnz (a,h) onthnccnc
1 J-Dichlorobcnzene
1 ,3-Diclilorobeoiene
1 ,4-Diclilorob*n^ene
3,?'-DichIorobeniidine"Z ,4-Dichloroplicnol
Diclhyl phthiiloxc
2.4-Dimclhylphcnol
Dimetliyl phlhilatc
Di-n-butyl phlhulutc
-4 ,r,-Dinitro-2-uielhylphi3iol
2,4-Dintrrophcnol
2,4-Dinitrowlucne
2.6-Dinilrotolucne
Di-l)-oc[jl phlbalate
Prepared; 11/19/03 Analyzed: 11/21/0316.817.120.6
8.71 .24.ft
27.9
24.220.128.28.40
1.370.770
24.219.424.f,
15.5
13.4
ND
17.6
23.3
21.4
ND
ND
ND
25.60.07
2J.O
8.07
20.6
24.3
22.0
11.320.8
19.8
22.S
tO.O ug/1
10.0
10.0S.CXJ
10.0
10.0
10.0 "
10.0
10.01.00
1.00 "
0.100
10.0
10,010.0 "
10.0
10.0
10.0
10.010.0
10.0
10.0 "
10.0
10.0
20.0
1 .00
10.0
1.00
10.0
10.0
5.00
5.00
10.0
10.0
10.0
2S.O
25.0
2S.O
2S.O
2J,0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25. 0
25.0
25.0
25-025.0
25.0
25.0
25.0
25.0
2*£
25.0
25.0
25.025.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
67JZ
63.4
S2.4
34.8
98.4
112
96.8
80.4
113
33.6
5.4X
3.08
96.8
77.6
98.4
62.0
53.6
70.4
93.2
85.6
102
36.3!J2.0
32.382.4
97.2
88.0
45.2
83.2W2.
91.2
10-11413.6-114
14.7-11570-130
20.5-124
17.2-121
13.6-13610-164
13.2-128
14.4-11211.5-110
10-11310-159
14.6-1 IK '
10-164
10.8-11310-110
U.4-110
12.6-11710-110
10-148IU-11U
10-110
10-110lo-no
10.2-112
16.2-121
10-110
1X-122
1(1-120
10-129
10-123
12.5-126
14.3-127
lft-122
L
L
L
L
LL
Great Lakes Analytical—Oak Creek 'flit rttulu In this report apply to the samples analyzed In accordance wjV/i the ch'i'.r.custody document. This analytical report must be rvprvductd In lu entirety.
idrca StatKos, Project Manager Page 2 I of" :9
12/02/2003 TL'E 17:04 [TX/RX NO 5084] 12) 0 J.i
HIE a: la FAA 4 i 4 b Y U S 4 b i Great Lakes Analytical ,4024/032
The results in this rrport apply to the samples analyzed in accartianc* with tlm chain c'custody document. This analytical report must frt- nprotluctd in Its entire!?.
Page 22 of 29
12/02/2003 TUE 17:04 [TX/RX NO 5084] CS 0 2 -t
12/02/2003 TDK 5:13 FAX 4145709461 Great Lakes Analytical 10025/032
The results in thii report apply to tha samples analyzed in actvnJancc with the clia:n r-fcuxtndv t/fteument. This analytical report must be reproduced in its entirety.
Great Lakes Analytical-Oak Creek Tlie results in this report apply (a th* lamftlr.i analyzed In accortlancr with the chair ofcustody dncumrnt. This analytical report mu.fi he rcproa'uccJ In lit entirtty.
idrca Stathas, Project Manager Page 24
12/02--2003 Tl'E 17:04 [TX/RX NO 5084]
12/02/2003 THE 5:14 FA1 4145709461 Great Lakes Analytical
The mula in this report apply 10 the lamplti analyzed in accordance with Ihi' chain n(custody document. This analytical rtport muit h* reproduced in IU infinity.
<^>
jidrca Stathas, Project Manager Page 25 of 29
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TUE 5:14 FAX 4145709461 Great Lakes Analytical 10028/032
Great Lakes Analytical-Oak Creek Ttia results in this rtpon apply to l/iesamplui analyzed In accordance with the ch-i'.rcustody document. '/Ait analytical report must be rtprnductd in its entirety.
Great Lakes Analytical—Oak Creek The raulcs In this report apply to thr lampla analyzed In accordance with the chain nfcustody document. This analytical rtpnn must be reproduced In Its tntirtry.
Luke Suites Industrial Service311 E. Greenfield Avc.Milwaukee Wl, 53204
Projcxt: MSCO Pre Treatment ListProject Number: [none]Project Manager. TomJacobson
Reported:12/02/03 17:03
Notes and Definitions.
A-01 this tmulytc WHS quantified using an open scan.
QC The result lor one or more quality control measurements associated with this sample did not meet the laboratory and/or sourcemethod acceptance criteria.
DET Anulytc DETECTED
ND AnalyLe NQT DETECTED «t or above the reporting limit
NR Not Reported
dry Sample remits reported on a dry weight basis
RPD Relative Percent Difference
L This quality control measurement is below the laboratory established limit
H This quality Conlrtl measurement is nbove the laboratory established limit,
Great Lakes Analytical—Buffalo Grove Wisconsin DNR Certification Lab ID: 999917160
Great Lakes Analytical—Buffalo Grove NELAP Primary Accreditation: Illinois #100261
Great Lakes Analytical-Buffalo Grove NELAP Secondary Accreditation: New Jersey #IL001
Great Lakes Analytical—Oak Creek, WI Wisconsin DNR Certification Lab ID: 341000330
it Lakes Analytical-Oak Creek, WI NELAP Primary Accreditation: Illinois #100307
Note: For analyses that require NELAP accreditation, all analytes, by matrix and method, are accredited following current NELAPstandards unless specifically noted by way of a qualifier listed above.
Great Lakes Analytical— Oak Creek
f]
\
The results in Ihh rtpart apply to th< lamplix analyzed in accordanct with tlie chain \custuJy document. 7'Ai.t analytical report must be reproduced In Its entlrvly.
Lake States Industrial Service311 E. Greenfield Ave.Milwaukee Wl, 53204
Project; MSCG Pro Treatment ListProject Number: [none]
Project Manned-. Tom JacobsoiiReported:
12/04/03 10:07
ANALYTICAL REPORT FOR SAMPLES
| Sample ID
Tank 1 3 Spill
Lnboratory ID Matrix
W3 12023-01 Water
DaCc Sampled Date Received
1 1/19/03 13:30 12/03/03 09:47
Great Lakes Analytical'-Oak Creek '111* result? in tkLi rtpvrt apply <O tile samples analyzed in accordance willi the chain nfcustody document, nit analytical report must be reproduced In lu entirety.
Andrea Stathas, Project Manager Page 1 of 4
12/04/2003 THU 09:58 [TX/RX NO 5097] 121003
urn; u \ u i 4 i i avu»4Di breai LaKes Analytical IP04/007
Lake States Industrial Service311 E. Greenfield A«e,Milwaukee Wl, 53204
Piujcct: MSCG Pre Treatment LiltProject Number, [none]
Project Manager. Tom JavobsonReported:
12/04/03 10:07
General ChemistryGreat Lakes Analytical—Buffalo Grove
Arnlytc
Tank 13 Spill (\V312023-01) Water
PHTotal Suspended Solids
ResultReporting
Limit Units Dilution
Sampled: 11/19/03 13:30 Received: 12/03/03 09
6.87ND S.OO
pH Unitsmg/l
1
Batch
:47
3120106312010S
Prepared
12/03/0312/03/03
Analysed
12/03/0312/04/03
Method
EPA 9040BEPA160J2
Molts
C5
Great Lakes Analytical-Oak Creek The result's in this report apply to the samples analyzed In accordance with the chain ofcustody document. This analytical nport must be reproduced In Its entirety.
Great Lakes Analytical—Oak Creek The nisulu In tills report apply to the samples analyzed In accordance with thecustody document. This analytical report must be reproduced in Its entirely.
Andrea Stathas, Project Manager Page 3 of 4
12/04/2003 THU 09:58 [TX/RX NO 5097]
nnu MA 4 i 4 & Y U S 4 b i i^reai Lanes Analytical 10006/007
GS This sample was received past the method specified holdtime.
DET Analyte DETECTED
ND Analyte NOT DETECTED at or above the reporting limit
NR Not Reported
dry Sample reaulbi reported on i> dry weight busi-H
RPD Relative Percent DifferenceL Thin quality control measurement u hclnw the laboratory established limit.
H This quality control measurement is above the laboratory established limit.
Great Lakes Analytical-Buffalo Grove Wisconsin DNR Certification Lab ID: 999917160
Great Lakes Analytical—Buffalo Grove NELAP Primary Accreditation: Illinois #100261
Great Lakes Analytical-Buflalo Grove NELAP Secondary Accreditation: New Jersey ML001
Great Lakes Analytical-Oak Creek, WI Wisconsin DNR Certification Lab ID: 341000330
Great Lakes Analytical-Oak Creek, WI NELAP Primary Accreditation: Illinois #100307
:>te: For analyses that require NELAP accreditation, all analytes, by matrix and method, are accredited following current NTELAPandards unless specifically noted by way of a qualifier listed above.
Great Lakes Analytical—Oak Creek
LjLK0ll#?
The results In this report apply to Ihv Samples analyzed in acuorJanct with ihv t-ltuin ufcustody document. Thh analytical rtpart must bf nproduetd in its tntirtly.
ANALYTICAL Oak Creek. Wisconsin 53154 (414)570-9460 FAX (4 14) 570-9461
06 January 2004
Tom JacobsonLake States Industrial Service311 E. Greenfield Ave.Milwaukee, Wl 53204RE: MSCG Pre Treatment List
Enclosed are the results of analyses for samples received by the laboratory on 12/23/03. Ifyou have any questions concerning this report, please feel free to contact me.
Sincerely,
Great Lakes Analytical
Andrea StathasProject Manager
01/07/2004 ID 3:49 PAI 4145709461 Great Lakes Analytical
Lake States Industrial Service311 E. Greenfield A ve.Milwaukee, Wl 53204
Project; MSCG Pre Treatment List
Project Number [none]Project Manager. Tomlacobton
Rep*rted:01/06/04 17:18
ANALYTICAL REPORT FOR SAMPLES
Sample ID
Fractonlc-pojl Tr«tm«ot
Labontorjr ID M»tri*
W3I2248-01 Water
Date Smpled Dmtc Rnrmd
nmim 14:40 1Z^3/03 14:38
Gnat Lakes Analytical-Oak Creek The rtmla In All report appfy to the lompla antlyzttl in accordma with tkt chain ofcustody document. Tliis analytical np«ri anat bi rtprvductd In la entirety.
Andrea Stattaa*, Project Manager Page 1 of 15
01/07/2004 m 3:50 FAI 4145709461 Great Lakes Analytical
GREATLAKESANALYTICAL
140 East Ryan RoadOak Creek. Wisconsin 53154
Email: lnf6Qgtalaba.com
(414)570-9460 FAX (414) 570-8461
Lake States Industrial Service
31 IE Greenfield Ave.
Mitortnkee, Wl 53204
Project: MSCGPre Treatment List
Project Number [none]Project Manager. TomJacobson
Rcp«rt«d:01 WO* 17:38
General ChemistryGreat Lakes Analytical-Buffalo Grove
AnatytB ResultRepotting
Limit Units Dilation Bttcb PiefaaA AoHlyied Method Notw
Great Lakes Analytical-Oak Creek 7S« route la this report apply to Ifi* sampla anafynd in accordance viidi fa chain ofau&ty document, nit analytical report ">"" *« rtproduced in la entirely.
Andrea Stathas, Project Manager Pago 2 of 15
01/07/2004 ID 3:50 FAX 4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek Tlis rtmta tn Alt raport apply u At sanplts anatyul In accordant* viitli the chain cfcustody document. Tnls analytical report must te reproduced In la entirety.
Andrea Stathas, Project Manager Page 3 of 15
ui/()7/2Ul)4 m 3:50 FA14145709461 Great Lakes Analytical
Tilt rtsulti In Ait rtport apply to the iampla onafymd la accordance viA die chain ofcustody document. Thii matytital rtport mat be rtprotucti in it* mtirtty.
Page 4 of 15
01/07/2004 ID 3:50 FAI 4145709461 Great Lakes Analytical
The result} in Oils nport apply to tk* «mpt*i anatyiett la accordance with the chain ofcustody document, nti analytical report must be reproduced In Its entirety.
Page 5 of 15
01/07/2004 ID 3:51 FAX 4145709461 Great Lakes Analytical
Great Lajces Analytical-Oak Creek TfW results In Ala nport apply ti> At samples aaefyud In aecordmc* wftA ike chain ofcustody docvmtnl. This analytical nport must be reproJuetd in its tatircty.
Andrea Stathas, Project Manager Pa$e6oflS
01/07/2004 ID 3:51 FAI 4145709461 Great Lakes Analytical
7%e results In Oilt report apply to tht lomptes analyied in accontanct witA iht chain ofcustody document Tkb analytical ntpyrt mat bt reprrxhictJ In its entlnty.
Page 7 of 15
01/07/2004 ID 3:51 FAX 4145709461 Great Lakes Analytical
n* rtntta In Alt npoft apply to At lamples anafyted In accordance with tht chain ofcustody document. This analytical rrport mutt 6* rsfrvdwxd In ill tntirely.
Page 8 of 15
U1/U7/2004 m 3:52 FAI 4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek n* muits in this report apply to Oa somplts anafyad in accordance wi'tA ttu chain ofcustody document. Thli analytical report must be reproduced In la entirety.
Andrea Stathas, Project Manasw Page9ofl5
01/07/2004 ID 3:52 FAI 4145709461 Great Lakes Analytical
The remits la Iliia report apply u ike samples analyzed in occordmct with tht chain ofcustody document. This analytical report muff 6* nproductd til Id entirety.
Andrea Stathas, Project Manager Page 10 of 15
1)1/07/2004 ID 3:52 FAI4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek Vie results in this report appfy 1C Iht stmpla analyiid in accordant* wiM ttu chain ofcustody document Ttiti analytical ntport mot bt nprotbictd In la snJlnty.
Andrea Stathas, Project Manager Page 11 of!5
01/07/2004 ID 3:52 FAI 4145709461 Great Lakes Analytical 1013/017
Great Lakes Analytical-Oak Creek n* raultt in this report apply to Iht sampla anafyitd In accordance with the chain ofcustody ttociantiu. This analytical rrport must h* reproduced In Its tnllrtlf.
Andrea Statfaa*, Project Manager Page 12 of 15
01/07/2004 ID 3:53 FAI 4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek The ruuta in till} report apply to Ih* iamplts anafyad in accordant* vith tkt chain ofcmtcxty docunwU. Thtt analytical rtpvrt omit b* reproduced in in uitirety.
Andrea Stathas, Project Manager Pagel3ofl5
01/07/2004 ID 3:53 FAI 4145709461 Great Lakes Analytical 8015/017
Great Lake* Analytical-Oak Creek The results in this report apply la ttu samples anafyud In accordance with the chain ofcustody documtnL This analytical report mat be reproduced la its entirety.
Andrea Stxthu, Project Manager Page 14 of 15
01/07/2004 ffED 3:54 FAX 4145709461 Great Lakes Analytical
Lake States Industrial Service3H E, Greenfield Avc.Milwaukee, WI53204
Project: MSCG Pre Treatment ListProject Number [none]
Project Manager TomJacobwnRcportadi
01/06/04 17:38
Notes and Definitions
A-01 Initial calibration verification recovery is 90%.
QC . TTic resuh for one or more quality control measurement! associated with this sample did not meet ihe laboratory and/or sourcemethod acceptance cntana.
OET Analytt DETECTED
ND AnaJyteNOT DETECTED at or abovt therepotting limit
NR Not Reported
dry Simple rejultjrqxjrtw) on* dry weight bau»
RPD Kdatrv* Percent DifleraeeL Th» qujdhy control mct»nmcnt if bdowU»Iaboratoty<at»bJiihcd limit.
H This quality control meuuraaenl ia above the bbontory crtaUisbed limit
Great Lakes Analytical-Buffalo Grove Wisconsin DNR. Certification Lab ID: 999917160
Great Lake* Analytical-Buf&lo Grove NELAP Primary Accreditation: Illinois #100261
Great Lakes Analytical-Buffido Grove NELAP Secondary Accreditation: New Jersey #IL001
Great Lakes Analytical-Oak Creek, WI Wisconsin DNR Certification Lab ID: 341000330
Great Lakes Analytical-Oak Creek, WI NELAP Primary Accreditation: Illinois #100307
Note: For analyses that require NELAP accreditation, all analytes, by matrix and method, are accredited following current NELAPstandards unless specifically noted fay way of a qualifier listed above.
Great Lakes Analytical-Oak Creek TTtt rault? In this report apply to tht aampla anafyted In accordant* with Ihe chain ofciatody document. This analytical report mutt be reproduced In ill trairwty.
Andrea Stathas, Project Manager Page 15 of 15
BSSBGREAT{LAKES(ANALYTICAL
CHAIN OF CUSTODY REPORT1380 Busch Parkway
Buffalo Grove, IL 60089-4505(847) 808-7766
FAX (847) 808-7772
140 E. Ryan RoadOak Creek, Wl 53154
(414) 570-9460FAX (414) 570-9461
Mothod:Ctom D Shrpmd D Courier D
XofBoWosPreservative Used
/O NUMBER
If
PfD:
PtD:
PBX
W
F
«0r
PfDr
a.-?
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX G-3
Asbestos Test ResultsClearance Testing
EarthTechA Tyco International Ltd. Company
L:\work\72534\Admin\Reports\Rpttext.doc
LAKE STATES INDUSTRI PAGE 02
*-3"MICRO ANALYTICAL, INC.11521 West North AvenueMilwaukee, WI 53226(800)771-9820 (414)771-0855Fax: (414)771-6570
'-\ <
Lake States Industrial311 E Greenfield Ave.Milwaukee WI 53212
PCM FIBER COUNT REPORT
Tob ID: Building 3
Sampled By: Shawn Christen
Vnalyat: Aaron Engelman
Sample ID
B3-01A
B3-01B
Report # 63763
Date Received: 03/29/04
Date Analyzed: 03/29/04
Fibers/CC F/IQO Fids Comments
2.0<0.00214:00 16:30
<0.002 5.014:00 16:30
Lpm 12.00 Ltrs 1800.0
Lpm 12.00 Ltrs 1800.0
LOB jUmic o£ Detection) policy of MicroAnslytlcnl, Inc. la fl.9JF/nmS or 7fbrij/100fIdedesignated with a "«" sign.
AIHA 101057
12-.J.J 1414B450645LAKE STATES INDUSTRI
PAGE 03
Micro Analytical, IDC.11521 West North Avenue
Mi lwaukee,WI 53226414-771-0855 * Fax 414-77]-6570
If you have any questions regarding this fax teansaction, please call (414) 771-0855.
TTiank-you.
ConTidoiuiilUy NoUcs; Unl«s Qlhsnvisc Ind^t^. UK iflfooMtkffl eeutined tn Ihls ftulmilt conmttniciiiMn ii eonridenGttliafomaUm intended fcr ut« of «b« taflvjflml noned above. If UK recipiam «f drin ftotimlle hw received II in error, you an berfcynotified ibii «y dineailnation or oopyinjof Oib ttOduiniaiieD is prohibited. If you hwe twolvod this ftasimlle In error, pleasedestroy it imnnaliaiejj. «ml notify the sender it the fhtrf number ibovo.
analytical
LAKE STATES INDUSTRI PAGE 83
FfW NO. : 4147716573 Feb. 23 2004 12:0SPM P2
MICRO ANALYTICAL, INC.11521 West North AvenueMilwaukee, WI 53226(800)771-9820 (414)771-0855Fax: (414)771-6570
Lake States Industrial311 E Greenfield Ave.Milwaukee WI 53212
PCM FIBER COUNT REPORT
Job ID: Building 12
Sampled By: Shawn Christen
Analyst: Aaron Engelman
Sample ID
B12-01
B12-02
212-03
0 ,003 8.013:15 15:20
<0.002 6.013:15 15:20
0.003 10.013:20 15:20
Report # 62962
Date Received: 02/20/04
Date Analyzed: 02/20/04
Fibers/cc F/100 Flda commente
Lpm 12.00 Ltre 1500.0
Lpm 12.00 Ltrs 1500.0
Lpra 15.00 Ltra 1800.0
AIHA 101057
of Ine-
2U04 aa:bb 14146450645 LAKE STATES INDUSTRI PAGE 04
FOX KO • 4147716570 Feb. 23 2004 12:07Pfl P3: -Micro Analytical "W NU. • *i«rrn»r.o
Micro Analyticiljnc.11521 West North Avenue
Mil waukee,W) 53226414-771-0855 * Paa 414-771-6570
IcfolD; yfr,j'£0/'f4* /I— Date/Time Duet 2f1Cf0Y
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Relinquished by Date/Time Received by Date/Time
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Notes: Call Results #
Received By Daca/Titae
Other
FROM : Micro ftnalyticalFflX NO. : 4147715570
Feb. 26 2004 04:52PM Pl_
MICRO ANALYTICAL, INC.11521 W. NORTH AVE.
MILWAUKEE, WI 53226(414)771-0855
FAX (414) 771-6570
Fax Transmittal
<\
Date:
To:
Company:
From:
Subject:
FAX #:
Comments:
Pages:
If.you have any questions regarding this fax transaction, please call (414) 771-0855.
Thank-you.
Confidentiality Notice: Unleu otherwiie indicated, the mfomittkm contained in this facsimile communication is confidentialInformation mtcoded for use of Die Individual named above. If the recipient of thi* facsimile ha received u in error, you are herbynodfiex) ftu my dissemination or copying of (his communication ii prohibited. If you have received tills facsimile in error, pleasedestroy it immediately and notify the sender at die phone number above.
Test method: EPA/600/R-93/116. Quantitation is done by Calibrated Visual Estimation which has an acceptedRelative Percent Difference of 35. This report may not be used to claim product endorsement by NVLAP orany agency of the U.S. Government. This test report relates only to the items tested and shall not bereproduced except in full, without the written approval of Micro Analytical, Inc.
Client: /
Job ID:
# Samples:
Micro Analytical, Inc.
31521 West North AvenueMilwaukee, WI 53226
414-771-0855 * Fax 414-771-6570
Type: PCM PLM Lead TEM (circle one)
Sample ID Date Collected Location/Remarks
n -
h
^ / '<?/<? /
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,.eceived by Date/Time ' ' /Relinquished by Date/Time
Relinquished by Date/Time Received by Date/Time
Relinquished by Date/Time
Notes: Call Results #
Received By Date/Time
Fax#
"Name/Pager #_ Other
/ » •' J.3-
//
MICRO ANALYTICAL, INC.11521 VJest North AvenueMilwaukee, WI 53226(800)771-9820 (414)771-0855Fax: (414)771-6570
Lake States Industrial311 E Greenfield Ave.Milwaukee WI 53212
PCM FIBER COUNT REPORT
Job ID: Building 3
Sampled By: Shawn Christen
Analyst: Aaron Engelman
Sample ID
B3-01A
B3-01B
Report # 63763
Date Received: 03/29/04
Date Analyzed: 03/29/04
Fibers/CC F/100 Fids Comments
2.0<0.00214:00 16:30
<0.002 5.014:00 16:30
Lpm 12.00 Ltrs 1800.0
Lpm 12.00 Ltrs 1800.0
LCD (Limit of Detection) policy of MicroAnalytical, Inc. is 8.92F/mra2 or 7fbrs/100fIdsdesignated with a "<" sign.
AIHA 101057
Micro Analytical, Inc.11521 West North Avenue
Milwaukee, WI 53226414-771-0855 * Fax 414-771-6570
Client:
Job ID: 3
Date Sampled:
Date/Time Due:
Sample ID Location/Name Start Stop LPM Vol
Relinquished by Date/Time Received by Date/Time
Relinquished by Date/Time Received by Date/Time
Relinquished by Date/Time
Notes: Call Results # Fax#
Received By Date/Time
Name/Pager #_ Other
LAKE STATES INDUSTRI
NU. : 4147716570 Mar. 29 5904 04: 20PM P2
PAGE 02
•fffjMICRO ANALYTICAL, '/,INC.11521 West North AVenueMilwaukee, WI 53226(800)771-9920 (414)771-0855Pax: (414)771-6570
Page 1 of 1
NVLAP 101247-0
BULK ASBESTOS ANALYTICAL REPORTUtilizing PLM and Dispersion Stain Technique
Lake States Industrial311 £ Greenfield Ave.Milwaukee WI 53212
Chry: Chryaotila fg,Amog: Amosita Ca:Croci Crocidolite Syn;Act: JVC t lnoli te H:Tram i Tramalicp Sc:Antti: AnsJiophylliGe
Fibrous GlassCeUuJosuSynthetic FiberHair
Ver:
PC:
Vermtculte«PcrlitaGypaumQia»« Shoeparciculata
PL-M: Paint Like MaterialMLKi Mixed Linentone MaterialQu: QuartzGil
KoainouaDiatomaceoua Earth
Tcit methodRelative Percent' Difference o£ SsT" "This report may __ ___ _ _any agency of the U.S. Government. This teat roport"relace« only to the Item«~tested~and~sivi5:I riot bereproduces except in full, without the written approval of Micro Analytical. Inc.
Quantltation ii done Cy Calibrated visual Estimation vlUcti hag an acceptednot fle uaed to cl«i* product endorseoient by MVLAP or
PL-M: Paint Like MaterialMLM: Mixed Limestone MaterialQu: Quartz
CalciteResinoug MaterialDiatomaceous Earth
Cal:
De :
Teat method: EPA/600/R-93/116. Quantitation is done by Calibrated Visual Estimation which has an acceptedRelative Percent Difference of 35. This report may not be used to claim product endorsement by NVLAP orany agency of the U.S. Government. This test report relates, only to the items tested and shall not bereproduced except in full, without the written approval of Mi-ero Analytical, Inc.
