appendix fsemspub.epa.gov/work/09/1143120.pdfprofile acceptance number is required: profile# i5s\.f...

$: APPENDIX Fsemspub.epa.gov/work/09/1143120.pdfprofile acceptance number is required: profile# i5s\.f blssl~ az. special waste id # 302033 ... n allied weste . industries operation)$
APPENDIX F

Investigative Derived Waste Documentation

SDMS DOCID#1143120

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----· ·---~- -- -------=---------· ====-=-"'

w . .... (/) <C 3: en ::::)

0 c a: <C'

~ J:

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l {

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... ,_~ ....... ;

...... NON-HAZAR.OOUS WASTE MANIFEST . ~ ..

G. Additional Descriptions for Materials L!s~ed Above

....

19. Discrepancy Indication Space

20. Facility Owner or Operator; Certification of receipt of the waste mateiials covered by this manifest, except as noted in item 19.'

F·14C2002. ~8(800)621~8 www.labelmaster.com

Manuest ·Document No.

H. Handling

13. Total

Quantity

for Wastes Listed Above

..

,,

14. Unit

W).Nol.

Year

Rev. 3/9S

4. Generator's Phone ( ~ 1:; 2..) Transporter 1 Company Name

~\\\tti T~\1..~ ~""t~I.G'\-. T\<\.'. 7. Transporter 2 Company Name

9. Designated Facility Name and Site Address

SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, ARIZONA 85326

11. Waste Shipping Name and Description

b.

d.

D. Additional Descriptions for Materials

15. Special Handling Instructions and Additional Information

10. US EPA ID Number C. Facilitiy's Phone

AZR000042184 12. Containers

No

!

E. Handling Codes for Wastes Listed Above

PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HOURS IN ADVANCE PROFILE ACCEPTANCE NUMBER IS REQUIRED: PROFILE# i5S\.f blSSl~ AZ. SPECIAL WASTE ID # 302033


or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19.


SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, AZ 85326


a.

b.

c.

d.

10. US EPA ID Number

AZR000042184

C. Facility's Phone

(623) 393-0085

12. Containers

No

IJ I I 0

13. Total

D. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes Listed Above

-c,;" li: 0-1Jb @ 15. Special Handling Instructions and Additional Information

PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HRS IN ADVANCE I PROFILE ACCEPTANCE NUMBER

IS REQUIRED: PROFILE# 1stl'fb' ~S,Z V



SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE AZ 85326



AZR000042184

'f J:,..) IVC/1

C. Facility's Phone

(623) 393-0085

12. Containers



IS REQUIRED: PROFILE# 7 55 y ~I s 52.~



SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, AZ 85326


a.

b.

c.

D. Additional Descriptions for Materials

15. Special Handling Instructions and


AZR000042184

C. Facility's Phone

(623) 393-0085

12. Containers

1.



IS REQUIRED: PROFILE# 7 ~5 y bl SS ~~

Signature


ORiGINAL - RETURN TO GENE

14. Unit

WWol

~outhwest Regional Landfill , I 4427 S. Highway 85 SITE _J TICKET GRID

. :1, 227494 i uckeye, AZ 85326 I

el: (62':3) 393-0085 WEIGHMASTER I KL00039 KATHY L i

n Allied Weste Industries Operation) I . DATE IN TIME IN ! 002020 17 June 2008 11:27 am

DIVERSIFIED TRANSPORTATION INC DATE OUT TIMEOUT )

DIANNE SHOLL 17 June 20.08 11 ~27 am I LAVEEN, AZ 8533'9 VEHICLE

i ROLL OFF i

DTK 102 2 l Contra;:t: #755Y615524 REFERENCE ORIGIN

' i

Gross Weight 67~ 940.00 lb Stored Tare Weight 40,480.00 lb Inbound SCALE TICKET I - ' I

Net Weight 27,460.00 lb 13.73 TN QTY. ·vt~.lt QESGRIP'Tf()N RATE EXTENsiON TAX TOT At.

13.1 3 TN sw-cmn SOIL ·-~ I

I

'

M"'n~~""·+ • :

NET AMOUNT

TENDERED

CHANGE

CHECK NO.

ft,.. ... ~···'

s th t R . n .I L df II ou wes eg1o a an I SITE J .~ICKET GRID

24427 S. Highway 85 !227577 I;

Bucke~, AZ 85326 '· ... '

Tel: (62S) 393-0085 WEIGHMASTER

(An Allied Waste Industries Operation) t<U)0039 KATHY L ' DATE IN TIME IN . :

002020 .t8 June: 2009 6:10 am DIVERSIFIED TRANSPORTATION ENC DATE OUT TIMEOUT

DEANNE SHOLL 18 .June 2008 6~ !0 Eli\ I'll

LAVEEN~ AZ 95339 VEHICLE ROLL OFF I

';1'f '[ 1 l ~ :;:! 1:

Contn:;a:t: #'755V615524 REFERENCE ORIGIN

li i

: Gross Weight 48 ~ 20(). 00 llb

' Stored Tare Weight 27,340.00 it Knbot.W\0 - SCALE TICKEr Net Weight 20~860.00 lJ.b 10.43 TN li

Q'FY. UNIT DESCFI!I"TTQN RATE EXTeHSIQN TAX TOTAL

10.4 31 TN SI>~-CONT S01L ·'·¥: .·· .. '

'

!i'co'~.,..,' of""'""*'. NET AMOUNT

CHANGE

}' '\~ l1\J ~ SIGNATURE-'\'-'' ·'-------5-· -='--------------

CHECK NO.

------·--

·- ·---~-- ----- ~- -- ---- ----.. -----· --- --·- ··---··· ---···.-·---·-.. ----- .----·· ···--- .. --·-·

Southwest Regional Landfill 24427 S. Highway 85 Buckefe,AZ 85326 Tel: (623) 393-0085 (An Allied Waste Industries Operation)

002020 DIVERSIFIED TRANSPORTAT!Oii;J ll\lC

DIANNE SHOLL LAVEEN, AZ "85339

Contract: #755¥615524

81""056 We'i ght 53~000.00 St.::~ red Tare Weight lf4 ~ 320.00

Net We:i.ght 8~680.00 9T:v. UNIT DEscRIPTION

4.~ 4 TN sw...;cmn SOIL

lb lb lb £.-t .:0 ;3.{~

-------·--- --- ----- ---------------- -- ---- --···--- -- ---~

SITE TICKET GRID

a •• ;ft 22741 () WEIGHMASTER

KL0003'9 KATHY L DATE IN TIME IN

17 June 2008 7:08 am DATE OUT TIMEOUT

17 June 2008 7:08 am '' VEHICLE ROLL OFF

Enbt:ltUud -~ SCALE TICKET TN

RATE EXTENSION TAX TOTAL

NET AMOUNT

TENDERED

CHANGE

CHECK NO.

-··· -·--- ----- - -·- -- -- -- --- ---- ~ . ----- .

·--- ---- ·-- -- --··· ---- -- ---- ~-- -··-- -- ---, --- -----·- ---- ----- -- --- -----·

"'outhwest R gion--1 L df"ll ::> e a an I SITE

d:ICKET GRID i ~4427 S. Highway 85 2276129 :

3uckeye, AZ 85326 '".!l

rei: (623) 393-0085 WEIGHMASTER ~n Allied W..ste Industries Operation)

KL00039 KATHY L l . DATE IN TIME IN

: 002020 U3 JI.Jrli12 2008 9:09 am

: RHVERSIFIEO TRANSPORT A 'f I ON .U~C DATE OUT TIMEOUT DIANNE SHOLL lS June 2008 9:09 am i

I LAVEEN~ AZ 8:'$339' VEHICLE ROLL OFF

I DTf u ·~ ? I Cord.:1ac:t~ fi755Y615524 REFERENCE ORIGIN :

Gl-oss Weight ·42 ~ 620.00 ~b ·' : StCiiiHJ Ta;e We'igrd: 127 ~ 34-0. 00 ]b {MbC·Lind -.- SCALE TICKET Net t..leight 25~280.00 1b ?' ~!iS4 TN Ql'Y. UNIT 0Escfll1?1'101!f RATE EXTENSION TAX TOTAL 7 .e 4 TN SW-CONT SOIL ! ! .,

i 1:

I

' I

:#! •. '· .-'I'~. '""''"' ·-- i:".ill 'I..> ~

NET AMOUNT J

TENDERED

CHANGE

CHECK NO.

