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C hem olite Hazardous W aste M anifest
Form 21172 C
Name
fA
US DOT D ESC R IPTIO N '
Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Phone
D ep t. No.
Bidg.
4 < ____
C ontainers 1
No.
Type
(and size)
Date
T o ta l Q uantity
CHEM 9 2 6 0 1
U nits, 2 W t/Vol
EPA W aste
No.
353-1
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Types Of Containers
DM - Metal Drums, Pails
TP - Tanks Portable
DF - Fiberboard or Plastic Drums TT Tank Trucks
CF - Fiber or Plastic Boxes, Cartons
BA - Paper or Plastic Bags CY -Cylinders
S ee W a ste M a n u a l fo r a d d itio n a l typ e s
2 .. Units E n t e r a p p r o p r ia t e l e t t e r
p ' Pounds (Use except as noted below) Q - Gallons(Use for a lt pumpable liquids in 10 gallon ,, containers or larger) Y - Cubic Yards(Use for landfilled ash or sludge only)
If Container Type is "DM" or " DF" , and N o t 55 gallon, Indicate size also, e g. " 5 gal" or "30 gal"
White Bldg, where waste originated
Canary - Incinerator file
P ro d u ced P u rsu an t to th e M ay 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C o n sen t O rd er b etw een 3M and M P C A
3M M P C A 00006608
C hem olite Hazardous W aste M anifest
Form 21172-C
Name
Phone
O U ^ t ' ? / 4 r . o r * ___________
US DO T D ESCR IPTIO N Proper Shipping N am e, Hazard Class, U N /N A No. (m ajor chem ical com ponents)
^3 7 7
D ept. No.
B l d g . ____
C ontainers 1
No.
Type (and size)
w f7
T o ta l Q uantity
chem 9 2 6 0 2
U nits, 2 W t/Vol
EPA W aste
No.
O/
(p & C i?
O o -o d
hf f
B o tto n c u % 2 >
& (>
S S S )M
Q oox
__ ___________
_ ______
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__________________ s7
Types Of Containers
DM - M etal Drum s, Pails D F - Fiberboard or Plastic Drums C F - Fiber or Plastic Boxes, Cartons BA Paper or Plastic Bags CY - C ylinders
"T P - ~T a n k s P o rta b l`e TT Tank Trucks
S ee W a ste M a n u a l lo r a d d itio n a l typ e s
2 ,U. n.i.ts
r . ....
E n te r a p p ro p ria te le tte r
P - Pounds (Use except as noted below) G - G a llo n s (U s e fo r all p u m p a b le liq u id s in 10 g a llo n
contain ers or larger)
Y C ubic Yards(U se for landfilled ash or sludge only)
If C o n ta in e r T y p e Is " D M " or " D F " , a n d Not 5 5 g a llo n , in d ic a te size a ls o , e g. " 5 g a l" or " 3 0 g a l"
White - Bldg, where waste originated
Canary - Incinerator file
P ro d u ced P u rsu an t to th e M ay 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C onsent O rd er betw een 3M and M P C A
3M M PCA00006609
C hem olite Hazardous W aste M anifest
Form 21172-C
Name
J
r .U J
f
US DO T D ESC R IPTIO N
W
Proper Shipping N am e, H azard C lass, U N /N A No. (m ajor chem ical com ponents)
D'-f- P L ^ ~ \o {
Phone
23 4 7
D ep t. No.
Bldg.
tC
C ontainers f
No.
Type (and size)
1 TT
Date
T o ta l Q uantity
3 ooo
c h e m 92603
U n its ,2 W t/Vol
EPA W aste
No.
(j A L , D o o l
<w>
Types O f C ontainers
DM - M etal Drum s, Pails
OF - Fiberboard or Plastic Drum s
TP - Tanks Portable TT - Tank Trucks
C F - Fiber or Plastic Boxes, C artons
B A -P a p e r or Plastic Bags
See Waste Manual for additional types
C Y -C ylin d ers
2 Units E n te r a p p ro p ria te le tte r
p ' Pounds (Use except as noted below)
G - G a llo n s (U s e fo r all p u m p a b le liq u id s in 10 g a llo n
,, contain ers or larger) Y - C ubic Yards(U se for land filled ash or sludge only)
If C o n ta in er Type is " D M " or " D F " , and Not 55 g allo n , in d icate size also , e.g. " 5 gal" or "30 g a l"
While Bldg, where waste originated
Canary Incinerator file
P ro d u ced P u rsu an t to th e M ay 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C onsent O rd er betw een 3M and M P C A
3M _M PCA00006610
C hem olite Hazardous W aste M anifest
Form 21172 C
Name
/ "\
J\f)
a
iJ J
US DOT DESCRIPTION U
Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Phone
9X 4 7
Dept. No.
