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Crosby Overton :CnC, MSTE PRODUCT QUESTIONAIRE 114604 <br /> [.GBEMTOR INFO 11014 <br /> Generator Name: UNIVERSAL SERVICE RECYCLING Billing Name: McDOUGALL ENVIRONMENTAL d <br /> Address: 3200 S EL DORADO ST Address: PO BOX 450 <br /> City,State Zip STOCKTON,CA 95206 City,State,Zip GEORGETOWN,CA 95634 fin_ i <br /> Contoct; Contact: SEAN MCDOUGALL <br /> Phone: Phone: 0 ( �1 <br /> Fax: Fax: 4� j <br /> EPA NU CALOM55717 <br /> Expiration Date: 16-APR-21 <br /> I!.WASTE PCP[PTION&CHARACTERSTICS <br /> A.Waste Product Common lame: ADHESIVES CONT A FLAMMABLE LIQUID'COMMODITY'PACK° <br /> Process Generating Waste: S,-_jL RPLVS AGED OR OFF SPEC PRODUCTS <br /> UNUSED PRODUCT IN ORIGINAL CONTAINERS <br /> B.Hazardous Properties- EPA Codas) EPA Code(s) <br /> D001 <br /> 1.US EPA Hazardous Waste? Y 331 -— <br /> 3.Is Waste Product Shock Sensitive Reyh�e Radioactive Pyrophanc Eildogicef X None <br /> C.Physical Propertlas&t70 deg r- <br /> 1.Physical State: 2.Layers 3.Flash Point(Closed Cup Only) 4.Vey,similarto: <br /> LIQUID HOMQGr'7dOUS <70 FF HONEY <br /> D.1.Danal#y <br /> 1,Density 2.%Wd 3.Odor 4.PH <br /> 5.1-9 PH <br /> -7.8 LB/GAL =.Q% <br /> Any debris In Waste: <br /> Explain: <br /> E.Chemical Composition{Aggauptfor 100%of total) Range Metals TTLC: Capper: <br /> FCONIIAODITY PACK�I 2xigd,lxlgal 0 _0 _ 46 Trial(PPM} Lead: <br /> ------ EP Toxicity(mg/1) Mercury: <br /> ,ADHESIVES ��--.—___. 100 -_-- 100 % <br /> AROMAnC OIL 30 60 _%____-.... Antimony: Nickel: <br /> CARBON BLACK 6 12 % Algerilc: Selenium: <br /> 't 11lYL ETHYL KETONE __—_ _ 5 7 % Barium: Silver <br /> -MdNERALSPIRITS 10 % I <br /> PETROLEUM ASPHALT.---._._.._._._ — 10 - 40 _ % _--- Beryllium Zinc: <br /> TETI2AHYDROFURAN 5 t5 Cadmium: Molybdenum: <br /> Chromium: Thallium: <br /> Cobalt: Vandum: <br /> Reacthes,&Other Pesticides,Heriaichies: <br /> Wastes(PPM): Endrin: <br /> Cyanides: Urbane <br /> Dioxin: MetMxcychlor. <br /> Sulfides: Tm . <br /> PCBs: P24D: <br /> HOC: P246TP: <br /> PYsnols: Pother: <br /> F.Shipping and Handling information- <br /> 1.D.O.T.Hamidous Matsrid7YES 2.D.O.T.Shirong Narne: UW133,Waste Adhesives,[containing ing a flammable liquid],3,II,RQ <br /> 3.D.O-T.Hazard Class: 3 4.D.O.T.ID Number Packing Grasp: If <br /> 5.Method of Shipment: Drum X Bulk Other 5.D.O.T.Shipping Container: <br /> 7.Projected Volume: <br /> Comments: <br /> GENERATOR CERTIFICATION STATEMENT: I hereby certify the as an Whaized mpiwwAaifve of the penwator named above,all Information submitted in this and all the <br /> aftachad documents is true ano,accurale. Analysis of the vete was conducted In a ocordw4s Win the appmed test methods In 40 CFR 261 at a repmserlaWe sample as defined <br /> in 40 CFR 261.20. To the bee of my knowhedpe,all knovm(40 CFR 261)and suspected hazardous components have bun included In this documentation. All material and packaorg <br /> will comply oath ail current regulations. <br /> Gsasrator°s Authorized Signature 7718 Date <br />