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ri <br />WASTE CHARACTERIZATION FORM <br />RETURN TO FORWARD INC. <br />ATTN: Environmental Compliance Officer <br />P.O. Box 6336 <br />Stockton, California 95206 <br />Color — Physical State. 0 Solid 13 Liquid 0 Slurry 0 Paste 0 Powder Free Liquids: 0 Yes C3 No <br />pH:— Odor. 0 Strong E3 Mild 0 None <br />SECTION A. GEN ERATOR/TRANSPORTER INFORMATION <br />SECTION D: WASTE COMPOSMON (see SECTION E for asbestos) <br />Waste Generator. Company Name: <br />Contact Person: <br />Phone: <br />Generating Facility: Address <br />_ [mg/kg) (MQII) <br />City. <br />Stater — Zip: <br />Transporter. Company Name: <br />Arsenic <br />Contact Person: <br />Phone: — <br />Consultant- Company Name: <br />Beryllium <br />Contact Person: <br />Phone: — <br />SECTION B: WASTE STREAM IDENTIFICATION <br />Chrom. (total) <br />General description of waste: <br />Chrom. V! <br />Process generating waste: <br />Cobalt <br />SECTION C: PHYSICAL CHARACTERISTICS <br />Color — Physical State. 0 Solid 13 Liquid 0 Slurry 0 Paste 0 Powder Free Liquids: 0 Yes C3 No <br />pH:— Odor. 0 Strong E3 Mild 0 None <br />SECTION D: WASTE COMPOSMON (see SECTION E for asbestos) <br />(include range of concentrations for multiple samples) <br />Total Petroleum Hydrocarbons <br />Metals: Total Soluble (Cal. WET) <br />as gasoline ppm <br />_ [mg/kg) (MQII) <br />as diesel ppm <br />Antimony <br />as motor oil ppm <br />Arsenic <br />other. ppm <br />Barium <br />Aromatic Hydrocarbons: <br />Beryllium <br />Benzene ppm <br />Cadmium <br />Toluene ppm <br />Chrom. (total) <br />Xylenes (total) ppm <br />Chrom. V! <br />Ethylbenzene ppm <br />Cobalt <br />Copper <br />Other Components (list): <br />Lead <br />ppm <br />Mercury <br />ppm <br />Manganese <br />ppm <br />Molybdenum <br />ppm <br />Nickel <br />ppm <br />Selenium <br />ppm <br />Silver <br />ppm <br />Strontium <br />ppm <br />Thallium <br />ppm <br />Vanadium <br />ppm <br />Zinc <br />ppm <br />Others (list): <br />ppm <br />ppm <br />(attach or submit additional sheets K necessary) <br />