Q_ r ALUEDWASU

002020

O/A: SouthwesfR·eglona'l LandflU 24427 S. Highway 85

Buckeye, Arizona 85326 Tel: (623) 393-0085

(An Allied Waste Industries Operation)

DIVERSIFIED TRANSPORTATION INC D f. {H•-lNE SHOLL LAVEEN. AZ 85339

Contract: ff755Y615524

Gross We1ght ~4.120.00 lb St0red T2~~ Welght 43.660.00 lb

N~t Weight 20!460.00 lb 10.23 TN ciTY. UNIT 'DEScRIPTION

St..i-CmJT SO!L

SITE GRID

0 49995 WEIGHMASTER

December· 2008

REFERENCE ORIGIN

TIME IN

11:59 e')ifl

TIMEOUT

11:59 ~m ROLL OFF

Inbound - SCALE TICKET

!EXTENSION TAX TOTAL

NET AMOUNT

TENDERED

CHANGE

CHECK NO.

---'··--·.,-··-·-'-------·-·---·--:---.. ;------.. --·-·-··-·----·-·-·--·.._._.__ .. _._. __ .. _~--·~·-

9.

11.

SOUTHWBST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, ARIZONA 85326"

s·hippin~, Name and Description

US EPA ID Number

0"0 0 0 4 2 1 8 4 ., ..

B. Transporter's Phone

c. Facilitiy's Phone

393-0085 12. containers

No

E,tC?J.s. <.iCv,l .... : .

13. Total

i


15. Special Handling Instructions and Additional lnforinatiol}.

PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HOURS IN ADVANCE PROFILE ACCEPTANCE NUMBER IS REQUIRED: PROFILE# 7 )~ j le ,{55 Z Lj AZ .. SPECIAL WASTE ID # 302033 '

~ - -

14. Unit

i " th .60U. •We$ tA . ··.•.eg1ona I L df"ll ·.an.· I 24427 S, Highway 85 Buckeye, AZ 85326 Tel: (62S> 393"0085 (An Allied W.f!Ste llldustries Operation) .

002020 OIVERSIF'IED TRANSPORTATION

DIANNE SHOLL LAVEEN, A2 85339

Contract: #755Y615524

Gross Stored Tare

SITE JTICK~ GRID

01 . 207947 WEIGHMASTER

RM00120 ROSEANNA M DATE IN TIME IN

as Jarn..1.arv 2009 1:31 INC DATE OUT TIMEOUT

25 J.anuarv aoos 1:31 VEHICLE ROUOFF

_ti_Tot_ 1 t"lel: .. ':1 REFERENCE ORIGIN

fnbound - SCALE TICKET

. . ~ .

1;)1'11

£)ffi

NET AMOUNT

,..,.,...,,..._;.·~""""'"'··.,,._.,..,.,.;:-·-:......;..·'i,~.:.,.,__~~~- ~ ~-~~· ·~· -~--~~ -~~ "~ ~-~;_,.;;,.~-~~ ,.;,:,;,..,~~~ ... ,;_;;,~· ~~-~:-·-- --'~-~:--"""'-~-~~-.,;..-,....-,.~---·-· --~,..-...-·. -;~~;--.;.

9. Designated Facility Name and Site



a.

b.

c.

d.

D. Additional Descriptions for Materials Listed Above


10. US EPA 1D Number

AZR000042184

JV'l~: v s~ S\-'. I S~E IVo AZ.. 'lSoYV

C. Facilitiy's Phone

393-0085 12. Containers 13.

Total No.

J


PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HOURS IN ADVANCE PROFILE ACCEPTANCE NUMBER IS REQUIRED: PROFILE# 7~S '(bf S.5l 'f AZ. SPECIAL WASTE ID # 302033


20. Facility Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19.

SouthWest. Regional Landfi II 24427 S. Highway 85 Buckeye, AZ 85326 Tel: (6a3) 393-0085 (An Allied Wpste Industries Operation)

DIVEkSIFfED TRANSPORTATION INC I)- I ?~t\if~JE: S t·i[\L~L~ L,_l~,vt::t-::l'J. ~ t\2 E~.:~~~:Jc;'

Contra~t; #755Y615524

c;r- c( 0;·.s· ~~e i ~Jtt t Stored Tare Weight

'? {i '1 :3Li· (J " ()(\ 1 b ::18 ~ b60. 00 1 b

GRID

WEIGHMASTER

DATE IN TIME IN

DATE OUT TIMEOUT

VEHICLE ROLL OFF

n1,r 1 ·~ ;::v:c REFERENCE ORIGIN

J nbcund · SCjC~LE T! CKE1 lb 18.B<t TN

Sl,.l-·CD!'H SOIL

NET AMOUNT

TENDERED

CHANGE

CHECK NO.




a.

b.

c.

d.