Teat method: EPA/600/R-93/116. QuantitdCion is done by Calibrated Visual Estimation which has an acceptedRelative Percent Difference of 35- This report may not be used co claim product en<lorH«n>ftnt by NVLAP orany agency of the U.S. Government. This teat report relates only to the items tested and shall not bereproduced except in full, without the written approval of Micro Analytical, Inc.
Test method: EPA/600/R 93/116. OuantitaLion iu done by Calibrated Visual Eatlnution whicft Das an acceptedR«l*t;ve Percent Difference o£ 35. This report may not be used Co claim product endorsement by NVLAP or,_.. "y °t tie V-S. Governmant. This cest report relates only co the Item* tested and ahall not be
id except in full, without cho written approval of Micro Analytical, Inc.
Teat meuhod: EPA/SOO/n-93/116. Quantitation is done by Calibrated Visual Estimation which has an acceptedRelative Percent Ditterenc* ot 3S. This report may not be unetf to claim product endorsement by NVLAP orany aaeney of the U.S. government- This teat report reiatca only to the itema tested and shall not bereproduced except in full, without the written approval of Micro Analytical, Inc.
ti BPVSOO/t-Sl/niS. guantitation is don* by Cnlibratod Vi«u»l Bitiiwtion which ha* an acceptedRelative Percent Ditierenee of 35. Tha« report way not be used to claim product endorsement by MVtAPorAny agtncy of th« U.S. Qovernment. This test report relate* oniy to the Ite«a tinted and ahali not Der«proauc«a eneept in full, without the written approval of Micro Analytical, Inc.
PL-M; Paint Like MaterialMUV. nixed Liwtsnotie Material
Si "RS;
Calcit*Resinous MaterialDiatoiMccoua Earth
Teat methodi EPA/SOO/R-33/ll*. Quancitaeion is dore by Calibrated Visual Estimation which has an acceptfielacive Percent Difference of 35. This report may not be uaerd to olaim product endorsement by SVUip nany agency of the U.S, Government. Tnla csat reporc relates <>nly to che items beacad and ahall nor bersfroducea sxcept in full, uisnout the written approval of Mic:ro Analycisal. inc.
FROM : Micro finalytical FOX 110. : 4147716570 I'lay. 13 2004 32:47PH P:
Test method: 8PA/<00/R-S3/11S. guantitation is done by Calibrated visual Estimation which has an acceptedRelative Percent Difference of 35. This report may not be used to claim product endorsement by tfVLM> orany agency or the U.S. Goverament. This teat report relates only to the items tested and shall not bereproduced except in Cull, without the written approval of Micro Analytical, Inc.
PL-H-, Paine Llk* MaterialMixed Limestone MaterialQuart*calciteResinous MaterialPiatojnaceoua Barch
QU;CaiHa,Da:
Teflt nethoO: EPA/600/R-93/H6. CmanCitstion is done by Calibrated Visual EatiirAtion which has an acceptRelative Perccrtt Dlffarancc of 35. This report may not be uflecl to claim pcoduct andorscmcnt by XVLXP oany agency of rbs U.S. Oovernment. This test report relates only to the Icema tested and shall r.ot bereproduces excepc in full, wiCJWut cho written approval of Micro Analytical, Inc.
T»»t msthod! EPA/eog/R-SJ/ilfi. Quantitation is done by Calibrated visual Estimation which has an jr,,,,,,™Relative Percent Difference of 35. This report may not be used to claim product endorsement; by NVLAP'oranvr 3*nei( thJ V'si 9?vcrrtitrf!Ht. This teat report relates only to tho items tested and shall not bereproduced «xc«pt in. full, »xtheut the writcnn .-ipproval o£ Micro Analytical, inc.
titition is done by Calibrated Visual Estimation which fta* an acceptedt may not be us«d to claim product endorsement by NVLAP or
, . report relates <>nly to che items tested and shall not ben £ull, witnout the written approval o£ Mivro Analytical, Inc.
method; EPA/600/R- 93/116. Ouantitition is done by Calibrated Visual Estimation which fta* aKelative percent Difference of 35, This report may not be us«d to claim product endorsement by
of the TJ.S, Government. ThiB test report relates <>nly to che items tested and shallin
PL-M: Paine LIKe MaterialK3M-. Mixed Limestone MaterialOUT QuartzCal: CmlciteS.B; Reeinou?) MaterialDC: DiacomaceouB Earth
Teat method: EPA/SOO/R-93/116. QuantitadoD la done by Calibroted Visual Estimation whicft haa an acceptedRelative Percent DiCterencs of 35. This report may not be usEid to claim product endorsement by NVLAP orany agency ot the U.S. Government. This test report related only to the itemi tested and shall not beproducedrepr
..except in full, without the written approval of Micro Analytical, loo.
Reviewed By Authorized Signatory;Soward Vartter, laboratory DtnetorIrmo. fwtwtki, Quality AwtiMwu* CoordinatorDavid Xv. US, Senior GamutFeng Jiang, MS, Stniof GtologittMichael A MtcUer, Quality Attunttux Manager
Results, represent the analysis of samples submitted by the client Sample location, description, area, volume, etc., was provided bythe client This report cannot be used by the client to data product endorsement by NVLAP or arty agency of tha U.S. GovernmentThfe report shan,not be reproduced except In fud. without the written consent of Environmental Hazards Services, LJ-.C. CaMbmiaCertification #2319 NY ELAP #11714. All Infbrrhatton concerning sampling location, date, and time can be found on Chain*)*-Custody. Environmental Hazards Services, L.LC. does not perform any sample coHecDon.
Environmental Hazards Services, LLC. recommends reanatysls by point count (for more accurate quanUflcatton) or TransmissionElectron Microscopy (TEM), tor enhanced detection eapablMe«) for materials regulated try the SPA NESHAP (National EmissionStandards for Hazardous Air PoKutanb) and found to contain less than ten percent (<10%) asbestos by polarized light microscopy(PLM). Both services are available for an additional fee.
* All CalHbmla samples analyzed by Polarized Ught Microscopy, EPA Method 600/MM2-02Q. Dec. 1982.
LEGEND NAD a no asbestos defected " ~
phn1-doU07JAN2002f kh- PAGE 03 at 03 - END OP REPORT -
ReeuRB represent the analysis of samples submitted by ttw ottwit Sample location, description, area, valuriw, ate., was prevMed bythe dtant This report cannot be used by <ht client to cWm product nndorsement by NVUAP or any «g«ncy of tha U.S. GovernmentThiB report <hafl not ba reproduced except in fuH. without the written consent of Environmental Hazards Servicea, L.LC. CafifamiaCerWcatton #2319 NY ELAP f1l714. AU informaUon concerning «ampHn0 location, data, and fime can be found onCustody. Environmental Hazardi Service*, LL.C. does not perform any sample collection.
Hazards Setvices, U_c. recommends naanalysh by point count (fcr more accurate quanWkatfon) or TransmissionElection Microscopy (TEM), for enhanced detection capablflOes) for materials regulafed by the EPA NESHAP (Nafiooal EmissionStandard* for Hazanioue Air Pollutants) and found tt contain ten than ten percent (<10%) asbestos by polarized light microscopy(PLM). SocnseMcee are available for an additional foe.
• All CaSfomfa samples analyzed by Polarized light Microscopy, EPA Method 600/M4-82-020, Dec. 1982.
Result* represent the analysis of samples submitted by the client Sample location, description, area, volume, etc., was provided bythe client This report cannot be used by the client to dalm product endorsement by NVLAP or any agency of the U.S. GovernmentThis report shall not be reproduced except in futt without the written consent of Environmental Hazards Services, LL.C. CaliforniaCertification #2319 NYJELAP#11714
LEGEND NAD = no asbestos detectedAD = asbestos detected
asbwipe1.dot/07JAN2002/kh- PAGE 02 of 02 - END OP REPORT -
Results represent th» analysis of samples submitted by the client Sample location, description, area, volume, etc., was provided bythe client This report cannot be used by the client to claim product endorsement by NVLAP or any agency of the U.S. Government.This report shaH not be reproduced except In full, without the written consent of Environmental Hazards Services, L.L.C. CaliforniaCertification #2319 NY ELAP #1 1714. All Information concerning sampling location, date, and time can be found on Chain-of-Custody. Environmental Hazards Services, LLC. does not perform any sample collection.
Environmental Hazards Services, LUC. recommends reanarysis by point count (tor more accurate quantification) or TransmissionElectron Microscopy fTEM). for enhanced defection capabilities) for materials regulated by the EPA NESHAP (National EmissionStandards for Hazardous Air Pollutants) and found to contain less than ten percent (<10%) asbestos by polarized light microscopy(PLM). Both services are available for an additional fee.
* AH California samples analyzed by Polarized Light Microscopy, EPA Method 600/M442-020, Dec. 1982.
Results represent the analysis of samples submitted by the dlent Sample tocatfon, description, area, volume, etc.. was provided bythe client Thte report cannot ba used by the dlent to data product endorsement by NVLAP or any agency ar the U.S. GovernmentTtt* report sfiaW not to reproduced except in fuH, without the written consent of Envtrenmental Hazarda Servicee. LLC. CaRfemiaCe/tffieation 42319 NY ELAP #11714. AN intbrmaten concerning sampling location, date, and time can be found on Chain-of-Custody. Environmental Hazards Services, UL.C. does not perform any sampte cofledfon.
Environmental Hazards Servicas. U.L.C. recommends regnalysis by point count (for more accurate quantification) or TransmissionElectron Mfcnwcopy (TEM). for enhanced detection capabilities) fbr msrteoals regulated by the EPA NESHAP (National Emission'Standards for Hazardous Air PoDutaws) and found to contain less than ten percent (<10%) asbestos by polarized light microscopy(FtM), Both services are avaBable for an additional fee.
* All California samples analyzed by Polarized Ught MIcrascopy, EPA Method 600/M4-82-020, Dec. 1962.
LEGEND NAD = no asbestos detected " "SCF ° suaoactad
- PAGE 02 of 02 - END OF REPORT -
12/03/2003 WED 09:41 [TX/RI NO 5058] g]oo2
ItPLMFWiSONMENTAL HAZARDS SERVICES, L.LC. ,
Cftcnond, Virginia 23237 Phone (804) 2754700 Fax {304} 275-4907 (EHS12-03-0156 HAIM QF CUSTODY FORM
Company Nona: . faf f^*R*<~j* 0210:
&tSCibnt Account*Pfcow*
Contact Name:Sampler Name: M<
SampleNumber
SampleDate 4Time
Astjestos
* Do wipe samples submitted meat ASTM E1792 requirement? YeftLJ
On May 27, 2004 I was invited to the Former Solvay Coke and Gas Site as analternate asbestos inspector, substituting for Shaun Criston the regular asbestosconsultant, who is on vacation. As the original pre-construction inspector (2002),I have complete understanding of the site and the covenants with the regulators.I have kept a limited role during abatement and demolition because I expect tohave an involvement in the excavation of surface soils in the later phases of theremediation. I am also an alternate for Shaun on the Historic Tewles SeedCompany project (1/2 mile north) where I was inspecting and observing thecomponent removal of Metal Window Panels with non friable asbestos in theglazing as well as suspected lead (very heavy weights for small strips).
Findings
Attached you will find the communications about the suspect and concealedasbestos materials identified on the tops of three boilers, the only remainingstructures left standing on Building 12 (the stack is also still standing).
The letter from Tom Jacobson to Mark Davis dated May 24th (Attached),describes the events of Saji's visit, the initial conclusions, and the responses ofall parties. Additional confirmation samples were also collected and rushanalyzed and submitted with this letter report. The following additionalinformation is not recorded in the original correspondence and is added for yourfurther consideration in the disposition of this matter.
Omitted in the letter was the conditions that led up to Saji's visit on the 26th. Notonly was the project stopped for the discovery of concealed asbestos (boilerbreeching collar), it was delayed for 7 days and 7 inches of rain. During theweather delay, the crew shifted to indoor work on Building 9. The two menreassigned to building 12 after a early morning bagout in Building 9 arrived at theboiler site (Bldg.12) about the precise time that Saji arrived. They arrived on footat the boilers before the other crew members moving the hoses from theprevious site. The two men reassigned to the boilers also had to move the reach(Lull) truck to the west side of the center boiler. While positioning the lift, theypicked up a few pieces of suspect mater (maybe two handfuls) Most of what thecollected was actually negative roofing insulation board (Sample FSC 104) andwhite "pyrobar" brick that was also negative (FSC 102). They did collect a fewstrands of rope gasket that Shaun had identified as positive ( and confirmed FSC103).
Conclusions
On May 27th at the site it became obvious that Tony was not kept up on thefindings, or response actions. This responsibility was previously the routine ofShaun, and I apologize for not realizing my role to continue this as Shaun'salternate for the week.
The circumference of each concealed breeching collar was <10 linear feet, andwere cleaned and set aside earlier (Tuesday) along with an unkown amount ofrope gasket. Upon reinspection on the 27th we found one small piece of yellowgasket less than 6", and it was sent for analysis.
In my opinion, after reviewing all of these activities, communications, andreactions this whole series of events is more a demonstration of a project underattentive management than anything else. And now two fine employees are outof a job because of the smallest lapse in judgment. Especially considering that allthe right things were going on (the water hosing was within 50 feet ofcompletion). Not to mention the whole activity was performed to search for anyscraps of material that were overlooked from the original abatement. One look atthe photos of the top of the boilers shows that it was important to stay on the lift,carefully inspect and pick up targeted suspect material without walking on theroof, or risking a spray of water that may dislodge the material down into the ribsof the boilers where it could not be retrieved.
I think the two workers should be reinstated following a verbal warning on theproper sequence of engineering controls. They each already lost hundreds ofdollars in pay for their infraction of a few handfuls of materials that were mostlynon-asbestos.
I repeat my apology to Tony for not knowing the constant communication he hadwith Shaun.
Attached:Lake States letter to Mark DavisPolarized Light Microscopy Analysis ReportsPhotos of the debris on top of boiler #3
FROM : Micro analytical FflX MO. : 4147716570 Hay. 28 2004 07:<57»l PI
MICRO ANALYTICAL, INC.11521 W. NORTH AVE.
MILWAUKEE, Wl 53226(414)771-0^55
FAX (414)771-6570
Fax Transmittal
*/**/<Date: ***<?
/fey/*/To:
Company: _
From: 4" —
Subject: _
FAX #: _
Comments:
Pages:
If you have any questions regarding this fax transaction, please call (414) 771-0855.
Thank-you.
Confitertutity Notice: Unlen otherwae indicated, *« infonnmian caooined in Dili fidimje communtartion it confidents)tofonrutkai mlendcd fbr use of ihc individiu) named above. If die rcciptant of this facsimile hw received it in error, you ire herfaynotified thai any taionination or copying ofthit coiranmiettion ia prohibit^, if you have received thii bcsirraie in error, pleasedestroy itimmaJwtdy and notify the sender «t (hs phone number tbovt
MICRO ANALYTICAL, INC.11521 West North AvenueMilwaukee, WI 53226(800)771-9820 (414)771-0855Fax: (414)771-6570
Page 1 of 1
NVLAP 101247-0
BULK ASBESTOS ANALYTICAL REPORTUtilizing PLM and Dispersion Stain Technique
Kevin O'Connell141 N. Jackson St.Suite #414Milwaukee WI 53202
Sample ID;
FSC-101
%Asbestos
Report # 65146Name Former Solvay CokeReceived: 05/27/04Analyzed: 05/28/04Analyst Kevin Hactw
Description & Composition
Tan CompactNone Detected 100% Pt MLM Qu Cal
FSC-102
FSC-103
FSC-104
Tan CompactNone Detected 5% Ce 95% Gyp Pt MLM Qu
Tan Plied80% Chry 20% Pt MLM Qu
Tan CompressedNone Detected 90% Ce 10% Pt MLM
End of Report
Chry i oiryaoeU*Amosi AnoiiC*ftroc: OrocidolitaAeti JLctinolit«Trftni TronwliCfAntni AnthoBhyl1icn
a;srBe.
Fibrou* QlaaiCilluloaaSynthetic Fiber•Aix
VanP«ri
Ot<Pt:
VeimiculiteP«rliC«aypaumOlki* 3hot?«rcicul»ct
PL-Hi Paine Lilt* (utcrialMJJ4: Mixad Limt»ron« M»t«rialu: Quarci^li 0»lait
Do; DiatOTK)C«"JU
Teac method: EPA/«OQ/n-93/ilS. Quantitacion iz done by Call&raced Visual Estimation which his an acceptedMlativ* p«rc«n( Diffarance of is. This report nay not be ufa-i to claim produce endorsement by NVLAP orany agency of the U.S. Oovammcnt. Thi» test report relates only to the Items tasted and shall nor, be
4««5 «X«»pt in fuU, without eft* yriccan approval of Micro Analytical. Inc.
PL-Mt Paine Uk* MaterialMLM: Mijud Linuiitan* M«c«ri«lQu: OuaxciCal i Calcic*
Do >
T«6C MCiiodi KM/<00/£-9l/ii6. Guantitjcion ii don* by Calibrated visual Estimation which h48 an acceptedS«l4tiv» p«rc*nt D{fr»r«nc« of is. Thii report may not be uaed to claim prooict andoraenjent by KVLAF orany agency of the U.S. Oovernmcnt. Thi» te»c reoort relateu only CO the. Items tested ano shall not bereproduced except in full, without tti* wriccan ifiprovtl or Micro Analytical. Inc.
# Samples: Type: PCM(PLM) Lead TEM (circle one)v—"-
Sample ID Date Collected Location/Remarks
02, cgltA C^- QJl W ^OO&
Date/Time ' Received by Date/Time
Relinquished by Date/Time Received by Date/Time
Relinquished by Date/Time
Notes: Call Results #
Received By Date/Time
Fax #
Name/Pager # Other
LAKESTATESNDUSmiAL 9EFMC88
Date: March & 2004
Mark DavisDepartment of Natural ResourcesDirector of Air ManagementMadison, Wisconsin
Re: Solvay Coke Site Visit to Building #12
Dear Mr. Davis:
1 am writing to address the clean up of ACM which was found during demolition operations onBuilding #12. The building had been previously abated and cleared for demolition activities, whichbegan on May 2004.
During the removal of the exhaust breaching from the northern most boiler on Wednesday May 19th,2004 it was discovered that there was a 1" layer of insulation in the seat of the duct which extendeddown into the boiler. Once the material was identified work was stopped, area was secured, a 10 manasbestos crew was dispatched to clean up the ACM using wet methods. Our project Manager BillCook contacted WDNR and notified what we found and discussed a procedure to be implemented toaddress the found ACM. A letter was written the same day and sent detailing the discussion. The letteris attached. After the clean up we investigated the remaining 3 boilers and found the next boiler in lineto the south contained what looked like a rope gasket but did not have the same type of insulation thatwas found on the third boiler. Shaun Criston to a sample for testing. The third boiler running southwas investigated and found to have a different type of insulation, which was sampled. The fourth andlast boiler was investigated which was found to again contain a different type of material. This wasalso sampled. When the results were received later in the day we found that boiler # 2 & # 3 had ACMand boiler # 4 was negative.
Upon assessment of how best to manage this small amount of ACM it was determined we wouldseparate the breaching from the collar that extended into the boilers which had the acm on it andremove this breaching in order to make it safe for our technicians to work on top of the boilers. Thiswork was done on Monday and the breaching was removed on Tuesday May 26, 2004. OnWednesday May 26, 2004 we directed a 2 man crew to investigate the top of the boiler and removethe ACM as specified in the letter dated May 19th, 2004. This crew began this work at approximately9:30. The Project manager had to leave the site for supplies and left the direction of the crews to ademolition foreman who is also a certified supervisor. The foreman told the 2 men where to work andwhat to do. There were directed as always to use water. At approx 10.30 am Saji Villoth observed our2 man crew in the boom lift with a single bag of ACM which was less than .5 cu' of material whichwas dry. Mr. Villoth then donned a harness and went up to the top of the boilers with one of theworkers. According to a discussion with Mr. Villoth when he came down he stated there was friableACM on top of Boiler # 2 which we were already aware. He asked why they were picking up looseACM with out water. And our 2 man crew being Hispanic and speaking very poor English stated thatdid not have a hose yet. In our discussion we determined that the 2 man crew went to the top of theboiler to survey the situation and began picking up the loose materials before the water line was setup. The 2 men were interviewed by you and found to hold valid license from the state to performabatement activities. In addition the site supervisor present during the incident also held a validlicense. After you and Saji left the site we interviewed the workers with our interpreter andreconstructed the event to determine how this happened. The results of our inquiry determined thefollowing;311 East Greenfield AvenueMilwaukee. Wisconsin 53204Office: 414-645-0635Fax:414-645-0645
LAKESTATESrjOUSTRIAL 9EFMCC9
1. The workers knew they should have been using water,
2. Water was available but the hose was not put in place yet.
3. They knew that a laborer was on his way to install a hose.
4. They mounted the boom lift to go to the top of the ovens to survey the situation.
5. Once on top of the ovens, they made an independent decision to pick up some loose ACMwhich was sitting precariously on the boiler. They explained they had planned to ad water tothe bag once they went down for the hose, but in there judgment the thought the ACM wouldbe safer in a bag than laying out.
6. The water was connected and the bag of ACM was wetted. \
7. The licensed supervisor was not in the immediate vicinity and was unaware they were notusing water.
In conclusion we had done the following,
1. Discharged the 2 employees for not using proper procedure.
2. Reviewed the incident with the supervisors and foreman of all our projects to be sure thisdoes not happen again.
3. We will hold an in service tomorrow morning with all employees to review procedures.
4. We will keep closer supervision of abatement activities.
Mr. Davis, I want to apologize for this incident and as the overall project manager I take fullresponsibility for the site operations. I do feel that there is always room for improvement and that thissite is constantly full of surprises for which we always try to be prepared for. Please contact me atyour earliest convenience to discuss this letter.
Regards,
Thomas P. Jacobson Sr.
Project Manager MSCGLake States Industrial Services, Inc.
311 East Greenfield AvenueMilwaukee. Wisconsin 53204Office: 414-645-0635Fax:414-645-0645
Photographs
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX H
MMSD Documentation
• H-1: Notice of Intent to Discharge to MMSD System
• H-2: Letter to MMSD Allowing the Discharge to TheirSystem
EarthTechA Tyco International Ltd. Company
L:\work\72534\Admin\Reports\Rpttext.doc
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
Re: Notice of Intent to Discharge Non-Domestic Wastewater, Former Solvay Coke and GasSite, 311 E. Greenfield Avenue, Milwaukee, Wisconsin
Dear Mr. Matyas:
The purpose of this correspondence is to provide a letter of understanding regarding the proposedwastewater discharge at the Former Solvay Coke and Gas Site. This letter will describe theprocess, operations, activities, and circumstances that will produce wastewater at this site as wellas plans for discharge. The Notice of Intent to discharge non-domestic wastewater, as requiredby Section 11.401 of the MMSD rules, is provided in Attachment A.
Site Background
The Former Solvay Coke and Gas Site is being deconstructed in phases by Lake States IndustrialServices. Various sized aboveground storage tanks (ASTs) associated with the Former SolvayCoke and Gas Production Facility are located throughout the site. The ASTs have deterioratedover time and currently contain residual coal tar and storm water. As a part of Phase I ofdeconstruction these ASTs will be emptied, cut open, cleaned, and removed from the site.
Proposed Discharges
Non-domestic wastewater is generated in one of two ways:
(1) Contaminated Water that has Accumulated in each AST as a Result of Rain Infiltration
As part of the deconstruction of the site, the ASTs will be emptied, cleaned and cut up for scrap.The first step in the AST removal process is to drain the water that has accumulated in the tanksas a result of rain water infiltration. It is proposed that the water that has accumulated in thetanks as a result of rain infiltration be drained from each AST and disposed of through thesanitary sewer. Because this water has been held in these tanks for a number of years, in directcontact with residuals within the tanks, and because cyanide has been detected in this water, thisdischarge would not be considered "unpolluted water" that could otherwise be routed directly tothe waters of the state under a WDNR permit.
ENVIRONMENTAL ASSOCIATES, INC,
The total volume of water that will be discharged from the draining of contaminated water thathas accumulated in each AST is expected to be approximately 25,000. Water will be dischargedin five batch discharges of 5,000 gallons each over a four week period of time. It is anticipatedthat all five discharges will be completed within four weeks of receiving discharge approval fromMMSD. The proposed discharge location is a toilet (4-inch line) located in Building #11 (Figure1, Attachment D).
A representative sample of water that has accumulated in the tanks as a result of rain infiltrationwas collected on November 19, 2003 and submitted to Great Lakes Analytical in Oak Creek,Wisconsin. The sample was analyzed for the compounds listed in MMSD section 11.202 and11.203(1 )(a). No compounds were detected, above laboratory method of detection limits, withthe exception of cyanide (0.0736 mg/L), which was detected below the MMSD limit of 5.0mg/L. Wastewater analytical results are summarized in Table 1, Attachment B, and presented inAttachment C of this submittal.
(2) AST Wash Water
After the contaminated water in each tank is emptied, coal tar residuals will be removed andproperly disposed. The empty tank will then be thoroughly cleaned using high pressure washingequipment. It is proposed that this AST wash -water also be discharged into the sanitary sewer.
It should be noted that AST wash water has not yet been generated and, therefore, has not yetbeen tested at the site for the pre-treatment parameters listed in MMSD Chapter 11.203. It isanticipated that this wash water will require pre-treatment prior to being discharge into theMMSD sanitary sewer to meet Chapter 11.203 limits. Treatment of this water will consist of aclarifier cell (frac tank) and liquid carbon canisters.
In order to gain approval for discharge, it is proposed that prior to each batch discharge a sampleof the treated water be collected for Chapter 11.203 parameters, pH and TSS. These results willbe compared to Chapter 11.203 limits prior to discharge and, if they fall below these limits,discharge will proceed. If any of the Chapter 11.203 limits are exceeded, additional treatmentwill be conducted and the effluent will be retested prior to discharge. All testing results will bemade available to MMSD at their request.
