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Ch : al Waste Management, c. <br /> Date Printed 06/20/05 Profile $ <br /> GENERATOR ' S WASTE P R 0 F I LE S ,. _ ET CWLEC3522 <br /> ( ) Check here if this 1s a Recertification LOCATION OF ORIGINAL KETTLEMAN HILLS FACILITY <br /> GENERAL INFORMATION <br /> 1. Generator Name: SHORE TERMINALS LLC Generator USEPA ID: CAD981997398 <br /> 2. Generator Address: 90 SAN PABLO AVE Billing Address: RINECO CHEMICAL INDUSTRIES INC <br /> ( ) Same <br /> PO BOX 729 <br /> CROCKETT CA 94525-1052 <br /> 3. ec nica <br /> Contact/Phone: SHAUNA SCOTT 501/778-9089 BENTON AR 720.8-0729 <br /> 4. Alternate Billing <br /> Contact/Phone: JASON COSTELLO 510/742-7332 Contact/Phone: BRENDA BARNETTE 800/377-4892 <br /> PROPERTIES AND COMPOSITION <br /> 5. Process Generating Waste: REMOVING AND REPLACING TANK SEAL - FROM GAS TANK TO PREVENT WATER SEPAGE <br /> 6. Waste Name: TANK SEAL (NON RCRA) <br /> 7A. Is this a USEPA hazardous waste (40 CFR Part 261)? Yes ( ) No (X) <br /> B. Identify ALL USEPA listed and characteristic waste code numbers (D.F.K.P,U): <br /> State Waste Codes: 352 <br /> 8. Physical State @ 70F: A. Solid(X) Liquid(_) Both(_) Gas(_) B. Single Layer (X) Multilayer (_) C. Free liq. range 0 to 0% <br /> 9A. pH: Range 0.0 or Not applicable (X) B. Strong Odor (_):describe <br /> 1011quid Flash Point: < 73F (_) 73-99F (_) 100-139F (_) 140-199F (_) >- 20OF (_) N.A. (X) Closed Cup (X) Open Cup (_) <br /> 11. CHEMICAL COMPOSITION: List ALL constituents (incl. halogenated organics) present in any concentration and forward analysis <br /> Constituents Range Unit Description <br /> DEBRIS to <br /> TANK SEAL CONTAINING FOAM/VINYL SEAL to 95 % <br /> BOLTS. NUTS. SMALL STEEL METAL BRACKETS 0 to 3 % <br /> RAGS 0 to 1 % <br /> PLASTIC 0 to 1 % <br /> LEAD to 13 MG/KG See attach2 <br /> IOTAL CUMPOSIT10N (MUSf EQUAL OR EXCEED 100%): =OUuu <br /> 12. OTHER: PCBs if yes, concentration ppm, PCBs regulated by 40 CFR 761 ( ). Pyrophoric ( ) Explosive ( ) <br /> Radioactive ( ) Benzene if yes, concentration _ ppm. NESHAP (-)-Shock Sensitive T_) Oxidizer (_T <br /> Carcinogen (_7 Infectious (_) Other <br /> 13. If waste subject to the land ban & meets treatment standards. check here: _ & supply analytical results where applicable. <br /> SHIPPING INFORMATION <br /> 14, PACKAGING: Bulk Solid (X) Bulk Liquid (_) Drum (_) Type/Size: CUBIC YARDS Other <br /> 15, ANTICIPATED ANNUAL VOLUME: 20 Units: CUBIC YARDS Shipping Frequency: ONE TIME <br /> SAMPLING INFORMATION Sample Tracking Number: 4979208 <br /> 16a. Sample source (drum, lagoon, pond, tank, vat, etc.): <br /> Date Sampled: Sampler's Name/Company: <br /> 16b. Generator's Agent Supervising Sampling: 17. (_) No sample required (See instructions.) <br /> GENERATOR'S CERTIFICATION <br /> 1 hereby certify that all information submitted in this and all attached documents contains true and accurate descriptions of <br /> this waste. Any sample submitted is representative as defined in 40 CFR 261 - Appendix I or by using an equivalent method. All <br /> relevant information regarding known or suspected hazards in the possession of the generator has been disclosed. I authorize <br /> 'WM to obtain a sample from any waste shipment for purposes of recertification. <br /> JIM PONDER PRESIDENT 6/16/05 <br /> Signature Name and fitle mate <br />