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r- <br /> � GENERATOR WASTE PROFILE SHEET (continued) Page 2 oft <br /> ALLIED WASTE <br /> Waste Profile# <br /> V. Physical Characteristics of Waste <br /> ' Characteristic Components %by Weight(range) <br /> 1. Gasoline & BTEX < 0,1% <br /> 2. Diesel < 0.1% <br /> ' 3. Lead < .0001% <br /> 4. <br /> 5. <br /> ' Color Odor(describe) Free Liquids % Solids pH: Flash Point Phenol <br /> ❑YES or ®NO <br /> Gra to Black Gasoline Content % 99% 7 OF m <br /> Attach Lahorato Ana! tical Report and/or Material Sae Data Sheet Including Required Parameters Provided or this Pro ile <br /> ' Does this waste or generating process contain regulated concentrations of the following Pesticides and/or Herbicides: <br /> Chlordane,Endrin,Heptachlor(and it epoxides), Lindane,Methoxychlor,Toxaphene,2,4-D, or 2,4,5-TP Silvex as ❑ Yes or ® No <br /> defined in 40 CFR 261.33? <br /> Does this waste or generating process cause it to exceed OSHA exposure limits from high levels of Hydrogen Sulfide or ❑ Yes or ® No <br /> Hydrogen C anide as defined in 40 CFR 261.23? <br /> Does this waste contain regulated concentrations of Polychlorinated Biphenyls(PCBs)as defined in 40 CFR Part 761? El Yes or Z No <br /> Does this waste contain regulated concentrations of listed hazardous wastes defined in 40 CFR 261.31,261.32,261.33, El Yes Or® No <br /> includingRCRA F-Listed Solvents? <br /> Does this waste contain regulated concentrations of 2,3,7,8-Tetrachlorodibenzodioxin(2,3,7,8-TCCD),or any other ❑ Yes or ® No <br /> dioxin as defined in 40 CFR 261.31? <br /> Is this a regulated Toxic Material as defined by Federal and/or State regulations? ❑ Yes or 9 No <br /> ' Is this a regulated Radioactive Waste as defined by Federal and/or State regulations? L1 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 generated at a Federal Superfund Clean Up Site? Yes or ® No <br /> MV1. Generator 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. I further certify that by <br /> utilizing this profile,neither myself nor any other employee of the company will deliver for disposal or attempt to deliver for disposal <br /> any waste which is classified as toxic waste, hazardous waste or infectious waste, or any other waste material this facility is prohibited <br /> from accepting by law. I shall immediately give written notice of any change or condition pertaining to the waste not provided herein. <br /> Our company hereby agrees to fully indemnify this disposal facility against any damages resulting from this certification being <br /> inaccurate or untrue. I further certify that the company has not altered the form or content of this profile sheet as provided by Allied <br /> Waste. <br /> ' Michael J. Kloberdanz/ Consultant M.J. Kloberdanz & Associates <br /> Authorized Representative Name And Title(Printed) Company Name <br /> e 02/15/05 <br /> Authorized Representative Signature Date <br /> ' V11. Allied Waste Decision <br /> ❑Approved ❑ Rejected Expiration: <br /> Conditions: <br /> Name,Title Signature Date <br /> ' REV 1 4 Allied Waste,February 2001 <br />