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381810188fle <br />A Clean Harbors Company <br />WASTE MATERIAL PROFILE SHEET <br />Profile No. 1655744 <br />A. GENERAL INFORMATION <br />GENERATOR EPA ID (//REGISTRATION It <br />GENERATOR CODE (Assigned by Clan Harbors) <br />ADDRESS 1515 N Main St <br />CUSTOMER CODE (Assigned by Clan Harbors) <br />ADDRESS f515NMain St <br />CAL000043665 <br />GENERATOR NAME: <br />W18372 <br />CITY Manteca <br />K118372 <br />CUSTOMER NAME: <br />NUMBER OF PHASESILAYERS <br />CITY Manteca <br />Me Country <br />STATE/PROVINCE CA ZIPIPOSTALCODE 95336 <br />PHONE: (999) 999-9999 <br />Kia Country <br />STATE(PROVINCE CA ZIP/POSTAL CODE 95336 <br />B. WASTE DESCRIPTION <br />WASTE DESCRIPTION: LATEX PAINT NOT IN CANS <br />PROCESS GENERATING WASTE: UNUSED, OUT OF DATE PRODUCT <br />IS THIS WASTE CONTAINED IN SMALL PACKAGING CONTAINED WITHIN LARGER SHIPPING CONTAINER? No <br />C. PHYSICAL PROPERTIES (at 25C or 77F) <br />PHYSICAL STATE <br />NUMBER OF PHASESILAYERS <br />VISCOSITY (It liquid present) <br />COLOR <br />SOLID WITHOUT FREE LIQUID <br />y 1 2 3 TOP 0.00 <br />1 -100 (e.g. Water) <br />0.8-1.0 Ethanol) <br />PONDER <br />MIDDLE 0.00 <br />�y 101- 600(e.8. Motor 011) <br />Vellea <br />MONOLITHIC SOLID <br />% BY VOLUME(Appr=) <br />2,0005,000 (4.6.11.6) <br />101 -140 (35-60) <br />LIQUID WITH NO SOLIDS <br />BOTTOM 0.00 <br />501 -10,000 (e.g. Molasses) <br />5,00010,000 (11.6-23.2) <br />LIQUID/SOUD MIXTURE <br />7.1 -12.4 <br />❑y 1.01.2 (e.g. AnBhaeze) <br />1,1.5.0 <br />ODOR <br />n <br />J > 200 (>93) <br />%FREE LIQUID 50.00.50.00 <br />> 111,000 <br />5.1-20.0 <br />%SETTLED SOLID 50.00-50.00 <br />NONE <br />BOILING POINT -F(-C) <br />MELTING POINT -F I'D) <br />TOTALORGAICC <br />%TOTAL SUSPENDED SOLID 25.00. 50.00 <br />CARBON <br />SLUDGE <br />❑y MILD <br /><= 95 (135) <br />85 -100 (3538) <br />`140(`60) <br /><.1% <br />GASIAEROSOL <br />STRONG <br />140-200 (60.93) <br />1-9% <br />101-129 (38-54) <br />Describe: <br />a >. 130 (>54J <br />Q >20D(>93J <br />y 10% <br />2) — <br />FLASK POINT aF ('Cl <br />PH <br />SPECIFIC GRAVITY <br />ASH <br />BTUfU9 (MJ/kg) <br />< 73 (<23) <br />e 2 <br /><0.8 (e.g. Gasoline) <br />based on my knowledge of the materiel. Select the answer below that applies: <br />`2,000 (<4.B) <br />100 <br />If yea, describe, Including dimensions: <br />0.8-1.0 Ethanol) <br />< DA > 20 <br />Q <br />73. (2318) <br />2.1.6.9 <br />(e.g. <br />0.1-1.0 Unknown <br />2,0005,000 (4.6.11.6) <br />101 -140 (35-60) <br />❑y 7 (NeubaO <br />1.0 (e.g. Water) <br />5,00010,000 (11.6-23.2) <br />141 -200 (60.93) <br />7.1 -12.4 <br />❑y 1.01.2 (e.g. AnBhaeze) <br />1,1.5.0 <br />> 10,000 (>23.2) <br />n <br />J > 200 (>93) <br />>=12.5 <br />> 1.2 (e.g. Methylene Chloride) <br />5.1-20.0 <br />Actual: <br />D. COMPOSITION (Ust the campus camposIIkn of the waste. Include any Ined components and/or debris. Ranges for Individual components ane acceptable. If a trade name is used, <br />. ,„aria o».a..., � - <br />� <br />CHEMICAL MIN — MAX <br />UOM <br />LATEX PAINT 100.0000000 — 100.0000000 <br />-------------------------------------------------------------------------------------------------------------------- <br />POTENTIALLY INFECTIOUS MATERIAL? <br />DOESTHISWASTE CONTAIN ANY HEAVY GAUGE METAL DESMSOROTHER LARGE OBJECTS (FX, METAL PLATE OR PIPING>1/4-THICK OR YES 0 <br />NO <br />>12' LONG, METAL REINFORCED HOSE >12" LONG, METAL WIRE >12' LONG, METAL VALVES, PIPE FITTINGS, CONCRETE REINFORCING BAR OR <br />based on my knowledge of the materiel. Select the answer below that applies: <br />PIECES OF CONCRETE >3`)7 <br />The waste was never espond to potentially Infectious material. <br />If yea, describe, Including dimensions: <br />Chemical disinfection or some other Ion of sterilba0on has been applied to the waste. <br />DOES THIS WASTE CONTAIN ANY METALS IN PONDERED OR OTHER FINELY DIVIDED FORM? YES Q <br />NO <br />DOES THIS WASTE CONTAIN OR HAS IT CONTACTED ANY OF THE FOLLOWING; ANIMAL WASTES, HUMAN BLOOD, BLOOD PRODUCTS, BODY <br />YES Q NO <br />FLUIDS, MICROBIOLOGICAL WASTE, PATHOLOGICAL WASTE, HUMAN OR ANIMAL DERIVED SERUMS OR PROTEINS OR ANY OTHER <br />POTENTIALLY INFECTIOUS MATERIAL? <br />I acknowledge that this waste material Is rather Infectious nor does it contain any organism known to be a threat to human health. This ar00ratlon Is <br />based on my knowledge of the materiel. Select the answer below that applies: <br />The waste was never espond to potentially Infectious material. <br />YES NO <br />Chemical disinfection or some other Ion of sterilba0on has been applied to the waste. <br />YES NO <br />I ACKNOWLEDGE THAT THIS PROFILE MEETS THE CLEAN HARBORS BATTERY PACKAGING REQUIREMENTS. <br />YES NO <br />I ACKNOWLEDGE THAT MY FRIABLE ASBESTOS WASTE IS DOUBLE BAGGED AND WETTED. <br />YES NO <br />SPECIFY THE SOURCE CODE ASSOCIATED WITH THE G71 SPECIFY THE FORM CODE ASSOCIATED WITH THE WASTE. W200 <br />WASTE. <br />