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A. 2 HazaWoua Wasta Managb Waste Generator Services Fingerprint Verification Analysis Checklist General Information Date submitted: & I I-/. e5 Sr- WDR #: t, 12 t i 7 Item #: l COC # if applicable): PIW# (if applicable): Generator: 1 d► OVOcG. 13 re.W ✓leIVE2 HM Field Technician: Bld ./Room: p RMMA ❑ Yes No WEF # if applicable): WEF annual verification: ❑ Yes C2 No PKE # if applicable): Conditional Profile ❑ Field Operations Complete applicable tests, as indicated P F N/A (P = Pass F = Fail N/A = Nnt Annlirnhlal ❑ 0 ❑ Waste Form: ❑ Solid Liquid (❑ AQ ❑ NAL) ❑ Sludge (estimated free liquid content range ) ❑ Gas ❑ Sediment (5 5% solids) - Additional info. (e.g., powder, granular, particle size?): ❑ ❑ Jo I Odor: ❑ No ❑ Yes, Explain: ❑ ❑ 10 1 If liquid, from top to bottom including non-li uid layers: pH Layer Percentage Color Turbidity S=Solid L=Li uid % volume light, medium, dark clear, cloudy, opaque Viscosity ve It, It, med, heavy ❑ I Specific Gravity 110 L a Normality ❑ 2 ❑SE;M 19 6> c� -c_ ❑ 3 ❑S ❑ ❑ ❑ ❑ ❑ ❑ Containerco tents match WDR: Identi [es ❑ No Quanti /Wei ht/Volume Yes ❑ No Container Size G'Yes ❑ No ILI I Waste container label matches WDR and container contents Yes [:]—No 1110 ❑ 1 Packing or sorbant material present ❑ Yes ZNo If yes, what type quantity) ❑ 10 © I pH_ ❑ Meter pH ❑ Paper Possible interference: ) ❑ ❑ 190 1 Alcohol Hydrometer test % Alcohol Elio ® lPeroxide test m Stabilized with Hydroquinone ❑ Yes ❑ No Final Peroxide ppm ❑ ❑ Eg Oxidizer test ❑ Positive ❑ Negative ❑ ❑ 11K I Cyanide test ❑ Positive ❑ Negative ❑ ILI Sulfide test ❑ Positive ❑ Negative Field verification performed by: Emp. #: mo? -t Date: A- /y_ og-. Field verification ❑ Pass ❑ Fail -+ if failure, complete back of form (Comments/Resolutions) Fingerprint Verification Laboratory Check all aDDlicable tests and document re.cult.c nn W0N Verifirntinn Ractiltc Rvntwt ❑ Rad. screening ❑ Cyanide test ❑ Solubility ❑ pH ❑ Oil & Grease ❑ I Specific Gravity ❑ Normality ❑ Oxidizer screen ❑ Sulfide test ❑ Flash point ❑ Paint filter ❑ Total solids ❑ Solvent screen: ❑ ❑ PCBs Peroxide test ❑ Water compatibility ❑ Other: ❑ Metals: ❑ Arsenic ❑ Barium ❑ Cadmium ❑ Chronuum Cobalt ❑Nickel ❑ ❑ Selenium ❑ Silver ❑ Zinc ❑Copper ❑Lead ❑Molybdenum ❑ Other Elements, Anions; ❑ Bromine ❑ Chloride Chloril Cyanide ❑ Fluoride ❑ Nitrate ❑ Sulfat Lab verification performed by: Emp. Date: K Z &,j Conditional Profile selecte,'• WEF# Lab verification ' Xass I, Fail _> if failure, complete back of lam, m (Comments/Resolutions)