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***A Copy of this acceptance pro must accompany every Hazardous & Non -T rdous manifest*** <br />When completed, please Fax to (909) 421-7103 <br />Profile Acceptance #: 06060243 <br />Filter Recycling Services, Inc. <br />7. Box 449 - Colton, California 92324 <br />Date: <br />Authorized By: <br />_ Generator Information <br />I Household <br />I <br />I CESOG <br />Checkifaanlicable <br />B. FRS Sales Representative: <br />Generator Name: Valero - Stockton Terminal <br />Mailing/Manifest Address: <br />If different <br />Name: D MARTINEZ <br />Site Address: 2941 Navy Drive <br />DECON Env. Svcs, Inc. <br />Phone # 510-670-9901 <br />City, State, Zip Stockton, CA 95206 <br />23490 Connecticut Street <br />C. Broker Information: <br />U.S. E.P.A. ID #: CAT000617514 Hayward, CA 94545 <br />Name: DECON Env. Svcs. Inc. <br />Technical Contact: Jason M. Costello <br />osition: DECON EH&S Mgr. <br />Address 23490 Connecticut St, <br />City/State: Hayward, CA 94545 <br />Phone Number: (510) 732-6444 x20 <br />Fax Number: (510) 782-8584 <br />Contact: Mr. Jason M. Costello <br />Name of waste: Vinyl Rubber Seal From Gas Reservoir Floating Roof <br />Phone: (510) 732-6444 x20 <br />Process Generating Reconditioning of Large Gas Tank / Reservoir <br />the Waste: <br />Fax: (510) 782-8584 <br />D. Characteristics ATTACH ANY MSDS and ANALYTICAL THAT HAS BEEN PERFORMED <br />Color <br />Odor <br />Phrsicat State A 70* <br />Lavers <br />Free Mau ids <br />E. Metals <br />VARIOUS <br />Liquid <br />Multi -layered <br />}{ <br />No <br />None <br />TCLP (MGIL) <br />Totals (Ppm) <br />BTU/LB <br />jone.g <br />Semi -Solid <br />Bi -layered <br />Yes <br />Arsenic <br />Below <br />Selenium <br />X <br />Solid <br />X <br />Single Layered <br />% <br />Barium <br />RCRA <br />Silver <br />Flash Point <br />140 - 200° F Densiti, <br />Cadmium <br />Levels <br />Copper <br />< 70° F <br />> 200° F Lbs/Gal <br />Chromium <br />Nickel <br />70-100° F <br />X <br />No Flash Lbs/Ft <br />Lead <br />Zinc <br />101-139° F <br />Exact API Gravity <br />Mercury <br />Cyanides <br />PHRan-ve <br />R PhysicaUChemical Composition <br />G. Shipping Information <br />- 2 <br />%Vinyl Rubber 90-100 <br />Plastic Sheeting / Debris 0-5 % <br />PPE 0-5 % <br />% <br />% <br />TOTAL (should =100%) % <br />Proper Shipping Non-RCRA Hazardous Waste Solid <br />Name: (Vinyl Rubber Seal) <br />2-4 <br />4.1-10 <br />Hazard Non-RCRA <br />Class <br />UN/NA #: Non-RCRA <br />10.1-12.4 <br />State <br />Code: 352 <br />EPA Non-RCRA <br />Code: <br />=12.5 <br />RCRA Hazardous <br />YesX <br />No <br />Exact <br />Volume: 2x55 -gallon 1A2 Drum <br />X <br />One -Time <br />Bulk Liquids <br />Bulk Solids <br />Drums <br />X <br />Drums <br />Boxes/ Sacks <br />Monthly <br />Method of Shipment <br />.2.x 55 -gallon 1A2 Drum _ - _ - - <br />_ <br />Gallons <br />Yards <br />Annually <br />H. Special Hand[[n2 <br />In ormation: <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 />ages, the generator will notify Filter Recycling Services Inc. prior to shipment. The generator is solely responsible for the <br />oral of any material that may be delivered to Filter Recycling Services, Inc, that is not disclosed in the above profile. <br />Signature: <br />- <br />Printed <br />Name: <br />Title: <br />Date: <br />