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FEB-UI-2UU8 FRI 04: 15 N t - J16 <br /> ;aB/11/2007 14:26 70774 27 UNIVERSAL PAGE 07/08 <br /> Y e ® , Inc, <br /> • ,;, lntem83 Use Only <br /> Job Number: <br /> WASTE PRODUCT QUESTIONNAIRE <br /> 6�5Da <br /> i;,Mto w_1 tfg7tih q' o v f7/ / <br /> .. . �eEratnc $ lirtR ItaPAe � UR'IFE2563. BPPln6Wffi.4Tdt. <br /> Addzcss � Addhrsa 4101 INDRSTRT.AI, W,AY . <br /> oty,Smt,,'Z, City,Stas,Zip SEAiCIA.. CA. 945_ Lt�_ <br /> � �mteCt Sd—'✓tnv e�AT'R[t�p <br /> Phone Pax - Phode 707-747-1i�9 Fax_ ]07-7 7 1927— <br /> BFA H=xber _ - <br /> 11. WASTE r ROD.UGT DESCRIFrnON A 0HARACTE19MI"DS <br /> A. Wasld Product Common Name <br /> 1- Process GeneCaSing waste <br /> 8, H=rdous Pmpartle2: <br /> 1. U.S.EPA Ha:ardom Waste? O No Z Stale Oeda(a): F <br /> EPA Cotle(s): <br /> c.Iaweste Ro4uot ❑Shock SensI1be ❑Reactive {]P,adioaptivt L1 Pyrophorio O Etloioglcai 17 None <br /> C. Phyvleol Properties at 74°P, <br /> 1 Sk,3-Cal$tdtc: <br /> .. -. . Zu4L/Rvuh..PFW(ateCup <br /> yr <br /> ni <br /> mnar ta: <br /> 0 Solid []Sludge O Mtleyer�7 Q140-200°F By <br /> ATquld O Empy Contafner EI BI.Layared F ❑No R20h OMotor oil <br /> myfiEati)°F I <br /> Oyes ❑W / , noue ❑101-13`F 0 Exec, Itloney <br /> ❑Omer <br /> D. 1. venally: 2 %6cAds S. Odor: 4. Ph. <br /> Uquld Ibsrgallon 0 By Weight ❑None Oct 00.1-125 <br /> Solid O Ibs/cublcit MMy volume frtrong O'2-5 1>125 <br /> Any'debris In mask. Total Ll nand 1- ❑Exact <br /> .,'�Expwr. <br /> •.BE� � (Apoount ivr 10095 of Soca!): Rang tals: 'Solei (ppm) p"Inades,iteft)IONGe.Ppm <br /> '€ €nddn. . . . . <br /> % —EP Toxicity(mgA) Underie. . . , . . <br /> Arse,rt)-(As) <br /> - — ' % TDtt6phene <br /> ., % Chmmlum(Cr) 24,5-TP <br /> % ce Aper(CU). Other _ <br /> _ % Lead(P¢) <br /> % Mercury(Mg) . <br /> Wasnesmi A Other <br /> % Ntokel IN) Wastes <br /> . ' Sotenium(Se) Cvanldex DIOXin <br /> 'A Silver(Agj Sulfides _PDBs <br /> uric(Zn) HOC _ Phenols <br /> �ht>•strrslca+W.aryYinl � � �...,.. . .... ........ ..-�. <br /> 'tet-:Stn <br /> 1. D.O_T.Hazardous Mmerial?�Yas _No Z proper O.O.T.Shipping Name?. <br /> a D.O.T.Hazard C*s: 4. D.D.T.rD Numbtr,: : <br /> 9_ Method o(Shlpment: .Drum nn(i r R u Other S. b O T Shipping Con bier <br /> T. F'ro0oted volume: Tom—o�0>�-�GaRons--Cu6f6 Yards OFher & RQ Amourri <br /> Pot . One nme 1Naek Month Ouaner Year <br /> Comments: ., <br /> ,. Ill, 3ENERATO9 CERTIFICATFQN s rAmmENT <br /> I heroby cnrtJy Inas ay en null wrlerd myres:nigl(vu of sns generdur nulnCn.n:uv¢, all Information rmbmlaed in thla and an mg attacnadiloollmerltl <br /> Is true and/accurale.Anaiysfs of the w%je wm oonuuulcu Irl Oaotn danrs wit)I fine upprovmd feet methods in 40 CFR 261 an a reprPsentatltu aampla <br /> as defined In 40 CFR 261.20',To the best of my knc,,,•redgo,Oil knuwn t40 Cr H 251)ant)aus"Otsd hilurdeua Components hew been includcd1r <br /> Shia docbmantalion,An material d packaging will comply with all curiont mpulettlonC. <br /> Signature Trak/Date �7 <br /> . PORM 4O2tRen',ovo11 <br />