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r' r 02/-IB/04 02:02pm P. 009 <br /> _V <br /> Waste Profle-# . <br /> ! <br /> V. PHYSICAL CHARACURISTICS OF WASTE <br /> ' <br /> CHARA=CHARS IC O PONENTS n BY WEIGHT(range) <br /> 1L. <br /> 3- <br /> ka pH. <br /> ,. . _. klasli. .. Phenol <br /> Odar..(describe): Free Liquids: %Solids: <br /> YES or NO Paint <br /> ( tea~ Content t/ % °F. Ppm <br /> _-. ._ .. ... . . <br /> ..,Attach Laboratory Analytical Report(and" Material Safety Data Sheet) <br /> -- ---- <br /> Including Required Parameters Pr vided for this Profile <br /> °Does this waste or generating process contain regulated concentrations o .the following Pesticides <br /> and/or,Herbicides:-Chlordane,Endrin,Heptachlor(and its epoxides),Lin ane,Methoxychlor, . YES <br /> Toxaphene,2, 4-D,2,.4,`5,-TP Silvex as defined in § 40 CFR 261.33? . <br /> Does this waste or generating process cause it to exceed OSHA exposure limits from high levels of <br /> YES or N <br /> 'Hydrogen Sulfide or Hydrogen Cyanide as defined in §40 CFR 261.23? <br /> Doe's-this" waste cbfiOin regulated concentrations of Polychlorinated Bipt enyls(PCBs) as defined in YES;'or <br /> §40 CPR Part 761? <br /> Does this waste contain regulated concentrations of listed hazardous wastes defined by §40 CFR YES pr O <br /> 261:31,261:32;261.33;including RCRA F-Listed Solvents? <br /> Does this waste contain regulated concentrations of 2, 3,7, 8 -Tetrachlor ibenzodioxin(2,3,7, 8 - . YES or <br /> TCCD),or any other dioxin as defined in§ 40 CRF 261.31? <br /> Is this a regulated Toxic.Material as defined by Federal and/or State regu lations? YES.or N <br /> Is this a regulated Radioactive Waste as defined by Federal and/or State egulations? YES.or <br /> Is this a regulatedMedical or Infectious Waste as defined by Federal and/or State regulations? YES..o <br /> Is this waste generated at a Federal Superfund Clean Up Site? YES o NO <br /> VI. GENERATOR CERTIFICATION = <br /> I hereby certify that to the best of my knowledge and belief,the information contained herein is a true and acurate description of the <br /> waste material being offered for disposal. I further certify that by utilizi g this profile,neither myself nor any other employee of the <br /> company will deliver for disposal or attempt to deliver for disposal an5 waste which is classified as toxic waste,hazardous waste, <br /> medical or infectious waste,or any other waste material this facility is prohibited from accepting by law.Our company hereby agrees <br /> to fully indemnify this dispqof facility ainst y damages resulting frc m this certification bei inaccura�f or untrue. <br /> rAU IZfiD PRESENTATIVE NA E AND TITLE(Printed) C MPANY NAMf. <br /> AUTHORI D REPRESENTATIVE SIGNATURE DATE <br /> V_II. ALLIED WASTE DECIS Oiv <br /> Approved Rejected Expiration. <br /> Conditions: <br /> Name.Title S ignature Date f <br /> - -.. . . _ <br /> i <br />