ALLIED WASTE


AZR000042184

C. Facilitiy's Phone

393-0085 12. Containers

No

!?" ~..., • . ":- u:•

13. Total



PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HOURS IN ADVANCE 7 •

PROFILE ACCEPTANCE NUMBER IS REQUIRED: PROFILE# 7.5 S Y 6! S~l,V AZ. SPECIAL WASTE ID # 302033


20. Facility Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19.

14. Unit

:r.· . ' ) .... :-··.

··.· . . ,.

~. :

.,

· ... , ... _ .......

·\. #.~ 1.... ~~ 'If

NON-HA'ZARDOU.$ WASTE MA"'IFEST. ... :· ";- . . ·:··

G. Additional Descriptions for Materials Listed Above

, 19. Discrepancy Indication Space

20. Facility Owner or Operator, Certification of receipt of the waste materials covered by this manifest, except as noted in item 19.

F-14 02002 . LABEtAASTER. 411 (BOo) 621-5808 www.labelmaster.com

Manifest Document No.

H. Handling Codes for ·

..-.. ~ .....

.<;"

Listed Above

: t.

14. Unit

·wtNol.

Year

Rev. 3/95

· . .:

:)

.".._!

.·, · ... ·.:

'-11 DIVERSIFIED

\; 6212=~!85339 17571

Tel (602) 455-0350 Fax (602) 455-0351

Date -----'-4-F-----/ J 1-"------------ 20 Cf1 In Account with---tvrAraf-+1· '-J___L_.>..Lio./e'""'-'g"'+'oc'-"'-u_VY1.:....:cC0"-'-m-'-----'-"' .~'-=---~~~~~~~-Address

Pick Up At DT\ \\r1r-d ttu!okJd , S+_ GJJud l 1-ecu- -fl-2 llli dtt Vl (l}V] us Deliver To

START 11; 00 DELAY REASON FOR DEDI : TRUCK:

0~ ~

TIME • TIME

FINISH 3 ' O(()Vrf ~~RS 3 hIll)_ TRAILER:

TIME ,

' QUANTITY DESCRIPTION UNIT RATE AMOUNT

DP l ; l'lY Bt n tf=: !JlS -to \nt "J().J-Q'

Y'f-h A 1\11 in ()T( \_ rAY?i. v

-l van~ {OR 3 /S-OD ;)}5 m Hlfv@ 10 ·;, .A~ CD

TOTAL c24'l 50 GENERATOR/SHIPPER TERMS: NET 30 DAYS. 1M1112% SERVICE CHARGE PER

MONTH IS CHARGED TO ALL PAST DUE ACCOUNTS. IF SUIT

BY IS INSTITUTED BY SELLER, REASONABLE COSTS AND ATTORNEYS' FEES AS FIXED BY THE COURT SHALL BE PAID BY THE BUYER.

DRIVER REC'D BY

p=ofl DNERSIFIBI

\; 6212~~~~!85339 17969

Tel (602) 455-0350 Fax (602) 455-0351

Jim~ Date

In Account With 4 [!) C. E Address ________________________________ _

PickUpAt _ _::D,.,__~T~/.__ __________________________ _

Deliver To J .2, J fo Cf VJ /.JubhlE'_ G oo If r?Jl..- A '7 /

START 53 l) DELAY REASON FOR DELAY: TRUCK: OY TIME TIME

FINISH 7 3 0 NET z.. TRAILER:

TIME HOURS

QUANTITY DESCRIPTION UNIT RATE AMOUNT

P/v ~ 2. Z.4 {'V, Drt ln,..l i v ~ ~ .:f::lu. z 2. '-l "1--o )-='bs:+e Pla~P ? U flU'<;. lt-- b~r'\ Re.f.vrl"\ i-o D\1 \-fnhS \.~L\ L- 15~ 150 ov w-eQe IO'fb l~ oo ~ lJJ.rvJvv --z_ 4t5. () () YO 00

TOTAL GENERATOR/SHIPPER TERMS: NET 30 DAYS. ~-1112% SERVICE CHARGE PER


BY IS INSTITUTED BY SELLER, REASONABLE COSTS AND ATTORNEYS' FEES AS FIXED BY THE COURT SHALL BE PAID BY THE BUYER.

