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APPENDIX F
Investigative Derived Waste Documentation
SDMS DOCID#1143120
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----· ·---~- -- -------=---------· ====-=-"'
w . .... (/) <C 3: en ::::)
0 c a: <C'
~ J:
I z 0
l {
z
... ,_~ ....... ;
...... 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
19. Discrepancy Indication Space
or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19.
9. Designated Facility Name and Site Address
SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, AZ 85326
11. Waste Shipping Name and Description
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
19. Discrepancy Indication Space
9. Designated Facility Name and Site Address
SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE AZ 85326
15. Special Handling Instructions and Additional Information
10. US EPA ID Number
AZR000042184
'f J:,..) IVC/1
C. Facility's Phone
(623) 393-0085
12. Containers
E. Handling Codes for Wastes Listed Above
PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HRS IN ADVANCE I PROFILE ACCEPTANCE NUMBER
IS REQUIRED: PROFILE# 7 55 y ~I s 52.~
19. Discrepancy Indication Space
9. Designated Facility Name and Site Address
SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, AZ 85326
11. Waste Shipping Name and Description
a.
b.
c.
D. Additional Descriptions for Materials
15. Special Handling Instructions and
10. US EPA ID Number
AZR000042184
C. Facility's Phone
(623) 393-0085
12. Containers
1.
E. Handling Codes for Wastes Listed Above
PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HRS IN ADVANCE I PROFILE ACCEPTANCE NUMBER
IS REQUIRED: PROFILE# 7 ~5 y bl SS ~~
Signature
19. Discrepancy Indication Space
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:'$339' VEHICLE ROLL OFF
I DTf u ·~ ? I Cord.:1ac:t~ fi755Y615524 REFERENCE ORIGIN :
Gl-oss Weight ·42 ~ 620.00 ~b ·' : StCiiiHJ Ta;e We'igrd: 127 ~ 34-0. 00 ]b {MbC·Lind -.- SCALE TICKET Net t..leight 25~280.00 1b ?' ~!iS4 TN Ql'Y. UNIT 0Escfll1?1'101!f RATE EXTENSION TAX TOTAL 7 .e 4 TN SW-CONT SOIL ! ! .,
i 1:
I
' I
:#! •. '· .-'I'~. '""''"' ·-- i:".ill 'I..> ~
NET AMOUNT J
TENDERED
CHANGE
CHECK NO.
Q_ r ALUEDWASU
002020
O/A: SouthwesfR·eglona'l LandflU 24427 S. Highway 85
Buckeye, Arizona 85326 Tel: (623) 393-0085
(An Allied Waste Industries Operation)
DIVERSIFIED TRANSPORTATION INC D f. {H•-lNE SHOLL LAVEEN. AZ 85339
Contract: ff755Y615524
Gross We1ght ~4.120.00 lb St0red T2~~ Welght 43.660.00 lb
N~t Weight 20!460.00 lb 10.23 TN ciTY. UNIT 'DEScRIPTION
St..i-CmJT SO!L
SITE GRID
0 49995 WEIGHMASTER
December· 2008
REFERENCE ORIGIN
TIME IN
11:59 e')ifl
TIMEOUT
11:59 ~m ROLL OFF
Inbound - SCALE TICKET
!EXTENSION TAX TOTAL
NET AMOUNT
TENDERED
CHANGE
CHECK NO.
---'··--·.,-··-·-'-------·-·---·--:---.. ;------.. --·-·-··-·----·-·-·--·.._._.__ .. _._. __ .. _~--·~·-
9.
11.
SOUTHWBST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, ARIZONA 85326"
s·hippin~, Name and Description
US EPA ID Number
0"0 0 0 4 2 1 8 4 ., ..
B. Transporter's Phone
c. Facilitiy's Phone
393-0085 12. containers
No
E,tC?J.s. <.iCv,l .... : .
13. Total
i
D. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes Listed Above
15. Special Handling Instructions and Additional lnforinatiol}.
PLEASE NOTIFY FACILITY OF SHIPMENTS 24 HOURS IN ADVANCE PROFILE ACCEPTANCE NUMBER IS REQUIRED: PROFILE# 7 )~ j le ,{55 Z Lj AZ .. SPECIAL WASTE ID # 302033 '
~ - -
14. Unit
i " th .60U. •We$ 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
SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, ARIZONA 85326
11. Waste Shipping Name and Description
a.
b.
c.
d.
D. Additional Descriptions for Materials Listed Above
15. Special Handling Instructions and Additional Information
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
E. Handling Codes for Wastes Listed Above
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
19. Discrepancy Indication Space
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.
9. Designated Facility Name and Site Address
SOUTHWEST REGIONAL LANDFILL 24427 SOUTH HIGHWAY 85 BUCKEYE, ARIZONA 85326
11. Waste Shipping Name and Description
a.
b.
c.
d.
ALLIED WASTE
10. US EPA ID Number
AZR000042184
C. Facilitiy's Phone
393-0085 12. Containers
No
!?" ~..., • . ":- u:•
13. Total
D. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes Listed Above
15. Special Handling Instructions and Additional Information
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
19. Discrepancy Indication Space
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
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 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
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. /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
22. Special Handling Instructions and Additional Information
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