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***A Copy of this acceptance pr. -,must accompany every Hazardous & Non -H, rdous manifest*** <br />When completed, please Fax to (909) 421-7103 <br />Color <br />Profile Acceptance #8 <br />Filter Recycling Services, Inc. <br />'.O. Box 449 - Colton, California 92324 <br />Lavers <br />Date: <br />E. Metals <br />Authorized By: <br />x <br />A. Generator Information <br />I Household I I CESOG <br />Check if applicable <br />B. FRS Sales Representative: <br />Generator Name: Valero Tenninal - Stockton <br />Mailing/Manifest Address: <br />If di erent <br />Name: <br />Site Address: 2941 Navy Drive <br />23490 Connecticut Street <br />Phone # 510-670-9901 <br />City, State, Zip Stockton, CA 95206 <br />Hayward, CA 94545 <br />C. Broker Information: <br />U.S. E.P.A. ID #: C A T 0 0 0 6 17 5 14 <br />Semi -Solid <br />Name: DECON Env. Svcs, Inc. <br />Technical Contact: Jason M. Costello <br />osition: EH&S Mngr. <br />Address 23490 Connecticut St <br />Ci /State: Hayward, CA 94545 <br />Phone Number: 510-732-6444 X20 <br />Fax Number: 510-670-9904 <br />Contact: Jason Costello <br />Name of waste: Flourescent Light Tubes <br />Phone: 510-732-6444 X20 <br />Process Generating Facility Light Maintenance <br />the Waste <br />x Solid <br />Fax 510-782-8584 <br />D. Characteristics ATTACH ANY MSDS and ANALYTICAL THAT HAS BEEN PERFORMED <br />Color <br />Odor <br />Physical Side (470• <br />Lavers <br />Free Liquids <br />E. Metals <br />VARIOUS <br />x <br />None <br />Liquid <br />Multi -layered <br />x <br />No <br />None <br />TCLP (MG/L) <br />Totals (ppm) <br />BTUILB <br />Mild <br />Semi -Solid <br />Bi -layered <br />Yes <br />Arsenic BELOW <br />Selenium <br />Strong <br />x Solid <br />x <br />Single Layered <br />Oxxx <br />% <br />Barium RCRA <br />Silver <br />F1ashPpint <br />140-2000F Density <br />Cadmium LEVELS <br />Copper <br />< 700 F <br />> 2000 F Lbs/Gal <br />Chromium <br />Nickel <br />70-1000 F <br />x No Flash Lbs/Ft <br />Lead <br />Zinc <br />101-1390 F <br />Exact API Gravity <br />Mercury <br />Cyanides <br />PHRanee <br />F.EkujcaUChemicalComposition <br />G. Shippinelnformabon <br /><2 <br />%q <br />% <br />Flourescent Light Tubes <br />% <br />(not broken) <br />% <br />% <br />TOTAL (should = I00%) % <br />Proper NON HAZARDOUS WASTE SOLID - <br />Shipping <br />Name: UNIVERSAL WASTE-FLOURESCENT <br />LIGHT TUBES <br />2-4 <br />4.1-10 <br />Hazard <br />Class <br />UN/NA #: <br />10.1-12.4 <br />State <br />Code: <br />EPA <br />Code: <br />> 12.5 <br />RCRA Hazardous <br />Yes <br />x <br />No <br />Exact <br />Volume: 2 x Cardboard Boxes <br />One -Time <br />Bulk Liquids <br />Bulk Solids <br />Drums <br />Drums <br />X Boxes/ <br />Sacks <br />Monthly <br />Method of Shipment <br />2 x Cardboard Boxes <br />Gallons <br />Yards <br />Annually <br />H. Special Handlinn <br />Information: <br />WEAR APPROPRIATE PPE WHEN HANDLING. <br />Generator of this waste certifies, that the information above is true and accurate. The determination of this waste stream was <br />derived by state certified analysis and/or generator knowledge. If the physical or chemical composition(s) of the waste stream <br />changes, the generator will notify Filter Recycling Services Inc. prior to shipment. The generator is solely responsible for the <br />'is osal of any material that may be delivered to Filter Recycling Services, Inc. that is not disclosed in the above profile. <br />,signature: <br />Printed <br />Name: <br />Title: <br />Date: <br />