Laserfiche WebLink
JAN 12 2015 <br /> UNWRONMENTAL <br /> gfolgaftlee s, WASTE MATERIAL PROFILE SHEET <br /> AClean HlarbeFsCmgmy Profile No. 921603 <br /> A.OERATO EPA ID <br /> GENERATOR NAME: Cooke Codiskn <br /> GENERATOR EPA D FIREGISTRATaO?I N CAL000280700 <br /> GENERATOR CODE(Assigned by Geon Harbora) COMBO CITY Traoy OTATEIPROVINCE CA ZIPMOSTAL CODE <br /> ADDRESS 200/Into Plon Hhy Sfe 110 863W <br /> PHONE: (900)000.0000 <br /> CUSTOMER CODE(Ass**by Clan Harbors) C098767 CUSTOMER NAME: Cooks Coxwon <br /> ADDRESS 1307 PMe 81 CITY 1Nakwl Cr"* OTATE,PROVWE CA ZIPIPOSTAL CODE 91600 <br /> B.WASTE DESCRIPTION <br /> WASTE DESCRPTIOW 3MPLATMW PLUS FILLER PONDO <br /> PROCESS GENERATING WASTE: WASTE FROM BODY SHOP REPAIRS <br /> M THIS WASTE CONTAINED IN SMALL PACKAGING CONTNNE0 WITHIN A LARGER SHIPPING CONTAINER? NO <br /> C.PHYSICAL PROPERTIES(sl 25C or 77F) <br /> �� <br /> YSICALSTATE NUMBER OFPHASE11LAYERS A�COSITY(IT"dpreeanl) COLOR <br /> 19 SOLID WITHOUT FREE LIQUID 1 2 3 TOP 0.00 1.100(e g.WNW) <br /> POWDER <br /> MONOLITHIC SOLID %SY VOLU E(Appmx.) MIDDLE 0.00 101-500(a g.Motor OA) am�� <br /> LKOD WITH NO SOLIDS BOTTOM 0.00 001-10000(4*M0166164)M01611e4) <br /> UwDBOLIO MwURE <br /> %FREE LIGUID ODOR >10000 <br /> %SETTLED SOLID <br /> %TOTAL SUSPENDED SOLID NONE &MING PONT-F rC) MELTING POW-F('C) TOTAL ORGANIC <br /> SLUDGE Q MILD t"95("M) CARBON <br /> DASIAEROSOL STRONG 95-SOD(86.38) <110(</D} i% <br /> 101-120(3651) 14x200(�) 1.9% <br /> Oasalbs: R) 1200(M) <br /> FLABH PRINT•F('C) PH BPECIFfc GRAVITY ASH BTUAA ft) <br /> K 731,23) 2 <OA(e.g.Gasoline) 40.1 >210 <2000(s4.$) <br /> 73.100(2398) 2.1-SA 0,1.1.0(e.0.Ethanol) 2,000.6,000(4.611.9) <br /> Q1-to � Unknown <br /> 101-140(80.00) © 7(Neutral) 1A(e.0•Weter) L1-eA 5.00010,000(11.1.23.2) <br /> 141•700(90.931 7.1-12A EM 1.&1.2(ca.AnWraan) I] >10-w(>2 2) <br /> 1.1•20.0 <br /> >200 P93) >12(6,0,Methylene Oftwe) Aduak . <br /> O.COMPOBITIOH (L kt the Complete oompo"on of ahs waste.Include arry krerl components andAor debde.Ranges fa Whlduet componsroa are acaplable.R a trade nems Is <br /> used,*see apply an MODS.Please do not use abbwAstiorm) <br /> CHEMICAL MIN _ <br /> MAX UOM <br /> BENZOIC ACID,C9-11-BRANCHED ALHYL ESTERS 10.0001000 — 30,0000000 % <br /> BENZOYL PEROXIDE ...............................•-•--............................... .J0.0000000. ..... .. <br /> .......................................-• - _ X600000000• .%. <br /> CALCIUMSULFATE• ........................................... ........_ ...... . .••-•.......... ..••. <br /> FERRIC AMMONIUM FERROCYANIDE 0.0000000 — 1.0008000 _ % <br /> FERRIC FERROCYANIDE................................................................. 0.0000000 ..- 1.000ID00- . <br /> IRON OXIDE(FE209) .. ... <br /> •. .••••••. •1.0000000 .... •. •%... <br /> ........ ...6.0000000 % <br /> OXIRANE,POLYMER W TH METHYLOXIRANE,MONOBUTYL ETHER 10000100 — 6.0000000 % <br /> WATER .............• --_............._....._._..._.._..._................_....... .. <br /> ...........................................• -..._.._. 110000000 — �30.00D0000 .; . <br /> ZINC 6TEARATE-•••--------------------------•-•••............•--•-••---•_• - --•'�000OODO 7.0000000 -. <br /> - -- ---•------%--- <br /> DOES THIS WASTE CONTAIN ANY HEAVY GAUGE METAL DEBRIS OR OTHER LARGE OBJECTS(EX.,METAL PLATE OR PFNG>-I W THICK OR>42- YES d❑ NO <br /> LONG,METAL REINFORCED HOSE>17 LONG,METAL WIRE>1Y LONG,METAL VALVES,PIPE FITTINGS,CONCRETE REINFORcm BAR OR <br /> PIECES OF CONCRETE W)7 <br /> If ys%describe,Indudhrg dwAosloov <br /> DOES THIS WASTE CONTAIN ANY METALS IN POWDERED OR OTHER FOJELY DIVIDED FORM? YES a NO <br /> DOES THIS WASTE CONTAIN OR HAS IT CONTACTED ANY OF THE FOLLOWING;ANIMAL WASTES,HUMAN BLOOD,BLOOD PRODUCTS,BODY YES © NoFLUIDS,MICROOMMGAL WASTE,PATHOLOGICAL WASTE,HUMAN OR MOMAL DERIVED SERUMS OR PROTEINS OR ANY OTHER <br /> POTENTIALLY INFECTIOUS MATERUIL4 <br /> 1 acknowledge Net IH$*SW tstletla[Is netOwr kdeelous nor does g ooldekr any o10enism known to be a Sept to human hasM.This certification 4 <br /> based on my kwWadge of Ire maWal.Sabot 9e aaawer below Stat applets: <br /> The weds was never exposed to petentlally InlsollaK aretedal. <br /> YES NO <br /> Chemical dlefn%c9on or some other loam of sledOsaflon hu been applled to the waste, YES NO <br /> I ACMDWLEDGE THAT THIS PROFILE MEETS THE CLEW HARBORS BATTERY PACKAGING REQUIREMENTS. YES NO <br /> I ACKNOWLEDGE THAT MY FRWBLE ASBESTOS WASTE IS DOUBLE SAGGED AND WETTED, YES NO <br /> SPECIFY THE SOURCE CODE ASSOCIATED WITH THE WASTE 011 SPECIFY THE FORM CODE ASSOCIATED WITH THE WASTE, W319 <br /> Repod Pdr"d On:Tum day.0eambcr 1/,2014 A NWEWPmIiIalWasfe Pmu.rdl Page 1 of 9 <br /> Attachment B - Page 3 of 9 <br />