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l-ieantiaraoES 11Vf-1J I C MM I CPCIHL rKurlLC JFICC 1 <br /> Clean Harbors Profile No. CH1676407 <br /> A.GENERAL INFORMATION <br /> GENERATOR EPA ID N/REGISTRATION 0 CAC002968664 GENERATOR NAME: Target Transport <br /> GENERATOR CODE(Assigned by Clean Harbors) TA22075 CITY LATHROP STATE/PROVINCE CA ZIP/POSTAL CODE 95231 <br /> ADDRESS 1000ERoth PHONE: (916)936.7564 <br /> CUSTOMER CODE(Assigned by Clean Harbors) PA000020 CUSTOMER NAME: Patriot Environmental Services <br /> ADDRESS 508 East E Street CITY WUmington STATEIPROVINCE CA ZIPJPOSTAL CODE 90744 <br /> B.WASTE DESCRIPTION <br /> WASTE OESCRIPTION: Debris Contaminated w/Hydraulic Oil <br /> PROCESS GENERATING WASTE: Spill Clean-Up of Leaking Drum Inside Intermodal Trailer <br /> IS THIS WASTE CONTAINED IN SMALL PACKAGING CONTAINED WITHIN A LARGER SHIPPING CONTAINER? No <br /> C.PHYSICAL PROPERTIES(al 26C orTIF) <br /> ,PHYSICAL STATE NUMBER OF PHASE$ILAYERS VISCOSITY(if liquid present) COLOR <br /> SOLID WITHOUT FREE LIQUID 1 2 3 TOP 0,00 1-100(e.g.Water) <br /> POWDER Yarles <br /> MONOLITHIC SOLID BY VOLUME(Approx.) MIDDLE 0,00 101-500(e.g,Motor 011) <br /> LIQUID WITH NO SOLIDS BOTTOM 0,00 501-10,000(e.g.Molasses) <br /> LIOUID/SOLID MIXTURE <br /> %FREE LIQUID '10,000 <br /> %SETTLED SOLID DDDR <br /> f� NONE BOILING POINT QF(aC) MELTING POINT IF(*C) TOTAL ORGANIC <br /> %TOTAL SUSPENDED SOLID CARBON <br /> <= <br /> SLUDGE MILD 95(<=35) <140(<60) <br /> GASIAEROSOL STRONG 95-100(35.38) <br /> 101•129(38-54) 140.200(60.93) 1-9% <br /> Desaibe: JV'; >200(>93) <br /> —130(>54) —10% <br /> FLASH POINT 4F(sC) pH SPECIFIC GRAVITY ASH BTU/LB(MJ/kg) <br /> <73(<23) <=2 <0.8(e.g.Gasoline) <0.1 >20 !�I <2,000(<4.6) <br /> 73-100(23-38) 2.1-0.9 0.8.1.0(e.g.Ethanol) i--' <br /> 0.1-1.0 Unknown 2,0005,000(4,6-11.6) <br /> 101 •140(U-60) <br /> �/' 7(Neutral) iVj 1.0(e.g.Water) 5.000.10,000(11.6-23.2)1.1-5.0 <br /> 141-200(60.93) 7,1-12.4 1.0-1.2(e.g.Antifreeze) 5.1-20.0 >10,000(>232) <br /> >200(>93) >--12.5 >1.2(e.g.Melhytene Chloride) Actual: <br /> D.COMPOSITION (List the complete composition of the waste,Include any inert Components and/or debris.Ranges for individual components are acceptable.If a trade name Is used, <br /> pl �,�pptj, KNenc Pin—An <br /> CHEMICAL MIN — MAX UOM <br /> ABSORBENT 0.0000000 -- 30.0000000 % <br /> .....•.............................................•,•••....-........•••----••-•-----•-•-•--••..-...•-••- ......... <br /> DEBRIS-RAGS,PAPER,PPE (0.0000000 -- 70.0000000 Qin <br /> ---------------------------------------------------------••--................................••-•-••-•--•--._...-.. <br /> HYDRAULIC OIL 0.0000000 -- 5,0000000 % <br /> DOES THIS WASTE CONTAIN ANY HEAVY GAUGE METAL DEBRIS OR OTHER LARGE OBJECTS(EX.,METAL PLATE OR PIPING>1/4"THICK OR YES +_� NO <br /> >12'LONG,METAL REINFORCED HOSE>12"LONG,METAL WIRE>12'LONG,METAL VALVES,PIPE FITTINGS,CONCRETE REINFORCING BAR OR <br /> PIECES OF CONCRETE>3-)? <br /> It yes,describe,including dimensions: <br /> DOES THIS WASTE CONTAIN ANY METALS IN POWDERED OR OTHER F)NELY DIVIDED FORM? YES !!�; NO <br /> DOES THIS WASTE CONTAIN OR HAS IT CONTACTED ANY OF THE FOLLOWING;ANiMAL.WASTES,HUMAN BLOOD,BLOOD PRODUCTS,BODY YES NO <br /> FLUIDS,MICROBIOLOGICAL WASTE,PATHOLOGICAL WASTE,HUMAN OR ANIMAL DERIVED SERUMS OR PROTEINS OR ANY OTHER <br /> POTENTIALLY INFECTIOUS MATERIAL? <br /> acknowledge that this waste material Is neither Infectious nor does it contain any organism known to be a Threat to human health. This certillcallon Is <br /> based on my knowledge of the material. Select the answer below that applies: <br /> The waste was never exposed to potentially infectious material. YES NO <br /> Chemical disinfection or some other form of sterilization has been applied to the waste. YES NO <br /> I ACKNOWLEDGE THAT THIS PROFILE MEETS THE CLEAN HARBORS BATTERY PACKAGING REQUIREMENTS. YES NO <br /> I ACKNOWLEDGE THAT MY FRIABLE ASBESTOS WASTE IS DOUBLE BAGGED AND WETTED. YES NO <br /> SPECIFY THE SOURCE CODE ASSOCIATED WITH THE G32 SPECIFY THE FORM CODE ASSOCIATED WITH THE WASTE. W002 <br /> WASTE. <br />