DRIVER ./_././/:)/~ REC'D BY L

I

"/'!1 DIVBISFIED \; 6212~~~!85339

18162

Tel (602) 455-0350 Fax (602) 455-0351

Date ~-Ji lt - t .-' lnAccountWith~~4~ )C:OJ4,z9 r~)c

Address ________________________________ _

Pick UpAt__:D=->'---'"""------------------------------

01", /3JhjLeJ!Jv.h&J -57-:. P~')( ,;!}__~ e 1ver o ' - .... /

START I--. ?0 DELAY REASON FOR DELAY: TRUC/ L-:2

TIME -#- TIME

FINISH '-/ • ·5o TIME ,

NET 6 HOUR<t

TRAIL~

QUANTITY DESCRIPTION UNIT RATE AMOUNT

D/J Yt::Jv~ I . .J . ./J /?;;f.,""' -:A)-:7 [),.., hJ>. ,.J _q}-_;~h f~];./l . ./..<.;..

(}_/ ~~ A). /3,--" ~-..#2 2 S£--1 YYlDIA~c/ ;f.-:w) ... ~. 1:',}/} t?Lh ~~~w ~ 1/.ccn lf?f.Acr/v-.

Re.ft''"' ' -ID [)f)

llr-o.n~ I. tL :3 h5.oo 225 00 k).pO fl {0 ./o 22- s

Ew llJLw:i- 2 45-00 qo 0

TOTAL ?31 15( [) GENERATOR/SHIPPER TERMS: NET 30 DAYS. 1·1112 % SERVICE CHARGE PER


BY IS INSTITUTED BY SELLER, REASONABLE COSTS AND ATTORNEYS" FEES AS FIXED BY THE COURT SHALL BE PAID

' ~ BY THE BUYER. /J7t .c ,~ DRIVER lt-, ~ / REC'D BY

/ /

ALUEDWASTE

~ON-Hf.ZARDOUS WASTE MANIFEST

3. Generator's Name and Mailing Address

Crane Co. 1oo -!=';rsi Srarnford Place..

Sfnn.t.t-ovd, CoPlnecbicC-rt OG'J02-4. Phone ( J) .

5. Generating Location (if different)

1o:;z ~. ufchfield 'Road Gtoodyea.r, A;<: ss-338

6. Phone ( )

9. Transporter 's Phone

11. US EPA 10 Number 12. Transporter #2's Phone

13. Designated T/S/0 Facility Name and Site Address 14. US EPA 10 Number 15. Facility's Phone

c.

d.

Soufhwe5t Recf.iona{ LandfiLl 2...442"1 S odh f..lrNJ s-s-, T6a.c/L.eye.

A7...

21. Additional Descriptions for Materials Listed Above

and Information

of receipt waste I I

ORlGiNAL • RETURN TO GENERATOR

)~\f.( ALLIED WASTE

NON-HAZARDOUS WASTE MANIFEST '

3. Generator's Name and Mailing Address

CroVJe Co· loo f:irtit Sfafl,{ford 'Place flfaMPord 1 Co11nec;ticu/;; 06Cf02

4. Phone ( ~.

13. Designated T/SID Facility Name and Site Address

5o~t-\tiwe5t 'RCWlOn.al La.nd{ilf 2.442-1- Sou+~ I-IWJ S'S, 8qckeye.

Az.. ~532G / 16. Waste Shipping Name and

Soil- Tf?W

21. Additional Descriptions for Materials Listed Above


or Operator:

5. Generating Location (if different)

102 5 · ukhfield RoQd C!:[oodyear, Az. 8'5"331?

6. Phone ( )

8. us 9. Transporter

602-455-11. US EPA ID Number 12. Transporter #2's Phone

14. US EPA ID Number 15. Facility's Phone

17. Allied Waste Approval# and Exp. Date

(except as noted in Item

Signature

ORIGINP,L - RETURN TO GENERATOR

i!tl ' - :!4427 S. Highway 85 SITE ' I TICKET

Buckeye, ArizonL 85326 Tel: (623)393:0085 ,1

01 276771 . {An Allied Waste Industria~ Operatijln)

O/A Southwest Regional landfill

. DATE IN . KL00039 KATHY . DATE OUT

002272 27 July 2009 AMEC GEOMATRIX VE;HICLE

8777 E VIA DE VENTURA #396 27 July 200 SCOTTSDALE, AZ 85258 REFERENCE ORIGI

DTI 112 2e ~ . ·~

Gross Weight 51,720.00 lb

TN SW-CONT SOIL

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