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FORWARfi <br /> INC. JOB # 2 =� rT3 <br /> APPROVAL# <br /> WASTE PROFILE FORM <br /> PLEASE DETACH AND RETURN TO:FORWARD INC., P.O.Box 6336,STOCKTON, CA 95207 F.ax(209)466.1067 PHONE(209)466-4482 <br /> A.GENERAL INFORMATION <br /> Generator Name: MALER INDUSTRIES Billing Name: JIM THORPE OIL, INC. <br /> Mailing Address: 40 Ashler Avenue Billing Address: P. 0. BOX 357 <br /> City: Los Gatos State: CA Zip: 95030 City: Lodi , State: CA Zip:95241-0357 <br /> Representative: Title: Representative: Martin Thorpe Title: Vice-President <br /> Telephone No.: Fax No.: Telephone No.: 209-368-6175Fax No.: 209-368-1851 <br /> Consultant Name: Transporter: same as above <br /> Mailing Address: Mailing Address: <br /> City: State: Zip: City: State: Zi <br /> Representative: Title: Representative: Title: p. <br /> Telephone No.: Fax No.: Telephone No.: Fax No.: <br /> B.WASTE STREAM IDENTIFICATION <br /> Site Address: <br /> Description of waste: <br /> Process generating waste: <br /> C. WASTE STREAM DESCRIPTION <br /> 1. Waste Type: A Soil ❑Sludge Q Ash ❑Treated Wood ❑Debris Q Asbestos ❑Other <br /> 2. Anticipated Volume: 192 Tons Cubic Yards #of Drums Other <br /> 3. Method of Shipment: Bulk solid ❑Containerized (Type); 4. DOT Proper Shipping Name: <br /> 5. Shipping Frequency: ❑Monthly Q Yearly XOne Time Q Other <br /> 6. Asbestos Containment Method: ❑Bags Q Canons Q Drums ❑ Wrapped ❑Other <br /> 7. Physical State: Solid Q Slurry Q Paste ❑ Powder Q Other 8. Percent Moisture: <br /> 9. Odor: ❑Strong ❑Mild XNone 10. Color of Material: Brown 11. PH: AOprox. 7 <br /> 12. Soil Type: % 75 Sand Silt 25 Clay 13. Free Standing Liquids: ❑Yes IX�No <br /> D. ANALYTICAL SUMMARY(ATTACH ALL CERTIFIED IAB RESULTS AND CHAIN OF CUSTODY DOCUMENTATION) <br /> TOTAL PETROLEUM AVG HIGH Units BTEX(EPA 8020) AVG HIGH Units <br /> HYDROCARBONS (PPM (PPM <br /> (S eci Method-re .8015) / b): / b) <br /> Gasoline 342 UO PPM e e .02 .026 PPM <br /> 12jesel 210 210 PPMu 1 .149 6.3 PPM <br /> Motor or TOG 3400 3400 PPM e e .966 5 .6 DPM <br /> VOLATILE ORGANICS SEMI-VOLATILE 9.828 47. PPM <br /> (Specify Method-e.g.8260) ORGANICS(EPA'8270) <br /> List Detected Analytes: List Detected Analytes: <br /> Other Analytical Methods: Other Analytical Methods: <br />