The total volume of AST wash water that will be discharged to the sanitary sewer is expected tobe approximately 25,000. AST wash water will be discharged in batches. It is anticipated thatthe discharging of AST wash water will be completed within four weeks of receiving approvalfrom MMSD. The proposed discharge location is a toilet (4-inch line) located in Building #11(Figure 1, Attachment D).
Lake States Industrial Services is requesting written permission to discharge the above describednon-domestic wastewater at the Former Solvay Coke and Gas Site: As Lake States IndustrialServices would like to commence discharge before freezing occurs, your prompt review wouldbe greatly appreciated. If you have any questions or concerns, please feel free to contact us.
Sincerely,
Environmental Associates, Inc. Lake States Industrial Services
Joe Michaelchuck, P.E. Bert SneadSenior Engineer President
Notice of IntentTo Discharge Non-domestic Wastewater,As Required by sec. 11.401, MMSD Rules
L Facility Information
(a) Facility name Former Solvay Coke & Gas Site
(b) Facility address311 E. Greenfield Ave.
Milwaukee, WI 53^04
(c) Mailing address311 E. Greenfield Ave.
Milwaukee, WI 53204
(d) Contact person Tom JacobsonNameV.P. (Lake States Industrial Services)
Tide
414-645-0635 (office)Telephone
(e) Business description
The Former Solvay Coke and Gas Site is being deconstructed
by Lake States Industrial Services. Various above ground
storage tanks (ASTs) associated with the Former Solvay Coke
and Gas Production Facility are located throughout the site.
The ASTs have deteriorated over time and currently contain
residual coal tar and water. As part of Phase I of deconstruction
these ASTs will be cut open, cleaned and removed from the site.
(f) Five digit NAICS code or four digit SIC code
IL Discharge information
(a) Reason for submitting this notice of intent:
Constructing a new facility that will discharge process wastewater to the sewerage system
Taking possession or control of an existing facility that discharges process wastewater
Changing the physical size or operations at an existing facility to the extent that wastewatervolume or content will be substantially changed, including, but not limited to, a change inthe annual average daily discharge flow rate of 20% or more
Proposing to discharge contaminated groundwater
Commencing or modifying a discharge of hazardous waste that requires reporting accordingto sec. 11.411, MMSD Rules
Proposing to discharge non-domestic_JL__ Other. Explain on an attached page wastewater not previously reported
to the District.(b) Proposed date for the commencement of discharge as soon as possible (12 / 0 5 / 0 3)
(c) Describe the processes, operations, activities, and circumstances that will produce the non-domestic wastewater covered by this Notice of Intent
see cover letter
(d) Wastewater discharge rates for the facility as a whole. Complete this section if the dischargeis not a one-time discharge
Flow rates (gallons per day)Existing Proposed
Domestic
Non-domesticProcess
Non-contactcooling approximately 1,785 gallons per day
(see cover letter)Other
(e) Discharge type (fill in the spaces that apply)
1. Continuous discharge: hours per day days per week
2. Batch discharge: 1 0, OQOgallons discharged per batch pet ( 5 batches total)Frequency Time
3. One time discharge: gallons discharged over days
4. Other (explain the timing and type of discharge)
(f) List the pollutants potentially present in the wastewater covered by this Notice of Intent
See attached analytics.
(g) Sample results. If you are able to sample the wastewater covered by this Notice of Intent, thenattach sample results according to the instructions.
(h) Would the wastewater covered by this Notice of Intent be regulated as hazardous wasteaccording to sec 40 CFR 261 if it was not discharged to the sewerage system?
Yes x NO
If yes, contact the District for additional reporting requirements.
(i) Describe any proposed treatment procedures or equipment
None.
(j) Enclose a drawing of the site where the discharge will occur, This drawing must identify allconnections to the sewerage system; the processes, operations, or activities generatingwastewater; treatment facilities, and potential sampling locations.See Figure 1 .
HL Certification and signature
/ certify under penalty of law that this document and all attachments wereprepared under my direction or supervision in accordance with a systemdesigned to assure that qualified personnel properly gather and evaluate theinformation submitted. Based on my inquiry of the person or persons whomanage the system or those persons directly responsible for gathering theinformation, the information submitted is to the best of my knowledge and belieftrue, accurate, and complete. I am aware that there are significant penalties forsubmitting false information, iypfuding the possibility of fine and imprisonment
violtions
Signature ' Date
Printed name and title
Notice of Intent
ATTACHMENT B
Table 1: Non-domestic Wastewater Evaluation, November 19,2003,
Solvay Coke and Gas Site, Lake States Industrial Services, 311 E. Greenfield Ave., Milwaukee, Wisconsin
Lake States Industrial Service311 E. Greenfield Ave.Milwaukee WI, 53204
Project: MSCG Pre Treatment ListProject Number [none]
Project Manager: Tom JacobsonReported:
12/02/03 17:03
ANALYTICAL REPORT FOR SAMPLES
Sample ID
Tank 1 3 Spill
Laboratory ID Matrix
W3 11 185-01 Water
Date Sampled Date Received
11/19/0313:30 11/19/0314:40
Great Lakes Analytical-Oak Creek Tht raula in this report apply to the lamplcs analyzed In accordance viih ihf chain ofcustody dacunient. 27ilf analytical rtpnrt must be reproduced In ill entirety.
Andrea Stathas, Project Manager Page 1 o f 2 ~
12/02/2003 TUE 17:04 [TX/R-X NO 5084] 12] 003
12/02/21)1)3 TIE 5:1)8 tAA 414i7U94bl lireai L3K6S Analytical
Great Lakes Analytical-Oak Creek The resulu in this report apply to the samples nnalyzvJ in accordance wfrt the chain cfcustody dncumcnt. This analytical report must bn rilprvJuced in itt entirety.
uidrea Stathas, Project Manager Page 2 of 2^
12/02/2003 TVE 17:04 [TX/RX NO 5084]
1 2 / U 2 / 2 U U 3 TDK i > : u & I<M 414&7 ua«i ureai Lanes U.K
Great Lakes Analytical--Oak Creek Tht rtsults in this report apply In the samples analyzed in accordance with the chain u;custody document. Thin analytical report must be reproduced in Its entirely.
Great Lakes Analytical—Oak Creek The results in this report apply to the tamplts analyzed in accordance with the chair, nfcustody document. This analytical repart mat he reproduced In Its entirely.
77i« rexulu in this report apply to me samples analysed In accordance with thecustody document. This analytical rrpr^r mat be reproduced in it* entirety.
Tlie resula in this report appfy lo the.tampltj analyzes! In acuonlanct with slit chaicu.iiady document. Hit's analytical report must bf reproduced in its tntirery.
Andrea Stathas, Project Manager Page 6 of I1?
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TUE 5:09 FA1 4145709461 Great LaKes Analytical
Great Lakes Analytical-Oak Creek The results In this report apply la the samples analyzed in accordance with thecustody document. This analytical repnit must be reproduced III its entirety.
Andrea Stathas, Project Manager Page 7 oil-
12/02/2003 TUE 17:04 [TX/RX NO 5084] @009
12/02/2003 TUE 5:09 FAX 4145709461 Great Lakes Analytical ISU1U/UJ2
The results In this report apply to the sarnies analyzed in accordance wllh the ch:nr. ~;custody document. Hits analytical npo*t mat bf reproduced In Its entirely.
Great Lakes Analytical—Oak Creek The rtiutu in this rcpart apply to the samples analyzed In acvunlance with the rl-j'r •'custody dacumant. TJiij analytical report muxt he reproduced in la entirety
Great Lakes Aoalytioal-Oak Creek Ihe results In this report apply la the samples analyzed in accnrdance wll/i //;•-• chain icustody document. This analytical rrport mutt be reproduced in its entirety.
Great Lakes Analytical— Oak Creek Tlie resulu in this repurl apply to the lampla analyzed In accordance, with tit? chain ofcustody document. Thit analytical report must be rrproductd In la fHtlmly.
irea Stathas, Projecc Manager Page 11 of 29
12/02/2003 TUB 17:0-1 ITX/RX NO 5084]
12/02/2003 TUE 5:10 FAX 4145709461 Great Lakes Analytical
Great Lakes Analytical—Oak Creek Tlit result! in Ihtt report apply tn the samples analyzed in accordance with thr chaicustody document. ThLs analytical report must br reproduced in Its entirely.
Andrea Statfaas, Project Manager Page 12 of 2S
12 /02 /2003 TUE 1 7 : 0 4 [TX/RX NO 5084]
12/02/2003 TUE 5:10 FAX 4145709461 Great Lakes Analytical
flTin n-sula in Ms report apply to the samples analyzed in accordant.* with the chain i,fcustody document. This analytical report must be reproduced tn Its entirety.
-ndrea Stathas, Project Manager Page 13 of 29
12/02/2003 TUE 17 :04 [TX/RX NO 5084]
12/02/2003 TUE 5:11 FAX 4145709461 Great Lakes Analytical
Great Lakes Analytical—Oak Creek The rcsulls In thLt report apply to the samples analyzed In accardanct with the chaincustody document Tills analytical report must be reproduced in lt.i entirety.
ndrea Stathas, Project Manager Page 15
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 THE 5:11 FA1 4145709461 Great Lakes Analytical
Tlic rvsulls in this report apply to the samples analyztd In aavordanr.r. with the choir. <-,fcustody document. TTii's analytical report must he reproduced in iu entirety.
Page 16 of 29
12/02/2003 TUE 17:04 [TI/RX NO 5084]
12/02/2003 TUE 5:11 FAX 4145709461 Great Lakes Analytical
77>o result! in thLi report apply lu tat x^nples analyzed in accordance with the cliiin acustody document. This analytical r^trf. must be reproduced in ia entirety.
Great LaJtes Analytical-Oak Creek The results In tin's report apply to the samples analyzed in accordance willi the chair, ofi-imtady document. Tills analytical rvpurt must be reprnduccd in its entirely.
.adrea Statbas, Project Manager Page 18 of 29
1 2 / 0 2 / 2 0 0 3 TLTE 17:04 [TX-'RX NO 5084)
12/02/2003 TUE 5:12 FAX 4145709461 Great Lakes Analytical IP21/U3Z
Great Lakes Analytical—Oak Creek The i-e.tulls In this report appfy to the samples analyzed In accordance with the chain ujtoeumunt. Thii analytical report must be reproduced in its entirety.
Statha.s, Project Manager Page 19 of 29
12/02/2003 TUE 17:04 [Ti/RX NO 5084]
12/02/2003 TUE 5:12 FAI 4145709461 Great Lakes Analytical
Great Lakes Analytical-Oak Creek Tfif resula in this report apply lo ll'f sample* analyzed in accordance with the chair, .ifcustody document. Tills analytical report must bf reproduced in Its entirety.
Lake States Industrial Service311 E. Greenfield Awe.MilwauVeeWI. 53204
Project: MSCG Pre Treatment ListProject Number [none] Rcporud:
Project Manager: Tom Jacobson 1 2/02/03 1 7:03
Base/Neutrals and Acids by EPA Method 625 - Quality ControlGreat Lakes Analytical— Buffalo Grove
AnulytoReporting
Result LimilSpike Source %REC RPD
Units Level Result %REC Limits RPD Limit Notes
Batch 3110424 - EPA 3510C
LCS (31KM24-BS1)Accnaphthcnc
Acenaphlhylene
Anthracene
Bcnzidiiie
Bcn7 (s) anthracene
Boi7.o (») pyrcnc
Bcnio (b) flunnmhcne
Benzo (ijhi) pcrylcne
Bcnzo QO fluoranlhene
Bi.i(2-cnlnrocthoxy)me<hane
B is(2-chtoTOcthyl)cthcr
B is(2-ch kmjisopropyl)cthcr
B is(2-elhyUlexyl)phlhiilutc
romopkenyl plienyl dher
>y\ bcnTyl plithal.Me
4 -Chloro-3-methylphcnoI
2-Chloronaphtluilcne
2-Chlorophcnol
4-Chlorophenyl phenyl ether
Chryscnc
Dibcoz (n,h) anthracene
I .2-Dichlorobenzenc
1 ,3-DicUlorobeiitene
l,4.DicMorob*rc«ne:
3,3'-Di't;hlorobeniid£ne
2.4-Dichlorgphcnol
Diclhvl phthalalc
2.4-Dimcthylphcnnl
Dimethyl phlhaljte
Di-n-b(jlyl phlhulutc
4 /,- D i r i tro-2-uielliylphenOl
2,4-Dmirroph.cilol
2 T4-Dinitn7tti!ucnc
2.6-Dinilrotolucnc
Di-n-oclyl phlhalatc
Great Lakes Analytical— Oak Creek
/ i ^ 1\ 1 -rt-lUlr^&lLgfi &77ft»2r^A
Prepared: 11/19/03 Analyzed: 11/21/0316.6
17.1
20.6
8.71 -24.A
27.9
24.2
20.1
28.2
8.40
1.37
0.770
24.2
19.4
24.f.
15.5
13.4
ND17.6
23.3
21.4
ND
ND
ND
25.G
9.07
23.0
8.07
20.6
24.3
22.0
11.3
20.X
19.8
22.8
10.0
10.0
10.0
5.00
10.0
10.0
10.0
10.0
10.0
1.00
1.00
0,100
10.0
10,0
10.U
10.0
10.0
10.0
10.0
10.0
10.0
10.0
10.0
10.0
20.0
1.00
10.0
1.00
10.0
1 0.0
5.00
5.00
10.0
10,0
10.0
ug/1 25.0
25.0
25.0
25.0
25.0
25.0
" 25.0
25.0
25.0
25.0
" 25.0
25.0
25.0
25.0
25.0
25-0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
67.2 10-114
68.4 13.6-114
82.4 14.7-115
34.8 70-130 L
98,4 20.5-124
1U 17.2-121
96.8 13.6-136
80.4 10-104
113 13.2-128
33.6 14.4-112
5.4.S H.5-110 L
3.04 10-113 L
96.8 10-159
77.6 14.6-11 K'
98.4 10-164
62,0 10.8-113
53.6 10-110
U.4-110 L
70.4 12.6-117
93.2 10-110
85.6 10-148
1U-11U E
10-110 L
10-110 L
102 10-110
36.3 10.2-112
92.0 16.2-121
32.3 10-110
S2.4 1X-122
97.2 20-120
88.0 10-129
4S.2 10-123
83.2 12.5-126
79.2 U.3-127
91.2 16-122
The results In this report apply to the samples analyzed In accordance vitll llic chair. <custody document. This analytical report mull bt reproduced in lit entirety.
<£=>
Andrea Stathas, Project Manager Page 21 of 29
1 2 / 0 2 / 2 0 0 3 TVE 1 7 : 0 4 [TX/RX NO 5084]
1 2 / U 2 / 2 U U 3 TDK u: i3 I'M 4i4b7084tii wear Lakes Analytical
Great Lakes Analytical—Oak Creek The results in this report appfy to the samples analyzed In accordance with ilia chain c:custody document. This analytical report must bv rrprutluctd in its entirtn.
'file results in thii report apply to tfl<: sampUs analyzed in ucvurdance with the clia:n rcu.itady document. TTi/j analytical report must bv reproduced in ia entirely.
Tilt results in this report apply to the lamri/t.i analyzed In accordanct with the chair, ofcustody dneumf.nl. This analytical report miat br. reproduced In Its enlirtly.
Andnra Stathas, Project Manager Page 24 of 2:
12/02-'2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TUE 5:14 FAX 4145709461 Great Lakes Analytical
Thu rvsulu in this report apply to Ihi: samples anafyitd in accordance with lh>! chain -jfcustody document. This analytical report must he reproduced In Its enllnly.
• 3
Andrea Stathas, Project Manager Page 25 of 23
12/02/2003 TUE 17:04 [TX/RX NO 5084]
12/02/2003 TUE 5:14 FAI 4145709461 Great Lakes Analytical
Great Lakes Analytical—Oak Creek 77ic results in this report apply to the samples analyzed in accordance with the chulrcustody document. '1'hLi analytical report tnusl be reproduced in lu entirety.
Andrea Stathas, Project Manager Page 26 of :r
12/02/2003 Tl'E 17:04 [TX/RX NO 50S4] ®0-
12/02/2003 TDK 5:14 FAl 4145709461 Great Lakes Analytical
Great Lakes Analytical—Oak Creek The mulu in this report apply la the samples analyzed In eccorclanmt with tlm cliai<custody document. This analytical rtjinn must be reproduced In its entirety.
Stathas, Project Manager Page 27 of
12/02.'2003 TIT 17:01 [TX/Ri NO 5084]
12/02/2003 M 5:l& KAJL 414570H4G1 Great LaKes Analytical IffllW/UM
Luke States Industrial Service311 E. Greenfield A.VC.Milwaukee \V1.53204
Project: M SCO Pre Treatment ListProjccc Number: [none]Project Manager. Tom Jacobson
Reported:12/1)2/03 17:03
Notes and Definitions.
A-01 this tmulytc was quantised using an open scan.
QC The result for one or more quality control measurements associated with this sample did not rneet the laboratory and/or sourcemethod acceptance criteria.
DET Analylc DETECTED
ND Analylc NOT DETECTED ac or (ibovc tlie reporting limit
NR Not Reported
dry Sample results reported on a dry weight basis
RPD Relative Percent Difference
L This quality control measurement Is below the laboratory established limit
H This quality control measurement is above the Uhonuoiy cjt»blijhcd Unlit,
Great Lakes Analytical-Buffalo Grove Wisconsin DNR Certification Lab ID: 999917160
Great Lakes Analytical-Buffalo Grove NELAP Primary Accreditation: Illinois #100261
Great Lakes Analytical-Buffalo Grove NELAP Secondary Accreditation: New Jersey #IL001
cat Lakes Analytical-Oak Creek, WI NELAP Primary Accreditation: Illinois #100307
Note: For analyses that require NELAP accreditation, all analytes, by matrix and method, ore accredited following current NELAPstandards unless specifically noted by way of a qualifier listed above.
Great Lakes Analytical—Oak Creek
UU !A#?The results in Ihti report apply to th*sample* analyzed in accordance wir/i tiia chain <cuslaJy document. This analytical report must be reproduced In Hi cntlrvly.
'I'll* raulu in ihlf rtport appfy to Uie samples analyzed in accordance wiili the chain nfcustody document. This analytical report must be reproduced In Its entirety.
General ChemistryGreat Lakes Analytical—Buffalo Grove
Antlytc
Tank 13 Spill (W312023-01) Water
pHTotal Suspended Solids
Result.
Sampled: 11/19/03
6.87ND
ReportingLimit Units Dilution
13:30 Received: 12/03/03 09:
5.00pH Units
mg/11M
Butch
47
3120106312010ft
Prepared
12/03/0312/03/03
Analysed
12/03/0312/04/03
Method
EPA 9040BEPA 160.2
Notes
G5
Great Lakes Analytical-Oak Creek The results in IhLf report apply to the samples analyzed In accordance with the chain afcustody document. This analytical report must be reproduced In Its entirely.
The raiulu In this report apply to tHa samples onatyttid In accordance with the cham ofcustody document. This analytical report must be reproduced in Its entirely.
Late Suits Industrial Service311 E. Greenfield Avc.Milwaukee WI, 53204
Project: MSCG Pic Treatment ListProject Number: [none]Project Manager. Tom Jacobson.
Reported:12/04/03 10:07
Notes and Definitions
GS This sajtiple was received past the method specified holdtime.
DET Analyte DETECTED
ND Analyte NOT DETECTED at or above the reporting limit
NR Not Reported
dry Sample rcsulta reported on a dry weight buxi.H
RPD Relative Percent DifferenceL This quality control measurement Li helnw the laboratory established limit.
H This quality control measurement a above the laboratory established limit.
Great Lakes Analytical—Buffalo Grove Wisconsin DNR Certification Lab ID: 999917160
Great Lakes Analytical-Buffalo Grove NELAP Primary Accreditation: Illinois #100261
Great Lakes Analytical-Buffalo Grove NELAP Secondary Accreditation: New Jersey #IL001
Great Lakes Analytical—Oak Creek, WI Wisconsin DNR Certification Lab ID: 341000330
Great Lakes Analytical-Oak Creek, WI NELAP Primary Accreditation: Illinois #100307Tote: For analyses that require NELAP accreditation, all analytes, by matrix and method, are accredited following current NELAP.candards unless specifically noted by way of a qualifier listed above.
Great Lakes Analytical—Oak Creek The results lit this report apply If Inv Samples analyzed in accordance with ihv clmin ufcustody dacumtnl. This anafytfcal rtport must b* reproduced in la entirely.
G Urgent D For Review D Pl«99e Comment O Pfoa*» Reply D Pfa
Andrea:As we discussed, please analyze the above sample for TSS and pH as we originally requestedverbally with Dave Krueger. - ~
Please Fax results immediately upon completion.
Thanks.
Joe
C:\WTNDOWS\DeslaDp\f«xcw4-01 .doc
12/04/200.3 THU 09:58 [TX/RX NO 5097] lg]007
ATTACHMENT D
0 Outfall#012
Concrete SlockSedimen\Trapx
36" Orchard Street sewer to river -
City Sanitary Se
#005.
306 #0.07
.Area
#008Coal Tar Consolidation and Holding Tank i
Q
:EL
Permanent Fencin
uvs«wer_
P O Crty Sanitary Sewer [_•>
Pipes
Proposed Decontamination Pad •'. .(See FIGURE S for details)
>-' 0
#004City Sanilary Sewer Railroad Tracks
I FftFND
A#001
Existing Permanent Fence Line
Temporary Fence Line
Site Rubble Pile
Site Building and Designation
Manhole/Sewer Grate
Storm Water Flow Direction
Drainage Area Delineation Boundary
Drainage Area Designation
Outfall Location and Designation
Shaded Area = Phase I of Demolition
Location of Non-DomesticWastewater Discharge
Subsurface Conveyances :
- - Kinnickinnick River (South)
- — Kinnickinnick river (North)
City Sanitary Sewer
Environmental Associates, Inc.
awn
I a/.-RRG
8/13/03
Drawing :
File :
03-03855-003
stormwatermap.cvS
\
\
Approximate Scale In Feet
FIGURE 1Former Solvay
Coke & Gas SiteStorm Water Runoff Map
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX H-2
Letter to MMSD Allowing theDischarge to Their System
€) EarthTechA Tyco International Ltd. Company
L:\work\72534\Admin\Reports\Rpttext.doc
Preserving The EnvironmentImproving Water Quality
December 4, 2003
Mr. Tom JacobsonLake States Industrial Services311 East Greenfield AvenueMilwaukee, WI 53204
Subject: Notice of Intent 2003.037
Dear Mr. Jacobson:
The Milwaukee Metropolitan Sewerage District (MMSD or District) has received a Notice ofIntent submitted by Environmental Associates, Inc., for the discharge of water from the formerSolvay Coke and Gas site, located at 311 East Greenfield Avenue, Milwaukee. The District isapproving the discharge of water from this site subject to the following conditions:
1. The former Solvay Coke and Gas site must be in compliance with the general and specificlimits set forth in Chapter 11, MMSD Rules. The pH discharge must be greater than 5.0standard units.
2. In the water discharged to the sewer system, the following pollutant levels may not beexceeded.
Cadmium 1.5 mg/1Chromium, Total 8.0 mg/1Copper 6.0 mg/1Cyanide, Total 5.0 mg/1Lead 2.0 mg/1Mercury, Total 0.0026 mg/1Nickel 4.0 mg/1Oil and Grease 300 mg/1Zinc 8.0 mg/1Total Suspended Solids 100 mg/1Total VOC Scan <5 mg/1
3. At least one sample must be taken and analyzed for the above pollutants during discharge.
4. No discharge may occur during periods of at least 0.5 inches of rain. If it does rain, alldischarge from the former Solvay Coke and Gas site must cease to the sewer system.Commencement of the discharge cannot occur until 12 hours after the rain has stopped.
wifmwfeee metropolitan sewerage district260 W. Seeboth Street, Milwaukee, WI 53204-1446
414-272-5100 • www.mmsd.com v®
Mr. Tom JacobsonLake States Industrial ServicesDecember 4, 2003Page 2
5. The total volume of water discharged should be reported to Mr. Harvey Maty as, DistrictSenior Industrial Waste Engineer, when the pumping is completed. At that time, the theformer Solvay Coke and Gas site will be billed by the District at the rate of $1.05 per 1.000gallons discharged.
The policies and procedures for these types of discharges to the sewer system are currently beingstudied by the District. You should be aware that this approval may be rescinded at any time orchanges to your conditions may occur.
If the former Solvay Coke and Gas site is in violation of this letter of approval at any time, theDistrict may take enforcement actions which may include, but are not limited to, issuing a Noticeof Noncompliance, a Notice of Violation or seeking injunctive or civil penalties up to $10,000 perday per violation.
If you have any questions concerning this matter, please contact Mr. Harvey Matyas, SeniorIndustrial Waste Engineer, at 225-2164.
Sincerely,
Peter R. TopczewskiWater Quality Protection Manager
Cc: Mr. Joe Michaelchuck, P.E.Environmental Associates, Inc.
PRT:HJM:jds
NOI 2003.037 Solvay Coke and Gas Site
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code) 1-C. Generator's Phone Number
1-0. Work Site Address 1-E. 24 Hour Emergency ResponseTelephone Number
Name and Complete Mailing Address Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number
414/529-6180
4. Name and Address of Responsible AgencyD Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department ot Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
Asbestos, 9, NA2212, III, RQ
non-friable asbestos Cat I Cat II.
