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GENER**A+OR'S WASTE PROFJLZ ET <br /> PM87 MW R{WK oft TYPE <br /> '. PHYSICAL CHARACTERISTIC&OF WASTE (See InstrucWM) <br /> Color ? Does the waste have 3 Physical State Q 70'F121-C: 4. Layers, b gravity 6. Free Liquids: <br /> a strong Incidental odor! Solid 0 SemtSolid ❑MkrlflAfayow ❑Yes OF No <br /> attb�+d ,❑ Yes; so,v ❑Ofher �► <br /> Liquid 0 Powder Phi Raw A volume. <br /> descr1 <br /> PH:0 92 ❑�2.4 K4.7 0 7 [37-10 ❑110-<i 2.5 d a1 ax. ❑Range ❑NA <br /> 1. Flash point: 'None <140-F/60°C 140-iwmeo-93-C ❑ Closed Cup ❑ C <br /> up <br /> 1.CHEMICAL COMPOSITION niutot t►rra+aaau► <br /> DIES c L f;n c�l •o_ •_o!96 2. Does tho wa*cin any of the following? <br /> (provide <br /> 11.1M. !fes �If Ietown): <br /> t •a e _ .S3-45b—% % ilio• or LW"TNM or ACIMAL <br /> PCBs Q<50 ppm ppm <br /> /e Cyanides 6t.. fl<3o ppm pprn <br /> % Sulfides M c 500 ppm ppm <br /> Total: ► _.� <br /> yp.".no(e: Unless analytical results are attached,the chemical composition identification shotfld InClude,at a minimum,Arsenic.Barium. <br /> Cadmiuin.Chromium,Lead,Mercury,Selenium,Silver,Pesticides,Herbicides,onQ lacy ocher TCLP constituents that may be <br /> present in the waste. The total composition must be greater than or equal to 1001A. (•0001`A=1 ppm or 1 mgA) <br /> Indicate method used to determine oomposifion(if provided): ❑ TCLP .1P TIAW ❑ Other: <br /> I.SAMPLING SOURCE(e.g.,Drum,iLegoon,Pit.Pond,Tank,Yat) Std `t� � •• -• <br /> REPRESENTATIVE SAMPLE LEER tQqCAT�U O N C� 2. Sample I)ats a9�tggy,� <br /> Print Sampler's Name <br /> Sampla(R Title k Lb o)trt--k - <br /> Samplar's Employer(if other than Generator): PR U o OLi T 4 E N v i Fop NE4ITAL. LASS <br /> me samptees signature certifies that any sample submitted is representative of the walte dj#4 lbed ebbe pumuant to 40 CFR 261.20(c)or <br /> equivalent rules. <br /> Sa nvior's Si9nsturo <br /> . GENERATOR CERTIFICATION <br /> y signing this profile sheet,the Generator certifies: <br /> This waste is not a"Hazardous Waste" as defined by USEPA or Canadian Federal mguNow tlilWor the statelprovince. <br /> This waste does not contain regulated radioactive materials or regulated concerttrat"s agPM's(Potyohlodnated Biphenyls). <br /> The un.haded portions of this sheet and the attachments contain true and accurate die of 1116 waste material. All relevant informa- <br /> tion reaardrng)mown or suspected hazards its the possession of the Generator has been 0.4Ciosod. <br /> The Generator has read and understands the Contractor's Definition of special Wasto Inetudsd in Part B.5.of the attached insuuctiorts form. <br /> All types and amounts of special wastes provided in incidental amounts have been IdenWod Imsoa;Mon 6.5.of this form. <br /> The analytical data presented herein or attached hereto wore derived from testing a repfeaentativa sample taken in accordance with <br /> 40 CFR 261.20(c)or equivalent rules. <br /> all notify the Contractor prior to providing the waste to the Contractor. <br /> If any changos occur in the character of the waste,the Generator sh <br /> Signature a. Title <br /> Name k T eorPrint i0.-Date <br /> Ifs <br /> 60 3EJVd -1ViN3WN081AN3 1HJIdM ZGTSZE860ZT ZT:GT 966T/6T/00 <br />