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FEB-01-2008 FRI 04: 24 PM I , J11 <br /> 05/11/(229©7�T1(4S.-226 7077 '{e3'227 j <br /> UNIVERSAL PAGE 06/08 <br /> ti3 i baa u �L 4� r {nterc9al use Ot1ty <br /> J Job Number. <br /> WASTE PRODUCT QUESTIONNAIRE - <br /> 5301.5 <br /> .ri%;_;. '•;•Lb.#7lo}h(JyRAd„ihFFD T4 � ., <br /> . •, <br /> MUM Name I1KI9dL AL <br /> TapA[S7 /lt <br /> C$y,Srata�Zip BE1Q"ICI6.. CA, 94,5�.0 <br /> Contact _ Contact^5.61D.ST_A 'OkD <br /> phone Fnx Phone_747-7474#09 Fax7D7-747-197 — <br /> FPA•Number <br /> IL WASTE PRODUCT OMORIP71ON A CHARADTHRISrl= <br /> A. Wvai�:Product Comnm Namo <br /> 1. Proc Generating Waste <br /> r <br /> t3. Hazardous Frdprties; <br /> 1. US.EPA Hazardous Was%? Pea O No P . state Uwe(s): . . <br /> EPA Code(s): <br /> . o,la Vfasta Product ❑Sneah 6enstuve El Raaclove ❑Radioactive ❑Pyrophohc d wolog'rcal ❑None <br /> 'G PI'rysical Froperdes at ib°F. <br /> 1. 'Pttystod State: R t.Ayera; S. Flash row(Ctosad Gvp Driy): 4. v6006-14-,aingae tm <br /> O 6olitl ❑Sludge ❑Murtkayered Q<70°F Y140-900°F t7 Water <br /> Qf!tqwd n Empty Carmol ner ❑Bi-layered 17 7.0-1w F O No Flash ❑Motor at; <br /> Any free Gquida at 70°F M2lWnD9QnDUG 13 101.1890F MExact0Honey <br /> . . <br /> 13 Yes ❑No <br /> d.:Detlsag p %691144; 9.Odcr: C_ ph. <br /> Uquldf—.JWgallon ❑By Weight El Norm - 04Rg8.1,r125 <br /> Sofid ibycubic it D By Voluma ❑strong ❑9,-5 13128 <br /> AnY deonvin waste: TStaI �9FId 9 Cl Fsact <br /> . •D Yes ❑No ((Describe: �! <br /> . .. .Ecpleln <br /> -E,. position(Armon!(or 1D0%of total):• 2g. g tats Pesfolldes.Heruiddes:PPM . <br /> � Total (PPM) <br /> —EP Toxicity(men) . <br /> . Araerrc(As) Undone . . . . . , <br /> % Malum(6a) nene <br /> hlor <br /> Gadlr;um(Cd) <br /> _ Chromium(Or) 2,a,5-TP <br /> % <br /> copper(OU) Olhar <br /> % Load(Pb) <br /> % Mercury(Hg) fieadtyes a Dthar <br /> % Nickel(NI) wastes(FPM); <br /> ah Se4enlum(se) Cyanides _ l "j, <br /> Silver(Ag) SrfFdes pCft <br /> Zino(Zn) HOC Phenols <br /> ' F. stgpWng end Ti�rdMg Intomtal6orc <br /> 1. DOT. Hazardous Matarial2Yes_No 2 Proper D.O.T.Shipping Name; J l 7 w N <br /> S. Method of Shipment—X—ilium and/or Bulk Diher 6. D.O.T.Shipping Oontamer <br /> T. Projected Volume: Tons k5Q Gallons Cubic Yells Ofher B,.RQ Amount <br /> o Quarter Year <br /> lar llrltal Is. <br /> Itl. GENERATOR Or"FIQATION STATEMENT <br /> I hor4y certify that as an euthefted mpresenurt(v5 or Me generator named above. all Wormation submttled In tliln rnd all the attacnsW documents <br /> Is true andlaocurata.Anaiyais of the weak vas conducted In accordance with the approved teal'mathcd;in 40 CFR 261 on a representative sample <br /> me dolled In 40 CFR W'r,yg;To the best of my knowledge.all known (40 OFR 261)and suspected hazardous components have been Included In <br /> anis documen h-Alt nd pautcaging will comply with alt wnent regulations. <br /> Sgnmto —_ _ "'�"'w-v�l 77� Oflte �• b <br /> FORW 442(Ro+,01rU71 <br />