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Common Name(same as Item#5): OIL FILTERS 16. Check all that apply. Marking any of these mayrequire additional documentation or follow-up information. 16a. 16b. 16c. Aerosols _ ❑ Metal Powders ❑ Used oil? PCBs? Air Reactive ❑ 0xiftr ❑ (per 40 CFR 279) Yes❑ No® (per 40 CFR 761) Yes❑ No Ammonia ❑ Pathogen ❑ 624202 ❑ Pesticide ❑ A i a t ❑ Polvmerimble ❑ Biokioical ❑ Pvroohodc ❑ Used oil mixed with If yes,PCB <50 PPM ❑ Carcinogen ❑ Radioactive ❑ hazardous waste? Yes❑ No® concentration? >50 PPM ❑ h 1 ag Agent ❑ Sanitary ❑ SomDressed Gas ❑ Shaws ❑ Etioloolcal xins 0 S egusly ❑ Total Halogens < 1000 PPM❑ Greater than 50 Yes❑ No❑ E31*2 e ❑ Combustible ❑ (TX)concentration? > 1000 RPM❑ PPM source? Herbicide ❑ gulfide ❑ Infectious ❑ To wrature 16d. Insecticide ❑ Control Reguired ❑ Does this material require any special handling? Yes❑ No Lab Pam ❑ Temperature Medical ❑ Sensitive ❑ Fin ❑ Water fleactive- ❑ If yes.explain: 16e. 16f. Volatile Organic Compound>500 PPM? Yes❑ No® Do any exclusions/exemptions apply? Yes❑ No Subject to Subpart CC? If yes, note the exclusion/exemption: (per 40 CFR 265.1080-1091) Yes❑ No 16g. 16h. Additional Comments: Generated from electroplating process? Yes❑ No 17. Transporter:Heritage Transport 0 Other (Complete below) 18. Packaging: Size: 19.Volume: Transporter Name Bulk Liquid Address Bulk Solid ❑ City,State,Zip Cu Yd Bag/Box ❑ 1/Year Contact/Phone Cylinder ElDrum ® 55 1/Shipment US EPA ID No. Tote(Metal) ❑ Tote(Poly) 20. Check or List Attachments: Lab Data MSDS Cylinder Form L1 Packing List Ll Other list 21. CERTIFICATION Sign and date the certification. I hereby certify that I am an authorized agent of the generator,and warrant on behalf of the generator,that all information submitted herein and attached documentation contains true,accurate and complete descriptions of this material. Any sample submitted for analysis is representative of the material being offered for approval. All relevant information regarding known or suspected hazards in the possession of the generator has been disclosed. I will notify Heritage Environmental Services,LLC or Heritage-WTI,Inc.of any changes in generator status,any information on this form,or any information on the attachments. This certification and signature apply to this form,to all attachments checked in section 20,and to the land disposal restriction notification (LDR)generated from this information. Signature Printed Name Date Company 22. COMPLETE THIS SECTION FOR NON-HAZARDOUS MATERIAL BEING MANAGED TO A NON-HAZARDOUS PROCESS EXAMPLE: SUBTITLED LANDFILL or MASS-BURN 22a.Does this waste exhibit the chemical characterization of an oxidizer? Yes No 22b.Is this waste a listed 22c.This waste is not characteristically hazardous for D001-13043 based on attached lab waste?(U,P,K,or F codes) Yes❑ No ® data mark LD) attached MSDS mark MSDS),or g enerator knowled a mark GK). DO01(Ignitability) TCLP VOLATILES 11 TCLP SEMI-VOLATILES D038 Pyridine D002(Comasivity) DO1S Benzene D023 o-Cresol D041 2,4,5-Trichlorophenol D003(Reactivity) D019 Carbon Tetrachloride D024 m-Cresol D042 2 4,6-Trichloro henol TCLP METALS D021 Chlorobenzene D025 p-Cresol HERBICIDES A PESTICIDES D004 Arsenic D022 Chloroform D026 Cresol D012 Endrin D005 Barium D028 1,2--Dichloroethane D027 1,4-Dichlorobenzene DO 13 Lindane DODS Cadmium D0291,1-Dichloroethylene D0302,4-Dinitrotoluene D014 Methoxychlor D007 Chromium D035 Methyl Ethyl Ketone D032 Hexachlorobenzens D015 Toxaphene DOW Lead 0039 Tetrachloroethylene D033Hexachlorobutadiene 0016 2,4-D D009 Mercury D040 Trichloroethylene D034 Hexachloroethane DO 17 2,4,5-TP(Silvex) D010 Selenium D043 Vinyl Chloride D036 Nitrobenzene D020 Chlordane D011 Silver D037 Pentachlorophenol D031 Heptachlor SLMHESWTIWSSFORMSEP2008 2 of 2