IJ J fie r i e uJA~rf-fc - t o ~ H
s
? O - n 0 s J o f P////L
Bldg.
/r
Containers 1
No.
Type
(and size)
_ L _ 7T
Dale t
.
Total Quantity
3 do o
c h e m 92604
Units, 2
Wt/Vol
EPA
Waste No.
Q a l Pool
4
Types Of Containers ..
DM - Metal Drums, Pails
TP - Tanks Portable
DF - Flberboard or Plastic Drums TT - Tank Trucks
CF - Fiber or Plastic Boxes, Cartons
BA - Paper or Plastic Bags CY-Cylinders
S e e W a ste M a n u a l to r a d d itio n a l ty p e s
2 Units E n t e r a p p r o p r ia t e l e t t e r ,, _ . ... p ' Pounds (Use except as noted below) G - Gallons(Use for a lt pumpable liquids in 10 gallon containers or larger) Y Cubic YardsfUse for landfilled ash or sludge only)
If Container Type is "DM" or " DF", and N o t 55 gallon, indicate size also, e.g. " 5 gal" or " 30 gal"
White Bldg, where waste originated
Canary Incinerator file
P ro d u c e d P u rs u a n t to th e M a y 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C on sen t O rd er b etw een 3M and M P C A
3M M PCA00006611
C hem olite Hazardous W aste M anifest
Form 21172 C
Name
,
rSi / t
US DOT DESCRIPTION Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Phone
Dept. No.
}U i
Bldg.
tr
Containers 1
No.
Type (and size)
/7
Total Quantity
c h e m 92605
Units, 2
Wt/Vol
EPA Waste
No.
\J I f
/ 1'
/
{ yt
......
Types Of Containers
DM - Metal Drums, Pails
TP - Tanks Portable
DF - Fiberboard or Plastic Drums TT - Tank Trucks
CF - Fiber or Plastic Boxes, Cartons
BA - Paper or Plastic Bags
S ee W a ste M a n u a l fo r a d d itio n a l typ e s
CY - Cylinders
Units E n t e r a p p r o p r ia t e l e t t e r
P - Pounds (Use except as noted below) G Gallons(Use for a ll pumpable liquids in 10 gallon
containers or larger) Y - Cubic Yards(Use for landfilled ash or sludge only)
It Container Type is " DM" or "DF", and N o t 55 gallon, indicate size also, e.g. " 5 gal" or " 30 gal
White - Bldg, where waste originated
Canary Incinerator file
P ro d u c e d P u rs u a n t to th e M a y 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C onsent O rd er betw een 3M and M P C A
3M M PCA00006612
l
1
C hem olite Hazardous W aste M anifest
Form 21172 C Name
US DOT DESCRIPTION Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Phone
Dept. No.
Bld9' 1
ls
Containers 1
No.
Type (and size)
T T0 3 o C & ___ L _
Date
.
Total Quantity
cZ S oo
c h e m 92606
Units, 2
Wt/Vol
EPA
Waste No.
C tL S
y , Cl)
r
**
Types Of Containers
DM - Metal Drums, Pails DF - Fiberboard or Plastic Drums CF - Fiber or Plastic Boxes, Cartons BA - Paper or Plastic Bags
CY - Cylinders
TP - Tanks Portable TT - Tank Trucks See W a s te M a n u a l f o r a d d i t i o n a l ty p e s
Units E n t e r a p p r o p r ia t e l e t t e r
P Pounds (Use except as noted below)
G GallonsjUse for a ll pumpable liquids in 10 gallon containers or larger)
Y Cubic Yards(Use for landfilled ash or sludge only)
If C ontainer Type is "D M " or " D F " , and N o t 55 gallon, indicate size also, e.g. "5 g a l" or "30 g a l"
White Bldg, where waste originated
Canary Incinerator file
P ro d u c e d P u rs u a n t to th e M ay 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C o n sen t O rd er betw een 3M and M P C A
3M M PCA00006613
C hem olite Hazardous W aste M anifest
Form 21172 C
Name _________ /
^
B,d9 s rPhone
__________________ ? - % */ *?___
US DOT DESCRIPTION Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Dept. No.
