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t US Ecology Nevada(Beatty) 800-239-3943 / <br /> logy US Ecology Idaho(Grand View) 800-274-1516 PROFILE# <br /> US Ecology Texas(Robstown) 800-242-3209 <br /> WASTE/MATERIAL PROFILE FOR I US Ecology Michigan(Detroit) 800-396-3265 <br /> A. GENERATOR INFORMATION <br /> 1. Generator: Universal Service Recyci ig Inc ❑Billing Information is same ❑P.O.required for payment <br /> 2. Facility Address: 12.Billing Com <br /> 3200 S EI Dorado St parry: McDougall Environment <br /> Stockton,CA 95206 13.Billing Address: PO Box 450 <br /> 3. Mailing Address: 3200 S 1=1 DoradoSt 14,City/State/?fp; Georgetown,CA 95634 - <br /> 4. City/State/Zip: Stockton,CA 962 15.Billing Contact: Sean McDougall <br /> S. Technical Contact: Steven Slater 16.Phone: 530-333.46B4 17.Fax: <br /> 6. Phone: 209-751-9946 Fax: 18.Emafl: sean@mcenvironmentoom <br /> 8. Generator Status: 13 CESC 0 SQG LQG <br /> 9. EPA ID Ik CAL000355717 10.State ID#.- <br /> 11. <br /> :11. NAiCS CODES: 42393D <br /> B. SHIPPING INFORMATION <br /> 1. _US DOT Shipping name: Non-RCRJ Hazardous Waste Liquid(aluminum trihydrate) <br /> 2. Hazard Class: NIA 3. UN/NA#: WA 4. Packaging Group: NIA S. RQ:-none- <br /> 6. Container Type: 0 Bulk I Totes Pallet Boxes 0 Drums ®Other,Describe: <br /> 7. Frequency: OYear [3Quarterly Monthly ®1 time [3Other,Describe: <br /> 8, Shipment: Size: 5 al Quantity: 1 9. Waste Import: Yes ONo <br /> ( yes,corn WastelmpartS kmemJ <br /> C. GENERAL MATERIAL&REGULAToRYINFORMA71ON <br /> 1. Common name: Mixed elastomeric =pounds <br /> 2. Process generating: <br /> Aged,off-specification products <br /> 3. Describe physical appearance: <br /> Viscous liquid or paste. <br /> { <br /> 4. Odor: ONone Sligh Strong S. Physical State: 0 Liquid Sludge/Slurry Solid <br /> 6. Describe Color: off-white 7. Liquid phases: OSIngle [3Double Layer 0 Multi-layer <br /> 8, Knowledge Is from: ❑La analysis [0 MSDS ✓ Process/generator knowledge <br /> 9. Waste/Material Type(US Ecology T s customers only): N/A ®Industrial Nan-industrial <br /> 10. Restricted under EPA Land Disposal estActions(§268)? Oyes 0 No <br /> 11. if LDR"Yes": wastem itei on-wastewater Debris(§258.2) . 12. Aft.Standards for soil? Yes ONo <br /> 13. is the material RCRA hazardous wa containing venzene and originating at a Petroleum Refinery(SIC 2911),Chemical <br /> Manufacturing Plant(SIC 2800 thru 99)or Coke by-Product Recovery Plant(SIC 3312)? (if yes,complete Benzene 13 Yes ONo <br /> Wasts/MaterialO eraKonsSupplement ormand ThermalSu ntForm; <br /> 14. VO Conc.(§264.1083): E I<500 ppmw 0 2500ppmw 15. Has it been treated after point of generation? 13 Yes ONo <br /> 16. CERCLA Regulated(Superfund)West n Ij Yes 0 No 17. Butadiene waste regulated by§63 Subpart XX: Yes ONo <br /> 18. Waste contains UHC constituents)( 268.48),above a treatment standard,other than those for which the waste exhibits a Yes ONo <br /> characteristic. (if M list all UMCs In S coon Opt <br /> 19. Waste exempt from definition of'st ld waste"or"hazardous waste" (If yes,list reference 40CFR 1: Yes ONo <br /> 20. State Waste Codes: 491 <br /> 21. RCRA Waste Codes; -none- <br /> f' <br /> 22. Source Code: G11 biscard 23. Forns Coda: W51�3 Other 24. Management Code: H (USE only) <br /> j Revision date:06/24/16 Page 1 <br /> : <br />