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title Date
1 0. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
-7 Cl
Driver Signature
Printed Name and Title
tJU? f LViDate
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
5 Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7 99
CANARY Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal}
/ WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
-A.Speciat Waste Profile Number NESHAP Notified i
YES _NO
WSR Number
7732521-By .Generator Name, Contact N>me, and Complete Mailing Address (including Zip Code)
'
For Disposal Site Use Only
Elevation
North East
1-C. Generator's Phone Number
1-P. Work Site Address
':<j\\ r - C. V' C\ i v \ i \ c i1 - E. 24 Hour Emergency Response
Telephone Number
2. Operator's .Name and Complete Mailing Address
"•' >\V V\
Operator's Phone Number
u \ - L i A v3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metrp RecycHng and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible Agency
P Southeast District) Wisconsin Department of Natural Resource?2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212
D South Central, Department of Natural Resources3911 Fish Hatchery Road, Fitchburg. Wl 53711
SvDescription of Materials 6. ContainersNo. Type
7. Total Quantityyd3
friable asbestoa. Asbestos, 9, NA2212, III. RQ
non-friable asbestpa Cat I Cat II
8. Special Handling. Instructions and Additional Information24 HOUR NOT|Ct GIVEN PRtOR TO DBPOSAL, MUST BE BURIED,
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and, are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations, t hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title
"'\ ,\ vv -V VASignature; Date
10. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver SigriSIure
Printed Name and Title
<",*' f
Date^/ -
11. Transporter 2 Company Name v N
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
VVDate1*'
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in trie case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest excepVas noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse lor Instructions)
1-A.Speclal Waste Profile Number NESHAP Notified
X YES NO
WSR Number
77GG98
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
Golden Marina Cauaaway311 last Graanfiald Av«nua» Milwaukoa, WI 53204
1-C. Generator's Phone Number
U4-64S-0635
1-D. Worksite Address
311 Eaat Graaofiald AvanucMilvaukaa, WI 33204
1-E. 24 Hour Emergency ResponseTelephone Number
414-645-0635
2. Operator's Name and Complete Mailing AddressLak« State* Industrial Services311 Eaat Graaafiald Avanu«; Mlltfaukae, tfl 53204
Operator's Phone Number
414-645-0635
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, WI 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyS Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, WI 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, WI 53711
5. Description of Materialsplacei
6. ContainersNo. Type
7. Total Quantityyd3 '
friable asbestos
non-friable asbestos ~~>
Asbestos, 9, NA2212, llf, RQ
Call. Cat II or8. Special Handling Instructions and Additional Information
24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hpza"rdous, PCB, and/or any special waste.
Printed/TypjdjMame and Title
Ax..../'iignature i" Date
10. Transporter 1 Company Name
Qt'j-p^jqj *][*|-n/»^JT<
Complete Mailing Address
PO Boa: 4JLOi>Jf>tj H»yl-tn 'JT
Telephone Number (including area code)
,^ i ,
Driver Signature
Printed Name and Title
/DriverDate
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title
/Gat •'.Signature Data
DCE-230-97-METRO 7.'99
WHITE - Disposal Site CANARY - GeneratoriTo be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse (or InstruoKuiuJ ""
-A.Special Waste Profile Number
10OVL-
NESHAP Notified
YES . NO
WSR Number
773667
For Disposal Site Use Only
Elevation
North East '
-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code) 1-C. Generator's Phone Number
1-D. Work Site Address 1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mail ess Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyD Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natdral Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3.
asbestos Asbestos, 9, NA2212, III, RQ
non-friable asbestos Call Cat II.
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper sfping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internation,and government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title Signature Date
10. Transporter 1 Company Name
Complete Mailing Address '/£>(, j, r j~ 2 ? v
^ /J f~~
'SO
Driver Signature
Telephone Number (including area code)
Printed Name and TWe
X p Cr /• /
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area codej
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
v> 13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is Issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE • Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
1 - B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)- - , \ \
1-C. Generator's Phone Number
1-D. Work Site Address 1 - E. 24 Hour Emergency ResponseTelephone Number
V, I2. Operator's Name and Complete Mailing Address Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyO Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
. 3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
friable asbestos , Asbestos, 9, NA2212, III, RQ
non-friable asbestos Cat I. Cat II
8. Special Handling Instructions and Additional Information24 HOUR NOTICE 6IVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland governmentregulations. I hereby certify that theasbestos is not contaminated with hazardbuyPCB, arid/or any special waste. • • • .
Printed/Typed Name and Title
-h r-Signature / / Date
l_
10. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13, Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted In Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
"tiii- :>' * ( L /I ^ -\-\ -• - /WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See/ieverse for Instructions)
.Special Waste Profile Number NESHAP Notified
y YES NO
WSR Number
773227
For Disposal Site Use Only
Elevation
North East
-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
\>
1-C. Generator's Phone Number
1-D. Work Site Address
'- - '.
1-E. 24 Hour Emergency ResponseTelephone Number
y. ; \\' . v^2. Operator's Name and Complete Mailing Address
"V\\
Operator's Phone Number
V- v... A\'.\3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyD Southeast District, Wisconsin Department of Natural Resources ,
2300 N. Or. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
friable asbestos Asbestos, 9, NA2212, III, RQ
i non-friable asbestos Cat! Cat II
8. Special Handling Instructions and Additional Information' • 24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationalantfgbvemment regulations, thereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
' / •Printed/Typed Name and Title
V \ i , V \Slgnatu Date
10. Transporter 1 Company Name
fa'tj /( ///* --Complete Mailing Address
/£.-(. J 7 ., S -Printeji Name and Title'
Telephone Number (including area code
rinte_ji Name a
* t f r ' tDate 7
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Special Waste Profile Number
[00\
NESHAP Notified
YES NO
WSR Number
773230[Name. Contact Name, and Complete Majling Address (including Zip Code)
5320]1-E. 24 Hour Emergency Response
Telephone Number
2. OoMaiprjjyvlame and Complete Mailing Address
1-C. Generator's Phone Number
Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyD Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo.
7. Total Quantityyd3
friable asbestos Asbestos, 9, NA2212, III, RCl
non-friable asbestos Cat! Cat II.
B. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazajAfus, PCB, and/or any special waste.
Printed/Typed Name and Title Sigi Date
10. Transporter 1 Company Name
U/Ajfa- /n>whComplete Mailing Address /
i
Telephone Number (including area code)
Driver Signature^— ^
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD • Generator(To be taken prior to disposal)
- A . ' > - ' - '' 'WASTE SHIPMENT RECORD ASBESTOS MANIFEST'See f\e.«r»« tor *vmM*ar»i
O Soufmat Outlet. Wisconsin Departmanf o» Kaftjra* Resources2300 N Dr. Marln Lutwr King > Drv«: U«w%Aae Wl 53212
South Central. Department of Natural Resources3911 Rsn Hatchery Road Rlchburg, Wl 53711
No.
-faf
7. Total Quantityyd3
Asoescs. 9. S*22'2.
Ca! '
a Sp«3» Kbnolng moructart* ird Ado«an«24 HOUR NOT1CC GIVEN PRIOR TO DISPOSAL MUST 3C 8UR*D
9 GBCRATOROPERATORS C£RT1F1CAT)ON ~wtr, <j*oan fat tw oyiterts o- 1~'.s onsgnn-eni am My and aoxvaMy descitoed above by proper ship-ping nam* and are dteMtadL iMLtad. martad. arc ir«i«d. and » r al raspects r JTOCW co<x>tioo lor iransport by ftghvay acco»Jnq to anpicahtB international
h«r«by oroty s net cortarnra'sc!»-~ -va&roous PCS andor any special i
PnnMd>T|g*d Name and T««
V\;'-iL\Data
ID T i ConpartyName
Da-e
11 T
.'ndudng araa code)
"tie
Da:e
•2 DacnaMrcy mdcatcr Soac*
1 3 Wasa* Diwos* So* Oww ar OperauySpeoai Aasse Approval s ;• a 3*"-c"; i
s -i- •€•«• « • : >: is - ;-«-r
^xc vtane and "at
\ V.Vv. t I..- OftH"; r
•IPMENT RECORD/ASBESTOS MANIFEST" (See Reverse for Instructions)
1-A.Special Waste Profile Number
RASB10642
NESHAP Notified
X YES _NO
WSR Number
774063
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
414-645-06352. Operator's Name and Complete Mailing Address
Complete Decon, Inc.4690 East Second Street, Unit 3; Benicia, CA 94510
Operator's Phone Number
707-747-48003. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible Agency3 Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materialspipe laggling/bpile* lagging
6. ContainersNo. Type
7. Total Quantityyd3
friable asbestos Asbestos, 9, NA2212, III, RQ
norvfriabld>asbestos Cat I. Cat!XXXX3XXXXXJXXXXXXXXXXXX
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that (he contents of this consfgnrnerrt are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and True Date
10. Transporter 1 Company Name Driver Signature.,
Printed Name and Title
/DriverDate
1 1 . Transporter 2 Company Name Driver Signature
, Inc.
21107 Omega CircleFranksville, Wl 53126
Telephone Number (including area code)
Printed Name and Title
Date
12. Discrepancy li Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title
/Gate Attendant
Signature Date
WHITE • Disposal Sit*
OCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK • Transporter GOLD - Generator(To be taken prior to disposal)
SHIPMENT RECORD / ASBESTOS MANIFEST<SM nevtne tor raruohm)
1-AS Nurtter
RASB10642
NESHAP
X
S-moef
774062
For Disposal Site Use Only
East
1-B Generator Name. Cortact Mini*, and Comcxaw Ua«ng Adores naming Zip Ccoe'
Milwaukee Solvay Coke & Gas311 East Greenfield Avenue; Milwaukee, VI 53204
1 -C. Generator's Phone Number
Hans Geyer414-645-0635
1-0 Work S* Addree*
311 East Greenfield AvenueMilwaukee, VI 53204
1-E 24 Hour Emergency ResponseTelephone Nviiwr
414-645-06352 Operator* Name and Complete Uaftng Address
Couple te Decon, Inc.4690 East Second Street, Dnit 3; Benicla, CA 94510
Operators Phone Number
707-747-4800Dwpoeal Sle nM>Sl Harm and OirnpM UaJrg Address
UMTO riauycfinq and Oopocal Faotry10712 Sou* 124* Street Frankfn. Wl 53132
414529-6180
4
s
M0no end AddYMB o> RMponsttto AQ<ncy
2300 N Or Martin LUher Khg Jr.
DMC paton of MftattrtMBpip«
Dnv« Miiwaukae. Wl 53212 391 1 Rsh Hatchery Road, F
laggling/boiler lagging
!
nort haote aabetfoe ! Call can _
6 ConNa
/
tanersType
&*
ii Natural Resources"rtchburg. Wl 53711
7. Total Quantity
0* &~
24 HOUR NOTICC carve* PRIOR TO OSPOSAL MUST BE BUREO
9 GENERATOHOERAKXTS C€RTF)CAT)ON *«njOy deotar* tnal tr* conarts * !hts coosl9nmert are My andpmg name and are cftaevAedi pectvrx merged, jnd ^oevo. and w ^ aa nsspects IT pro^or cooofton for transport by ta
ery descntwd above by proper ship-
and jo»am»iiai« ngUiatnrn. I haraby camfy nal 9x avi«n»n» a not cortarmated <r*- -azardous °C3. anoVor any special waste.ng to 3ppfec3tote
Eagle Disposal, Inc.
21107 Onega CircleFranksville, Wl 53216
i code)
262-895-4800 Daie
12 DaoepaiiLv tufcjaan Space
j
13 WafM OspoHl S» O*oar or OperatorSpeoal Wane Approval a 33000 oy S -JS^B .- r« ^s« o* a 3«ne-<c *soest:s ^co^va.Certfcaton o> necavi d asbestos -jae'as s>vec ^ r^s -a i'es: eicew as ->:•«! f iterr '2
Pmeo/Typad Name and T«e
/Gate Attendant
Sgr-S^B Date
30LO-Ts a* aun oror B dnpmali
» ,*»» !
ASTE SHIPMENT RECORD/ASBESTOS MANIFEST
1-A.Spedal Waste Profile Number' NESHA1* Notttod
* YES .
WSR Number
T73902
For Disposal Site UM Only
Elevation-'
a«lC^
^ji*!^';vr4" '
nut «r,«ucnu AW*! MUwii-.. in1-
1-0, Work Stte Addrfta*
MM* M «Wt J
1-E. 24 Hour EmtfQenty ResponM
v- ' ,
2. Operator Name vrfCoji1c**MttnaAddrM«" Operator's Phone Number
.C& M310
a Waste DiaposatSW (WOS) Nttnt M> Cdmpto» Mallno Addres*
UptfoflQdycDnflanttDlsftosalFadlliye,. 'i0712 SoJlh 124th Street; FranW i \Wf53t 32 ,
WDS Phono Nutnbv414/529-6180
4. Nairn and AUdrOMOtRespohsfete Agency _, ^S&irtNastDfefrfet vsfttoonslo Department of Mifturaf230&N? Or. Martn Lu«wr Klnfl Jr. Drive; MiW ukei.Wl 53212
Sbuth Centralk Department of Natural Resources3911 Fish Hatchery Road, Frtchburg.Wl 53711
2* HOUR NOTtCE'Qrv * PRIOR TO
9. GENEflAtORADPeBATOFTS CeRTIFteATION'. I hertfay dectareteat the corrterte of thh O«»Qnment are fully and accuracy described above by proper ship-ping name and ar* dassWed, packed, marked, and labeled, and am Kt at rea(!Bt* In prapaT«anJHIon<or transport by highway ao^8^ gWr«wr*regulatio«iU hereby carttytrwtto ' •
ir>. Transporter t Company Name
tat xuv.ta.fe*CompletoMaJlhgAddn
WX24F«1U» Wl 33031
code)
11. Transporter 2. Company Name
. - ' - ' . . . ' - 1! t .. • . . ... , .- .
Complete MaUftSg Address '
DrtwStgnatum
NameiindTWe
.' ^'-:' i,, ^f'^y^,-. ?&-..>:'?*•••..12. Discrepancy Indication Space
13. , ; ^ - . .Special V^aste;Apprci teJ88ued by sia iafuiw In tCertHicafion of receipt ofasbdsfce materials covered ttythtomaniteateweptaB notedln Hem 12.
Printed/Typed Name and TitleAtt**4*nt
Date
WHITE- CANARY-QanBrator PINK GOLD - Gwtwatorrr« h. igk
1-B. laana. and CorapM* Oalng Addran OnAdng Zip Coda)
tolvay Co4» ft CM3U iMt OrMBfi*U ATMMI )fctlm»k*«» Wl 33204
1-C.
414-445-0435
i-a 1-E.MHovEa
414-445-0435
44M Str*«C, Vmlt 3| , CA 14510
414^29-618010712 Sou*) 124ti SVMC FrwMn. Wl 53132
4. HMW •no AddraM d 1rf TH«MM< mmrtrt Yflrrmin nipartmanl nf f IrtraT nnmnirrm
2300 ft Or. Uarth Lu*w Kino > CMw fcB*"Uu>«. Wl 53212Sauh.C«n(nlOapartniantaiNaluiralRe90urc8(3911 Rrfi Ha*c*w«y Rotf, Ffettug, Wl 53711
Track
7.TaMCkMrtky
CM)
2« HOUR MOTlXGWa*PWOR TO DCSPO6AL MUST B€BU«S>
9. GB<EBAI OHO rngnmert ara My »id
tff tfMf ifw•«! •« in al rwptea in prapar oontMon tar tampan by higt
it not corcvTWtvd v4h f jvdnji. PCB, snifu 3ftf i
10. TcMpaVr I Company MM*
Pnmed Name and T«« j:1 1 . T 2 Cotnpviy Drv«r
PrntBd Nara and Title
Tatanhi •*duarqi I . . ^ \ \ ( :^
12. Oaoapaney Mfcafti
to Approval it iajuad by aignalu* h Micaw o< * flarwnc AjbaakM Appnwal.of twaipl at lahxfa mi»nnai cowvrad by »w manfast «rcap» a notod n hem 12.
and
ODLD
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(SM Reverse for Instructions)
I 1-A.Special Waste Profile Number
USB10C42NESHAP Notified
YES _NO
WSR Number
7739031-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
MllvaufcM 3olT*T Coka k G*»311 bat Grt«nfl«ld Av«nu«j Mlluauk*a, VI 53204
1-C. Generator's Phone Number
Bait* Gayar414-645-0635
1-D. Work Site Address
aaxa aa abova
1-E. 24 Hour Emergency ResponseTelephone Number
414-645-06352. Operator's Name and Complete Mailing Address
Covplfta Dacca laie,4(90 Ua* Sacond Straat, Unit 3| Banloi«, CA 94310
Operator's Phone Number
707-747-48003. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street: Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyB Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Rtchburg, Wl 53711
5. Description of Materials UMint/K>ll« W|!:.vi :-;^-->;i^.;6. ContainersNo. Type
7. Totat Quantityyd3
friable asbestos Asbestos, 9, NA221Z, III, RQTruck
non-friable asbestos Cat! Cat II.
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are In all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated wRh hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title Signature 77? Date
1Q. Transporter 1 Company Name
UM MUvmvkA*Complete Mailing Address
W124 MS945 Boundary loadXanopooa* F«ll«. Wl 53031
Telephone Number (Including area code)
262-251-4000
Driver Signature f tf f^/t. I T
Printed Name
/DriverDate
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or Operator :
Special Waste Approval is issued by signature In the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title
/Cat* AttendantSignature Date
WHITE - Disposal Slta
DCE-230-97-METRO 7/99
CANARY - Qensrator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
2300 N. Or. NMta Uttwr King Jr. Drive W! 532123out» Ctrtat, Dcpartmeieot Nrtural Rasourcea3911 Rati HMctwy Road. FacNw» Wl 53711
« HOUR Nonce oivei PR«« TO oei oeAt. MUST BE BUWED
a. oe I fwBby dadipi tat Bv ccimvi& tf this c&nsjgrvrwtf ana katy MdKCtfliBly dncrtMi( )0¥A by propflr &(•{>-and aoateo, and w n al rnpvcB ^ ^vry^ contfbofi to/ Imnaport oy t40hMay ajooofOnQ to SBfaicBDia i
twnoa a not oartavninaMd «Ti T*zardau«. PCS. ancMor any
i^
M445fell*, n 53091
11. Ti
T«ta|ta«NMti«(hcta*rgapa.ood.)
. r V .
ama md TM*
12.
13.by S^Hfen • h* CM* Of • QwrlC AatMMM AOfTOMLi matariok COMKTWI bf Hi irmirtail ocopt as rated in Nam 12.
and TV*
ict•MTC QOLD-
(Tob*
I L-Z774051
1-B. Generator Name, Contact Name, and Complete Mailing,
G l i " i-1^ •->Q.l-..\«LK • I* ! • : .< . f ~ | j i . '..,_ - (.' ,i ..
;yu '•' • " •• -.- • : • - ll '*••'•-
le)
For Disposal Site Use Only
Elevation
North East
1-C. Generator's Phone Number
1-0. WorKSHe Address
-?"«'- .A-
1-E. 24 Hour Emergency ResponseTelephone Number
.'J2. Operator's Name and Complete Mailing Address
L'iJr-1- ^.-MI (?•: .
I'.., :L ' - . 0 - JVOperator's Phone Number
I3. Waste Disposal SHe (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number
414/529-6180
4. Name and Address of Responsible Agency& Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212O South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fltchburg, Wl 53711
5. Description of Materials ' ' j ' > • '• ' ' • • . - - • i 6. ContainersNo.: Type
7. Total Quantityyd3
frlabl* asbe*o»\
^ ^/, 9. NA221X ID, RQ
non-friable asbestos: Cat.l. Cat It
8, Special Handling Instructions and Addttfonal Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated'with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title Signature Date
10. Transporter 1 Company Name
Complete Mailing Address
'" '• ' ' ' ': i i . '
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
T*513. Waste Disposal Site Owner or Operator
Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
1
*
WASTE SHIPMENT RECORD ASBESSee Reverse tar mtuucaons)
55 '3 *as«e Dspos* S«e Oner ar OperatorJ Sc*oa« *a«» Aocrcva a .ss^ec :'. = ;.-i j-« - ri :aie :• a 3c"^'C -itrs'cs 4«-'2.a:
date
Cisco.**
,>v"#"'V
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(Sou Ravwrtt tor Inunxflon*)
NtSIAPNOtrRad
_YES .
1-B.
WSH Nianbw
. mid CompWt Mailing AddrtM (Wcludlnfl Tip Onto)
Wl <S2*3C4-
Metro Rocycllnfl and DitpuHMl i-»oiDty10/12 Smith I24th SVOOt, FrBnKDn, Wl 53132
4.NBTM «n Agwcy
El»v«lcn
Nonh _l
1-0. OoiUKuturti Rmw Numtw
1 E. 24 Hour Emaro*rtty RttMrtMluiuplioniiNuinbtr
Op*r»Wn Phono Numbor
414/529-6180
X SOU*I«HI Dtsoka, Wiaoorwin Department ol Natural Reaourcai' N. Or Martin LutfW Wiig Jr. Dftva; MlMMukM. Wl 53212
11 South Cflrtral, rv»partmom of Nahiml HHMUFOM3911 Fbh Halctiwv Hoid, DtchburQ, Wl 53711
B. DMoripdan n« Maloriolt
Ajb»itoi. 9. NA??1i> HI. HQ
Coil Cltll.
HNu
7. Total Quantityyd3
0. SCMCial Handing Irnliudtanf ind AdriMontf Irtformotton24 HOUR NOTICE QIVf-N HHIOR TO DBPOKAJ U»L<5T HE BURIED.
9. CCNrRATORAOPERAI UKtt CERT1RCAT1AN- I hereby dod*i« tn«i UM contann ol thin flmM>mivnl ora hdy and accuntary dMerflMd abOMi hy [X0|«« oliipping MfM tnd sm rtCKXuhud. pmiwd, mwfcud, «nd IA«l*d. ano aro in ufl rinpwat In pmp«r condition for nntpwl by lilghwmy •ocordno tn .Tp lcotfu imuiiulloortand flttMrrmMnt n ukdom. I hmby nuwy <h* ttn acbctlw it ml containlratMi with hrtrOnfcin POH antVor any iptcal wart*.
10. Tntntpvttor 1 Company Namn
frjA-ftz.Comoktt Uaing ArMrcco
(Including area o«V»)
11 Transport* 2 UuufNuiy Mama
u ft&yiDnvur 8ign«%rJ
Data
r>iMiud Num* an) I KM
Data
Driver signature
PtintaO NBJTW inn TMa
Dulo
12. OlMtrnpancy Indrawn Spact
13. Wacta OdpoMl Rrw Uwimr or OptratorSpecial Wieti Apprayal I* IttiMd hy niflnilluru in Uw cata
rUllcutlon of rectjft^antxwoc malmiuiy oovar«d by th
666T-9T-Nbr
/
'K
ftASTE SHIPMENT RECORD / ASBESTOS MANIFESTSa* n*v«r»* tor mamjetomi
I r .- ^ « 774\ -.j j1-8 Ganaralor Kama. Cortaet Nam*, and Comcie'.a UaAng Adoress rx*j<sr>c Zo C ae
24 HOUR NOTICE GIVEN PfUOfl TO DSPOSAL. UUST BE BURCO
For Osposat Ste Use Onty
054 M ^:-C Generator's Phone Number
i-E 24 Hour Emergency ResponseTelephone Number
Operator's Phone Number
WDS Pnona Number
414/529-6180
boun t QHim. uspdiiiieiN in rtuu^aj rwsources•MI i Ft* HMt**v FVwl Rfcl iim Wl 1171 1
6- Container* 7. Total Quantityr' '•'.-;?.. NO. Typa. yd3
i ^3'- V — »V 0^- ./j J
PvWtv< ypwl MaW tntf TIM GayijftfB « '
njMMpf.il **j t W 1 ' "^H *" TVT^^^*0 intomatinnaland 'of any mocn^ wssate.
Data
-. ' z -,, -.-xyLt iv / -J '- ' ^
"^x // f^T aK.C *\ f ' • > > .^^ Prated Name a^ Tifle
T>m>torn y**rt»r dndbdng arx codt)/ y y * <" • '* / / Daae - i<~±>T- .^ r 1 s 1 , .}( j, |
:>'''~tec ^4aT^e arc Ttie
Twaphon* Nurpber induing araa cod*)
i? Dsorvpancy fdcaton Spaca
I•3 A«s» 0«potat Se» O«nar or OperatorSoaoai Waste Approval «
a» -ocecf jf isbesrcs•< iasa o< a 3**-e-': ifCesSDS *co'3.aa
Prm«3 Tf^^d Hame and Dale
Ooccui Si*": ae 3««" 3-0- c
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Speclal Waste Profile Number
/O 5*6NESHAP Notified
YES NO
WSR Number
774055
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
(Ero3/1
nV* t nt a_ C£L_ & e /../y<rv y^r^C-n^f lct [fit fji
1-C. Generator's Phone Number
1-D. Work Site Address , 1-E. 24 Hour Emergency ResponseTelephone Number
/< 7 :;
2. Operator's Name and Complete Mailing Address Operator's Phone Number
Address3. Waste Disposal She (WDS) Name and Complete Mailing
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin. Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsbl* AgencyID Southeast District, Wisconsin Department of Natural Resource!
2300 K- Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212South Central, Department of Natural Resources3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials
Asbestos, '9, NA2212, HI. RQ
6. ContainersNo, Jype
f4
7. Total Quantityyd3
noD-Wabte asbestot Cat II.
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are In .all respects In proper condition for transport by highway according to applicable Internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title
I rK.>
Date
10. Transporter 1 Company
Complete Mailing Address
' ji. ^-5 I ^ 4"v> l Akl , {UL, / - ; !
Telephone Number (Including area code)
Driver Signature
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
VWnonsbi Dapanmant of Nakxal Resources2300 M. Or. Marfn Lulher (Qng Jr. Dnv« »«ra*ae. Wl 53212
South Central. Department of Natural Resources3911 Fish Hatchery Road. Frtchburg, Wl 53711
&ContainarsNo.
