Laserfiche WebLink
t L�-USS Ecology Nevada(Beatty) usencs@usecology,com <br /> USI Ecology Idaho(Grand View) uselcs@usecology,com PROFILE# <br /> US Ecology Texas(RobstoWn) usetas@usecology.com <br /> WASTE PROFILE FORM ( _.� US Ecology Michigan(Detroit) usemcs@usecology.com COR ID:7-H4JP <br /> 1.Generator SIERRA CHEMICAL ❑Billling InformaHan Is same ❑ P0,required for payment <br /> 2.FacilltV Address: 10101NbUSTRIAL DR 12.Billing Company; ADVANCED CHEMICAL TRANSPORT,INC. <br /> 3. Mailing Address:' 10101NDUSTRIAL DR 13.Billing Address: 1210 ELKO DR. <br /> 4.City/State/Zip STOCKTON,CA 95206 14.City/State/Z(p: SUNNWALE, CA 94089 <br /> 5.Tech,Contact: HENRY DESOUSA 15,Billing Contact: lOANN RICCI <br /> 6.Phone; 2097224228 7.Fax: 2097228228 16,Phone: '(415)756-4329 17.Fax; (408)548-5052 <br /> B. Generator Status: . ❑ CESQG, ❑. SQG, Q LQG -18.Email: - <br /> 9.EPA Ib# CAL000221604 10,State ID# i <br /> 11.SIC Codes: 424690 .325181 <br /> B`:I SHIPPING;INFORMATION ' --- <br /> 1.US DOT Shipping Name: NON'-RCRA HAZARDOUS WAS",SOLID(SODIUM METABISULFITE) �. <br /> 2.Hazard Class: N/A I 3.UN/NA: I 4.Packaging Group:N/A I S.RQ: <br /> 6.Container Type! ❑ Bulk ❑ Totes []Pallet I ❑Bags ❑X Drums ❑ poxes ❑ Other Describe: <br /> 7.Frequency: 0 Year ❑ QTR ❑Month ❑ 1 Time ❑ Other,Describe: - <br /> 8.Shlpment Size: 5 - Quantity:1 9.Waste Import: ❑Yes ❑X No <br /> If yes complete Waste lmportSupplement <br /> ,=G ENERALMATERIAL&REGIILATCIRYINFORMATION . i" - <br /> _ <br /> �__ � ry <br /> 1,Commoh Name for this Waste: SODIUM META WSULFITEFCC/PHOTOGRADE - <br /> 2.Process.Generating the Material: UNUSED EXPIRED_ OR DISCARDED PRODUCT - - - <br /> i <br /> 3.Describe Physical Appearance and odor of the Waste: WHITE OR SLIGHTLY YELLOW CRYSTAL POWDER,PUNGENT SULFUR DIOXIDE ODOR - <br /> I <br /> i <br /> 4.Odor ofthe Waste: ❑None ❑Slight ❑X Strong S.Physical State: ❑ Liquid ❑ Sludge/Slurry Q-solid <br /> 6,Describe Color. WHITE OR SLIGHTLY YELLOW T Uquid phases, ❑Single ❑ Double Layer ❑ Multi-layer <br /> 8.Knowledge isfrom: ❑lab Analysis Q MSDS [_jprocess/Generator Knowlege <br /> 9.Waste Type(US EcologyTexas customers only): ❑ industrial ❑Non-Industriai <br /> 10,Is the waste restYicted under EPA Land Disposal Restricf(ons(§268): ❑ yes ❑X No _ <br /> 11,If UDR"Yes",is waste: ❑Water LX Non-Waste Water ❑ Debris 1 12,Alt.Standards for soil? ❑ Yes ❑X No <br /> 13.Is the waste RCRA hazardous waste containing benzene and originating at a Petroleum Refinery(SIC 29111, <br /> Chemical Manufacturing Plant(SIC 2800 thru 2899)or Coke by-Product Recovery Plant(SIC 3312)7 <br /> If"Yes"complete Benzene Waste Operations Supplem. ❑ Yes ❑X No <br /> 14.VO Conc.(§2641083):, ❑X c500 ppmw ❑250oppmw 15.Has waste been treated after point of generation? ❑ Yes O No <br /> 16.CERCLA Regulated ISuperfund)Waste ❑ Yes 0 No 17.Butadiene waste regulated by§63 Subpart XX: Yes 0 No <br /> 18.Waste contains UHC constituettt(s)(§258.48),above a treaEment standard,other than those for which the waste - <br /> exhibits a characteristic,(If"yes",list all UHCs in Section D)Wast8 Operations Supplem! ❑Yes ( -No <br /> 19.Waste exempt from definition or"solid waste"or"hazardous waste"(If Wes",list reference 40CFR ❑ Yes ❑X No <br /> 20.state Waste Codes 181 - <br /> 21.RCRA Waste Codes - <br /> 22.Source Code: G G11 23•Form Code: W W319 24.Management Code: H <br /> 3evfslan dote:2/2013 Page 1/ 2 <br />