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Clean Harbors Profile No. CH1324286 <br /> F.REGULATORY STATUS <br /> YES ��Q NO USEPA HAZARDOUS WASTE? <br /> YES t`"1 NO DO ANY STATC WASTE CODES APPLY? <br /> Tens Waste Code <br /> YES Q NO DO ANY CANADIAN PROVINCIAL WASTE CODES APPLY? <br /> �' I _ i <br /> YES U NO IS THIS WASTE PROHIBITED FROM LAPID DISPOSAL WITHOUT FURTHER TREATMENT PER 40 CFR PART 2687 <br /> LAR CATEGORY: No(subfoct(o LDR <br /> R-11 <br /> VARIANCE INFO: <br /> YES L� NO IS THIS A UNIVERSAL WASTE? <br /> YES NO IS THE GENERATOR OF THE WASTE CLASSIFIED AS CONDITIONALLY EXEMPT SMALL QUANTITY GENERATOR(CESQG)7 <br /> YES NO IS THIS MATERIAL OO1NG TO BE MANAGED AS A RCRA EXEMPT COMMERCIAL PRODUCT,VMICH IS FUEL(40 CFR 261.2(C)(2)(11))? <br /> YES NO DOES TREATMdENT OF TI IIS WASTE GENERATE A F000 OR FO 10 SLUDGE? <br /> YES NO IS THIS WASTE STREAI,1 SUBJECT TO THE INORGANIC METAL BEARING WASTE PROHIBITION FOUND AT 40 CFR 206.3(C)7 <br /> YES NO DOES THIS WASTE CONTAIN VOC'S IN CONCENTRATIONS--SOD PPM? l <br /> YES NO DOES THE WASTE CONTAIN GREATER THAN 20r/e OF ORGANIC CONSTITUENTS WITH A VAPOR PRESSURE>e.3KPA(.044 PSIA)? <br /> YES Q NO DOES THIS WASTE CONTAIN AN ORGANIC CONSTITUENT WHICH IN ITS PURE FORM I IAS A VAPOR PRESSURE>77 KPA(11.2 PSIA)7 � <br /> YES Q NO IS THIS CERCLA REGULATEO(SUPERFUNO)WASTE 7 <br /> YES F%J1 NO IS THE WASTE SUBJECT TO ONE OF THE FOLLOWING NESy1AP RULES? <br /> Hazardous Organic NESHAP(HON)rule(subpart G) Pharmaceuticals production(subpart GGG) <br /> YES NO IF THIS IS A US EPA HAZARDOUS WASTE,DOES THIS WASTE STREAM CONTAIN BENZENE7 <br /> I <br /> YES NO Does the szasle dream conic from a facil;ywitli one of the SIC codes listed undo(benzene NESHAP or Is Ihls wasto regulated under the benzano i <br /> NESHAP rules because the original source of the waste Is from a chemical manufacturing,coke byproduct recovery,or pelroleum refinery process? <br /> YES NO b the generating source ofthis caste sVcam a facility Min Total Annual Denzeno(TAB)>10 ldglyear? <br /> What is Vie TAD quantity for your racillty7 1 F�1 Magagrainlycar(1 Mg a 2,200 Its) <br /> 1 <br /> The basis far Oils dolerminatlon Is:Kno•aaodge of the Waste Or Test Data Kno•.%Iodgo Testing < <br /> Oesc6bo the knoarlodgo: _` _•___ <br /> G.DOT7TOO INFORMATION <br /> OOMOG PROPER SHIPPING NAME: <br /> NON HAZARDOUS,NON D.O.T.REGULATED ORGANIC MATERIAL <br /> H.TRANSPORTATION REOUIREh1ENT�S <br /> ESTIMATED SHIPMENT FREQUENCY LJ ONETIME WEEKLY MONTHLY QUARTERLY YEARLY OTHER <br /> CONTAINERIZED BULK LIQUID BULK SOLID <br /> Q� <br /> CON TAINERSISHIPMENi <br /> GALLON SfSHIPt.fENT: 07461•0 Ajax GAL. gHIPIAF.NT UOId: TON Q YARD <br /> STORAGE CAPACITY: <br /> CONTAINER TYPE: TONSfYARDSISHIPI.IENT: 10.00 1 fiza-f5,00 ydax <br /> eeelAal(TO((TXN< 1aX.KW0:.,CAa( <br /> CUIXY,.weeX a=uu <br /> omen. <br /> Oie:a SUE' <br /> 1.SPECIAL REQUEST <br /> CO!"ME>RS OR REQUIEM: <br /> OVIERATOR'S CERTIFICA110•'I <br /> I cmffy NalIem auNodaed Io axa(ule Mks documentes on ouNorUed agont.I Percbycoddy that e:1 IWcr CU,tukrn'tied N Ike andetm(hedd>aunuels U correct to Na test el myknaa!ilgo.l dla conA that en7 <br /> ssmp:es suemlttsd arer(peeten-item of Neeclual wasla.11 Clain Ilarbondsca.en a dsuepancy dodng Na eppaid process.Geneetc,gran,Clem mbar No auNaray to­M Na pof:o,as Caen Hubou <br /> deems necessary,N(Kaci Ne dwepaecy. <br /> UTHORIZEO SIGNATURE NAME(PRINTT TITLE DATE <br /> Sr /n f�I( �(`�'z'i a��( �`•��5' ( .11Vll'i1Vt\'Vti yl(CL� 1017rr I (� <br /> J <br /> Report Pdnled On:Thursday.October 27.2016 AMNWE DIP rolllelWasto P(ordo.rdl Pana 3 of 3 <br />