7. To«^ Ouantrtyy<0
AstwctDS. i NA22-2 Jl. RO
Cat It
8 Sp. iQlng InrtucSo I Add24 HOUR NOTKC GIVB4 PfOOR TO DISPOSAL. MUST BE BURIED
. tereby declare Ihat ffte contorts 34 this consujrynent are My and ipn0 name and arec
id above by proper ship-Mi packed, marked, and jceted and arc n al impacts m proper condoon tor uarmaon by hQTway jixm>^ to appfcrjbte international
and ju»«inmer« rerjeatitu I nareby carMy tt\a! r* jirwan« a not corttmir ieo <rr< .itartJous PCB. anoVor any special i
Prrf.*dTyfMd Hm and TV* C j' j Date
1 0 Traroponir 1 Company Name ' _)
ana Tfle
cods}
11 Traropoder 2 Company Name ~T.fr- ^igr.aruie
Ca:e
• 2 Dtscr<cAnc> fdcaaey Soac*
I
I
*W» Ctsoosal Sk* Owrer or Coeratars
Date
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse for Instructions)
1 - A.Special Waste Profile Number NESHAP Notified
YES NO
WSR Number
7740411 - B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
ft] -• 1 /"<- ( / /L •—/ <"
For Disposal Site Use Only
Elevation __
North:
1-C. Generator's Phone Number
<M ; i . -.1rD. Work Site Address 1-E. 24 Hour Emergency Response
Telephone Number
i ! ' • ' • • • i ' t2. Operator's Name and Complete Mailing Address
•Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number
414/529-6180
4. Nam* and Address of Responsible Agency• & Southeast District* Wisconsin Department oi Natural Resources-
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212'D South Central, Department of Natural Resources
391 1 Fish Hatchery Road, Frtchburg, Wl 5371 1
5. Description of Materials T;o' •->•• -;.,'. VV. 6. ContainersNo. , Type
7. Total Quantityyd3 ,
friable asbestos Asbestos, 9, NA221Z, III, RQ
non-friable asbestos Cat 1 CatH
w8. Special Handling Instructions and Additional Information
24 HOUR NOf ICE GIVEN PRiOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable internationaland government regulations, t hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
* fi.Printedflyped Name and Title Signatuf*'/- :; Date
10. Transporter 1 Company Name .
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
1 1 . Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
1 3. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 1 2.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator PINK - Transporter(To be mailed by Disposal Site)
GOLD - Generator(To be taken prior to disposal)
TOCSTE SHIPMENT RECORD ASBESTOS MANIFEST(See r>e»er«e tor tietucteni)
1-A.Sp te Picfte Number NESr-*3 '•ct-'ec ASP '>*-!
For Ospcsa Ste Use Only
Eevaton
East r1-8 G*ww«or NOT* Corttd Myrw Aodress *» i-C. Generator's Phone Number
i-D . 24<Hy Emergency Response
Telephone Nwnber
2 Operators Name and Complete Uaftna Add Operator's Phone Number
3 Waste r>epo*« SM rWOS) Nam and Corroew Uari Address
S Spea* HanrJng kvBucaor* and Additonal Wtor-jcon24 noun NOTICE GIVEN PRIOR TO OSPOSAL MUST BE BLBHED
9 GeeUTOROPBUTOfTS C€RTF)CATK>ipng nttne and 4re dbtcAvdl pflcted. ntarkad. arcand gpvmrmtr* leg Mont. 1 h«nby o*r*fy ttat r«
-wvby Otoan lhal the ccrteots o' rus consiyvnent are h^y and dascrtMd above by proper ship-and art o al rvapects proper condition for b^niA t ty t ^Miay aooonftng to appicable intemationaJ
• not ancantnaiecl ws- hazardous. °CB. anoVor any special «as*8-
PnrM»T]!>ed Ham* and Tte Sgnabxn Date
10 T i Corroany Name 3-vf Signature
nt^d ^4ame ana Title
T*)ieQitfioifie t jpftttr .'.vkdudvip •veil code)D3ts
11 T^araponer 2 Conpany Kan**
P-'-:*G Narv arc "tie
Telapfona fc fflQer ^unckjdkno area code)
12 DiVDToarcv J-dcaoor Scan
-3 ftass* disoc** S*» Owar or OperatorSc*o* Waste Aoorjsa/ s ss *: ~. s jy T« :ise c< a G*->*x
e'r'3 ^> ~s -ar 'es1 i.-*c- as
5 FrrMioT,5eeNai-« arc '"fie i 5.^-ar_^e
i
Date rDnccaj
" '3*
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(Sea Reverse for Instructions)
1-A.Special Waste Profile Number
U3(AfNESHAP Notified
YES NO
WSR Number
7740*8
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
in v •/4/. Vl.kv wi
1-C. Generator's Phone Number.
1-D. Work Site Address
-i" t. C ]] K , i i (
1-E. 24 Hour Emergency ResponseTelephone Number
,'Vf - ///' ~I/,L 1
. Operator's Name and Complete Mailing Address . i
' .2.11 £ O r ^ i i f u M A/
Operator's Phone Number
i v i3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility1071 2 South 124th Street; Franklin, Wl 531 32 . .
WDS Phone Number
414/529-6180
4. Nam* and Address of Responsible Agency». Southeast District, VVIsconstn Departrnent of Natural Resources
/ 2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
391 1 Fish Hatchery Road, Fitchburg, Wl 5371 1
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
non-triable asbestos
Asbestos, 9, 1 2, lit, 3dCatl Cat II
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable internationaland government regulations. 1 hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 1 2.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7 99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD ASBESTOS MANIFEST
A Sp*c* WM»
IC5U* 774050
For Disposal Site Use Only
North East
IB Gpnerator Nam*. Cortact Nam. Ua*ng Vuress rcludmg Zip Ccoe< i C Generator's Phone Number
ID Work Sto MrJnm l-E-24 Hour Emergency ResponseTelephone Number
2 Opentgr-f Nam* and CompM* Ua*ng Address
3n A/
Operator's Phone Number
iv/3 Was** OivoMl Sto (WDS) Nm and CornrjMe Ua*ng AdO>«ss
IMro Ftocycfing ant Oispool Fac«y10712 SouBi124ti Street Frartdln. W1 53132
414^29^180
Souflwast Dttfct Wboonat Department of Nafcral Resources2300 N. Dr. Martn Luttv King jr. Drive. Mfc»autoo, Wl 53212
Sou* Central, Department of Natural Resources3911 Fish Hafchery Road, Rfchburg, Wl 53711
6-CortaitnrsNo. Typ*
7. Total Quantityy<*3
NA22-2. HI, BG
Cat! Cat II.
8 Special Handfc kwucftc atx24 HOUR NCmCC GrVEM PttOA TO C«SPOSM_ MUST B€ BURIED
9 GOCRATOROPERATORS CERTF1CAT1ON r«nby decbr* !hal ihe corttnts cv trxs corisjgnmeni are My and n.i.ui.aely desotod above by proper snip-prg name and am dawked. packad. markad. and 'aceied. and an *\ al respects <n proper condition tor Tampon by righmy axuctng to appfcrarte internationaland tfmmvi.mn prjuH iini I hereby certfy fat ft asbestos a not oonumratad «r- hazardous ^C8. anoVor any special waste.
T^Z/^/iAr *»*.
ID Trwportar l Conpony Ham*
anc Titt»
TOaprone Numtw )«<dUJng are* code)Dae
Tranaponcr 2 Company Hame
code)Dale
• 2 r> Soac«
i 1 3 Wasa* Oroposal Sat OMTW or OperatorSpacnat Waste Aoprosal s ssu*o :>
or -«ce<xr ~« is« o- a 3*-«r
-.erec e> -vs Ta- '«• e.:ec: is
^sec Mane and Jate
~: "x aur a-cr r a socaa
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse (or Instructions)
1-A.Speclal Waste Profile Number NESHAP Notified
y YES NO
WSR Number
774027
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code) 1-C. Generator's Phone Number
1-D. Work Site Address
J
1 - E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Phone Number
g. f \< tn \ t \ t \A Av Mi 111/ wt(WDS/I3. Waste Disposal SKe Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin,; Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyJ^S6utr»as*tte1ric^WHW»nsto Department of Natural Resource*
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212South Central, Department of Natural Resources3911 Rsh Hatchery Road, Fitchburg, Wl 53711
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in aH respects In proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCS, arid/or any special waste.
Printed/Typed Name and Title cWt<\
Date
10. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature -J
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (Including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator PINK - Transporter GOLD - Generator(To be mailed by Disposal Site) (To be taken prior to disposal)
WASTE SHIPMENT RECORD / ASBESTOS MANIFEST *» o**** **« u*> <**»tSee rteneree tor ka*u4ons)
^ 11 f^ /• ->" r c/r*v/2. /Jr £_ ,H/TP^*• I 1 V— J i t - " - '
'7.1 p ^ t f t
^.(,, ,,, /U( i i iv7-^^
'\ ( IA S i &, iiv \i\i\ 5^.J;~ i3. WaM Dtopo** Sto (WdS) Mw and Como-en Waring Address
Metro Recyrtng and Dvposat FacOtyX 10712 Sou* 124fi Street FrarMn. Wl 531 32
North East
r1-C Generator's Pnone Number
, ,
1-E 24 Hoi* Emergency ResponseTelephone Number
1 • . r • '
Operator's Phone Number
WDS Ptions NtfvAnr414^29^180
Wh ki Department ol Natural Resources2300 M. Or. Uartn Lutier Kjr^ Jr. Drive: Mtoortae. Wl 53212
South Central, Department of Natural Resources3911 Fan Hatchery Road, Rfchburg. Wl 53711
6. CorttnersNo. Typ«
7. Total Quantityy<*3
n. 30
C*l CatM
8 SpeoM Handtag bwuctanc and MdMorM Womafcn24 HOUR NOTICC GIVEN PfOOfl TO CXSPOSAL MUST BE BURSD
9 GBC3UTOROPBUTORS CERHRCATK** I hereby dKttr* tnat t» color** o> this consgnment are Uy and acg»j*u*» dasotwd above by proper snp-pmg njHie and a»e otHeAed. pulnd marked, and laoeted. and are n al respects f proper condrtKxi tor transport by NgrMay dtxmfcig to appfcab4e international
. l hereby cerofy 9-M ft asbeetoi a not oontamraied **• lazarocus PCS. anotor any«
Name «nd TJfc
/ ) /«" / ^ In/;/ h /< C(_L10 Transporter l Company Name D—.•e' S<o.riatjre
Pn-rec Name anc Ttte
Cate
11 TransporMr 2 Company Name
Cornplele ItaftriQ Address
Teiepnone Number 'H^KfcHj y area cuds)
Stgnatjre
p'-ec Sane
Dae
12 Cw
' ^3 Wts» Disposal Se» Owner or OperatorSpeoai Waste Approval a r T-S ^ave ^ 3
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Special Waste Profile Number NESHAP Notified
< YES _NO
WSR Number
77402G1-8. G Name, Contact Name, and Complete Mailing Address (Including Zip Code)
E. A*.
For Disposal Site Use Only
Elevation
North East
1-C. Generator's Phone Number
1-D. Work Site Address
A1-E. 24 Hour Emergency Response
Telephone Number
2. Operator's Name and Complete Mailing Address
Ynil \ \
Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address•
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin. Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible Agency8. Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo, Type
7. Total Quantityyd3
Asbestos, 9, NA2212, III, RQ :
non-friable asbestos Call. Cat II
8. Special Handling Instructions and Additional Information24 HOUR" NOTICE'GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are In all respects In proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos Is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title Sign
/ /Date
10. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature J
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METHO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK • Transporter GOLD - Generator(To be taken prior to disposal)
SHIPMENT RECORD/ASBESTOS MANIFEST
NESHAPNcaBad
NO
WSP
773871
For Disposal Sto Use Only
North Edst_
a G««nK)r NHIW. OortKt Nvn«. and Co' Zip Cooe;
t-l.
i-C. Generator's Phone Number
1-0. 1-E. 24 HM Emagency Response
2. Operator* Main* and CompMa Uaflng Addn Op8ntof*s Phovw Nun wr
v .'• /' -S WMM OtopoMl Sto (WD6) Mm and Co
UMro tecycftng and Oiopocal FacaVy10712 Souti 124ft SVMl; FnnUn. Wl 53132
WDSPtan414^29^180
O Soutufret Dafrtet Wbcomin Depertnent 01 Nan** I2300 N. Or. Itartn lufter King Jr. Drive: Mwa*M. Wl 53212
G South Central, Department of Nawrat Resources3911 Rsft Hafcftery Road, Rfchburg. Wl 53711
9. GaaBMTOfVOPBUTOfTS CEKmCATlON I -wreby dactars ihel t» oomarts of this consjgnmert am My and •n.maMif ttoajtied above by proper ship- vctv v*. t o^dH cond^on for tampoit by IvQtwBjy aooordbvj to appficabte ntamabonala^wrh hazardous. PCS. anoVor any special was**.
PfWldrT ypvd Mw «WJ Tito SiQfVMLaTV ij ' U8t*t
' V^> /* ' *J t^^£f ^ ''/ • ' > ^* * + * / f
\
t&tftvtiQ M*nftflf (incfcjjiiij WB onto)
~~- . l,Pnrted Namf ana Tae
''-" X ' -^
Date - /y /
l>T\*f Signature
Prr-TBd Nam» ant) TBe
Datt
12 0>v»^vpwy ivoCarton SpMO9
{• HWaMiOMposalStoOMMr orOpmtor
r*
Sp*oal Wad* Affvoval is «au*d by kgnatura n v* cas« of a G«nanc Asbestos Approval.CcnitcaMn of r«o«t» of astestos 'lateruti cow«d oy ** manias; etoecx as ootad m nam 12.
itWASTE SHIPMENT RECORD/ASBESTOS MANIFEST(4« Reverse for Instructions)
-A.Special Waste Profile Number NESHAP Notified
: YES .
WSR Number
7738721- B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
1-D. Work Site Address
perator's Name and Complete
gc'-'-v^i #Complete Mailing Address
3. Waste Disposal. Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility • • •. • • •10712 South 124th Street; Frankllp. Wl 53132
For Disposal Site Use Only
Elevation. ' • •"'. '
North :
1-C. Generator's Phorte Number
1-6. 24 Hour Emergency Response.Telephone Number
Operator's Phone Number
WDS Phone Number
414/529-6180
4. Name and Address of Responsibly AgencyO Soutbcfast District. W»c6nslrv Department of Natural Resources
2300 N. Dr. Martin Luthar King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Rsh Hatchery Road, Fttchburg, Wl 53711
5. Description of Materials .; .•
friable asbestos ,
.ripn-friableesbwtoa
Asbestos, 9, NA22
<0 A>/4>
NA2212, Ilk RC>
Cat II
6. ContainersNo. Type
7. Total Quantity.yd3 . •
Wrtduf(N0ffibE'GrvENpmoRto:DispoSAL, MUST B| ^URIEP,"
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, am) labeled, and are in all respect* In proper 'condition for transport by highway according to applicable Internationalanil gpverhmentVegulatibns. I hereby certify that the asbestos b not contaminated wimriazardoijs, PCS, atxltor any special waste.
PrlnteoVTyped Name and title
10. Transporter 1 Company Name
UComplete Mailing Address
Printed Nane .and Title
Telephone Number (Including area code)
1 1 . Transporter 2 Company Name
Complete Mailing Address
Printed Name and Title
Telephone Number (including area code)
12. Discrepancy Indication Space
13. Waste Dlsposar Site Owner or Operator ~ ... >.. .. ' ' -Special Waste Approval Is issued by signature in the case, of a Generic AsbestOJi Approval.
'• Certification of receipt of asbestos materials covered by this rrtanffetf except as noted in Item 12.
Printed/Typed Name and Title Signature Date
\
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY • Generator PINK - Transporter(To be mailed by Disposal Site) ..
GOLD - Generator(To be taken prior to disposal)
WASTE SHI<S*aHtvtntfe*
RECORD/ASBESTOS MANIFEST
i-ASptt
_YES NO 773873pMaUa Zip Code)
For Disposal Sia» Use Only
NortV EaJ-
1-C. Generator's Phomr Nwrt»r
i-E. 24 Haw Emageouy
Opantofs Phon* Numbsr
X Waaa Oaaoaal Sae (WPS) Mama and Oompua Uat
UMoRacyctngandOiapo«iFaca%10712 South 124* S»Mk RwMtfi. Wl 53132
- •» 11 . • » :..
414^29^180
Mctmai Oepanmeri ot Wfcm Rescues*2300 M. Or. Uartn UJih«r Wng Jr. Driv«; kAMAae, WI 53212
Soum Centra^ Department of Natural Resources3911 Rsh Hatchery Road Frtchburg. WI 53711
2« HOUR HOTCS GKO« WttOB TO DISPOSAL MUST Bt
9 GaaBMTOaOPBtATOfTS C€BTIF1CATX)N rwrvby deoar* mat ffw caments of the consqnraan are Uy and i«m*»l| deacnDed above by proper snip-OV^Q napia and an cflaavttad. packad% fnarkad, and abataHL and are *i al raapects in proper condition tor tuiupufl by rHQtaay aooonflng to yi^'rff*if iilOfnaflonal.
"". f hereby oat*y rv( r« aabadcB « •« contarrwi«ed »r* lazardojs. !>ca andtor any spacM«wl»: ""
S-gnaixj-7
10 Tranaponw 1 Company Nan*
v/rConpHi \
and Tfle
Dale _ -. iI- 3 - 2
i v Trawponar 2 Company Nama Orv»r
oods)
PTTIBO Name and TiBe
Dale
13. Waala Oiaposal Sta Ower or Operator• Approval « «so«o by sgnaLn r Jie case of a Generic Asbestos Approval.
i of racaipl of asbestcs -vaamafr cowed gy tfvs rraiVes1 eicapl as noted n item 12_
Data
MMTE CANAPV GOLDpnor 0 tfaponl)
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(Se« Reverse for Instructions)
1-A.Spectal WMte Profile Number NESHAP Notified
YES . NO
WSR Number
7-73614
For Disposal Site Use Only
Elevation. ' - . • - ' : - _-
North-
1-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code) 1-C. Generator's Phone Number
1-D.:WorkSK* Address 1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and CompleteMalllnc; Address Operator's Phone Number
3. Waste Disposal Site (WDS) Name find Complete Mailing Address
• Metro Recycling and Disposal Facility . • :1Q712 South 124th Street; Franklin, yvt 53132
WDS Phone Number
414/529.-6180
4. Name and Adq>ess ol Hesponslble Agency• -Q Southeast Dfatrtot, Wteconsfti Department of Natural Resources.
• 2300 N. Dr. Martin Luther Kina Jr. Drive; Milwaukee, Vyi 53212O Soum Central, Department of Natural Resources
391 i Fish Hatchery Road, Rtchburg. Wl 5371 i
5. Description of Mdterlale 6. ContainersNo. . . Type
T. Total Quantityyd3
Asbestos, 9, NA2212, lit, RO iCat I. Cat II.
8, Special Handilna Instructions arid AddfttenaJ IntprmaBon' •'•'•'" 24fHbyRNOTie'E GivEft'PWOSTO DISPOSAL; Must B$ SuPiieb';:' ..
9, dENERATOFVOPERATOR-S CERTIFICATION: thereby declare that the contents of this consignment are fully and accurately described above fey proper ship-pine) name and are classified, psctied, marked,, and labeled, and are In ajl ^aspects In proper condition (or transport by highway, according to applicable internationaland government regulatfons. \ hereby certify'that ihe asbestos is not (xuiiarWr ed **i hazardoi.iB,PCB, and/or any special waste. • ' ' :
11 Waste Disposal StteOWnar w Operator ; • •Special Wasta Approval is issued by signature in the case of a Generic Asbestos Approval.Certification'of receipt of asbestos rtiatertate covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE • Disposal Site
OCE-230-97-METRO 7/99
CANARY - Generator PINK • Transporter(To be mailed by Disposal Site)
GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST
- A^peoeJ WM» Pwfc Ntntoer NESHAPNaefied
YES NO
WSP Number
773676
For Disposal Sto Use Only
Name. Uafing Address (indudnc Zip Code) 1-C. Generator's Phone Number
2300 N. Or. U**i Luffw King Jr. OnV*. . W1 53212Sooth Conlrat Departnflrt of Natural Raseurbes3911 Rah Hafcrfwy Road, RfcNjuy.Wl 53711
7. Total Quantityyd3
S. NA2212. Ul.no
I Addftwl kntvmelo» HOUR NOTICE OWEN PBIOfl TO D«SPOSAi-MUST BE BUHaK>;
guMone. I t*n certry tm tie atom** « not cortatnfnred ***• ^szattout. PCB. trtfdr any
if aionrnett ere fca> and >n.ualel» daacrfjerl above by proper shp-iKMoo tor tcaraport by rej fpey eopORftno to mifc rfiia kibMiNitfonal
10 Tranaponarl
X
Nunfcer fnoutng are* code)
' Primed Name atd TIMI
.f'' <• "'~
IV Ti
11 waatt Mooed 9» Oww or QprntotSpecial *m* *pprn i al H taauea by »QRMLM B tn one o< « Qanertc Aabettoi Approve.
-nata^Msowid9y Wair*nr*eet«x»pt at
PrtrtHtTyped N*ne and TVa
WWTE OOLODCC zrnr-»«rnio 7
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(Se» Reverse for InstQjfiVbns)
1-A.Special Waste Profile Number NESHAP Notified
YES NO
WSR Number
773873
For Disposal Site Use Only
Elevation . •
1-a Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code) 1-C. Generator's Phone Number
1-D. Work Site Address 1-E. 24 Hour Emergency Respon'seTelephone Number
2. Operator's"
Complete MaHlia Address Operator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
• Metro Recycling and Disposal Facility. .10712 South 124th Street; FranKIJn, Wl 53132 . . ,
WDS Phone Number
414/529-6180
4. Name and Address of Responsible Agency. O Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212 .. D South Central, Department of Natural Resources
3911 Fish Hatchery. Road. Fitchburg, Wl 5371J
S. Description of Materials . - - , 6. ContainersNo. Type
7. Total Quantity• ' . yd3 .
friabte asbestos Asbestos, 9, .NA2212, III, RC1
f*.fetl U, •_', , , . ;non-friab|easbestos Call. Cat|l.
8. Special Handling Instructions and Additional Information• : /: 24 HbUfi NQTIClfe Grv€NrPRiOR tb DISPOSAL, MUSTBE BORIEft
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are In aH respects In proper cordition for transport by highway according to applicable internationaland govemrnentVegulations. I hereby certify that the asbestos is not contaminated with Hazardous, PCB, and/or any spedar waste.
Pri Name and Slgi
MT:
Date
10. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Dat»
12. Discrepancy Indication Space
1 3 . Waste Disposal SitaOwrfar o f Operator . . . • ' ' r ' _ .Special Waste Approval la issued by signature in the case o< a Generic Asbestos Approval..Certification of receipt of asbestos materials covered by this manifest except as noted in Kern 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator PINK - Transporter(To be mailed by Disposal Site)
GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD / ASBESTOS MANIFEST(S«* AMO* far Mtuclm)
24 HOUR NOTCE QIVBl PflKM TO 0«POSM-MUST BE BUREO.
v>d iflbctad* vd w in rf rwpvcti m pnjpv ooNiftion tor twport by N tw r •ocofdhig 101I fNrabr c*rtfy •« r« IUJMIM • -xx ccnttnin«M ** huwtxxj*. PCS. wvVix «iy ^wdM i
10 Trmport* 1 Cenpcny NHM
; J ,;' /' / 3 J
Kt»>
D'v*r Sigmtur*
Prtm*d N«m* and TIM
///1 1 - T
ooov)
11 orQpmor
^-^-_ ""Ovwcrton of fvo^pt ofnffwiv««d Sy t«i .•nttVMt «)tc«p( u nowl m tarn 12.
MMTE OOLD
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Spedal Waste Profile Number NESHAP Notified
A YES NO
WSR Number
77387*
For Disposal Site Use Only
Elevation. .
North
1-a Generator Name, Contact Name, and Complete Mailing Address (including Zip Code) 1-C. Generator's Phone Number
1-D. Worksite Address
"> .\
1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mailing Address Operator's Phone Number
/?; '<j'!
3. Waste Disposal Site (WDS) Name and Mailing Address
' Metro Recycling' and Disposal facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number
414/529-6180
4. Name and Address.of Responsible Agencyd Southeast Distrtcf, Wlsconiirt Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212 •D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Deecriptlon of Materials f - - i^eTO 6. Containers'No. , Type
7. Total Quantity
frtatte asbestos , 9, NA2212, III. RO • inon-friable asbestos,! Cat) Cat II
8, Special Handling Instructions and Additional Information ,•;'.'" ' ' 24 HOUR NOTICE GIVENi PRIOR TO DISPOSAL,- MUST BE BURIED:.- ' '. . •;; . ';,--- >i v ' ,
a. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship,ping name and ar» classified, packed, marked,, and, labeled, and are in all respects irVppper.condition for transport by highway according; to applicable internationaland government regulations. I hereby certify ftiat the asbestos Is not contamkateclt hazardoiis, PCB, and/or any special wast», ' • -
PrinteoVTed Name ar Title
1 Company Name
Complete Mailing Address
7 '. >' .
Printed Name and Title
Telephone Number (ncluding area code)
Driver Signature11. Transporter 2 Company Name
Complete Mailing Address
Printed Name and Title
Telephone Number (fncfuding area code)
12. Discrepancy Indication Space
It3. Waste Disposal Stte Owner or Operator '. ,-Special Waste Approval Is Issued by signature In the case of a Generic Asbestos /approval.Certification of receipt of asbestos materiats covered by this manifest except as noted in Item 12.
Printeo/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY • Generator PINK - Transporter(To be mailed by Disposal Site)
dada/v ffnt tfia cociiercs erf ttw oonsiQnniart aj*a Utjr and aocuataly daaxrtbad abova by ptopar 9Np-and ara in at raepects n proper condfton tor tiananorl t»y NgN*» aixun*ig to appfcabta imeinallunal
4. Name and Address of Responsible AgencySoutheast District, Wisconsin Department of Natural Resources2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212
noivWaJ)(e asbestos,,, rj
8. Special Handling Instruction* and Ackfittonal Information'' QlWNP IOR TO blSPOSAL,MUsTBk BURIED,:,: P /,
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are dassHled, packed, marked, and labeled, and are In all respects-in proper condition for transport by highway according to applicable Internationaland go'ierhrnerrf regulations. I hereby certify trial the asbestos Is hcrt contaminated with hazardous, PCS, and/or any special waste.
