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REPUB IC SPECIAL WASTE PROFILE Page 2 of 2 <br /> E Waste Profile# <br /> V. Physical Characteristics of Waste <br /> Characteristic Components % by Weight(range) <br /> 1. Soil 100.000 <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Color Odor(describe) Does Waste Contain Free Liquids? %Solids pH: Flash Point <br /> i <br /> Brown-grey None-Hydrocarbon ❑YES or©NO 100.00 7 NIA of <br /> Attach Laboratory Analytical Report(and/or Material Safety Data Sheet) Including Chain of Custody and <br /> Required Parameters Provided for this Profile <br /> Does this waste or generating process contain regulated conc0trations of the following Pesticides and/or <br /> Herbicides:Chlordane, Endrin, Heptachlor(and it epoxides),Lindane,Methoxychlor,Toxaphene,2,4-D,or ❑Yes or ©No I <br /> 2,4,5-TP Silvex as defined in 40 CFR 261.33? I <br /> Does this waste contain reactive sulfides(greater than 500 ppm)or reactive cyanide(greater than 250 ❑Ye5 or ©No <br /> ppm)[reference 40 CFR 261.23(a)(5)1? <br /> Does this waste contain regulated concentrations of Polychlorinated Biphenyls(PCBs)as defined in 40 CFR [-]Yes or ©No <br /> Part 761? I <br /> I <br /> Does this waste contain concentrations of listed hazardous wastes defined in 40 CFR 261.31,261.32,261.33, ❑Yes or ❑No <br /> including RCRA F-Listed Solvents? <br /> Does this waste exhibit a Hazardous Characteristic as defined by Federal and/or State regulations? ❑Yes or ©No <br /> Does this waste contain regulated concentrations of 2,3,7,8-Tetrachloradibenzodioxin(2,3,7,8-TCCD),or any ❑Yes or ZNo j <br /> other dioxin as defined in 40 CFR 261.31? <br /> Is this a regulated Radioactive Waste as defined by Federal and/or State regulations? ❑Yes or ©No <br /> Is this a regulated Medical or Infectious Waste as defined by Federal and/or State regulations? ❑Yes or ©No <br /> Is this waste a reactive or heat generating waste? ❑Yes or[Z]No <br /> i <br /> Does the waste contain sulfur or sulfur by-products? []Yes or ©No <br /> Is this waste generated at a Federal Superfund Clean Up Site?. ❑Yes or ❑No a <br /> Is this waste from a TSD facility,TSD like facility or consolidator? [—]Yes or ❑No <br /> VI. Certification <br /> I hereby certify that to the best of my knowledge and belief,the information contained herein is a true,complete and accurate <br /> description of the waste material being offered for disposal and all known or suspected hazards have been disclosed. All Analytical <br /> Results/Material Safety Data Sheets submitted are truthful and'complete and are representative of the waste. <br /> further certify that by utilizing this profile, neither myself nor any other employee of the company will deliver for disposal or attempt to <br /> deliver for disposal any waste which is classified as toxic waste' hazardous waste or infectious waste,or any other waste material this <br /> facility is prohibited from accepting by law. I shall immediately give written notice of any change or condition pertaining to the waste not <br /> provided herein. Our company hereby agrees to fully indemnify this disposal facility against any damages resulting from this certification <br /> being inaccurate or untrue. <br /> I further certify that the company has not altered the form or content of this profile sheet as provided by Republic Services Inc. <br /> Eric Price/Professional Geologist Ground Zero Analysis, Inc. <br /> Autha 7. <br /> �:�ntative Name And Title(Type or Pring Company Name <br /> 01/26/2011 <br /> Authorized Representative Signature Date' <br /> C Republic Services,Dec 2009 <br />