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1AM. EZ Profile TM WASTE MANAGEMMY Requested Facility: Kettleman Flills(Hazardous Waste Facility) ❑Unsure Profile Number; CA615739 ❑Multiple Generator Locations(Attach Locations) ❑Request Certificate of Disposal ❑Renewal?Original Profile Number: A.GENERATOR INFORMATION(MATERIAL ORIGIN) B.BILLING INFORMATION O SAME AS GENERATOR 1. Generator Name: Con-Fab California, LLC 1.Billing Name:Advanced Chemical Transport 2.Site Address: 1910 E. Lathrop Road _ 2. Billing Address:9.6Mabu[y Rd (City,State,ZIP) I athrop CA 25330 (City,State,ZIP) San.lose GA 95133 3.County: San Joaquin 3.Contact Name:Accniint-Parable 4.Contact Name.-Jose Ratliff 4.Email. ancoun inaaa_Ctenviro cam 5. Email: iratliff actenviro com S. Phone: (408)548-5060 6. Fax: 6. Phone: (209)220-4357 x805 7. Fax: 7. WM Hauled? ❑Yes ❑No 8. Generator EPA ID: CAL000 ❑N/A 8. P.O.Number: 9.State ID: N/A 9. Payment Method: ❑Credit Account ❑Cash ❑Credit Card C.MATERIAL INFORMATION D.REGULATORY INFORMATION 1.Common Name:Non RCRA Soil - CA 1.EPA Hazardous Waste? Ll Yes* Fd No Describe Process Generating Material: ❑See Attached Code: Chemical spill clean up.(Chemical spilled on a concrete pad and sand 2.State Hazardous Waste? m Yes ❑No was used to absorb material.MSDS and Analytical are attached) Code: 352 3. Is this material non-hazardous due to Treatment, ❑Yes* if No Delisting,or an Exclusion? 4.Contains Underlying Hazardous Constituents? ❑Yes* W No 2.Material Composition and Contaminants: ❑See Attached 5. From an industry regulated under Benzene NESHAP? ❑Yes* 14 No 1.Sand 95-100°� 6. Facility remediation subject to 40 CFR 63 GGGGG? ❑Yes* fd No 2,soi 1 0-5% 7 CERCLA or State-mandated clean-up? ❑Yes* W No 3,WRDA-64 See MSDS 1-30°� B NRC or State-regulated radioactive or NORM waste? ❑Yes* p No 4. *if Yes,see Addendum(page 2)for additional questions and space. Total comp.must be equal to or greater than 100% z100`Y g Contains PCBs? -) if Yes,answer a,b and c. LJ Yes 64 No 3.State Waste Codes:352 El N/A a. Regulated by 40 CFR 761? ❑Yes ❑No 4.Color:various b. Remediation under 40 CFR 761.61 (a)? ❑Yes ❑No 5.Physical State at 70'F: RlSolid ❑Liquid ❑Other: c. Were PCB imparted into the US? ❑Yes ❑No 6.Free Liquid Range Percentage: to m N/A 10.Regulated and/or Untreated ❑Yes No 7 pH: to N/A Medical/Infectious Waste? 8.Strang Odor: ❑Yes m No Describe: 11,Contains Asbestos? ❑Yes m No 9.Flash Point: ❑<140'F ❑ 140'-199'F ❑z200' lid N/A If Yes: ❑Non-Friable ❑Non-Friable-Regulated ❑Friable E.ANALYTICAL AND OTHER REPRESENTATIVE INFORMATION F.SHIPPING AND DOT INFORMATION 1.Analytical attached m Yes 1,0 One-Time Event ❑Repeat Event/Ongoing Business Please identify applicable samples and/or lab reports: 2.Estimated Quantity/Unit of Measure: 4 Sample-1)8260 Full list and Cam17 ❑Tons 61 Yards ❑ Drums ❑Gallons ❑Other: 3.Container Type and Size:20 Yards 4.USDOT Proper Shipping Name: ❑N/A 2.Other information attached(such as MSDS)? 0 Yes NON RCRA HAZARDOUS WASTE SOLID Sad S°B G.GENERATOR CERTIFICATION(PLEASE READ AND CERTIFY BY SIGNATURE) By signing this EZ Profiler"form,I hereby certify that all information submitted in this and all attached documents contain true and accurate descriptions of this material,and that all relevant information necessary for proper material characterization and to identify known and suspected hazards has been provided.Any analytical data attached was derived from a sample that is representative as defined in 40 CFR 261-Appendix 1 or by using an equivalent method. All changes occurring in the character of the material(i.e.,changes in the process or new analytical)will be identified by the Generator and be disclosed to Waste Management prior to providing the material to Waste Management. if I am an agent signing on behalf of the Generator,I have confirmed with the Certification Signature Generator that Information contained in this Profile Is accurate and complete. Name(Print): 04l4'WW w LIMN _ Date: Title: P 6,Wb_ 51vr- Company; Revised June 30,2015 THINK GREENO QUESTIONS?CALL 800 963 4776 FOR ASSISTANCE 02015 Waste Management