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'~ � �F-:PCBInfoi•maiion. ._- - - Does this waste material contain any Polychlorinated Biphenyls (PCBs): ❑ Yes D No If yes, please specify concentration: If any PCBs are present in this waste material at < 50 ppm, did they result from any dilution of materials containing> 49 ppm PCBs. ❑ Yes ❑ No D N/A G.7: Re ulator',Status U.S Deportinent of Transportation (DO 7) Is this waste material defined as a Hazardous Material under 49 CFR Section 171.8: ❑ Yes No Proper Shipping Name (PSN): Non-RCRA Hazardous Waste, Liquid Hazard Class: N/A ID #: NIA Packing Group #: NIA Subsidiary Hazard Class: N/A Emergency Response Guide #: 171 Additional Descriptions: (Latex Paint) U.S. Environmental Protection Agency (EPA) Is this waste material defined as an EPA Hazardous Waste under 40 CFR Section 261.3: ❑ Yes D No If yes, please identify EPA Hazardous Waste number(s): Is this waste material excluded from regulation as an EPA Hazardous Waste as specified in 40 CFR Section 261.4 (b): ❑ Yes D No If yes, please identify exclusion: Does this waste material qualify for EPA Universal Waste management as specified in 40 CFR Section 261.9: ❑ Yes No Is this waste material subject to regulation under the Benzene Rule of Waste Operation in NESHAP as specified in 40 CFR Part 61 Subpart FF: ❑ Yes D No If yes, please identify SIC code listed under NESHAP: California DepardnenI of Toxic Snbstances Control (DTSC) Is this waste material defined as a California Hazardous Waste under 22 CCR Div 4.5, Section 66261.3: D Yes ❑ No If yes, please identify California Hazardous Waste number(s): 291 Is this waste material excluded from regulation as a California Hazardous Waste as specified in 22 CCR Div 4.5, Section 66261.4 (b): ❑ Yes D No If yes, please identify exclusion: Does this waste material qualify for California Universal Waste management as specified in 22 CCR Div 4.5, Section 66261.9: ❑ Yes D No I3. Sh► ilii Eackii JnfOrmati0p� , Shipping Rate: 2-10 per: ❑ one-time only ❑ month ❑ quarter D year Packaging Method(s): D Drums ❑ Triwall Boxes ❑ Bulk Liquids ❑ Bulk Solids ❑ Other Check all that "apply •S' ecific Ri ues(s oInstrucfions Please specify any specific requests or instructions for disposal: I certify that all information submitted in this and attached documents is correct to the best of my knowledge. I also certify that any samples submitted are representative of the actual waste. If Evergreen Oil discovers a discrepancy during the approval process, Generator grants Evergreen Oil the authority to amend the profile, as Evergreen Oil deems necessary, to reflect the discrepancy. I further certify that any changes regarding any information concerning this profile will be communicated to Evergreen Oil accordingly. Print Name Title Date /// Awsreen UJ* only Last 4nalysrs Dale Page 3 of 3