Containers 1 No. (anJ stre)
-- t Tr
e-t-r?Date
c h e m 92607
Total Quantity
Units,2 Wl/Vol
EPA
Waste No.
Au S c o
-
/O Ji j r
If
7
i
"-
types Ol Containers DM - Metal Drums, Pails DF - Fiberboard or Plastic Drums C F - Fiber or Plastic Boxes, Cartons BA - Paper or Plastic Bags CY - Cylinders
T P -T a n k s Portable TT - Tank Trucks See W aste M a n u a l to r a d d itio n a l types
Units E n t e r a p p r o p r ia t e le t t e r P - Pounds (Use except as noted below) G -Gallons(Usefora//pumpable liquids in 10 gallon containers or larger) Y - Cubic Yards(Use for landfilled ash or sludge only)
If Container Type is "DM" or "D F", and N o t 55 gallon, indicate size also, e.g. "5 gal" or "30 gal"
White - Bldg, where waste originated
Canary - Incinerator file
P ro d u c e d P u rs u a n t to th e M ay 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C onsent O rd er betw een 3M and M P C A
3M M PC A 00006614
C hem ollte Hazardous W aste M anifest
Form 21172 -C
Name . .
r US DOT DESCRIPTION Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
W ^ a)
Phone
Bldg.
92608Date S ' - 7^f7 c h e m
Dept. No.
Containers 1 No. (andfsbe)
Total Quantity
Units,2 Wt/Vol
EPA Waste
No.'
y<rLo 1
TT
zn s m
9*4
V
_________________________, n
i(
J_______________________ / ________________
Types Of Containers
DM - Metal Drums, Pails
TP - Tanks Portable
OF - Fiberboard or Plastic Drums TT - Tank Trucks
CF - Fiber or Plastic Boxes, Cartons
BA - Paper or Plastic Bags CY-Cylinders
S ee W a ste M a n u a l fo r a d d itio n a l typ e s
Un,,its_ Ent.er appropriate letter p ' Pounds (Use except as noted below) G - Gallons(Use for a ll pumpable liquids in 10 gallon ,, containers orlarger) Y - Cubic Yards(Use for landfilled ash or sludge only)
If Container Type is "DM" or "DF" , and N o t 55 gallon, indicate size also, e.g. "5 gal" or " 30 gal"
White - Bldg, where waste originated
Canary-Incinerator file
P ro d u c e d P u rs u a n t to th e M ay 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C on sen t O rd er betw een 3M and M P C A
3M M PC A 00006615
C hem olite Hazardous W aste M anifest
Form 21172 C
Name
/
--------
Phone
__ ________________________ *34-7
r US'DOT DESCRIPTION
Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Dept. No.
Bldg.
/r
Containers 1
No.
Type
(and six)
Date
Total Quantity
chem 92609
Units, 2
Wt/Vol
EPA Waste
No.
Hr
d tJ j
DOGO 2 ?
OH
P om . r*
Types Of Containers
DM - Metal Drums, Pails DF - Fiberboard or Plastic Drums CF Fiber or Plastic Boxes, Cartons BA - Paper or Plastic Bags CY - Cylinders
TP - Tanks Portable TT -Tank Trucks
S ee W a ste M a n u a l fo r a d d itio n a l typ e s
Units E n t e r a p p r o p r ia t e l e t t e r
P Pounds (Use except as noted below) G - Gallons(Use for a ll pumpable liquids in 10 gallon
containers or larger) Y - Cubic Yards(Use for landfilled ash or sludge only)
If Container Type is "DM" or "DF" , and N o t 55 gallon, indicate size also, e.g. " 5 gal" or "30 gal'
White - Bldg, where waste originated
Canary - Incinerator file
P ro d u c e d P u rs u a n t to th e M a y 2 2 , 2 0 0 7 S e ttle m e n t A g reem en t and C o n sen t O rd er betw een 3M and M P C A
3M M PC A 00006616
C hem olite Hazardous W aste M anifest
Form 21172 - C
Name
Phone
3 c Q 6 r . A T ____D e r i - 3 o U o _______
r US DOT DESCRIPTION ^ Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
Dept. No.
Mf U&5)T f l R ' B o 4 W s
3 o <oO
- IS
Containers 1
No. (and s*26)
r? 5 x > M
T n _____ ..................
S .