Special Waste Approval Issued by signature In the case qf a Generic As&estos.Approval.Certification of receipt of asbestos materials covered by this manifest except as noted In Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Dfepoul SiteDCE-230-97-OR Team 7/03
CANARY-Generator(To b« mailed by Olspoul Site)
PINK-Transporter GOLD - Generator(To be taken prior to disposal)
Ig
I
'
|
•
1
OCX
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(Sfra n»«nM tor matrudfanal
U/=J,i/- V- - 773215\ '^ J L I/ V_ fi-a. GenKaiar Ham. Gonna Name, and Comptaai Miing Address j*x3uoing Zip Code) 1
, v v.\ XV ^. k. -r. ~ x . - ''\ ' ; . NJX u ( ' L - ''• r^ C4. S. ' ; ^ - . • ' v x .r 'r iW^ \ v AvV «y^nv\3.WaaaiOH(KM«Sto(W06)Nan«andC<vTvMaMaB^/W>drw3 1
'x \./if t f t f ^ 'WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Speclal Waste Profile Number NESHAP Notified
YES .
WSR Number
773213
For Disposal Site Use Only
Elevation .
Norttv-
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)1 • .V-\ \ > \'0- v \. ', ! '' • • ' . , ' i \ ._ <V.
1-C. Generator's Phone Number
"-\>Vi. \, '.. \' )' ( -^
1-p. Worksite Address
.) > r . \\ \ C' \
1 • E. 24 Hour Emergency ResponseTelephone Number
\ ,\
2. Operator's Name end Complete Maillno Address
f r'\ ^ f ' .- \
Operator's Phone Number
3. Waste Disposal Site (WDS) Name %nd Complete Mailing Address
, Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number
4. Name and Address of Responsible AgencyD Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212O South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fltchburg, Wl 53711
5. Description of Materials 6. ContainersNo.
7. Total Quantity
asbestos; Asbestos, 9, NA2212, III, RQ
non-friable asbestos Call. Cat II
8. Special Handling Instructions and Additional Information: ' 24 HOUR NOTICE GIVEN1 PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed., marked, and labeled, and are In all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby' certify"trial the asbestos is not contaminated with hazar/fous, PCB, and/or any special waste. '
Printed/Typed Name and Title '
o A^ HrDate• „- -s
10. Transporter 1 Company Name
Complete Mailing AddreuC /
,..:. •) i .- ., •+ '•"/ x-'-7
Telephone Number (including area code)
Driver Signature
Printed Name and Title*Date
11. Transporter 2 Company Name
Complete Mailing Address
' Telephone Number (Including area code)
Driver Signature
Printed Name and Title
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or Operator i •'Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted'in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METHO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK • Transporter QOtO - Generator(To
/ I
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See ne»eue far tnrtruotons)
NO
WSM Number
773216
For Disposal Site Use Only
North East
1-B-GerwaBvMarne. Contact Name, and CompM Uaeng Address «<x3ucirfl Zio Codei 1-C. Generator's Phone Number
D.Wo*S«eAddree» 1-E. 24 Houf Emergency ResponseTelephone Number
-d.Z Operatr* M*m and Complete Uaflng Address Operator's Ptione Number
I? SouftMtt Prtrtct. Wsconsn Department at Nafarat ResoureasZ300 N. Or. Uvto Lmher King Jr. Drive hHwaiAae, Wl 53212
D South Centrat. Oepartmert of Natural Resources3911 Rsft Hachery Road. Rtcttxjrg, Wl 53711
&0eecnp*onolND- Type
7. Total QuwTbtyy«B
9. MA2212 IB.
Catl. Cat II
bvlrudkn andZ« HOtF NOTCC QfVBt PWOfl TO CXSPOSAL MUST BE BURCO.
pvv nane and aw c• CERTIFICATION- inacfced. marked, and
f hereby certify tat r«
declare mat 0w contents 3! thts consignment are Uy and accurately itnutmi above by proper shp-wid are fat respects r proper conctabn lor transport by Mglaray aumfcig to appicabte jntemational
a not cxxitarrjnafee *ff ^azarbcus. PCB. ancVor any special vaste.
PrtniedrTyped Name and Tile
r: . .; - - J . r tDale
Traneponei \ Company Nvne
17
Tetephi dkxlng are* code)
oo
Name and Tiae
3 - 3 -11 Traneponar 2 Company Name
Cunqleli Ualng Address
Telephone NiMtoer rjndbrAnQ area code)
Pnrted Name arw Tn)e
Date
12 DiBfiepancy Indcaaon
11 Waat Oopocal Set Owner or OperatorSped* Watte Approval« ssuea o> s nabs* r ?w case o< a Geneve AsbestosCertfcaMn of rec*pt ol asoestta -a»naa a flfec By uvs nar. est etceo; as ictec in rwn 12.
Sgna&re Date
MMTTE
: a* -*«: ;> >«pc» 3«30LD.To IN
JON-10-1999 03370TO:96^50645
WASTE SHIPMENT RECORD /ASBESTOS MANIFESTpoo FtaMTN tor MUructfMM)
t-B QMttTttor NariM, Contna Nwrw, und CnnpMa Milling AtidrMi (Including Zip Co*)mpMB Milling Addn* l-t! Qcwntar't PhoiM Nundnr
1-D.WwKftlMMdnao 1 -E. 24 Hour PnwrgMKy Riyipomw
OMCrDlWI Phatt NumtMT
y. W«M ObixNuil Sit (Wixt) Nam* unri campta
Metro Hooycung and OlnpoM* Taofbiy1071? Soutti 124|n StHXK. Fn«)Wln, Wl 83132
W08 Wxir» Numbw414/529 6180
4. Nwiu nnd MHRNO of RM|MnalM« AovwyG SaulhoMt OMncL Wisconsin ntqartment m Natural Hmourcm
2300 N. Ui. Martm Lulhor King Jr. DrivM. Mlwauluw, Wl 53212D South Contra), Doponmwi ul Natural HMOUHUM
3911 F-feh HuWwy Road, Fttchbuvj, Wl 5371 1
A ContaiiWiNO lyiw
/ Tod/QuoriUvyd3
frUM ubcalM Ill, HO
non-frfcWu DdMtol
6 fl|iKii< H«vf Ing (rwttjctktfu uiU AddMeml lufncmHtenM 1 UUP NOTCta QlvrN PHIUR TO DBHOSAL. MU81 HF BUHIbD
U. GCNtBATOfVOI'tRATOR'S UGRTinCAI HtH: I hinby (ktolart tilt On corttm ol Ihli cwt*igniiMnl vti IgDy anri •eourWflly dMcribu) abovw by P»up<w <Np-pkig ndd» and M ctacOM, pwdnd. rMrtwii. onri labtltd. ixxlan In U ronrndi rn piupw condition tar trmnapott by hlghwuy nooorthg to appfcaw Numntfoniland UUY»TWI>O*« ngtMUon* I horuby c«ct>y thul |tw aibflkM « not conuniinflMd wilh homrdouw. PCR. «noVoi any ipaclll nuOM.
DCE-2SOIW METRO 7-»9rWABV-U»nwwor WNK - Tr*Spir*r(To hr ni.iikKJ by vMWOMI OM1
UOkO-OMWMgr(TO M Hktn F»Kx to <h«fiiv.il)
/ * IWASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See RMTW tor InMuctonB)
- Sbeoal Waae Pro** Number NESfAP Motaed
YES NO
WSR
773237
For Disposal Site Use Onry
East
1-B Gararalor Name. Oirtacl Nanw. and Com0eti UaAng Address .nouctng Zo Code: l-C. Generator's Phone Number
10 Work S«» Address 1-E- 24 Hour Emergency ResponseTelephone Number
2 Operators Name and CpmplHi UaaYig Man Operators Phone Number
G SoutiBMl Planet Wiaconain Departnert o> Nafcjrai Resources2300 N. Dr. Uartn LuOwr King Jr Orv«: UtomAM. Wl 53212
Sou» Central, Department at Natural Resource!3911 fish Hatchery Road, Htdtourg, Wl 53711
No. Type7. Total Quantity
y<*3
Asbestos, 9 NA2212. ill,
Cat I Cat II
nttoekucft)M HOUR NOT1C( QWBIPMOB TD 0*SPOS*U MUST 3E BUWED-
PriflAVdTTyPMf MeaMe) VVl Tito f*Qf\&kf9f.
'• ,. '•* \ \ • •- ( \6'/>
. ,i.,W..1 T***on» Ntfrt* CndUftng .VM cod»)
1 11 Trwwpomr 2 Company Mtro
Ttf hon* Hunter fvckatftng am cod»)
"• / /' Dal*
^A- ,-.^"ted ftene and Tato
Caie ___, : i
OTI-*' Signatu'B
(*-1ed Name and Ta»
Oam
tf
• 13 Was»DopoMl S»a Oaner or Operator
Oai*faalui of recee^ of x#*wn ~fjer*a coverec
PnvaovTyped Name and T«e
» case of a 3en»rK Asbesuw Aporoval• by tms -an^es! *xcep( as --wed m tem 12.
S^natua Date
GCXD-Jo t» u**r pnor 10 dopoor)
' 7
/ft/(S*
TF
ASTE SHIPMENT RECORD /ASBESTOS MANIFESTSee Revere* for Instructions) j
-A.Speclal Waste Proflte Number NESHAP Notified
Jd-YES . NO
WSR Number
7T32381-B> Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
For Disposal Site Use Only
Elevation . . • .
North
1-C. Generator's Phone Number
1-D..Work Site Address
V .1-E. 24 Hour Emergency Response
Telephone Number
131CA1iling Address
" AOperator's Phone Number
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metp» Reeydinfl-and PtepoMii10712 South 124th Street; ffinfc|}
WDS Phone Number
4. Name and Address of Responsible Agency••pi SoutheastOetrict, WlsCoosiRDepartment o( Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee. Wl 53212Q South Qeritralj Department .Qf Natural Resources :
3911 Fish Hatchery Road. Fltchburg, yyi KI7J1
8. Containers
•11,7. Total Quantity
;Ca^ r.. '.,..,,: .. ( Cat» .__,......
8. Special Handling Instructions ap<J Additional Information^>?^M:-24>fouR:Nicl(3JVI^p|^
9. GENERATOR/OPERATOR'S CERTIFICATION: t hereby declare that the contents of thli consijjnmerif are fully and accurately described above by proper ship-name and are classified, packed, marKed, and labeled, and are In all rftbects |n proper condition for transport oy highway according to applicable international30-vBmrflenir-e^ulafens/l hereby certify thai the a^stoi is not '! • ' '
13. Waste Dlspoeal Sjte Owner er Operator . . > : . • ; :Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials'covered by mis manifest except as rioted in Item 12.
Printed/Typed Name and Title Signature Dafe
WHITE - Disposal Sto
DCE-230-97-METRO 7/99
CANARY • Generator . PINK - Transporter(To be mailed by Disposal Site)
.^"7.^ K
GOLD - Generator(To be taken prior to disposal)
-
i1i
iK
9
I
PISTE SHIPMENT RECORD /ASBESTOS MANIFEST
/ £> 5 Q G» ^s "0t-tt. Generator Men*. Cwttct Nam, and CcmoM* Mating Address ,«*j*»; Bo Coda!
1 O.Wa*Sa*Adj*MK . vA
„ -x ' . .:. V\ t r s i • • v
^\\V?"<rr--. • • • * ' , 1 / w'v.3 Waale Oapoeal Sat (WfOS) Name and Comptew «a*ng MOrtsa
Matro Rwycino and Otopool FarJMy10712 Soult 124ti S»Mt;Fnr*fin, Wl 53132
4 NMW and AMwa of Reaporet* Agency
2300 M- Or Marto Lutfw Kr>g Jr Otv«' fuaTuntiJunt Wl 5321 2
5. Oetcnpton of MMenab V •
' kbJH* aatMetoa . Aabastoa. 9. NA2212. ill. R(
nort-fctatte aataekw Cat) Cat II
24 HOUR NOTKX GIVEN PROR TO OBPOSAU laUST BE BURtECX
PrinMTTyped Name and TWe Signature '
'. <* f ' v- \ v ' ,^- 1 - V / /'
/ / T "7 ^ -i -7 X .„ -'' /— | /: PTTad Name <
T-. .H r ,«*««,«« j J-'ff
\ Ut f] L '• 1 /^/j Date ^/
r t Traceporte' 2 Company N*r«e ' C-.-e' Stgr u--
CornpMe Uaftng Adrjra«
P--tse »4ame ,
Date
12 DexiepanQf Indcafton Space
13 Waala Oapocal Sa« Owier or OperatorSped* Want Approval a asuec D> s rtam n 3-« case of a Genenc Asoestos
•^Ta^aWi ^ttO NaTO «vv] iflc &OT^XL^O
For Disposal Site Use Onry
773242 M M- 1
t-C. Generator-* Prone Number
1-E- M Hour Emergency ResponseTelephone Number
- . . i •.I "
Operator's f iom Nmnbor
-\\^\-(j ;>-i-'. -C Or ">SWDS Phone Number
414/529-6180
aouui \jtntu, UojxaiBiwiB ui Natural riesources
V S.Cantainen 7. Total Quantity• '. -' r? ' i*-. "- l*x T*l* y**3
1
sjgnn.fft «B My wu jmtfianli onciiMKl atxive by proper ship-
us f*ctJ. andiV any spaod •astt.
Oato
,y M-/V^'/"/
ind Tide /
- / 'J ' J W8
I"X3 TrBe
Approval
Dafc
r^ '
•u
CAMARY - Gerwacr acxo «TO bt 5*«n pnor la dapoal)
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Special Waste Profile Number NESHAP Notified
YES . _NO
WSR Number
7724571-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code) 1-C. Generator's Phone Number
1-Q. Work Site Address
31
1-E. 24 Hour Emergency ResponseTelephone Number
444-aiLaozaA\\^A~Fzrp"}--^ ),.2. Operator's Name and Complete Mailing
^I ' l ^i- (
a \ \ v O
Operator's Phone Number
3. Waste Disposal Site (WDS) Nam* and Complete Mailing AddressOrchard Ridge RDF • W124 N?355 Boundary Road; Menomonee Falls, Wl 53051
4. Name and Addres* of Responsible Agency- Sdiitfaasf DtBtrk* Wiscqrwjrt pepartrnpBj of Natural Respureesi2300 N- Or. Martirt Luther King Jr. Drive; Milwaukee, WJ 53212
8. Special Handling Instructions and Additional Information'
9. GENERATOR/OPERATOR'S CERTIFtCATtON: I hereby declare thai the contents of this coniilgnment are fully aiid accurately described above by proper ship-name and are classified, packed; marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable International> • " -"-'-^'^" • - •
PrlntedfTyped Name end TWe
0. Transporter 1 Company NameTeam, Inc.
4901 North 3KI StreetMilwaukee. Wl
Telephofw Number p'rctudbig area <414-871-907d
Printed Name and Title
BiliK
Date-'"
11. Transporter 2. Company Name' WM Milwaukee
Complete Malting Address'
W124 N8925 Boundary RoadMenomonee Falls, Wl 53051
Telephone Number (including area code)262-251-4000 V
Driver Signature
Printed Name and Tito
x £i< ,,
Dalerf:< \,
12. Discrepancy Indication Space
I13. Waste Disposal Site Owner of OperatorSpecial Waste Approval Is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted In ftem 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-OR Team 7i
CANARY - Generator PINK - Transporter(To be mailed by Disposal Site)
GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD ASBES(See
MANIF
i - A. Spec* Warti ProBe Number NESHAP Scaned
YES 773243Name, and Cerate* Uaing Address ndudng Zip Code!
For disposal Site Use Only
Beaton
East
1-C. Generator's Phone Number
1-0. \Mork See
•?!)l-E-24 Hour Emergency Response
Telephone Number
and CompMi Ua*ng Address Operator's Phone Number
I Set (WOS) Name and CompHw Uaflng Addresa
ino am inpniflt racany10712 Sou* 124* SkJMt Frarttn, W S3132
WOS Phono NmtMf
414^29^180
D Sou*MM OWLVfiKonin Department o< HaMa* Resources2300 H Or. Mar*f LJtm Kng J». Dnv«; MwaukM. Wl 53212
D SoutiCflrttaLOepartmanloi Natural Resources3911 fish Hatchery Road. Rtehburg. Wl 53711
li;-&No.
7. Total Quantityy<B
AsfaeEK*. 9. NAZJ12 ID. RQ
Call Cat il
•. SpecMl HandVig horucCam and Adcttonri mfcrrvaton24 HOUR NOTCC QWW PWOH TO DISPOSM- MUST BE BUHED.
I hereby dedare t<at t»e ccrteofc of irt* consignment are **V and aocuraWf described above by proper sNp-and '-abeftad, and are f al respects -r proper cudJoun lor kamport by h May acoofdng to appicable international
I lB»by certfy 9w tw aabaooi * not oontarari,- cad M * hazardous/PCs andtor any special «asai.
Paired Name anc Tiie
i T( . code^Daw
12
i11 Wa«e Oepocat S*> Owier or OperatorSpeoaJ Wast* Approval a ssi c c>Ortecakon or -voecx of asbestos -
r r« ^se c< a Generic Asoestos3> r* "•jrfes; e«ceci as ii'ec m tern 12.
5 PrmeaT^eo Nam and T*e ! S^-ar^-e
ii
Date
VtHTTH -DiocxuSta7: a* aur grcr E cldpcsai
// WASTE SHIPMENT RECORD /ASBESTOS MANIFES
(See Reverse for Instructions)
1-A.Special Waste Profile Number
Jh ^generator Nam
NESHAP Notified
YES NO
WSR Number
773250
For Disposal Site Use Only
Elevation. •__
North East__ _Name, Contact Name, and Complete Mailing Address (including Zip Code)
?-? \Yi\tAA
1-C. Generator's Phone Number
1-D. Wori> Site Address 1 - E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mailing Address' Operator's Phone Number
V..U i v u \ \ A j l3. Waste Disposal Site (WDS) Name and Complete Mailing Address
; Metro Recycling and. Disposal Faculty • . .107121 South 124th Street; Franklin, Wl 53132
. . ' . <,'S* :> : v :.:>.r •-' '• . ' i '
WOS Phone Number414/529-6180
4, Name and Addres* qlRe_spons(ble Agency
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 5321?Q South Centra*, Department of Natural Resources
3911 Fish Hatchery Road. Frtchburg, Wl 53711
6. Containers 7. Total Quantity. yd3 .
Asbestos, a, NA2212, ,|J| • RO
Caitv:_ :_ .; ... Cat 11^
8. Special Handling mstrucflona and Additional Information. I i-r •": \ # WCUH Nortel Q&ter* PBiotf.td DJSPOSA
' , .'K'.., .!.!.....-.-. . -,,;.., ...I - .1 .
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that tha contents of this consignment are Mty an? accurately described above by prepef shlp-' name and are' classifjedjpqcked, marked, and labeled, and are in ajj respects in proper condltjon for transport by. highway according to applicable International
: * ' • ' • i ' " '
10. Transporter 1 Company NaTJ^
Complete M^Hng Address
Telephone Number (including area codeumber (including
- Y A
• / //A r>Printed Name and Titte
V'W, 7Date
11. Transporter 2 Company Name
Complete Mailing Xddress
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date .
12. Discrepancy Indication Space
13. Waste Disposal SHeOwnef or Operator •Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except aa noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITf- Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator PINK - Transporter(To be mailed by Disposal Site)
GOLD - Generator(To be taken prior to disposal)
WASTE SMPMENT RECORD/ASBESTOS MANIFEST(SMl
_Yt8 NO 773246l-i. Ga
tiJ J
10712 Soutfl 12«ti SMM: FrwMn. Wl SS132
Far OtpOHt 3* UM Only
1C Q
1-E_ M Hotf EJM^Bncy nKponcA
414^29-6180
SouftMi OtaMet. Whoonto O^vtnvt of Nanl RMOUCM2300 It Or. MMi Lutar Hng > CW*r. MM*M. Wt 53212
(2.305*2.WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Speda! Waste Profile Number NESHAP Notified
YES _NO
WSR Number
741689B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
t t \\ A\/.
For Disposal Site Use Only
Elevation .
North
1-C. Generator's Phone Number
1-D. Work Site Address
-'II f.
1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mailing Address Operator's Phone Number
''11. t tt 71/73. Waste Disposal Site (WDS) Name and Complete Mailing Address
Orchard Ridge Recycling and Disposal FacilityW124 N9355 Boundary Road; Menornonee Falls, Wl 53051
WDS Phone Number
414/253-8620
4. Name and Address ol Responsible Agency:
j" Southeast Dfefrict, Wisconsin department of Natural Resources230Q N. Or. Martin Luther King Jr. Drive; Milwaukee. Wl 53212
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
Asbestos, 9. NA2212, III, RQ
rioofriable asbestos Cat I. Cat II
8. Special Hanaing Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR1 TO DISPOSAL, MUST BE BURIED
9. GENERATOR/OPERATOR'SI CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name arid are classified, packed, marked, and labeled, and are In all respects In proper condition for transport by highway according to applicable international'and government regulatiorft. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste. '
Printed/Typed Name and Title Signature Date
10. Transporter 1 Company Name Driver Sign
Complete Mailing Address
/Ot.27Printed Name and Title
Telephone Number (including area code)Date
7/J /></1.1. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval Is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
DCE-230-97-OR
WHITE - Disposal Site CANARY • Generator PINK • Transporter(To be mailed by Disposal Site)
O;; 3ot*M« DHMX. mtoamm Qppertr** at HaMtf Hwourcas2300 hLoTSlrtn tutw King *. D**; MhraiABa Wl S32«?
" • - • ' • • • • ' ' • •3911
S. Otacf /ton ol Ua»Mi ti!', 35': 7. ToM Ouvrty
Cass
•I 24 PWOA TO dlSPOS*. HUST B6 BURIED
9 Ot@4BWTORCfRArC)(rS C&mFICAtlCISI: ' fw*r dBdara <hj| DM ccr-jrrj o( Dis consiff mart are fcJr and acxuaMy desoiwd above by pnpw sl%)-«jlp«c*»<l. fTBrV«J and jD*»d, and i-e m al lespacs - yope> condfcon'or u»»<)ort by higfrnay acuxtfnq to appfcatte intematiooal
:CATX>4 i lereoy deoare ?al me contents o< ihs consignmenl arefcjy and accur Jtul| desofced above by proper ship-ifcad. andtaoeted and are n al respects m proper condnon tor uanapon by highway auxmtm to appicafile international
a not contarntaiecJ «rtt hazardous. PCS. andVor any special
Prr«KtTyp«j Nvna and Tto Date
10 Transporter 1 Company Name
\AJt\--ff fCompMe lia«ng Addma
r- ,.,Tanptiune Number (induing aree code)
anc3 TiOe
CV> • )Da-e
11 Transponer 2 Cornpany Name
Har-.e anc Title
code)
' 2 Dacnoarcy fx*ca*on Space
1« 13 WuMDoposat SrMOwier or Operator"1J.5 Prime
Speoal Wane Approval a &so«<: 5. s-.jr.arj-e .- r« :ase o4 a Ge'- '>c -sc-e-sros ^cc'?vadC*nAcaccr» of 'ocwot 3< aswar j, ' i>- is .-. •M i~, -.--s -'jr 'ei'. -•:«.• it •'i.' 1 ir ".wi ' 2
<5'f5e«3 Hame ard Tee ' i4-*\a: e
i
Dare
3CXC Ger«acrTc at awr
» -J -t
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Special Waste Profile Number NESHAP Notified
.YES . _NO
WSR Number
7416901-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
3l/ £. fytmfald Av , iV/ 33204-
For Disposal Site Use Only
Elevation
North_
1-C. Generator's Phone Number
1-D. WorKSite Address 1-E. 24 Hour Emergency ResponseTelephone Number
Av. , wi 44-708-. Operator's Name and Complete Mailing Address Operator's Phone Number
Southeast District, Wisconsin Department of Natural Resources2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
Asbestos, 9, NA2212, III, RQ
non-friable asbestos Call Cat II.
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title
TomSignature Date
10. Transporter 1 Company Name
(J3MComplete Mailing Address
Driver Signal
Telephone Number (including area code)
Printed Name and Title
/Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title
1 I l>:imiu
Signature
^.nrrvvn rDat
DCE-230-97-OR
WHITE • Disposal Snte CANARY - Generator PINK - Transporter(To be mailed by Disposal Site)
I DMd. Wtaxntfn Oapwtmam of Naftnt FtoxxrcesZ300 M. Dr. UMttn Lutwr King Jr. DnVe: M«waiAM. W1 53212
Na Typ.7. Total Quantity
y<0
non ftttbto
9. KA2212. III. RQ
50CM I Cat II
Ca Spaoal HandBng toeMtaana end Ac tf
24 HOUR Nonce Give* pmon TO DISPOSAL MUST BE BUWED
«M In* contents cy -Ns consignment am My and I id above by preper ship- ""v. /
. I hereby oanry net r* •and ar* *\ al rnnmrti r proper condition tor tiargport by hig>ti«By jucmJaig to appicabto intematkxiaJM « not contamnred wr ruzardous PCS. and/or any special waste
PfM«yTtpad Nam* and TIM
ShortSigrabin) Date
10 Ti i Company Name
Caaftmi llafcig Koanm
s. 1„ a//. P-irtod Name a'VJ Tfle
cod*) y/ -
Date
1 1 Tianaponv 2 Company Nam*
Comptakt UaAng
T*daption* NuvntMr i
P*i"ied Nana anc
Dal*
12 Diacrapancy l vAcaaon Spar<
ir * 13 Watte OapoM S*» Oww or Operator"5 Soeaa) Wan* Approval a saueo r-. r ?w casa o( a G«re-c 'i&estos
r^es: e>;ec-t as 12
P-ir aOTjpad Nam* and Tg*
x..nnr-r»;iDate
^€ • DWOMI &«
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Speclal Waste Profile Number NESHAP Notified
•* YES NO
WSR Number
7740571-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
. \A/I
For Disposal Site Use Only
Elevation
North East
1-C. Generator's Phone Number
1-D. Work Site Address 1 - E. 24 Hour Emergency ResponseTelephone Number
744 12. Operator's Name a Operator's Phone Number
533143. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin. Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyS/Southeast district, Wisconsin Department of Natural Resources
N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchbtirg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
MabTtasbesto* Asbestos, 9, NA2212, IH, RO
non-friable asbestos Cat I >L CatH.
