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bt'COMPOSITION(use add/tfonal form lfnecessary) '- , <br /> Values are: TCLP D Totals Range Total>=100% <br /> Constituents Test Method units Typical Min Max <br /> WATER JTotals % 5.000.00 10.00 <br /> ABSORBENT,SOIL,GLASS,PLASTIC,RAGS Totals % - 85.00 75.00 95.00 <br /> Sodium hydroxide Totals % -10.00 1,00 15.00 <br /> @� .!(34GT s SICS� <br /> 1. Oxidizer- [ Yes No 9, Reactive Sulfides 'ppm ❑ Yes i]J No <br /> 2. Explosive ❑ Yes i]J No 30, Reactive Cyanides - :ppm <br /> Yes QJ No <br /> 3. Organic Peroxide Yes Q No 11. Water/Air Reactive ❑ - Yes Q No <br /> 4, Shock Sensitive. 0 Yes J] No 12: Thermally Unstable - LJ <br /> Yes No <br /> S. Tires (] Yes []J No 13. TSCA regulated PCB waste(Control sheet ❑ Yes 10 No <br /> required with shipment) <br /> 6. Pyrophoric (] Yes []J No 14.Medical/Infectious waste - <br /> Yes []J No <br /> 7. Compressed Gas ❑ Yes QJ No 15. Radioactive(if yes,complete profile [ Yes Q No <br /> 8, Halogenated Organics E:) Yes Q No Supplementfor Radioactive waste) <br /> 16.Hazardous Secondary Material(HSM)? <br /> Yes no <br /> 17, Possibility of incidental liquids from transportation? ❑ Yes QJ No <br /> 18. Is waste/material a solid using the paint filter test? QQ Yes LJ No <br /> 19. pH:(if solid,what is pH if mixed with water?) Range TO Typical <br /> ❑_<2 [i 2<12.5 QQ 212.5 <br /> 20, Flash Point; '>210 -°F - [(<1407 <br /> 21,Is the waste/material oil bearing from Petroleum Refining,Production or Transportation practices? - ❑ N/A []Yes (ONo <br /> kla" k" <br /> ❑Yes (Z No I certify this waste/material may be disposed without further treatment. <br /> ❑Yes ©N/A I certify this waste/material meets all requirements of legitimate recycling of Hazardous Secondary Materials <br /> under 40 CFR 260.43 and/or I am complying with the conditions for generators using the verified recycler exclusion. <br /> I authorize US Ecology to correct inconsistencies on the waste/material profile form that impact management decisions with my oral or written <br /> authorization.US Ecology will require re-submittal of the waste/materlal profile information if substantial changes are determined necessary.I <br /> understand waste/material that does not conform to spedflcations described in this profile may be rejected by US Ecology unlessothercontractual <br /> arrangements have been agreed to by both parties.(:'certify,under penalty of law,that I am famillar with this waste/material stream through analysis <br /> and/or process knowledge,and that all information provided is true,accurate,representative and complete,that all known or suspected hazards have <br /> been disclosed,and that this form was completed In accordance with the instructions provided. <br /> Print Name Signature Title Date <br /> ISI£LGevIC(Cv pinoil <br /> �JGCLt ��-�--; Flan F ntia.t <br /> ' RPVICInn datctt/t/t6 <br />