~i
S ; Vo
, V
/
Total Quantity
CHEM 92610
Units, 2 WtiVol
EPA Waste
No.
(X Z L
v
)
p, ______________________ l
J)
c/
_________________________j t t L m i
)/ 7 ___________________
i
Types Of Containers
DM Metal Drums, Pails
TP - Tanks Portable
DF - Fiberboard or Plastic.Drums TT - Tank Trucks
CF - Fiber or Plastic Boxes, Cartons
BA Paper o r Plastic Bags
See W a s t e M a n u a l t o r a d d i t i o n a l t y p e s
CY-Cylinders
Units E n t e r a p p r o p r ia t e l e t t e r
P - Pounds (Use except as noted below) G - Gallons(Use for a ll pumpable liquids in 10 gallon
containers or larger) Y - Cubic Yards(Use for landfilled ash or sludge only)
It Container Type Is "DM" or "DF", and N o t 5 5 gallon, Indicate size also, eg. "5 gal" or "30 gal"
White - Bldg, where waste originated
Canary Incinerator file
P ro d u ced P u rsu an t to the M ay 2 2 , 2 0 0 7 S ettlem en t A g reem en t and C on sen t O rd er betw een 3M and M P C A
3M M PC A 00006617
C hem olite Hazardous W aste M anifest
Form 21172-C
Name
\
.
^ ' US DOT DESCRIPTION Proper Shipping Name, Hazard Class, UNfNA No. (major chemical components)
\ y ) d j C t i IJ s D $ U j
1
Phone
Dept. No.
Bldg.
/S
Containers 1
No.
Type (and size)
Date
Total Quantity
CHEM 9 2 6 1 1
Units,2 Wt/Vol
EPA Waste
No.
JO Lo
/ 77"
DOO 1
a
,
I
Types Of Containers
DM - Metal Drums, Pails
TP Tanks Portable
D F - Flberboard or Plastic Drums TT - Tank Trucks
C F - Fiber or Plastic Boxes, Cartons
BA - Paper or Plastic Bags
S e e W a s te M a n u a l fo r a d d itio n a l types
CY - Cylinders
Units E n te r a p p r o p r ia t e le t t e r P Pounds (Use except as noted below) G - Gallons(Use tor a i l pumpable liquids in 10 gallon containers or larger) Y - Cubic Yards(Use for landfilled ash or sludge only)
If Container Type Is "DM" or "D F", and N o t 55 gallon, indicate size also, e.g. "5 gal" or "30 gal"
White Bidg. where waste originated
Canary Incinerator file
P rod u ced P u rsu an t to the M ay 2 2 , 2 0 0 7 S ettlem ent A greem ent and C onsent O rder between 3M and M PCA
3M M PCA00006618
C hem olite Hazardous W aste M anifest
Form 21172-C
+N a m e
-.
______ A L D A i Z . ___ i t t A f x o f o S us d o H j e s c r i p t i o n
Proper Shipping Name, Hazard Class, UN/NA No. (major chemical components)
r i F T A \L ClJfT(Ln
4cJ
Q oiJcy^ s ^/,
(czgi)
Phone
i-S tf
Dept.
No.
3oCo
Bldg.
/S
Containers 1
No.
Type
(and size)
ms SS0#y
i/V. /t*f
Date
CHEM 9 2 6 1 2
Total Quantity
Units, 2 Wt/Vol
EPA
Waste No.
2- 1
JO V ) 3o6Q 3
s s t > f S jrA ^
bOO 2. Jhof
PZ
( ''
V. Types Of Containers
2 . ..
' ,,
,,
DM - Metal Drums, Palls
"T"P - Tanks Portable
DF - Fiberboard or Plastic Drums TT - Tank Trucks
CF - Fiber or Plastic Boxes, Cartons
Units E n te r a p p r o p r ia t e l e t t e r P- Pounds (Use except as noted below) G Gallons(Usefora//pumpable liquids in 10 gallon
BA - Paper or Plastic Bags CY - Cylinders
S ee W a ste M a n u a l fo r a d d itio n a l typ e s
containers or laraer) Y - Cubic Yards(Use for landfilled ash or sludge only)
It Container Type is "DM" or "DF" , and N o t 55 gallon, indicate size also, e.g, " 5 gal" or "30 gal'
White Bldg, where waste originated
Produced Pursuant to the May 22, 2007 Settlement Agreement and Consent Order between 3M and MPCA
Canary - incinerator file
3M MPCA00006619
