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US Ecology Nevada(Beatty) 800.239-3943 <br /> xmlogy US Ecology Idaho(Grand View) 800.274-1516 PROFILE# <br /> US Ecology Texas(Robstown) 804-242.3209 <br /> WASTE/MATERIAL PROFILE FORM US Ecology Michigan(Detroit) 804-396.3255 <br /> A. GENERATOR INFORMATION <br /> 1. Generator: Universal Service Recycling Inc ❑Billing Information is some ❑P.O.required for payment <br /> 2. Facility Address: 12.Billing Company: McDougall Environment <br /> 3200 S El Dorado St _ <br /> Stockton,CA 95206 13.Baling Address: PO Box 450 <br /> 3. Malting Address: 3200 S Ei Dorado St 14.Clty/State/ZIp: Georgetown,CA 95634�v <br /> 4. City/State/Zip: n Stockton,CA 95206 15.Billing Contact: Sean McDougall <br /> S. Technical Contact: Shaven Slater 16.Phone: 630-333-4684 � 7.Fax: - <br /> 6. Phone: 208-751-9946 7. Fax: 18.Finail: sewn@mconvironmentcom <br /> 8. Generator Status: CESQG 0 SQG LQG <br /> 9. EPA 11)#: CAL000355717 10.State ID#: <br /> 11. NAl(S CODES: 423930 <br /> B. SHIPPING INFORMATiON <br /> 1. US DOT Shipping name: Waste Corrosive Liquid,Basic,Inorganic,N.O.S.(sodium hydro)dkia) <br /> 2. Hazard Class: 8 3. UNINA#: UN3266 4. PaclkAiging Group: III S. RQ: 100 lbs <br /> 6. ContainerTypv: Ll Bulk Totes Pallet ®Boxes Drums Other,Describe: <br /> 7. Frequency: OYear Quarterly Monthly El 1 time Other,Describe: <br /> 8. Shipment: Size: `-gal Quantity: 1 9. Wasta►mport: Yes No <br /> M a Waste! Suppkmene) <br /> C. GENERAL MATERIAL&REGULATORTINFORMAT1Otd <br /> 1. Common name: Alkaline deaning aatution <br /> 2. Process generating: <br /> Aged,off-specification products <br /> 3. Describe physical appearance: <br /> Lav-viscosity liquid <br /> 4. Odor: ONone SlightStrong S. Physical State: Liquid Sludge/Slurry Solid <br /> 6. Describe Color:dear 7. Liquid phases: Single Double Layer Multi-layer <br /> 8. Knowledge Is from: _ OLati analysis ✓ MSDS to Process/generator knowledge <br /> 9. Waste/Material Type(US Ecology Texas customers only): N/A ®industrial Non-Industrial <br /> 10, Restricted under EPA Land Disposal Restrictions(9268)? ®Yes NoV yN <br /> 11. If LDR'Yes': [7 Wastewater Non-wastewater []Debris(§268.2) 112. Aft.Standards for sail? Yes ONo <br /> 13. Is the material RCRA hazardous waste containing benzene and originating at a Patroteurn Refinery(SIC 2911),Chemical <br /> Manufacturing Plant(SIC 28M thru 2899)or Coke by-Product Recovery Plant(SIC 3312)? (1/yes,compete semen D Yes ONo <br /> WastelMatefial Opemdaris SuMement Form and Thermal ment far!. <br /> 14. VO Conc.(§264.1083): 0 e500 ppmw a500ppmw 15. Has it been treated after point of generation? Yes ONo <br /> 16. CERCLA Regulated(Superfund)Waste: ®Yes 0 No 17. Butadiane waste regulated by 663 Subpart XX: 0 Yes ONci <br /> 18. Waste contains UHC eonsthuent(s)(§258.48),above a treatment standard,other than those for which the waste exhibits a Yes ONO <br /> charaderlstic H s,Ilse a1I UHC's rn sedkn A: <br /> 19. Waste exempt from definition of"solid waste"or"hazardous waste" (ff yes,fist reference 40CFR ): ®Yes ONci <br /> 20, State Waste Codes: 122 <br /> 21, RCRA Waste Codes: D002 <br /> 22. Source Code: G11 Discard 23. Form Code: W110 Caust 24. Management Code., fs (USE only) <br /> Revision date:06/24/16 Page l <br />