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C� i (,1 W Arm 0 003 3 ) � Yl',7.T� <br />Generator's Waste Profile Worksheet�� <br />E,rrgr,•.m Um OdY / <br />/ Evergreen Oil, Inc. Approval #: 141314 <br />6880 Smith Ave. Approval Date: b/bo <br />Newark, CA 94560-4224 Process: urrP- +tw - 9 tas <br />,, Phone - (510)795-4400 Fax - (510)796-2559 <br />EPA 1D# CAD980887418 <br />A. Generator & Customer Information <br />Generator Name: &14 5TAA L2!__ _ ___ Generator EPA lD#: C4rG'Jb4 17 ,>`(V <br />Generator Code p::isnmq•E.e,r,Kni . Phone #: 02 0�7-'fqj_ j <br />Address:s2/YII�%*�y %I Fax#: <br />City: s�'J_CYJE�±✓y State:,::�tc�c, _ _ Zip Code: k �.P' <br />Technical Contact Name: <br />Customer Name: <br />Customer Code t ,:tea by E .,aeeni <br />Phone <br />#: <br />Address: <br />Fax #: <br />City: <br />State: <br />Zip Code: <br />B Waste Description <br />Explosive- ❑ Yes 21 No Loose -Packed Material- <br />❑ Yes <br />Ej <br />Waste Name: <br />Oily Water <br />❑ Yes <br />Q <br />Process Generating Waste: <br />Various, including Cleaning, General Maintenance <br />❑ Yes <br />Waste Source: ❑ Unused Product or Chemical <br />❑ Spill Cleanup <br />'❑ Planned Site Remediation <br />cn",'Fafldw r't'tl' ❑] Waste By -Product from Process ❑ Lab Pack <br />❑ Other <br />Cleaning <br />C. Physical Characteristics <br />❑ Yes <br />❑' <br />No <br />Reactive Cyanide- - ❑ Yes R1 No Halogenated Organic Compounds>1,000 ppm- <br />❑ Yes <br />2 <br />No <br />Color: Cloudy/Dark <br />Odor: <br />Mild/Oil-like <br />Physical State Q 70 F: Flash Point: <br />❑ < 73 degrees F pH: <br />❑ <2.0 <br />Specific Gravity: <br />Liquid <br />❑ 73-140 degrees F <br />❑ 2.1-6.0 <br />0 < 1.0 <br />❑ Solid lfliquid,: ❑ Single -Layer <br />❑ 141-200 degrees F <br />El 6.1-8.0 <br />❑ 1.0 <br />❑ Sludge 0 Bi -Layer <br />7 > 200 degrees F <br />❑ 8.1-12.4 <br />❑ > 1.0 <br />❑ Gas ❑ Multi -Layer <br />❑ N/A <br />❑ >12.5 <br />❑ N/A <br />Viscosity: Low (e.g. water) BTU/Ib: ❑ < 5,000 <br />rlmrvm. ❑ Medium (e.g. motor oil) ❑� 5,000-10,000 <br />❑ High (e.g. molasses) ❑ > 10,000 <br />Do any of the following characteristics apply: <br />Explosive- ❑ Yes 21 No Loose -Packed Material- <br />❑ Yes <br />Ej <br />No <br />Shock Sensitive- Yt-s"f�l-No'—Bio=Hazardous- - -- -- -- <br />❑ Yes <br />Q <br />No <br />Pyrophoric- ❑ Yes❑ No Radioactive- <br />❑ Yes <br />E <br />No <br />Polymerizable- ❑ Yes e❑ No Asbestos containing- <br />❑ Yes <br />E <br />No <br />Reactive Sulfide- ❑ Yes 2 No Volatile Organic Compounds> 500 ppm- <br />❑ Yes <br />❑' <br />No <br />Reactive Cyanide- - ❑ Yes R1 No Halogenated Organic Compounds>1,000 ppm- <br />❑ Yes <br />2 <br />No <br />ID Ciemical Composition <br />Musi add up to of least 100%. Include inert materials and/or type of debris of applicable <br />--Chemical Constituent ---- --Range ---- Unit — - Chemical Constituent <br />Range <br />Unit <br />Water 50-99 % <br />Petroleum Hydrocarbons 1-50 %o <br />Solids (Dirt, Rust, Sludge) 0-30 %d <br />Page 1 of 3 <br />