Laserfiche WebLink
GRANITE CONSTRUCTION 20333S76330 4/02 01:03pm P. 003 <br /> ALLIED WASTE-FORWARD INC.; 209 464 2803; JUN-24-02 2; PAGE 3/3 <br /> fi <br /> Waste Profile# <br /> PHYSICAL CH&MCTERTSTJCS OF WASTE <br /> CHARACIERISM.COMPONE,M qb BY WETGL[ (range) <br /> 757& <br /> 3. <br /> Color Odor(describe): Free Liquids: - %Solids: pH: I1ash Phenol <br /> /v _ YES o(q) /00 7$`1 4o Point: <br /> Conwnt_% 7.9 f° mR __pptn <br /> - Attach Laboratory Analytical Report(and or Material Safety Data Sheet) <br /> Jacludiaag Required Pammnetars Provided for thin Profile <br /> Does this waste or generating process contain tegulated concentrations of the following Pcstieides <br /> and/or Herbicides:Chlordane,13ndria,Heptachlor(arid its epoxides),Lindane,Methoxychlor, YES or tY0 <br /> Toxaphene,2,4-1y,2,4.5,-77 Silvex as defined in§40 CFR 26133? <br /> Does this waste or generating process cause it to exceed OSHA exposure limits from high levels of Y13S or NU <br /> Hydrogen Sulfide ar Hydrogen Cyanide as defined in§40 CFR 261.23? <br /> Does this waste contain regulated concentrations of Polychlorinated Diphenyla(PCBs)as defined in YES o9) <br /> §40 CFR Part 7617 <br /> i Does this waste contain regulated concentrations of listed hazardous wa,4tes defined by§40 CFit YL-S <br /> 261-41.261.32,261.33,including RMA F Listed Solvents? <br /> Does this waste contain regulated concentrations of 2,3,7,8-Tett-achlorodibenzodioxin(2.3,7,8- YES or NO <br /> TCCD),or any other dioxin as defined in§40 CRF 261.319 <br /> Is this a regulated Toxic Material as defined by Foderal and/or State regulations? YES or NO <br /> Is this a regulated Radioactive Waste as defined by Federal and/or State regulations? YES or Q <br /> is this a regulated Medical or Infectious Waste as defined by Federal and/or State regulations? YES or NO <br /> Is this waste gencrated at a Federal Superfand Cie,=Up Site? YES or O <br /> VI. QENERATOR CERA /ION <br /> I hereby certify that to the beat of my knowledge and belief,the information contained heroin is a true and&curate description of the <br /> waste material being offored for disposal.I further certify that by tailizing this profile,neither myself nor any other employee of the <br /> company will deliver for disposal or attempt to deliver for disposal any 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 indemulfy this disposal facility against any damages resulting from this certification being inaccurate of untrue. <br /> jVeJo Cc, L�e-e A 4,%c p1ct nfi Eel I i neer �r�.►�-I Ca„s$. Go. <br /> AUTI D RF-PRESENTATNI3 NAME AND TIX(Printodr COMP NAXH <br /> 6"�&4 ap a4/ 6Z <br /> AU ttORl D REPRUSI NTATiVE SIONATU DA <br /> VII. ALLMD WASTE DECISION <br /> Approved Rejected Expiration: <br /> o ditionQ- <br /> Name,Title Signature _ Date <br />