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FIProfileTM WASTE MANAGEMEVOT Requested Facility: Lockwood Regional Landfill (Refuse, Inc.) ❑ Unsure Profile Number: 117103NV ❑Multiple Generator Locations(Attach Locations) Ild Request Certificate of Disposal 0 Renewal?Original Profile Number: 117103NV A.GENERATOR INFORMATION(MATERIAL ORIGIN) B.BILLING INFORMATION ❑SAME AS GENERATOR 1. Generator Name: USR Nevada 1. Billing Name:Universal Service Recycling Inc. 2. Site Address: 8455 Sheep Dr 2. Billing Address:3200 South EI Dorado (City,State,ZIP) Carson City NV 89701 (City,State,ZIP) Stockton CA 95206 3. County: 3. Contact Name:Richard Balch 4. Contact Name:William Mendonca/Tom Hightower 4. Email: rbal h est_rscran.com 5. Email:wmendoncafa_usrscrap com 5. Phone:(209)944-9555 6. Fax:(2009)944-5552 6. Phone:(209)944-9555 7. Fax:(209)944-5552 7.WM Hauled? ❑Yes 0 No 8. Generator EPA ID: Id N/A 8. P.O.Number: 9. State ID: Ud N/A 9. Payment Method: 0 Credit Account ❑Cash ❑Credit Card C.MATERIAL INFORMATION D.REGULATORY INFORMATION 1.Common Name:Metal Shredder Residue 1. EPA Hazardous Waste? ❑Yes* m No Describe Process Generating Material: ❑See Attached Code: Material delivered to site in and processed to recover metallic's and 2. State Hazardous Waste? ❑Yes la No plastic using eddy current separator,magnets and infrared scanner. Code: Materials shredded are aluminum,tin and appliances.No auto bodies 3. Is this material non-hazardous due to Treatment, have been or will be shredded Ll Yes* 0 No Delisting,or an Exclusion? 4.Contains Underlying Hazardous Constituents? L1 Yes* 0 No 2. Material Composition and Contaminants: L3 See Attached 5. From an industry regulated under Benzene NESHAP? L3 Yes* 0 No 1.Rubber 6. Facility remediation subject to 40 CFR 63 GGGGG? L3 Yes* 0 No 2.Di rt so0%F ass 7.CERCLA or State-mandated clean-up? Ll Yes* 0 No 3. 8. NRC or State-regulated radioactive or NORM waste? Yes* 0 No 4.Foam Rubber so0% Ll Yes,see Addendum(page 2)for additional questions and space. Total comp.must be equal to or greater than 100% >_100% 3.State Waste Codes: CI N/A 9• Contains PCBs? 4 If Yes,answer a,b and c. 0 Yes ❑No 4.Color:Brown and White a. Regulated by 40 CFR 761? ❑Yes 0 No b. Remediation under 40 CFR 761.61 (a)? Ll Yes C)No 5. Physical State at 70°F: PJ Solid L]Liquid Ll Other: ' c. Were PCB imported into the US? L3 Yes 0 No 6. Free Liquid Range Percentage: to 0 N/A 10.Regulated and/or Untreated 7. H: to �N/A ? Ll Yes No p Medical/Infectious Waste. 8. Strong Odor: ❑Yes el No Describe: 11.Contains Asbestos? ❑Yes 0 No 9. Flash Point: ❑<140°F ❑ 140°-199°F 162!200' ❑N/A 4 If Yes: ❑Non-Friable ❑Non-Friable-Regulated ❑Friable E.ANALYTICAL AND OTHER REPRESENTATIVE INFORMATION F.SHIPPING AND DOT INFORMATION 1.Analytical attached 0 Yes 1. ❑One-Time Event 0 Repeat Event/Ongoing Business Please identify applicable samples and/or lab reports: 2. Estimated Quantity/Unit of Measure: 7200 20020736-001,20020736 0 Tons ❑Yards ❑Drums ❑Gallons ❑Other: 3. Container Type and Size:40 Yard Roll-off or Endump 4. USDOT Proper Shipping Name: 0 N/A 2.Other information attached(such as MSDS)? ❑Yes G.GENERATOR CERTIFICATION(PLEASE READ AND CERTIFY BY SIGNATURE) By signing this EZ ProfileT11 form,I hereby certify that all information submitted in this and all attached documents contain true and accurate descriptions of this material,and that all relevant information necessary for proper material characterization and to identify known and suspected hazards has been provided. Any analytical data attached was derived from a sample that is representative as defined in 40 CFR 261 -Appendix 1 or by using an equivalent method. All changes occurring in the character of the material(i.e.,changes in the process or new analytical)will be identified by the Generator and be disclosed to Waste Management prior to providing the material to Waste Management. ❑ I am an Authorized Agent signing on behalf of the Generator,and I have confirmed with the Generator that information contained in this profile,as well Certification Signature as supporting documents provided,are accurate and complete. n Name(Print): Alexis Williams Date: 03/23/2020 Title: CFO Company: Universal Service Recycling, Inc. THINK GREEN. QUESTIONS?CALL 800 963 4776 FOR ASSISTANCE Revised June 30,2015©2015 Waste Management