Laserfiche WebLink
Stericycle` <br /> r Environmental Solutions <br /> Work Order# <br /> Reviewed by: <br /> Date: <br /> Approval#: <br /> NFPA Class 4 Oxidizer Evaluation Form <br /> Generator Name: Generator Code: <br /> Generator Address: Contact Name: <br /> Generator Phone: Contact Phone: <br /> Important! Upon discovering an item requiring evaluation,do not remove it from the storage location. Only handle the container if <br /> necessary to gain access to the labeling information. You should make every attempt not to handle the container(s). If you need to <br /> handle the container to gain information,do so with extreme care. <br /> Shipping Description RCRA <br /> CHEMICAL NAME check one <br /> Tetranitromethane �UN1510 Waste Tetranitromethane, P112 <br /> Colorless to pale yellow liquid 5.1(6.1),PGI ZONE B,POISON INHALATION HAZARD <br /> Ammonium Perchlorate UN1442 Waste Ammonium perchlorate, D001 <br /> white powder 5.1,PGII <br /> D001 <br /> Guanidine Nitrate UN1467 Waste Guanidine Nitrate,5.1, <br /> white powder PGIII <br /> D001,D002 <br /> Hydrogen peroxide>90% UN2015 Waste Hydrogen peroxide,stabilized, <br /> Clear liquid 5.1(8),PGI <br /> *Ifparticle size is<15 microns,ammonium perchlorate is an explosive,per NFPA.Ammonium perchlorate may also bean explosive per DOT,as well. In both cases,a <br /> manufacturer MSDS is required to determine micron size and shipping information prior to approval If the material is determined to bean explosiveper NFPA and/or <br /> DOT,it will requirespecialized handling/removal;contact technical Services for disposal options <br /> Virgin/Sealed Material? Yes No or Spent? Yes No <br /> has the container ever been opened?(confirm with customer) Yes No If Yes,enter the date opened: <br /> Is there any evidence of crystalliztion,cloudiness,wisp-like structures,discoloration,solid mass or any other indication of <br /> contamination? Yes No If yes,describe: <br /> Yes <br /> Has the container been under pressure,bulging,ect.?(confirm with customer) No <br /> Container Information <br /> Yes <br /> Is the product in the original manufacturer's container? No <br /> Manufacturer: Purchase Date: <br /> Lot Number: Expiration Date: <br /> Container size: Volume/Weight remaining in container: <br /> Container Type: Glass Plastic Metal Other <br /> Cap Type: Glass Plastic Metal Other Cork <br /> Condition of Container: Rusted Bulging Dented Other <br /> Storage Conditions(confirm with customer) <br /> Was the material... <br /> Subject to direct sunlight? Yes No Unknown <br /> Subject to thermal or physical shock? Yes No Unknown <br /> Mixed with incompatibles(Alcohols, Yes No Unknown <br /> Call technical services for approval <br />