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NVIGEIl _ � <br /> NERATOR WASTE PROFILE SHEET (continued) Page 2 of 2 <br /> ALLIED WASTE <br /> Waste Profile # <br /> �V. Physical Characteristics of Waste <br /> Characteristic Co on is %by Weight(range) <br /> 1 r <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> Color Odor(describe) Free Liquids %Solids pH Flash Point Phenol <br /> E]YES or MO <br /> Content % FTP <br /> Attach Laboratory Analytical Report and/or Material Sa Data.Sheet)Includtn Re uired Parameters Provided or this Pro de <br /> Does this waste or generating process contain regulated concentrations of the following Pesticides and/or Herbicides <br /> Chlordane,Endnn,Heptachlor(and it epoxides),Lindane,Methoxychlor,Toxaphene,2,4-D, or 2,4,5-TP Silvex as ❑ Yes or E+ <br /> defined in 40 CFR 261 337 <br /> Does this waste or generating process cause it to exceed OSHA exposure limits from high levels of Hydrogen Sulfide or ❑Yes or Riq.6 <br /> Hydrogen Cyanide as defined in 40 CFR 26123? <br /> Does this waste contain regulated concentrations of Polychlorinated Biphenyls(PCBs)as defined in 40 CFR Part 761 ❑ Yes or <br /> Does this waste contain regulated concentrations of listed hazardous wastes defined in 40 CFR 261 31,261 32,26133, ❑ Yes or E+110- <br /> includin RCRA F-Listed Solvents? <br /> Does this waste contain regulated concentrations of 2,3,7,8-Tetrachlorodibenzodioxm(2,3,7,8-TCCD),or any other ❑Yes or 2 ego <br /> dioxin as defined in 40 CFR 261 377 ❑ <br /> Is this a regulated Toxic Material as defined by Federal and/or State regulations? Yes or ❑"110 <br /> Is this a regulated Radioactive Waste as defined by Federal and/or State regulations? Yes or Lu <br /> =1±Co <br /> Is this a regulated Medical or Infectious Waste as defined by Federal and/or State regulations? ❑ Yes or L-lWo <br /> Is this waste generated at a Federal Superfund Clean Up Site? ❑Yes or[•�-h�o <br /> ANIL Generator Certification <br /> I hereby certify that to the best of my knowledge and belief,the information contained herein is a true,complete and accurate <br /> description of the waste material being offered for disposal and all known or suspected hazards have been disclosed All Analytical <br /> Results/Material Safety Data Sheets submitted are truthful and complete and are representative of the waste I further certify that by <br /> utilizing this profile,neither myself nor any other errzployee of the company will dehver for disposal or attempt to deliver for disposal <br /> any waste which is classified as toxic waste,hazardous waste or infectious waste, or any other waste material this facility:s prohibited <br /> from accepting by law I shall immediately give written notice of any change or condition pertammg to the waste not provided herein <br /> Our company hereby agrees to fully indemnify this disposal facility against any damages resulting from this certification being <br /> inaccurate or untrue I further certify that the company has not altered the forrn or content of this profile sheet as provided by Allied <br /> Waste <br /> aSS C / <br /> Authorized Rep sen ve Na e And Title(Pnnted) Company Name <br /> E�—' <br /> "" t - Date <br /> Authorized Re r ntative Si nature <br /> VII. Allied Waste Decision <br /> ❑Approved ❑ Rejected Expiration <br /> Conditions <br /> Name Title <br /> Signature Date <br /> ©Allied Waste,February 2001 <br /> REV 1 <br />