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
V 9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are In all respects in proper condition for transport by highway according to applicable internationaland government regulations, t hereby certify that the asbestos Is not contaminated with hazardous, PCS, and/or any special waste.
Printed/Typed Name and Title Signature Date
10. Transporter 1 Company Name
Oj^STt *V»'*Complete Mailing Address
Telephone Number (including area code)
Printed Name and Title
ft o t\ u) £•Date 8
<< f c
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Sits)
PINK - Trarraporter GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD ' ASBESTOS MANIFESTSee Weverse *x •narucsons
i - A. Seecia' Want Prom« Ffcs-oer
fr' 774058• B Generate* Mame Contact Name, and Corx'ece Uawng *ocr»ss Zc ~coe
For DsocsA Site Use Only
North East
-C Generator's Phone Number
wc«» sae »aare«iir d..
•-E 24 Hou- Emergency ResponseTelephone Nurfter
Z Operators Name and CompteM Uakng Address
r•. \
Operator's Phone Number
3 WMM Oapcaal Sa» 0»JDS) NOT» and ComptoM Uairg AooYass
Itako RKycang and Oispoeai FaaNy10712 Soud 124tt SVWt; Ffwftfe. Wl 53132
WDS Ptions NurntMr
4147529^180
G Soutnart Dana. Wiaconaln Department of Hafcrt Resources2300 N. Dr. Uarto Luttwr Nng Jr. Dm*: Mtaaukee. WI!
South Central. Department of Natural Resourcesish Hatchery Road. Rtcnburg. WI!
6-ContamertNo.
7. Total Quantity
9 \A22-:. II.
Cat I Cat i
24 HOUR Nonce GIVEN pmoR TO DISPOSAL. MUST BE BURIED
9 GENERATOROPEnATORS CERPRCATtON . hereby declare thai tie corteots crt tf»s consignment are My and JCtujeJy descnbed above by proper ship-ping name and are danAed. perted. narked, and latieted, and are in at reepects IT. groper oondtor tor transput by Ngtnoy amoidng ID appicaKe irtemaSonaland tfcoerimien reoUMonc. I hereby certry Vat ihe jmetrn a -o( contanrtatetf wt~ "azardous 9CB. anoVor any special i
PnrteoVTyped Name and TMe
10 T 1 Company Name
oodv)
Pntted Name anc T«e
Dae
11 Traraponer 2 Company Mane
CompM* Uafcng Addres*
Sime
> nctudog area code)
• 2 Dscmepanc* Jnbcasor Soace
i • 3 A isa» Dsposal Su» Ow^er y CperaaorSpecial Aaste Aocf^-a) s 4i-*c :-. i yi-^-i - -^ ^aM :• 3 ;*"&•: isoes:c.s i.wr.aS«r?ScaDcn ^ -»ceot 3f asc*s:c< -i'-K-is rc.^ec r. ~ s -i- 'es: ei :ec' 55 -:•»: - •»- '2
'.•sec »**-« arc Tc*
CJ'' o .. >>>
•NT RECORD/ASBESTOS MANIFESTr Instructions)
Profile Number NESHAP Notified
YES
WSR Number
773688
For Disposal Site Use Only
Elevation :
North
1-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code) 1-C. Generator's Phone Number
1-D. Work Site Address* 1-E. 24 Hour Emergency ResponseTelephone Dumber
2. Operator's Name and Complete Mailing Address Operator's Phone Number
3. Waste Disposal Site (WDS) Name agd Complete Mailing Address
Metro Recycling and Disposal Facility10712South 124th Street; Franklin. Wl 53132
WDS Phone Number414/529-6180
4. Name and Address pf Responsible AgencyD Southeast district. Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212 ,D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Rtchburg, Wl 63711
*-*—"~ :• 6. ContainersNo. Type
7. Total Quantity, yd3
friable asbestos Aab&stos, 9, NA2212. Ifl, RQ
non-friable
B. Special Handling Instructions and Additional Information' 24'HOUR NOTICE QIVEN PRIOR TO DISPOSAL, MUST BiE 0URIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, arid are in all respects In proper condition for transport by highway according to applicable Internationaland government regulations. I herebycertify that the asbestosIs'.hot wrttamlnated *ith hazardous, PCB, and/or any special waste.
Printed/Typed Nam6 and Title Signature Date
10. Transporter 1 Company Name
Complete Mailing ArJdress
Telephone Number (including area coda)
Driver Signatui
Printed Name and Title
Date I (
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Pate
12. Discrepancy Indication Space
I13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature In the .case pf a Generic Asbestos. Approval.Certification of receipt Of asbestos materials covered by this manifest except as noted In Kern 12.
Printed/Typed Name and Title Signature Date
DCE-230-97-METRO 7/99
WHITE - Disposal Site CANARY • Generator PINK • Transporter(To be mailed by Disposal Site)
773669wiMor Name. Coral Name, and Compew Uaftng Aden** indjOng Zip Code!
For Di jort Site UwOrty
1-C Generator Phone Number
1-tX 1 F 71 \tru fn»cgent> noopomo '
Operator's Ptaw Number
WMto OwMri Sto (IVDS) NKN «rri CompM* Uaing A<ttw*
UNO RKycfng and Ohpooi FteNy10712 SouH 124* S»Mt; FranMn, Wl 53132
WDS Phnw Nunbw
414^52^6180.
rtnent of Nafcrt Resources2300 N. Or. Mart* LU*MT King Jr. Om»: kBwauka*. Wl 53212
SoOlh Cartra*. Oepartmani of Natural Resources3911 Fish Hatchery Road, fifchburg. Wl 537t1
No. Type7. TaW Quanttr
, 9. NAZ?1?, m. RO
CalH
M HOUR NOnCC QIV9IPFHOA TO DISPOSAL MUST BE BURKD
9 GENBMTCMOPEflATOAS CatmCATION; I henby
I h0Fvby owffy ffvc Vv
Hat »• oont>ntt o< Ttm consignment an July and mcu rttfy Ueautml above by proper ship-witiori tor transport t p h^w f flccovcftrtQ ID dppftcsbta vrfjwiwJi^wksJ >, ^^
i11SpwW Wta» Aspw* h inu*d try agn*u* n »» CM ol» Generic AsbectosQrtfcetoi o* r»cejp> c* Mbeam r-awUb ccwerad by ttM mantosi excan as ncted m torn 12.
rYv««^«4lypvo Signalur* Date
DMTE- CAHARY SOLD
'
WASTE SHIPMENT. RECORD/ASBESTOS MANIFEST•(See Reverse for Instruction*)
T-A.Special Waste Profile Number NESHAP Notified
YES NO
WSR Number
7738701-8. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
For Disposal Site Use Only
Elevation ' .
North_
1-C. Generator's Phone Number
1-D. Worksite Address 1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mailing Address Operator's Phone Number
3. Waste Disposal Srt» (WDS) Name and Complete Mailing Address
• Metro Recycling and Disposal Facility • • • - •10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible Agency[ Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
friable asbestos Asbestos, 9, NA2212, III, RO
X'non-friabje asbesffiS^ST Cat I..
cff8. Special Handling Instructions and Additional Information
24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL. MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are hi all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is hot'contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title Signature . Date
«/1 0. Transporter 1 Company Name
W A Si £ <wA jv^ C-Complete Mailing Address
< o u i -» w z -rTelephone Number (including area code)
4 14 u -
Driver Signature
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Data
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by. signature in the case of a Generic Asbestos, Approval.Certification of receipt of asbestos materials covered by this manifestexcept as noted in Item 12.
/ame and Title Signaturs Date
llhDCE-230-97-METRO 7/9fl
WHITE - Disposal Site CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
/ff IWASTE SHIPMENT RECORD /ASBI
• l8ae nuarai fcr ustueaom)
,
/&£~^"7 / YES
l-B- Generator Name. Coraaa Name, and CompMe Uaang A
- V - '- \ .X-A\ •-• ' . . _ • .• r : -\ i i \ V \ ,"
1 D Mo* Se» Add*w
' ' . ( *\ < f\ \~ \£Opa^« Hare and CompliailaaangAdo>es« _
:STOS MANIFEST
WSR Nur-b«f
773217ddress nodudrif Zip Code)
1 ..'— w.V v- • 1 ^V- V— '
\ )
.: iKy^ ^ \\0 J\
' . v v \v ' \ "' r M
3. Wane Otapoea) Sat (»»8» Name and Compute Uaang Address
MakoRacycfeg and DiRiosal ftdBy10712 Sou* 124ft Street (FranWn. Wl 53 1 32
4 Name art Ad*aaiot RMponaU. Agency
2300 N. Or. Uarfn Luffwr King Jr. Orfw; UftvaUi
S-OeeovaoMolUatoriato *5k ' f i •" ; ' ~ >: V1;?* W *> *• . 1 . *&?*"
% -cXT24 HOUR NQfndtf dfVBI PfVOIt TO DCSPOSAi. UU6T BE BURIEO.
9 GBgRATQROPerUTORS CEITDFlCtATTOH: • hereby dxJare tfm t*> oomprs ot ma coraignmerf are Ujy ardm-umuJi deacrteJ above by proper ship- \_,/pjap riaae and am cta»»«>d. pectadl mertod. and tttHid, and are «i a* r»tpaca m proper oond*en tot tr»^oi1 by K^« i) «jujii*ig to appicatite intefnalionaland pownnani faojj oro. I hereby cwttfy thM the asbeslDS s not cortvtwdod
PtMeaYlyped Nan* and T«e
10 T< Company Name
A. /. /^-^ *>v
(•ndbdbiQ «VM oodi)
V/2. and Tale
Data
r/''11 Tranepmr 2 Company Name
ConpMi Ua*ng Mdnee
Nunber (indbdrig area code)
Over
Prr-ed Name and Title
Oat»
Oiaoepancy kxicaton Space
i Owter or OperatorSpeoal WaM Approval « asuta by s nanre n 9* case o< a Gerenc Asbestos Ajjprovat.Certfcakon of receipt of asbestos -Jtenafc cowed Cy 9*s Tan>»s! e.capt as noted in torn 12.
jiV.'W frjabje asbestos Asbestos, 9, NA2212, til, RQ
Cat! X Oat II.
0. Special Handling Instructions and Additional Information• • : 34 HOUR NOTICE GiVBJPRlOPr JO DISPOSAL, MUST BE BURIED.
9, GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by 'proper ship-ping name and are classified, packed , marked, and labeled, and are in, all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby" certify that the asbestos isnmcontamfnmed with azardousjPCB, and/or any special waste. • ' ' -
Priritod/Tybedt Name-arid Title -
MSignature.1 Date
10. Transporter 1 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature!'
Printed Name and Title
Date
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
12. Discrepancy Indication Space
'Tf13. Waste Disposal Site Owner or Operator : .> .
Special Waste Approval is issued by signature in the case of $ Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE • Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Stte)
PINK - Transporter GOLD • Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Revne
1-A.S Number NESHAP So«*ed
* YES 773226.noudrvg Z* Cooe.
For Deposaf Site Use Only
East
l-C. Generator's Phone Nvnber
i-D Work S»» Addrees
3"
1-E 24 Hou Emergency ResponseTetoptarw Nuntwr
2 Opennrs Nvna jnd Compua Uaing Address Opentofs Phone Number
1 WM» OMpOMl Sto (VKOS) Mvn* «nd Comprtw U ng Adorass
2300 M Dr. Uartn Lutw King Jr Drive Mwaukae. Wl 53212~ South Central. Department of Natural Resources
3911 Rsh Hatchery Road. Rchburg. Wl 53711
6 CortanersNa Type
7. Total Quantityyds
. 3. VA221J III. RQ
-5a7r£7C* I
8. Spec* Handing Mructo24 HOUR NOTICE GIV»I PRIOR TO DISPOSAL MUST BE BURIED
a GENERATOROPEHATORS CERTIFICATION i hereby dedere that ffw comens at ttw consqnmer* are luly and auuaalBly doscrtoed above by proper snip- ^png neme and are otoaetted. pedod. markad. and tabeied. and are m al r«specs «- proper condition tor aansport by liighauy accantm to JTr ^a^ rtemat)Ofiar*[
. I nentty oenfy irtai »w iiit«i>» a not contarvxad «ttn i-.azaroous PCB. and>ior any special •ast*.
PrvwATyped Name and TMe
ffl.rt10 Ti
Compt
1 Company Name SignaturB
P-rac Name arxl Tfle
code)Date
11
Cont**» IWhng Addrws
!> *f Sigr.atjre
- -lea Nar>e a-xJ Tffle
Number fmdUJng area cod*)Date
12
ISpeoel Wacki Appnjvai a ssuee ^ s raare r r« case aCe>lfcJ*on of rec»(X o< asbesas -
Asoes-ose«:«cl as -oted r tern 12
5 Pnr«eaT>ped Name and T«e ,
ii
Sgraxre Date
3CXD - G«n«raDrDCE :
SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Spedal Waste Profile Number NESHAP Notified
YES NO
WSR Number
773240
For Disposal Site Use Only
Elevation , . •
North
-B. r Name^ontact Name, and Complete Mailing Address (including Zip Code)
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; ,f rapk|n. Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of RwpprwiR^ Agency: PI Southeast DJsJrj&A|Visi?on$ii Department of Natural Resources
2300 N. Or. Martjn Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitchburg, Wl 53711
5. Description of Materials 6. ContainersNo. , Type
7. Total Quantityyd3 "
. IriaWe'asbeptos. ASbestos. 9, NA2212, III, RQ
pat I - Cat II
8. Special Handling Instruction* and Additional Information'' ••'•' • 24 HO«|R'N«>T)CI GIVEN PfllOHTd DISPOSAL. MUST BE. BURIED:
9. GENERATOfVOPERATOR'S CERTIFICATION: I hereby declare that the contents oTthls ransignment are fully and accurately described above by proper ship-ping name and aw classified, packed, marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable Internationalarid govemmert regulator hereby ,^>, ^ • . ' • . :
Printed/Typed Name arid Title
T '6ate
10. T Company Name, ' Driver Signature
Complete Mailing Address
/el * "7' Printed Name and Title, ,
Telephone Number (including area code)
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site.Owner or Operator •Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE • Disposal Site
DCE-230-97-METRO 7/99
CANARY • Generator PINK - Transporter(To be mailed by Disposal Site)
13 W«M DopoMt Se» Owner or OperatorSpeae) Wane Approval a cssued s> sgnabxe /i He case ol a Generic XsOestos fporoval.Cenacjrjon o( receipt ol asbestcs -jft^ats cc%«r«d Or ttw r-ar-<esi et:w as nared in item 12
PrrttevTypad Nam* and Tic* Sgnafore Dale
DCS-iJCHT-METRO *
QOLOTo M attn poor n daBcsa1-
'Ifur
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse lor Instructions}
1-A.Spedal Waste Profile Number NESHAP Notified
YES . NO
WSR Number
773239
For Disposal Site Use Only
Elevation .
Norths
1-B. Generator Namej ontact Name, and Complete Mailing Address (including Zip Code)
f. '&<?rrM ^ .Ul\\\J t—V
1-C. Generator's Phorte Number
1-D. Work Site Address 1-E. 24 Hour Emergency ResponseTelephone Number
2. Open and Complete Mailing Address
9Operator's Phone Number
J - •
UVU- ta3. Waste Disposal Site (WDS) Name and Complete Mailing Address
: ^etro Recycling and Disposal Facility10712 South 124th Street; Franklin, Wl 53132
WDS Phone Number414/529-6180
4. Narrw and Address of ReppgnsMeAgBncyD SoQtl*^d(str(ct/Wi$( ii»DiBp*rtmantrt Resource?
23QON, Dr, Martin Luther King Jr. Driva; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fttchburg, Wl 53711
beecripflp»i pi Materials- 6. Containers/ 7. Total Quantity
!C-i,»i.'-' ; friable,.asbestos.; : •'
Asbestos, 9, NA221J; III, RQ
Cat!
8. Special Handling Instructfon* and AddWonaj Information'? : : ::-'24r^ftNOTICl<^ENP&^^
9. GENERATOR^JPERATOR'S CERTIFICATION: I hereby declare that tne coriferrts of this conislgnmenrarii fuiry and accurately (fescrloed above by proper shlp-plng name and are classified, packed, marked, and labeled, and are in all respects In proper coruJHion for transbbrt by highway according to applicable (frtemationalandg&VeiWefrtr^ulaWns.trfer&vcer^ ' ; - ? / < :
Printed/Typed Name and Trtte
7Date
fit-10. Transporter 1 Company Name
lM^Complete Mailing Address
Telephone Number (Ihdudfng 3rPa code)
Printed Name andT__., -
>:*J«^' PfUifc-
11. Transporter 2 Company Name
Complete Mailing Address
Telephone. Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or Operator :" \ ,Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted hi Item 12.'
fcji.rkad.rx) an in af (aspects IT prefer cooa ton lor tranapeiB Bj li||i»«|it fid conOirt* -&i BC *'ftr " uin^CHJt. ^"Co, I
•IMW* by prop*f at >-Q to appfcabb Waniaflooal
. Slitr-f-ia Trarwportw i Corapwy Mmt D-vw
/,/'Pnrrtad >
CXver Signature
CoepMt Utfng
and !»•
MjrtHr (Incfludhf aMtt oodb)
itv sgrtctm in ** COM rt a QarMnc Ajboitoa Approval.
cowwvdby MmanlMI ai pt as noted in Ham 12.
Nan* and Tito Signatrs Dale
DC€-230-»7-CR »•» 7093OU)(Tot)»
PMENI|»ECORD/ASBESTOS MANIFESTfor Instructions)
A.SpeciajVgBte Profile ..Number NESHAP Notified, . ' • • . v . . - f
* YES
WSR Number
7738511-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
Hilwaukaa Solvay Coka * Caa311 laat GraatiflaU Avamia} Milvaukaa, HI 53204
1-C. Generator's Phone Number
Bana fiayar414-645*0*35
1* D. Work Site Address ;
MMtt a* abova
1-E. 24 Hour Emergency ResponseTelephone Number
414-645-0*352. Operator's Name and Complete Mailing Address
CoKplata Dacon* Inc.4*90 laat lactma1 fttraat, Dale 3j Banicla, CA 94310
Operator's Phone Number
707-747-4M03. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin, WI 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible Agency( Southeast District, Wisconsin Department of Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, WI 53212D South Central/Department of Natural Resources
391 1 Fish Hatchery Road, Fitchburg, WI 5371 1
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
friable asbestos Asbestos, 9, NA2212, III, HQ
non-friable asbestos Cat I Cat II
Truck $08. Special Handling Instructions and Additional Information
24HOIJR'NOtieE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
w 9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping naw and are classified, packed, marked, and labeled, and are In all respects in proper condition for transport by highway according to applicable Internationaland government regulations. I hereby certify that the asbestos Is not contaminated with hazardous, PCS, and/or any special waste. •
Printed/typed Name and Title Signature
77Date
*10. Transporter 1 Company Name
DM Kllwauk««Complete Mailing Address
V124 1*945 Boundary *o*4ttenowm** fall,, WI 53051
Telephone Number (including area code)262*251-4000
Driver Signature
/Driva*
1 1 . Transporter 2 Company Name
Complete Mailing Address
telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
i'2. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is Issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except? as nota^ in Item 12.
Printed/Typed Name and Title/0«t« Att*nd*n
Signature Date
WHITE - Diapoial Site
DCE-230-97-METRO 7/99
CANARY • Generator(To be mailed by Disced Site)
PINK • Transporter GOLD • Generator(To be taken prior to disposal)
^cfe SHIPMENT RECORD/ASBESTOS MANIFEST
1-AJ
1AJH0133
NESHAP T"1YES
WSP Number
NO 7738521-1 Generator Nam*. Comet Nam*, ml Complete Ua*ng Adores* ndudhg Zip Code)
7738531-B. Generator Name, Contact Name, and Complete Mailing Address (Including Zip Code)
311 liiit Gr«*nfl«U AY*IW«| lUlvaufca*. ttt 53204
1-C. Generator's Phone Number
H*n» G*j«r • •''414-445-0635
1-D. Work Site Addres*
«
1-E.24 Hour Emergency ResponseTelephone Number ,. ' -
414-443-0435
Z. Operator's Name and Complete Mailing Address
CoapUU DtttO* Int.4490 &MC I««oad Strut, U*iC B«ai«i«, CA 94510
Operator's Phone Number
707*747-4*003. Waste Disposal Site (WDS) Name and Complete Mailing Address
>
Metro Recycling and Disposal Facility10712 South 124th Street; FranWin, Wt 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyO*Southeast District, Wisconsin Department of Natural Resources'
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee. Wl 53212
5. Description of Materials
O South Central, Department'of Natural Resources3911 Rsh Hatchery Road. Fitchburs(, \$ 53711
7. Total Quantityyd3
Asbestos. 9. NA2212, III, FK1
non-friable asbestos Cat). Cat II.Tnwk
8. Special Handling Instructions and Additional Information' 24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
:>iwi li'-i".*'.;,'9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately descrifttf above by proper ship-ping name, and are .classified, packed, marked, and labeled, and are In att respects In proper condition for.transport by highway according to apptifable Internationaland government regufafiorts. I hereby certify thai the asbestos is not contamirwted with hazardajs, PCB, and/or any special waste. '" •' =' ''\ ~
Printedn-yped Name and Title
10. Transporter 1 Company Name
WM KttiNrak**Complete Mailing Address
V124 M945 Boundary loud. VI 53051
Telephone Number (Including area code)242-351-4000
Driver Signature
Printed NaWe and Title,/Driver
DateV
1.1. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (Including area code)
Driver Signature
Printed Name sind Title
Pate
12. Discrepancy Indication Space
t3. Waste Disposal Site Owner or Operator ' :Special Waste Approval is Issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title/Cat* Att«nd«xt
Signature Date'
WHITE - Disposal Sit*
DCE-230-97-METRO 7/99
CANARY - Generator(To to mailed by Disposal Site)
PINK • Transporter GOLD • Generator(To be taken prior to disposal)
i- B Generator Name. Contact Name, and Complete Ua*ng Address fndurjng Zio Code) 1-C-Generatar's Phone Number
.-.:'. ... ^ • _ .-,< -x*c <v v^
'~DT'~^^r:>-1-E. 24 Hour Emergency Response
Telephone Number
414^871-90JO x-jr—
i Operator's Name and Cumplati llalnj Address y
Team, tec. '
3 waste Oepoael Ssa (WOS) Name andrt«. *.«.•< o>>««a one . utiioj ijcnc
* or| Metro ROF« 10712 SoUh 124* Street Frar**n.W1 531 32i I MIM uul • hh^a rf f^^^Ml 1 1 A
2300 N- Or. Martm Lu*wr King Jr
5. OeMcnpton of MtteVVtt »?;i£ '
trwteaatMetoe
,nr *"?-o' /;;a SMcari Handana kMrucSora and Add
Drive Mihvautee. Wl 5321
&*' •• -V .H'V f
Asb
Cat
"*."••/ 4TWTt-907e^
* " * - ' . <^ "™r " N "* . »
xiee Faite Wl 53051 262-253-8620414-529-6180
as2
% . * l i • , s • .. - . . • ' 6. Cominers^^tt ' ' " V ••• v v::» '. ""•Ji.'fHJ Mo. Type
sstos. 9. SA2212. III. RQ
I Cat H "»'
7. Total Quantity
.. —
24 HOUR NOTICE GrVB4 PRIOR TO DISPOSAL. MUST BE BURIED
9 GENERATORiOPERATORS CERTIFICATION ' »w«t>y oeokn ttw «M camwts of 9v oxttjymam m Uy and »u.uam» deecifced above by proper ship- \png name and are ae*e*ad. peekad, marked, and tatMtaa and •/» n «• mpecit r proper condoon tor traraport by Njfrnay auxmiiig to appfcaMe international
l hereby certty i • nol oortamnalecJ vrfr hazardous PCS. anoVor any
PnmadrTyped Name and TMeBel K Cook. President
Signature Data
10 TT i Company Name
4901 Norn 31« Street
) Mtrttwr fnAKflno «WM cods)4.14-871403)
Name and TiBeBill K Cook, PreeirJer*
Date
11 TiWM
2 Company Name >-v»r
W124 N8925 Boundary RoadUenomonee Fate. Wl 53061 and Tree
(toidbdfeig avee code)
262-251-4000 Dale
12 Oaoreparcy
1
i
13 WastsOepoeal Set Owier or Operator
Cenacaiui d fece^H ot atneara -naMnat» cov«rc<:
PnreaaTjped Name and Tla*
i case o» a Senate Asbestos Approval.1 Oy !Ni rianf!er except is ->olea r Mem 1 i v
Signature Date
DCH ;so-»r<» T.GOU) •(To 0* n**i prior o dapoaO
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(Sea nenaraa tor tnatrudtona)
1-A.SpacW WMto Pro* Number
RASB10643
WSA Number
774064
For DbpoeaJ See U»e Only
Elevation
Eaat
1-fl. Generator Name, Contact Name, and OompM* UMng Address (Indudng Zip Coda)
Milwaukee Solvay Coke & Gas311 East Greenfield Avenue; Milwaukee, WI 53204
1-C. Generator1* Phone Number
Hans Geyer414-645-0635
1-D.WorttS*aAddreas
311 East Greenfield AvenueMilwaukee, WI 53204
1-E. 24 Hour Emergency ReaponaaTelephone Number
414-645-0635£Opei«tor*hlaflie art Cample* MatogAddrMe
Complete Decon, Inc.4690 East Second Street, Unit 3; Benicia, CA 94510
Operator's Phono Numbflf
707-747-48003. Waste Dtapoaa) Sto (WOS) Nam wd Compta
Metre FtecycOng and Dtepoaal FadBty10712 South 124ft Street; FranMn, WI 53132
414/529^180
4. Naitw and Addraw of Rnponrtito AQtncy
2300 N. Or. Martin Luther King Jr. Or)nt of Natural Resources; MHwaufcM, WI 53212
D South Central, Department of Natural Resources3911 Fteh Hatchery Road. Rtchburg, WI 53711
5. Dwcripton of Materialsgasket?* floor covering
B.ConWnemNo. Type
7. Tool Quantityyd3
Aebeetoe. 8, NA2212. III. IKI
non frisble CMI Cat III.
