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✓J US Ecology Nevada(Beatty) usencs@usecology.com <br /> US Ecology Idaho(Grand View) useics@usecology.com PROFILE# <br /> US Ecology Texas(Robstown) usetcs@usecology.com - -- <br /> WASTE PROFILE FORM �. ' US Ecology MIChigan(Detroit) usemcs@uSecology.com Cog ID:7-H4KW <br /> 1.Generator SIERRA CHEMICAL []Billing Information Is same Ll P.O.required forpayment <br /> 2.Facility Address: 1010 INDUSTRIAL DR - 12.BIIIIng Company: ADVANCED CHEMICAL TRANSPORT,INC. <br /> 3.Mailing Address: 1010INDUSTRIALOR 13,Billing Address: 1210 ELKO DR. <br /> 4.City/State/Zip STOCKTON,CA 9S2Q6 14.City/State/Zip: SUNNYVALE, CA 94089 <br /> S.Tech.Contacn HENRY DESOU5A 15.Billing Contact: JOANN RICCI <br /> G.Phone: 2097224228 7,Fax:2097228228 16.Phone: (415)756-4329 17.Fax: (408)548.5052 <br /> 8.Generator Status: L] CESQG, [f SQG, LOG 1-87C <br /> 9,EPA IDN CAL000221604 10.State ID# - <br /> 11SIC Codes: 424690 .325181 - <br /> i <br /> b"S1iIPRTNG,iNFORfV('- 1T bN - •,"-'---rT--'- .-_ __.;,. :--,- <br /> 1.US DOTShfpping Name: UN1690,Sodium fluoride,6,1,PG-III <br /> 2.Hazard Class: 61 I 3..UN/NA: UN1690 - I 4,Packaging Group:It I S.RQ: <br /> 6,Container Type: Q Bulk [] Totes �E]Pallet Bags rXI Drums D Boxes Ej Other,Describe: <br /> 7,Frequency: M Year El QTR E Mdnth El I Time n Other,Describe: II <br /> 8.Shipment Size: 5 1 Quantity:2 9.Waste Import: [-]Yes [X]No <br /> 1/yes complete Waste lmport5upplement <br /> C„GEN FiA4i(VIATERIAC&;REC+ULATRR .INFO <br /> RMAj(ON _------------- <br /> 1.Common Name for this Waste: SODIUM FLUORIDE.AWWA <br /> 2.Process.Generating the Material: DISCARDED OR EXPIRED UNUSED PRODUCTS - <br /> 3.Describe Physical Appearance and Odor of the Waste: 50LID POWDER - <br /> 4.Odor of the Waste: O None 0.Slight 0. Strong 5.Physical State: <br /> Liquid Q Sludge/Slurry [% Solid <br /> i <br /> 6,Describe Color. .VARIES 7.Liquid phases: D Single -0 Double Layer � Multf-layer. � <br /> 8,Knowledge Is from: <br /> g ❑Lab Analysis LK MSDS ❑Process/Generator Knowlege <br /> 9.Waste Type(U$Ecology7exas customers only): D Industrial Non-industrial i <br /> 10 Is the waste restricted under EPA Land Disposal Restrictions(§26$): L] Yes [X No - <br /> 11.If LDR"Yes' is waste Q Water - QX Non-Waste Water i� Debris 12,Alt.Standards for soil? ❑ Yes N1 No <br /> 13 is the waste RCRA hazardous waste containing benzene and originating at a Petroleum Refinery(SIC 2911), <br /> Chemical.Manufacturing Plant(SIC 2800 thru 2899)or Coke by-Product Recovery Plant(SIC 3312)? <br /> (if'Nes"complete Benzene Waste Operations Supplem Dyes XX No <br /> 14.VO Conc.(§264.1083): Q<500 ppmw ❑t5oopptpw 15.Has waste been treated afterpoint of generation? Yes G No <br /> 16.CERCLA Regulated(Superfund)Waste D Yes a No 117.Butadiene waste regulated by§63 Subpart XX: Yes 0 No <br /> 18.Waste contains UHC constituent(s)(§268.48),above a treatment standard,other than those forwhich the waste <br /> exhibits a characteristic.(if"yes",list all UHC's in Section D)Waste Operations Supplem: ❑ Yes M No <br /> 19,Waste exempt from definition of"solid,waste"or"hazardous waste"(If"Yes",list reference 40CFR Q,Yes No <br /> 20.State Waste Codes 181 <br /> 21,.RCRA Waste Codes - <br />?2.Source Code: G G11 23,Form Code: W W319 24.Management Code: H <br /> Reylsion dote:2/2013 Page 1/ 2 <br />