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Sierra Chemical Co. <br /> Hazardous Waste Management Plan <br /> Appendix E: Hazardous Waste Survey Template <br /> WASTE DETERMINATION SURVEY <br /> This survey is intended to assist Sierra Chemical Co. in determining if a waste exhibits hazardous waste <br /> characteristics in accordance with Title 40 Code of Federal Regulations (CFR)section 262.11 and Title 22 <br /> California Code of Regulations section 66261.10.The following table should be completed for each <br /> waste stream generated by the facility and approved by the Plant Manager and/or EHSS Manager. <br /> General Information <br /> 1. Name of Waste Stream: <br /> 2. Brief Description of Process Generating Waste: <br /> Hazardous Waste Determination <br /> Answer yes or No to the questions below. If you are Yes No Comments <br /> unsure,write reason(s)in comments. <br /> 3. Is the waste a product of a process line or operation that <br /> uses hazardous materials? <br /> 4.Are there Safety Data Sheet(s) (SDS) available for the <br /> Material? <br /> 5. Using generator knowledge and/or SDSs does the waste exhibit ANY of the following hazardous waste <br /> characteristics including: <br /> a) Ignitability: Flash point of less than 140 degrees <br /> Fahrenheit (40 CFR 261); <br /> b) Corrosivity: pH of less than 2 or greater than 12.5 <br /> (40 CFR 261); <br /> c) Reactivity: Normally unstable and undergoes violent <br /> changes, reacts violently with water, and readily <br /> capable of detonation (40 CFR 261); <br /> d) Contains concentrations of a constituent in excess <br /> of regulatory thresholds as identified in 40 CFR 261; <br /> e) Is the waste a listed waste (P-list, Wist, F-list, and K- <br /> list); and/or <br /> f) Is there reason to believe the waste can cause, or <br /> significantly contribute, to an increase in mortality, <br /> increase in illness, irreversible effects, or poses a <br /> threat to human health and/or the environment? <br /> (22 CCR 66261) <br /> If you answered Yes to any of the questions listed in 5(a)to 5(f),then the waste is considered a hazardous <br /> waste, proceed to question 7. If you answered No to any of the questions,the waste is not considered a <br /> hazardous waste. If you did not answer yes or no to any of the questions below and are unsure, proceed to <br /> question 6. <br /> Prepared By: Issue date: Replaces: Page: <br /> ACT Environmental Services, Inc. May 5, 2016 March 4,2016 26 of 27 <br />