8. Spedel Handeng kwkucttom end Addeo24 HOUR NOTICE GIVEN PWOR TO DISPOSAL, MUST BE BURIED.
9.OBtfRATOaOPERATOR-SCEHTMCATION: ItanbydedanlMlheconlmliof*t*iplno nainaflrid ve deHMed« padced, merited! end labeled, and are In al lejpacbi bifand uoxermneU rBgiaiaua). r heraoy carMy tat Via la not contan*«*ed with hazntloua, PCS, andtor any apodal waste.
nt are My and accurately described above by proper «hip-for imiopuil by raonvMy socoraViQ to sppfcflbte iniBnwtlonfll
Telephone Number (Indudhig ana code)
CHacrapancy Indteatton Space
13. Waste Diapoaal Saa Owner or OperatorSpedaJ Watte AppravaJ ia iawed by slgnatum In the caw of a Generic Aabegtoe ApprovalCertification of receipt of asbestos matanato covered by thfa inanMeat except as noted to Itam1&
T8, Special Handling Instructions and Additional Information
24 HOUR NOTICE GIVEN PRIOR T0 DISPOSAL, MUST BE BURIED,
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping; narrje and are classified, packed, marked, and labeled, and are In all respect? In proper condition for transport by highway according to applicable international
" government regulations. \ hereby certify that the asbestos Is not contaminated with hazaidous, PCB, and/of any special waste. •and
Printed/Typed Name and Title Signature Date
10. Transporter 1 Company Name
VM Milim«lM«Complete Mailing Address
¥12433031
Telephone Number (including area code)262-231-4000
Driver Signature
and Titlei
Dafe"
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or Operator' ' •Special Waste Approval I; Issued by signature in the case of a Generic Asbestos Approval.
• Certification of receipt of asbestos materials covered by this manifest except as noted In Kern 12.
Printed/Typed Name and Title/Cat*
Signature Date
WHITE - Disposal Site
DCE-230-97-METHO 7/99
CANARY - Generator(To oe mailed by Disposal Site)
PINK • Transporter GOLD - Generator(To be taken prior to disposal)
RECORD 'ASBESTOS^MANIFEST
1AJ110443NCSHAP
»-
11 YES NO 773953i-aG«MntorNMn*.C«MKtNMn*. and CompM*U4«ng Address nducfc^ Zip Code)
MUvrakM f«iT»y Celu ft C«»311 I«tft GTMafl«14 AT«no*» MUMuk««( VX 53204
l-C. GtrwnWs Phooa Nurrber
Baa* 6*y«r
1-0 WokSfct i-E- 24 How Emvgancy Response
414-445-OUSI and ConpMi Uaeng Addrao*
eoa IM.4490 iMt fi«o«4 ftrat. Obit 3| tonlcU. CA 94310
Oparalar's Ptuna Nurtwr
707-747-4100(WOS) Nw» and GtynpMi Ua*ng Add
Men "r f'T) ml10712 Soufi 124* Street Fnrtfln, Wl 531 32
WDS Pforv Ntfnbar
414529^180
atOMfctWi enOepi tof Nefexaj Resources
2300 N. Dr. Men* Lulher Mr? Jr. Dnve; Ma\»auke>. Wl 53212So* Central, Department of Natural Resource!3911 RshHathery Road, Ftetiourg. Wl 53711
6.1Mo. Typ«
7. Total Quantity
1.9. N^22'2. 111. RQ
Cai Can
24 HOUR MCmCt GIVEN PRIOR TO DISPOSAL. MUST BE BURIED
9 GB*BUTOaOPERATORS CERTFICAT1ON !pinQ naw and am cttaeBatf. pedvd^ martad. andand 1f**mmit najaaJoni. I hanby carHy »al f
•wtby dactm ihat ma co-torts cX ttus consgranant ant Uy and a<latialad. and am r al raapaos ^ proox condton tor tianapuit by highiM> .
•tydaacrtndi by proper ship- >^y
» not oortaminrad w<tD tazardous °CB anoVor any apaciatrdng to appfcatato intemational
Sqnann
Conpvny Nvne
VU4 M945* Fall*. VI 33051
Totantan* ikvi Mf 6nchjdra212-251-4000
cod>)
ll.Ti 2 Cor. rNama Signarura
and TJB«
Date
Own*
Sa» Oanar or OparatorSpaoal Want Approval • -ssuea Dy sgnatm n 0>a casa ol a Gar*nc Asbestos *op-ov».CarMkaaon ol racafpl of MMntrn -ftrja ao*«r«d by tr*s mani vst eicept as ->o;ec in .tarn '2-
/Gat* ACC«a4«acS naiur. Date
NMTTE'o b* Tatae 3, >•»•• Sw
GOLD(To t» Uttr poor to rtBUMifl
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Speclal Waste Profile Number NESHAP Notified
* YES NO
WSR Number
795823
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)Golden MAIin* C*u»«vay311 U»t Greenfield Av«nu«t Milwaukee, WI 53204
1-C. Generator's Phone Number
414-645-0633
1 -p. Wo* Site Address
311 Ia»t Greenfield Av«nu«Milwaukee, VI 53204
1-E. 24 Hour Emergency ResponseTelephone Number
414-645-0635
2. Operator's Name and Complete Mailing AddressLake State* Industrial Services311 But Gronfltld Avenue| Milwaukee, WI 53204
Operator's Phone Number
414-645-0635
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
• Metro Recycling and Disposal Facility10712 South 124th Street; franklin, WI 53132
WDS Phone Number
414/529-6180
4. Name and Address ot Responsible AgencyO^Southeast District, Wisconsin Department of Natural Resources'
2300N.pr. Martin Luthtr King Jr. Drive; Milwaukee, WI 63212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Rtchburg, WI 537,11
9. Description of Materials 6. ContainersNo. :Type
WabW asbestos Asbestos, 9, NA2212, III, RQ
7. Total Quantityyd3
Call. Cat II
. Special Handling Instructions and Additional Information' 24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are. classified, packed, marked, and labeled, and are In all respects In proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos Is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Title f I ±,
mpl t/t/l/f
Signature.
d
Date
10. Transporter 1 Company Name
Starline TruckingComplete Mailing Address
PO Box 410M«w Berlin. WI 53151
Telephone Number (including area code)
262-786-8280
Driver Si
Prinjed Name and Title
Date •r /•-•//11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (Including area code)
Driver Signature
Printed Name arid Title
Date
12. Discrepancy Indication Space
I13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title
Attend tatSignature Date
WHITE - Disposal Site
DCE-230-97-METRO 7/99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
I '; 'Zc24 HOUR NOT1C€ GIVEN PflJOfl TO DtSPOSM- hAJST BE BURIED
• ' ' f
r ' i /, , 1 / / / ' . .
% , TfM0hon§ fittMr nindbiftng JPM codt)
fJ 1 1 Ttanaportar 2 Company Name
TMpncne NUTT** tiruutra VM code)
•2 Dacrfloancr Tcfcaoor Space
Signature Date
p. -.
~-
Pnrite<3 Name and T«e
Date
. .«: «ar-« a-c .«
Date
ihr Aaae Dsposa Sat Ow* or Operatoraste Aoprcval a :AS« 5- 3 j -*'.: iiC*5!;s *w:.
> -.5 -a- '&r ei :ec: as ->:•€•.•; >-
Date
- '.rf " ^-?c»:-"c--
WASTE SHIPMENT RECORD/ASBESTOS MANIFEST(See Reverse for Instructions)
1-A.Special Waste Profile Number NESHAP Notified
YES NO
WSR Number
774043
For Disposal Site Use Only
Elevation
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address includinq Zip Code)me, and Complete Mailing Address includinq Zip Code)
! &*?* ' ^- 1' i « /* ' ~
1-C. Generator's Phone Number
1-D. Work Site Address r 1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mailing Address Operator's Phone Number
,•",.'.*'•,- •••>' I'
3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility10712 South 124th Street; Franklin. Wl 53132
WDS Phone Number414/529-6180
4. Name and Address of Responsible AgencyD Southeast District, Wisconsin Department of. Natural Resources
2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Central, Department of Natural Resources
3911 Fish Hatchery Road, Fitcnburg, Wl 53711
5. Description of Materials 6. ContainersNo. Type
7. Total Quantityyd3
friable'asbestos
-
Asbestos, 9, NA2212, III, RQ
non-friable apbesto* Cat I Cat II
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations. I hereby certify that the asbestos is not contaminated with hazardous, PCB, and/or any special waste.
Printed/Typed Name and Titleinted/Typed Signature Date
10. Transporter 1 Company Name
U^"-,!r>/Complete Mailing Address
><• '?'"„• .5 ";•')*.*
I. '- i- •>' 'Telephone Number (Including area code)
/;///} ?/: / .
Driver Signature
Printed Title1
Datef..
11. Transporter 2 Company Name
Complete Mailing Address
Telephone Number (including area code)
Driver Signature
Printed Name and Title
Date
12. Discrepancy Indication Space
13. Waste Disposal Site Owner or OperatorSpecial Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal SiteDCE-230-97-METHO 7-99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taken prior to disposal)
WASTE SHIPMENT RECORD ASBESTOS MANIFESTSee nenne tor rstruOars
i- I Nwntoer '•SS° '..-t
774044
For Disposal Site Use Only
Bevafton
v B Generator Nam. Contact Nam* andCorrcfete Uadng Aodress >nau*ng. Zc C coe<
^Sa**&C*^WItcort&tpaTrnei*al *****&**&*^2300 N. Or. Marfn Lutfiar King Jr Drive: Mhmutoo, Wl 53212
Sou*) Central, Department of Natural Resources3911 Fan Hatcnery Road, Fitchburg, Wl 53711
5. Oeecr*»an of; v. ,
6. Containers 7 TotaiQuantty
. 9. MA?2'J. n.
Cat 1 Cat l'' I' s '•• •> ' '
8. Sp ffjng ctont and AdMo c2« noun Nonce orvo4 PRIOR TO OSPCS*L MUST BE BURIED
9 QEHEHATOROPeRATOR-S CCRTFICATXDN I -weby oectare that !he conaenis of ttxs cons nmert are My and jLuiatart daacifceU above by proper ship-pno name and are dMeAed. packad. marked, and aoeted. and are r al respects r proper coodrtor tor Banspon by highway aooonfng to appfcabte internationaland gun nmenl regUMonc. I hereby oertfy tvt f* *»* T* a not oor*arrana~ed *r*~ hazardous PCS. anoVor any*
Mm *id Tito
"'l' J / l l , . . .
9ana«ure, Date
10 Transporter'. Company Name Sionat j-e
Pimeo Nama and T»e
TcieiJtione Ntfvber (OdudnQ mM code)Case
1 1 TranscorMr 2 Company Name
CompM* Uaftng Acttns
Tuapfarn NUitter fndulng area ax>»i
P-r-ac Nane aio ~ne
Date
•2 Dacrvparcf VtSc
I1 3 Was** Disposal Sat Owner ar OperatorSoeoM Was* Aoprovai s ssc«o :•, r* case * a
5 f^iraeoTjped Name aro T«« ' >flratjfe date r~: r* •»•*- 3-0-1:
WASTE SHIPMENT RECORD /ASBESTOS MANIFEST(See Reverse lor Instructions)
1-A.Speclal Waste Profile Number NESHAP Notified
, VES „WSR Number
774045
For Disposal Site Use Only
Elevation ..
North East
1-B. Generator Name, Contact Name, and Complete Mailing Address (including Zip Code)
> i n
1-C. Generator's Phone Number
-' ! 4 I. Ji r. / /. '
1-0. Work Site Address 1-E. 24 Hour Emergency ResponseTelephone Number
2. Operator's Name and Complete Mailing Address
/ n K'e c-j\f\\r ^ V i >Ht i -. ' ' ><-/;,Operator's Phone Number
t M3. Waste Disposal Site (WDS) Name and Complete Mailing Address
Metro Recycling and Disposal Facility . .1 071 2 South 1 24th Street; Franklin, Wl 531 32
WDS Phone Number
414/529-6180
4. Name and Address of Responsible AgencyXf Southeast District, Wisconsin Pepartment ot Natural Resources
' 2300 N. Dr. Martin Luther King Jr. Drive; Milwaukee, Wl 53212D South Centra), Department of Natural Resources
391 1 Fish Hatchery Road, Fitchburg, Wl 5371 1
5. Description of Materials 8. ContainersNo. Type
7. Total Quantityyd3.
friable asbestos; Asbestos, 9, NA221 2, III, RO
/ non-friable asbeetos. Cat I X • CatIL
W'
8. Special Handling Instructions and Additional Information24 HOUR NOTICE GIVEN PRIOR TO DISPOSAL, MUST BE BURIED.
9. GENERATOR/OPERATOR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fully and accurately described above by proper ship-ping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable internationaland government regulations. 1 hereby certify that the asbestos is not contaminated with hazardous, PCS, and/or any special waste.
Special Waste Approval is issued by signature in the case of a Generic Asbestos Approval.Certification of receipt of asbestos materials covered by this manifest except as noted in Item 12.
Printed/Typed Name and Title Signature Date
WHITE - Disposal Site
DCE-230-97-METRO 7'99
CANARY - Generator(To be mailed by Disposal Site)
PINK - Transporter GOLD - Generator(To be taKen prior to disposal)
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX 1-2
Coal Tar ManifestsWaste Management, Inc.
EarthTechA Tyco International Ltd. Con puny
L.\work\72534\Admin\Reports\Rpttext.doc
METROSPECIAL WASTE MANIFEST DISPOSAL TICKET
BILL TO:WM Milwaukee
GENERATORS SIGNATURE:
WASTE DESCRIPTION:
PROFILE # .
ACCEPTED BY:
DRIVERS SIGNATURE.
300416
A Waste Management Company
mt/~' TRANSPORTER:
GENERATOR:
WM Milwaukee
6olden Marina Causewflf LLC/ / /
Date
DateTRUCK NO.
WHITE t YEU.OW • GENERATOR COPY / PINK - CMSPOSAL SUE COPY / OOLO - TRANSPORTER COPY*Htn cow
TONS/YARDS
DCE-OW-WM
METRO SPECIAL WASTE MANIFEST DISPOSAL TICKET 8nn414
WM MIIWUIIK.-K IMfiVil A WMIe M«n,g,m«nt Company
vvM MilwaukeeTHANSI'OHIt-H
C-*>M»'n Mrinrtn 'CciiiiPway 1.1.COENthAiuH
OENfnATOHS SlGNATUHfc
Cool Tor
WASTF OFSCHIPTION
PROf II F #
ACCUMLOHY0*1*
DRIVERS SIGNATURE ^^.-f ,~-~ '" ' _/ Z TRUCK NO ^ JL/-- ' _____—, TONS/YARDSDilt
WMT1 » VIUOW MNMArOM CO^V ' MNK • (NtPOtAL UTI COf V / OOCO TNAMtMMTIII COf V OCI40*«M
METRO SPECIAL WKSl'E INVIINIF'ES \ tJfSf*l>SAt TICKt I
BSU.1t>:
TRANSPORTER:
GENERATOR:Golden Marina Causeway ILC
QEMERATORS SrSN'AruRE:
WASTE DESCRIPTION.
PROFILE # •
Co/Tar
ACCEPTED BY:
DRIVERS SIGNATURE:
Oat*
797881
A WMtt Mantgwiwnt Company
TONS^ARDSDate
WHITE 4 YELLOW - OCNIfcktO* COPY I PIN*. DISPOSAL SITE COP Y / GOLD • THANSPOHTEM COPY
SPECIAL WASTE MANIFEST DISPOSAL TICKET 769253
A Waste Management Company
aLLTO
RANSPORTER
iENERATOR
JAjrv\Ukt
iENERATORS SIGNATURE:
/ASTE DESCRIPTION
ROFILE*
CCEPTEDBY
AVERS SIGNATURE: .TONS/YARDS
OC£-00»«4 FtoviMd M»
it: 706551 Driver: JBABCOCK«d by: AJONES.amor: 477-106O1B LAKE STATES INDUSTRIAL
311 GREENFIELD AVE EMILWAUKEE. CITY OF WI 53204
.: BERT SNEADtested by. ASAP
10627 Sotrih 27th SIFranMn. WI 53132(414) 761-2100(414) 761-3899 Fax
Date Requested: 08/05/2004Date Dispatched: 08/06/2004
414-645-0635
id Type:9 Site:
SWITCH OUTTONNAGE (METRO)
Map Code: Map Grid: OBR
Quantity P YardafARD SPECIAL WASTE OPEN TOP LOO T 30OSAL PER TON LOO T
Weight Job Special DescriptionCOAL TARMW483719
5-30S AFTER 7AM SEE CREW FOR SPOTTING INSTRUCTIONS-FRIABLE ASB10566-FRIABLE RASB 10567 FRIABLE COAL DUST RASE 10012 12-9-04X) NOT PUT ANY ORDERS IN FOR CUSTOMER WITHOUT CHECKING WITH ANTHONY
ature: Date:
Waste Management of Wisconsin, Inc.10627 S. 27th StreetFranklin, V1-800-640-5571
Tickcti 660426 , Driven ROBERT OBRIEN Date Requested: 04/2L/20O4Opened byi KAMMERMA ~ Date Dispatched: 04/27/2004Customeri 477-10601B LAKE STATES INDUSTRIAL-PREPAY
311 GREENFIELD AVE EMILWAUKEE, CITY OF^-WI 33204 414--64S--0&3S
-:-*^, -;;-; ' TService T)u_antjt'y P YfrdjL Weight Job Special Da»cript.xon __30 YARD SPECIAL WASTE OPEN TOP LOO T 30 ALL TONS DTN COAL TAR riW48-'.7l9DISPOSAL PER TON LOO 7 *,/<-, to -3O..
DEL 5-30S AFTER 7AM SEE CREW FOR SPOTTING INSTRUCTKJNS-FRlABl FNON- FRIABLE RASB 10567 FRIABLE COAL DUST RASB 10'.»12 12--9-04***DU NOT PUT ANY ORDERS IN FOR CUSTOMKK WJ1 HOUT CHF.CKJNP, WTlH ANT HUN
Signature! ( \JV 7 A x Datt-r ..'/ ^ '* '
Wl
Ticket: 66O434 Driven MIKE JOpened by: KAMMERMACustomer: 477-10601B LAKE STATES INDUSTRIAL-PREPAY
Date Requested: O4/21/2OO4Date Dispatched: 04/22/2OO4
MILWAUKEE, CITY OF WI 53204Attn.: BERT SNEADRequested by: TOM J KLA CWD
414-645-0635
Load Type:Dump Site:
SWITCH OUT - -*»"TONNAGE (METfH&
Map Code: Map Grid: OBR
• MM!Service """""Quantity ""P Yards Weight Job30 YARD SPECIAL WASTE OPEN TOP 1.00 T 3O ALL TONS DTNDISPOSAL PER TON 1.OO T
Special DescriptionCOAL TAR MW483719s/o 1O-30S
• tt
i DEL 5-30S AFTER 7AM SEEJ NON-FRIABLE RASB 10567! ***DO NOT PU
Signature:
CREJi 'OR SPOTTING INSTRUCTIONS-FRIABLE ASB10566COAL DUST RASB 10012 12-9--O4CUSTOMER WITHOUT CHECKING WITH ANTHONY
6&L Date:
o WM203-FrankHnWI
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Ticketi 660421 Driven JBABCDCKOpened byi KAMMERMACustomer: 477-10601B LAKE STATES INDUSTRIAL-PREPAY
311 GREENFIELD AVE EMILWAUKEE, CITY OF WI 33204
Attn.i BERT SNEADRequested byi TOM JACOBSQN KLA flpre««
Date Requested!Date Di«p*t<-hed«
414-64 * O6"N«»
Load TypeiDump Sitei
SWITCH OUTTONNAGE
M«P Codei Map Gridi
10627 South 27th St.RunWIn.WI 53132(800) 640-6671(262) 261-4000(414) 761 -3899 Fax
04/22/2004
OBR
30 YARD SPECIAL WASTE OPEN TOPDISPOSAL PER TON
LOO TLOO T
30 ALL TONS DTN_De*cr vptiun
COAL TAR MW483719»/o 10-30«
'EL 3-308 AFTER 7AM SEE CREW FOR SPOTTING INSTRUCTIONS-FRIABLE ASB10S66NON-FRIABLE RASB 10367 FRIABLE COAL DUST RASB 10012 12-9-04***DO NOT PUT ANY ORDERS IN FOR CUSTOMER WITHOUT CHECKING WITH ANTHONYMW483719
• •Ml
:*0Signature! D*tei M M
Waste Management of Wisconsin, Inc.10627 S. 27th StreetFranklin, W153132
SERVICE DESCRIPTION WASTE TYPE BILL CODE MEASUREA^.
SERVICE DATF
TIME OUT
COD AMOUNT
BILL QUANTITY"1
AMOUNT
COMMENTS
SERVICES ACCbP I hD SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE 3!DE AND PAYMENT AGREED TO BE MADE !N ACCORDANCE WITH THE CONTRACTOR'SCURRENT RATE SCHEDULE
CUSTOMERSIGNATURE .
WM 213CIMS
CONTRACTORSIGNATURE
CUSTOMER COPY
••«*•«"[
NMMftUNflfl
Tickvti 660423 Drivvrt JWILTZIUSOp«n«d by i KAMMERMACumtom«n 477-106018 LAKE STATES INDUSTRIAL-PREPAY
311 GREENFIELD AVE EMILWAUKEE, CITY OF MI 93204
Attn.i BERT 8NEADR«qu«mt»d byi TOM J KLA
10827 South 27th St.FrtnkHn.WI63132(800) 840-5571(282)251-4000(414) 781-38M Fta
Service30 YARD SPECIAL WASTE OPEN TOP LOO TDISPOSAL PER TON LOO T-
36b _30 ALL TONS DTN
Soacial DamcrlptionCOAL TAR MW4837199/0 10-3O*
NttM* ; DEL S-30S AFTER 7AM SEE CREW FOR SPOTTING INSTRUCTIONS-FRIABLE ASB1O56&NON-FRIABLE RASB 10567 FRIABLE COAL DUST RA6B KXU2 12-9-04***DO NOT PUT ANY ORDERS IN FOR CUSTOMER WITHOUT CHECKING WITH ANTHONY
Signature Dat«i
•n^«
Milwaukee Solvay Coke and Gas Co. Project - Removal ActionsMilwaukee, Wisconsin Final Report
APPENDIX 11-3
Other Non-Hazardous Waste ManifestsWaste Management, Inc.
Waste Management of Wisconsin, Inc.10627 S. 27th StreetFranldin,W1531321-800-640-5571 - (262) 251-4000 • (262) 251-7257 Fax
SERVICE TICKET AGREEMENT/NON-HAZARDOUS WASTES
88010ORDER NUMBER
TIME IN
SERVICE DATE
/ TIM^OUOUT
DIVISIONNUMBER
CUSTOMER
'ACCOUNTNUMBER
SERVICETYPE
ROUTE ID DISPOSAL ID DISPOSAL TICKET
( ACTION ORDQTY SERVICE DESCRIPTION WASTE TYPE BILL CODE MEASURE BILL QUANTITY AMOUNT ^J
OMMENTS
SERVICES ACCEPTED SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE AND PAYMENT AGREED TO BE MADE IN ACCORDANCE WITH THE CONTRACTOR'SCURRENT RATE SCHEDULE
CUSTOMERSIGNATURE.
WM213CIMS
CONTRACTORRIRNATIJRF
CUSTOMER COPY
iwca•TC MU MBMT
Waste Management of Wisconsin, Inc.10627 S. 27th Street
ACTION ORD QTY SERVICE DESCRIPTION WASTE TYPE BILL CODE MEASURE BILL QUANTITY AMOUNT
»Ilit ,\
MMENTS
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VICES ACCEPTED SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE AND PAYMENT AGREED TO BE MADE IN ACCORDANCE WITH THE CONTRACTOR'S3ENT RATE SCHEDULE .
'I f\ * _ • / / ' . ' /\ / - CONTRACTOR
f finfd: ,'S\ SIGNATURE
* ' ^ ' CUSTOMER COPYOIMb
METRO SPECIAL WASTE MANIFEST DISPOSAL TICKET 763680
BILL TO:Lake States Industrial Service, Inc. A Waste Manag*m«nt Company
TRANSPORTER:.
GENERATOR:.
Eagle Disposal
Golden Marina COUSZW/IY LLC
GENERATORS SIGNATURE:
WASTE DESCRIPTION:
\fl ' IX" DateConstruction A Demolition Debris
PROFILE
ACCFPTPn RV:
DRIVERS SIGNATURE:
Date
TRUCK NO.. .TONS/YARDSDate
WHITE * YELLOW - GENERATOR COPY / MNK • DISPOSAL SITE COPY / QOLO •Tn^^DRTIR COPY OCI
SPECIAL WASTE MANIFEST DISPOSALTICKET
Lake States Industrial Service, Inc.
ISPORTER.
iRATOR: Solden^o.infl Cauazway LLC
GATORS SIGNATURED
^^E nr OPTION: _/___^^ ^r^-uction A DemolitionDefans