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DEC-15-201510:46 From: e To:12094683433 Page:3/4 <br /> M L <br /> y DEC 15 2015 <br /> Approval#: <br /> Approved by, <br /> FNA III#A7ROo(1.515�,'�t{ ... C It . T. '` pp Date: <br /> FACILITY INFORMATION "-`T'-'-sr_^"`'T"' - <br /> Contact Dina J Pat!Phi! <br /> Facility Name Pro-Touch Auto Repair Telephone 707-448-3 <br /> Address 255 Moffat Blvd Billing Address 6940 Tremont Road <br /> Manteca, Dixon, CA 95620 <br /> County San Joaquin Billing Contact ap Phazwasteremoval,com <br /> EPA ID No. CAL 000 299 266 Telephone 707-448-3700 <br /> SHIPPING INFORMATION Non-Hazardous❑ DOT Hazardous[] RChA Regulated❑ State Hazardous <br /> Shipping Name Non-RCRA Hazardous Waste Solid (Brake Shavinqs) <br /> DOT Hazard Class NIA UN/NA# NIA Packing Group NIA EPA Hazard Class NIA ERG# 171 Guide Year <br /> EPA Waste Codes State Waste Codes Additional Description(Section J) <br /> N/A 172 N/A <br /> Common Name of Waste Special Handling (Section 15) <br /> Brake Shavings <br /> CHARACTERISTICS Physical State SQI-ID Density N/A Specific Gravity N/A <br /> Reactivity ❑Shock Sensitive Liquid Solid XXX Flash Point(F) N/A Bolling Point(F) N/A <br /> El DOT Explosive ❑Water Reactive Sludge Gas Color/Appearance VARIES <br /> ❑Pyrophoric [f Air Reactive PhaseslLayers <br /> ❑Oxidizer ❑Acid Reactive Viscosity N/A 'Odor Q None 0 Mild M Strong <br /> ❑Cyanides M Alkaline Reactive Chlorine Content NIA Describe <br /> []Sulfides ❑Polymerizable pH N/A BTU/Lb <br /> CONSTITUENTS Avg% Min% Max% OTHER COMPONENTS PCI3's <br /> Cyanides NIA Phenolics N/A <br /> Cast Iron Shavings 100 100 Sulfides NIA Dioxins NIA <br /> Pesticides N/A Halogens NIA <br /> ANTICIPATED VOLUME <br /> Quantity Point of Measure <br /> Container Type- Per Type Selection <br /> Container Size <br /> REGULATORY INFORMATION <br /> _ Generating Process maintenance on Brakes <br /> _ and Rotors <br /> Infectious or Biological NRC Regulated <br /> Waste?NIA Radioactive? NIA <br /> Is this waste regulated under Spent <br /> METALS None Total(ppm) TCLP(mg/L) Subpart CC(VOC>=500 ppm? Slovent? <br /> Gallons Gallons NIA NO <br /> Avg Min Max Avg Min Max Is this waste regulated as an ozone depleting <br /> Antimony NIA Lead N/A substance(40 CFR part 82)? N/A <br /> Arsenic NIA Mercury N/A Does the waste contain scap metal pieces <br /> Barium N/A Nickel N/A greater than 2 inches In size? NO <br /> t3uryllium NIA Selenium_ N/A Is this waste subject to Benzene NESHAP <br /> Gadmlum NIA silvar N/A Regulations(D018,U019)? NO <br /> chromium NIS_ Thalllum N/A Is this stored in vented drums? NO <br /> Copper N/A zinc NIA Is this water pumpable? N/A <br /> Facility Certification <br /> I hereby certify that the above and attached description is complete and accurate to the best of my knowledge and ability to <br /> determine that no deliberate or willful omissions of composition properties exist and that all known or suspected hazards <br /> have been disclosed. I tify tha the annals tested are representative of all material describe by this profile. . <br /> Facility Signature Date r <br />