EPA Form 8700-22 "Uniform Hazardous Waste Manifest"

What Is EPA Form 8700-22?

This is a legal form that was released by the U.S. Environmental Protection Agency on December 1, 2017 and used country-wide. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on December 1, 2017;
  • The latest available edition released by the U.S. Environmental Protection Agency;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of EPA Form 8700-22 by clicking the link below or browse more documents and templates provided by the U.S. Environmental Protection Agency.

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Download EPA Form 8700-22 "Uniform Hazardous Waste Manifest"

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Please print or type.
Form Approved. OMB No. 2050-0039
4. Manifest Tracking Number
1. Generator ID
2. Page 1 of 3. Emergency Response Phone
UNIFORM HAZARDOUS
Number
WASTE MANIFEST
5. Generator's Name and Mailing Address
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
10. Containers
9a.
11. Total
Unit
12.
13. Waste Codes
and Packing Group (if any))
Quantity
HM
No.
Type
Wt./Vol.
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
15. GENERATOR’S/OFFEROR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged,
marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Port of entry/exit:
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Partial Rejection
Full Rejection
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
1 1 9 . . Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
4.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
Month
Day
Year
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
Please print or type.
Form Approved. OMB No. 2050-0039
4. Manifest Tracking Number
1. Generator ID
2. Page 1 of 3. Emergency Response Phone
UNIFORM HAZARDOUS
Number
WASTE MANIFEST
5. Generator's Name and Mailing Address
Generator's Site Address (if different than mailing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
Facility's Phone:
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
10. Containers
9a.
11. Total
Unit
12.
13. Waste Codes
and Packing Group (if any))
Quantity
HM
No.
Type
Wt./Vol.
1.
2.
3.
4.
14. Special Handling Instructions and Additional Information
15. GENERATOR’S/OFFEROR’S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged,
marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Signature
Month
Day
Year
Generator's/Offeror's Printed/Typed Name
16. International Shipments
Port of entry/exit:
Import to U.S.
Export from U.S.
Transporter signature (for exports only):
Date leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
Transporter 1 Printed/Typed Name
Signature
Month
Day
Year
Transporter 2 Printed/Typed Name
Signature
Month
Day
Year
18. Discrepancy
18a. Discrepancy Indication Space
Quantity
Type
Residue
Partial Rejection
Full Rejection
Manifest Reference Number:
18b. Alternate Facility (or Generator)
U.S. EPA ID Number
Facility's Phone:
18c. Signature of Alternate Facility (or Generator)
Month
Day
Year
1 1 9 . . Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.
2.
3.
4.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printed/Typed Name
Signature
Month
Day
Year
EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete.
DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM