Document 0qdn81BKvJymBwzz4V3bE2GMV

Mins EnvironmentalServinas imInn P 0 Box 609. Deer Park. Texas 7 7536 1713) 479-6001 1 BILLING INFORMATION 2 PICK-UP LOCATION HO 4ZZ94- WILL 8E ASSIGNED BY RES(TXV IN company namf PPG Industries, Inc. AnnnFssP. 0. Box 1000 riTV Lake Charles statfLA 7IP 70601 contact ^ere Clark PHONF-^ 8 491-4215 company namp PPG Industries, Inc. AnriRFSs P. 0. Box 1000____________ CITY Lake Charles Mike Huber CONTACT LA .STATE 70601 -ZIP. 318 491 4858 .PHONE 3 MANIFEST INFORMATION 4 GENERATOR INFORMATION company name Industries, Inc. USEPA i D LAD-008086506 Twr , 0 99922 ADDRFSS P, 0. BOX 1000 riTV Lake Charles STATF ^ contact Anne Corbello phone name 7IP 70602 name 318 491 4364 Gerald L. Perry TECHNICAL CONTACT .PHONE 318 491 437( Shift Superintendent PHnNF318 491 434( EMERGENCY CONTACT 5 GENERAL INFORMATION GENERAL WASTE DESCRIPTION Trichloroethylene and Perchloroethylene Heavy Still Bottoms & F Cartridges Production of Trichloroethylene and Perchloroethylene PROCESS GENERATING WASTE OUANTITY OFNFHATFO 2000 lbs UNITS PFR year TIME .FREQUENCY OF REMOVAL. 18 NUMBER . TIMEfSl PER. year PERIOD 6 SHIPPING INFORMATION DOT HAZARDOUS MATERIAL7 0 YES 0 NO TEXAS WASTE CODE NO. 992030 OOT PROPER SHIPPING NAME ____ HazaxdODS Wa$te_golid, .,n.o_.,s.--------------------- DOT HAZARD CLASS ORM-E OOT 10 NO NA 9189 1 pound USEPA HAZARDOUS WASTE NUMBERfS). K030 and Polychlorinated Biphenyls REASON FOR THE ABOVE CLASSIFICATlONlS) Listed Specific Source Hazardous Waste 40 CFR 261.32 HAZARDOUS SUBSTANCE Chlorinated Hydrocarbons CONCENTRATION 40-60Z HAZARDOUS SUBSTANCE CONCENTRATION 7 SHIPPING METHOD 0 ENCLOSED VAN OPEN TOP VAN O TANK TRUCK 0 VACUUM TRUCK DUMP TRUCK 0 TANK CAR 0 FLATBED ROLL-OFF BIN 8 GENERATOR'S METHOD OF COLLECTION DRUMS TYPE v7cD0T 21-C/55.g,fol DUMP BIN 0 CUSTOMER DELIVERY 0 OTHER_________________ other OTHER SHIPPING REQUIREMENTS OR INFORMATION _____________________________________ _____ SL 022033 dd D ADDITIONAL DATA ATTACHEO 0 SAMPLE PROVIDED 0 GENERATORS SAMPLE NO Lab Log #817 ___ EVERY ITEM ON THIS WASTE DATA SHEET MUST BE RflMPi FTt CHAMPION BUSINESS FOAMS - form Ho f? 10 HAZARDOUS CHARACTERISTIC Qc OSHA LISTED COMPOUNDS PESTICIDES WITH SPECIFIC DISPOSAL REQUIREMENTS ETIOLOGICAL AGENTS RADIOACTIVE S9 PCB's-- 50 ppm INFECTIOUS AGENTS DIOXIN BIOLOGICAL MATERIALS PATHOGENS ASBESTOS 11 CHEMICAL COMPOSITION CHEMICAL name CONC ' SHOULD TOTAL 100CHEMICAL NAME CONC Solids (Steel, Fiber, polypropylene) 40-60 Fentachloroethane 1-2 Irons Trlchloroethene 20-40 Hexachloroethane 1-5 Pentachlorobutadiene .1-. 1-2 Tetrachloroethanes (sym & unsym) . 1-.5 Hexachlorobutadiene 1-2 PLEASE ATTACH ADDITIONAL SHEETS AS REQUIRED 12 CHARACTERISTICS COLOR Black APPEARANCE CORROSIVITY pH. Corrosion Rate, ipy_ ODOR OTHER N/A NONE PHYSICAL STATE a 70 F LAYERING FREE LIQUID: H MILD S STRONG Solvent GASEOUS S SOLID LIQUID SEMI-SOLID Z POWDER 5f NONE z bi-layered Z MULTI-LAYERED X YES % BY VOLUME . I IGNITABILITY Flash Point. F. N/A Vapor Pressure, mm Hg 25'C. N/A Open Cup Closed Cup Specific Gravity.-JV/A- 13 METALS TOTAL/UNITS UNKNOWN TCLP or EP TOX/UNITS TOTAL'UNITS Pb. TCLP or EPTOX'UNITS 14 REACTIVITY EXPLOSIVE PYROPHORIC REACTIVE CYANIDE REACTI\ Ag, Se. WATER REACTIVE Z SHOCK SENSITIVE OTHER___ As. Cu. 15 TOTAL HALOGENS Ba. K , UNKNOWN FLUORINE. . BROMINECHLORINEI00INE. Cd. Na. 16 OTHER PROPERTIES A H COMBUSTION .BTU/* Cr. Mn, Hg MELTING POINT - CHLORIDES ;o ASH P 7n BOILING POINT F TOC mn/l TOTAL CN Sb Si i ..... Be. Tl Ni totai soi ms TOTAL OISSOLVED SOLIDS. BOD . mq/l TOTAL s COD______ mg/I VISCOSITY UNKNOWN 17 EP TOX ORGANICS NOT EXPECTED ENDRIN_ LINDANE. .ppm _ppm methoxychlqr. TOXAPHENE _ _ppm .ppm 2 4 DICHLORPHENOXYACETIC ACID 2 4 5 - TRICHLOROPHENOXYPROPIONIC ACID. 18 LAND DISPOSAL RESTRICTIONS IS THIS WASTE RESTRICTED FROM DIRECT LAND DISPOSAL BY ANY REGULATIONS THAT ARE IN EFFECT ON THE DATE OF THIS WASTE DATA SHEEP B YES NO . cP .ppm .ppm IF YES. DESCRIBE WHICH RESTRICTIONIS) APPLIES TO THIS WASTE SEE 40CFR PART 268 40 CFR 268.10. First Third Rule St 0K34 I HEREBY CERTIFY AND WARRANT THAT THE INFORMATION SUPPLIED ON THIS FOAM AND ON ANY ATTACHMENTS OR SUPPLEMENTS REGARDING THE IDENTIFICATION OF THIS WASTE iT$ CONSTITUENTS ANC KNOWN OR SUSPECTED HAZARDS IS COMPLETE AND ACCURATE I FURTHER CERTIFY AND WARRANT THAT THE IDENTIFICATION IS THE RESULT OF AN ANALYSIS OF A REPRESENTATIVE SAMPLE OF ThF wa OBTAINED AND ANALYZED in ACCORDANCE WITH TESTING PROCEDURES of the U S ENVIRONMENTAL PROTECTION agency OR av The APPUCATIOH of KNOWLEDGE OF the process generating WASTE fA A i k. I AA (SHADED AREAS FOR RES USE ONLY) 1i nnc no - ; SAMPLE NO. ROLLINS ENVIRONMENTAL SERVICES UNIFORM WASTE DATA SHEET (SCHEDULE A) RFS RAI FS EXFC: tt CONTRACT NO . STRFAM NO H0"42294 A. GENERATOR INFORMATION 1 Generator Name: ______ PPG INDUSTRIES. INC. 2 Technical Contact: WILLIAM H. COOPER, ASSOCIATE RESEARCH CHEMIST,3 4 Emergency Contact: SHIFT SUPERINTENDENT 6. Generator USEPA I D.: LADn08nfi6506 SAME 'TM* Title 1 8 7 Generator State 1 D N/A Phone No. Phnne No 318-491-4250 318 491 4340 3 Disposal State I.D.: TWC ID 99922 B. PICK UP LOCATION i Company Name; 2. Address. PPG INDUSTRIES, INC. COLUMBIA SOUTHERN ROAD 3 City URSTTAtTF, 4 State T.A 5 7ip Code- 70669 6 PickuD Contact: CHARLES PARNELL AREA FOREMAN. C. MANIFEST INFORMATION 1 Company Name: ppq INDUSTRIES 2. Address: P 0 BOX 1000 TNG, ENV. .Title! 7 Phone No 318-491-4858 3 City LAKE CHARLES 4 state- LA 5 7ip Code- 70602 6 Manifest Contact: VICKI CORMIER. ENV. SECRETARY 7 Phone No 318-491-4831 . Title! D. INVOICE INFORMATION 1 Company Name: ? Address PPG INDUSTRIES. INC. P 0 BOX 1000 3 City: LAKE CHARLES 4 state- LA A 7ip Code- 70602 6 Invoice Contact: GINGER BUSBY - ACCOUNTS PAYABLE CLERK Title! 7 Phnne Nln 318-491-4526 E. GENERAL WASTE DESCRIPTION i Name Of Waste: TRICHLOROETHYLENE AND PERCHLOROETHYLENE HEAVY STILL BOTTOMS AND FILTER CARTR 3 Process Generat.no Waste- PRODUCTION OF TRICHLOROETHYLENE AND PERCHLOROETHYLENE 3. Quantity Generated: 2000 LBS Per YEAR ................ iYearMonthi F. SHIPPING INFORMATION Yes No G i EPA RCRA Hazardous Material 2. EPA Hazardous Waste Number(s): ip 3. Disposal State Regulated Material ___________ mGO, NAQ189 ip 4 DOT Regulated Material 5. State Waste Number Generating State:________ Disposal State:. 99203Q 6. PmnernnTShinpwgMem*- HAZARDOUS WASTE SOLID, N.O.S., ORM-E, NA9189 (K030 AND CONTAINS POLYCHLORINATED.. BIPHENYLS) RQ 7, DOT Hazara Class: ORM-F 8. DOT IIN/NA No NA9189 G. METHOD OF SHIPMENT 1. C3 Drums: Type/Size:. DQT-21-C/55 GAL 2. Bulk: Type/Size:. 3. Other (Please be specific):__ 4 D Transportation Requirements: Paae 3 of 6 ENCLOSED VAN 3. RQ (lbs!____ 1 SL 022035 'IS 0^ 9t I. REGULATORY COMPLIANCE Yes No G 1 OSHA Listed Compounds Specify ------------------------ 2. Radioactive Material E 3. PCS: < 50 ppm IS 50 - 500 ppm > 500 ppm 4 Biomedical Waste G 5 FIFRA Pesticides Specific Disposal Requirements Q 6 Asbestos____________________ CHEMICAL COMPOSITION* (must add up to 100/ 1 Chemical Name TETRACHLOROETHENE 1,1,2,2-TETRACHL0R0ETHANE PFNTAC.HT .OROETHANE 1,4-DICHLOROBENZENE HF.XACHLOROETHANE 1,2,4-TRICHLOROBENZENE *k HEXACHLOROBHTADTENE Stream No. HO 42294 Yes No 0 7. Benzene jp 8 California List Regulated Waste 0 9. Solvent Regulated Waste G 1^] 10. Dioxin Regulated Waste (F020. F021, F022. F023, F026. F027, F028) E Oil. First One Third Regulated Waste G G 12. Second One Third Regulated Waste G Q 13 Third One Third Regulated Waste Concentration 15-20 % 1-2 % 1-5 % .5-1% 1-2 % .5-1% 10-15% CASRN RQ(LBS.) j 1 'PLEASE ATTACH ADDITIONAL SHEETS AS REQUIRED i. PROPERTIES OF WASTE 1 Color____ BLACK_____ 2. Odor: _____STRONG 3 Ignitability (Flash Point) ______ >140F 4 Corrosivity pH NA *F 5 Melting Point. fi Roiling Point7 TOC 8 TOX: Q Vmrosity 10 Vapor Pressure11 Bromine1? Ifxf'ne I^JItionne- -NA------------------- F NA F NA rng'i 30.59% ______________ JD9.1 NA CPS <3 25-C NA mmHa (3 NA % NA % NA 0>/ 1 l^^ianide 15, Sulfur: age a of 6 5-50-419 12 99 NA -U____________ % % Yes No 16. Flowable @ 25 ;C G 17. Physical State @ 25C (68F): Q Powder G Gas G Sludge or Semisolid G Liquid G Other 18. Heat of Combustion ,, Ash 17 20. Sulfur 0.47 ED Solid % Solid Q Single Phase G Multilayered 8,674 BTU/lb /0 Ib.NaOH/lb 21. Specific Gravity/Bulk Density: 75 T.RS________ 22. Chlonne 30 * 59 % Turn Page and Complete Page 5 Stream No. HO-42294 K. REACTIVE CHARACTERISTICS Yes No H! '3 1. Explosive Yes 5. Air Reactive 6. Reactive Cyanide: 1 2. Pyrophoric 7. Reactive Sulfide _ Zj lx] 3. Shock Sensitive 8 Oxidizer:________ Zj 51 4. Water Reactive 9. Other __________ L. ELEMENTAL ANALYSIS (Total Metals required for incineraDle waste; TCLP or EpTox Metals required for landfill waste.) Total/Units Total/Units TCLP or Eptox/ Units ; Antimony 2. Beryllium 3. Copper 4. Nickel 5 Thallium 5. Zinc NA NA 9.9 11 <2.0 31 ng/Kg mg Kg mg/Kg mg/Kg mg/Kg Additional Requirements for RES (TX) Inc. 7, Arsenic 3. Barium 9. Cadmium 10. Chromium 11. Lead 12. Mercury 13. Selenium 14 Silver <1.2 ' mg/Kg 46 mg/Kg < 0.5 mg/Kg 9.1 mg/Kg 7.3 mg/Kg < 0.2 < 1.2 < 1.0 mg/Kg ma/Kg mg/Kg 15. Manganese 16 Potassium 28 NA mg/Kg 17 Silicon 18. Sodium NA NA Additional Requirements for RES (NJ) Inc. 19. Molybdenum 20. Vanadium M. TCLP ORGANICS "" nn47-Ter-rar,hlorethvlene. D046-1.1.2.2-Tetrachloroethane, D030, -1,4-Dichlorobenzene D037 Hexachloroethane, D036-Hexachlorobutadiene N. DISPOSAL CERTIFICATIONS i Is this waste excluded from direct land disposal by land disposal regulations that are in effect on the date of this Waste Data Sheet9 O Yes No if yes. describe which restrtction(s) applies to this waste. (See 40CFR268 and 40CFR761.) 2. Under 40CFR268. can this waste be landfilled directly or chemically stabilized and landfilled? If yes, completed RES Certification Form must be attached to each Manifest. 3. Under 40CFR268, should this waste be incinerated? G Yes Cj No If yes, completed RES Certification Form must be attached to each manifest. 4 Additional information Yes K3 No i hereby certify and warrant that the information supplied on this form and on any attachments or supplements represents a compiet ind accurate identification and description of this waste material, its constituents and its known or suspected hazards. I further certi' and warrant that this information is the result of an analysis of a representative sample of the waste obtained and analyzed i accordance with testing procedures of the U.S. Environmental Protection Agency or by the application of knowledge of the proces Generating the waste materials. / Signature: TITI P Associate Research Chemi DATE: June 9,__1989 SL 022037 Dage 5 of 6 AA-JtiO Ppv ' 'J PR Turn Page and Complete Page 6 llor PC8 Hem $OZZq IS Stream No. POLYCHLORINATED BIPHENYL (PCB) ITEMS A. IDS. 1 Name of Original Fluid 2 Name of Solvent____ 3 PCB Concentration _ B. CAPACITORS: 1. Quantity ' ounds ___ C. TRANSFORMERS: 1 Dimensions__________________________________________________ 2 Nameplate Gallons ___________________________________________ 3 PCB Concentration._______________________________________ __ 4 Shipping Weight__________________________________________ 5. Ship Full: Drained Only, D Drained and Flushed iER PCB ARTICLES: 1. Specify method of Shipment on page 3. section _ Specify method of shipment on page 3. section C Specify method of shipment on page 3. section C Specify method of shipment on page 3. section G ROLLINS ENVIRONMENTAL SERVICES Corporate Office Rollins Environmental Services ISALESi in; Mail To One Rollins Plaza P.O. Box 2349 Wilmington. DE 19899 Ship To: One Rollins Plaza. 2200 Concord Pikc Wiimmoton. DE 1980? (3021429-276? 1-800-X-WASTES Fax 13021 479-3335 NEW JERSEY Rollins Environmental Services ISALESi me Mail To PO. Box 33" Briageport NJ 080i 4 SniD To Rt, 322 & I-2S5 Briageport NJ 0801 a 16091 467-3105 Fax (6091 467-104C LOUISIANA Rolnns Environmental Services ISALESi mMail To' P,0. Box 741 r ILLINOIS Rollins Environmental Service ISALESi In. 135-C East St. Charles Roac Carol Stream IL 60185 13121 260-94TT- Fax 1312) 260-0161 TEXAS Rollins Environmental Services ISALESi m: Mail To P.O. Box 60- Deer Park Texas 77536-060: Snip To. 2027 Battiearound Roac Baton Rouge LA 70874-413" Snip To 13351 Scenic Hignwa. Deer Park tx 77536 17131 479-60C- "Fax 17131 479-669- Baton Rouae. LA 7080' 15041778-1242 Fax (5041 774-858: CALIFORNIA Rollins Environmental Services ISALESi in: Rollins Environmental Service of Louisiana ir _ 1781 Fox Dnv? Mail To Deep Well Facility. Rt 2 P O Box 120: Piaouemine LA 7076- San jose, CA 9513' 14081 437-9770 Fax 14081 437-066: Snip To: West Sorrell Roaa. Gracie Lar-: Piaouemine. LA 70764 1504) 659-2434 Fax 15041 659-78- Page 6 o! . Be. 2 8- 21-701 WASTE ANALYSIS REPORT Environmental Laboratory PPG Industries, Inc., Lake Charles, LA Sample SfiJ/c/s -Prtw j/cr/lri' iJhii Y4s>\Ve.d Location of Sample Sample Collector /lesu/teJ Sfl/j StP4v>^s Ccrr>*r oP dornj Sr^iP/s Sp Qern Perjlr / Sample Method/Device 4pi Ar*Jo /Sceo/* Date of Sampling - n/nfif />ts~ Date All Analyses Completed - OiJ/t/gf Report Submitted by: ____________________________________________________________ __________ *________________Tfo-P* ; ANALYSIS RESULTS Teat Faxaaatara Icnitabilitv ( ""I - N/A Corroaxvity pH 1 : ** - N/A Rleya)cti-viNty/A :neh/Yr Standard 140QF mxn 2 - 12.3 0.230 max M) Lab Lex Sarnia Identification Number EP Toxicity Ik K A - H/A Aa 3.0 max Ba 100.0 max Cd 1.0 max cr _ 3.0 max > 3.0 max aa . . 0.2 max Sa 1.0 max At 3.0 max w-- l Other FuaMun (If needed) ( ) - M/A II CBLCRmASIS HYDROCARBONS Chioxeatfena _ CPC) Oiloroathane (EC) OlchUmnathanm _ OMU) l.l*01aUANUMB. (PDC) l.l-Dtchloanetfean* _ (DC*) A/x) 1.2-Dlehlacaathana (ele/trana) A/O Trlchlmuneehana (OCU) NO 1.2-OUhlaMathaie (EDC) NO 1.1. l-Trlcbloreettaane (MC) NO Tatraehlanxaathie (CC11) NO TrlchLoroethene (Trlchlor) A>> 1.l.Z-Trlchloroethane (TCE) A/O L. 1.1.2-Tetrachloroathene (unrra) NO l. 1.2.2'Tatrechloroethana (sym) _ >* 03 t Tetrachleroethene (Parehlor) isr.U \ PantachLoroethene (Panta) . _ 0,02, V. Saxeehleteethane (Haxa) a!D Haxaehlorebtitadlene (RCBO) o '/<r*/. TOTAL CLBC UM) o/a ____ihL*t Pa. tea// 3tf.Z./4n /jh /3,XV* _. I 1 .. t 092039[ Jl1 i L&Je Lag * '/ TEST PROCEDURE -------------------------------------------------------------------------------------------- -------- -------------- ---------------------- W Paramet r Method Used 1 Ignitability O-fJ/A Pensky-Martens Closed Cup Tester ASTM Standard D-93-79 Setaflash Closed Other (specify) Cup Tester ASTM Standard D-3278-78 Corr sivity (pH) C^N/A SW-846 Method 9040 pH Measurement other (specify) Corrosivity (inch/yr) 'fl'N/A National Association of Corrosion Engineers Standard TM-01-69 a Other (specify) Reactivity ^X/k (One affirmative answer will classify waste r activ ) 1) Normally unstable without detonating? 2) Reacts violently with water? 3) Forms potentially explosive mixture with water? 4) Cyanide or sulfide bearing waste which can generate toxic gases, vapor or fumes under pH conditions between 2 and 12.5? 5) Capable of detonation or explosive reaction if subjected to strong initiating source or if heated under confinement? 6) Readily capable of detonation or explosive decomposition or reaction at standard temperature and pressure? 7) Forbidden Class A, or Class & explosive as defined in 49 CFR 173.51, 173.53, and/or 173.88? SV 846 Parameter Method Parameter EP Toxicity As 7060 _ SW-846 Be 7080 C1HC (Method 1310) Cd 7131 $r N/A Cr 7190 Pb 7420 TCLP* Hg_ 7470 Q'N/A Se 7740 * Toxicity Characteristic Leaching Procedure SV 846 Method 7761 5030 Parameter Method Used CLUH lQjstiz d CU . _ LABORATORY IDENTIFICATION Laboratory: fPA Analyst(s): . c. Test Parameters Analyzed and Date ' ------------------------------------------------------------------ :-------------------- 2o^ 02 S^ Revision 1-18-89 F. A. Corbello Rollins EnvlronmsntalServicesmo Inc. P 0 Box 609. Deer Park. Texas 77536 (7 13) 479-6001 PPG File 505,6.89 1 BILLING INFORMATION 2 PICK-UP LOCATION company name PPG Industries, Inc, ADDRESSP 0 Box 1000 riTv Lake Charles<;tate LA ;ip 70602 contact Jere Clark phonf 318/491-4215 COMPANY NAMF PPG Industries. Inc. ADDRESS______ Columbia Southern Road city Westlake statf LA 7ip 70669 contact Mike Huber phonf 318/491-4858 3 MANIFEST information company NAMF PPG Industries r Inc ADDRESS_______ P 0 Box 1000__________ i-ity Lake Charles STATF LA 71 p 70602 ccintact Anne Corbello phtinf 318/491-4364 5 GENERAL INFORMATION 4 GENERATOR INFORMATION USEPA i D LAD-008086506 rwr. i o 99922 name Gerald L, Perry TECHNICAL contact name Shift Superintendent EMERGENCY CONTACT phcimf 318 7491-43 70 PHnNF318/491-4340 Filter Cartridges PROCFSS GENERATING WASTE Production of Trichloroethylene and Perchloroethvlene QUANTITY GFNFRATFO 2000 lbs UNITS 6 SHIPPING INFORMATION pfr year TIME frequency of rfmovai 18 NUMBER _ TIMEIS) PER DOT HAZARDOUS MATERIAL7 G3 YES Q NO TEXAS WASTE CODE NO. 992030 DOT PROPER SHIPPING NAME Hazardous Waste Solid, n.o.s. year PERIOD DOT HAZARD Cl ASS , QRM"E nnT in no NA 9189 USEPA HAZARDOUS WASTE NUMBER(S). K030 and Polychlorinated Biphenyls Rn 1 pound reason for the above CLASSIFICATIONS) Listed Specific Source Hazardous Waste 40 CFR 261.32 HAZARDOUS SUBSTANCE Chlorinated Hydrocarbons CONCENTRATION 40-601 HAZARDOUS SUBSTANCE CONCENTRATION 7 SHIPPING METH00 O ENCLOSED VAN OPEN TOP VAN DUMP BIN TANK TRUCK O VACUUM TRUCK Q DUMP TRUCK 0 CUSTOMER DELIVERY D TANK CAR 0 flatbed ROLL-OFF BIN OTHER_____________ 8 GENERATOR'S METHOD OF COLLECTION DOT 21-C/55 gal nRIIMS TYPF ' SI7F TANK OTHFR OTHER SHIPPING REQUIREMENTS OR INFORMiatidn JL1 SL 022041 ADDITIONAL DATA ATTACHED 03 SAMPLE PROVIDED 0 GENERATORS SAMPLE NO Lab LB #817 EVFRY ITFIH DM THIS WASTE DATA SHEET MUST BE COBIPtFTF CHAMPION BUSINESS FORMS - Form No 80 Revision 1-18-". FAC 10 HAZARDOUS CHARACTERISTICS HO-42294 OSHA LISTED COMPOUNDS PESTICIDES WITH SPECIFIC DISPOSAL REQUIREMENTS ETIOLOGICAL AGENTS RADIOACTIVE G9 PCB's-- 50 ppm INFECTIOUS AGENTS DIOXIN BIOLOGICAL MATERIALS PATHOGENS ASBESTOS 11 CHEMICAL COMPOSITION SHOULD TOTAL 100J- CHEMICAL NAME CONC ' :hemical name CONC Solids (Steel, Fiber, Polypropylene) 45-55 Hexachloroethane 1-2 Tetrachloroethene (Perchlor) 15-25 Pentachlorobutadiene 3-6 Tetrachlnrnethanes (svm L lmsvml <1-5. Hexachlorobutadiene 5-12 Pentachloroethane PLEASE ATTACH ADDITIONAL SHEETS AS REQUIRED 5-10 Unknowns <1-10 12 CHARACTERISTICS COLOR Black APPEARANCE CORROSIVITY pH. Corrosion Rate. ipy. ODOR NONE PHYSICAL STATE a 70 F LAYERING MILD GASEOUS 3 NONE IS STRONG OTHER solvent 9 SOLID LIQUID 3-7 IGNITABILITY Flash Point. F >140*? SEMI-SOLIO 0 POWDER si-layered 0 MULTI-LAYERED Vapor Pressure, mm Hg <S> ?5JC Open Cup S9 Closed Cup 514 lb/yd3 Specific Rramtv FREE LIQUID- 13 YES % BY VOLUME <1 NO N/A_____ 03--05 g/mL 13 METALS TOTAUUNITS AgI TCLPor EP TOX/UNITS TOTAUUNITS Pb. Se. TCLPor EP TOX/UNITS 14 REACTIVITY EXPLOSIVE -4 w None PYROPHORIC REACTIVE CYANIDE WATER REACTIVE SHOCK SENSITIVE OTHER REACTIVE SU^| As' Cu. 15 % TOTAL HALOGENS Ba/ CO/ Cf/ Hg______ /____ K. Na,, Mn. Sn. FIllORINE . 0 BROMINE 0 CHLORINE 40-5QODINE 0 16 OTHER PROPERTIES A H COMBUSTION 9,000 BTU/# MELTING POINT 40-50 F CHLORIDES ASH 1 -2 % P! Zn. BOILING POINT F TOC mq/l TOTAL CN % Sb/ Si/. Be______ I Tl_ Ni. TOTAL SOLIDS % BOD _ mq/l TOTAL DISSOLVED SOLIDS___ ___ % COD______ mg/I TOTAL S VISCOSITY % CP 17 EP TOX ORGANICS ENDRIN_ LINDANE. .ppm _ppm METHOXYCHLOR. TOXAPHENE _ _Dpm -ppm 24 OICHLORPHENOXYACETIC ACID 2.4.5 TRICHLOROPHENOXYPROPIONIC ACID_ 18 UNO DISPOSAL RESTRICTIONS I IS THIS WASTE RESTRICTED FROM DIRECT UNO DISPOSAL BY ANY REGUUTIONS THAT ARE IN EFFECT ON THE DATE OF THIS WASTE DATA SHEET SB YES NO _ppm .ppm IF YES. DESCRIBE WHICH RESTRICTION(S) APPLIES TO THIS WASTE SEE 40CFR PART 268 _________________ 40 CFR 268.10. First Third Rule______________________ SL 022042 42294 19 I I HEREBY CERTIFY AND WARRANT THATTHE INFORMATION SUPW.IEDON THIS FORM ANOON ANY ATTACHMENTS OR SUPPLEMENTS REGARDING THE IDENTIFICATION OF This WASTE ITS CONSTITUE NTS ANOIT5 '~~l KNOWN OR SUSPECTED HAZAAOS IS COMPLETE ANO ACCURATE I FURTHER CERTIFY AND WARRANT THAT THE IDENTIFICATION IS THE RESULT OF AN ANALYSIS OF A REPRESENTATIVE SAMPLE OF thf WASTE OBTAINED ANO ANALYZED :N ACCORDANCE WITH TESTING PROCEDURES OF THE US ENVIRONMENTAL PROTECTION AGENCY OR BY THE application OF kNOWlEOGE OF The PROCESS GENERATING THE U ,f) / /**/**- En_n_v__.j _Control ROLL' ENVIRONMENTAL SERVICES UNiHORM WASTE DATA SHEET (EXHIBIT B) 30C. NO.. CONTRACT NO.. A. GENERATOR INFORMATION RES SALES EXEC: # SAMPLE NO________ STREAM NO./ -HQ-42294 SAMPLE RECaVEO-OATF^^ 9 Pumtaainn extant- Gerald Clark, Manager-Purchasing Dept. d Technical rnntart- William H. Cooper - Env. Control Spec'. fi Emeraenoy Contact- Shift Superintendent (Tide) R Generator IJSFPA ID- LAD008086506 (Title) B. PICK UP LOCATION 1. Company Name: _ 2, Address (not P.O. Box):. 3. City._________________ 6. Pickup Contact: Same Columbia Southern Road Lake Charles _____________________ 4. State: r.arcnn Fog T2T 3. Phone No. I318 > 491-4215 5. Phone No. (318 ) 491-4250 7 Phone No. (318 , 491-4500 5. Zip Code:. 70602 7. Phone No. (--218)__ 491-432S C. MANIFEST INFORMATION (it same as "B", write "SAME" but indicate Manifest Contact below if different)1 1. Company Name:_____ SAME___________________________________________________________________ 2. Address: P f) Rot 1000 3. City:______ Lake Charles 4. State: 6. Manifest Contact- Vicki Cormier. Env. Secretary LA 7T1W _______ 5. Zip Code:. 70602 7. Phone No. ( 318 ) 491-4618 MNVOICE INFORMATION (if same as "B" or "C" write "SAME" but indicate Invoice Contact below if different Company Name: SAME2 3 2. Address:______ SAME AS ABOVE 3. City: 4. State: 5. Zip Code:. 6. Invoice Contact:. Cinger Bushyr Aret. Payahle Clerk TRBST 7. Phone No. ( 318 ) 491-4526 E. GENERAL WASTE DESCRIPTION 1. Name of Waste: Tr-irhlnrnethy1ene and Perchloroethvlene Heavy Still Bottoms Cartridges 2. Process Generating Waste: 3. Quantity Generated: Production of Trichloroethylene and Ferchloroethylene______________ 2200 lbs. Year Per. (YMr of Month) F. SHIPPING INFORMATION (check all that apply) Yes No Yes No 1. Gt EPA RCRA Hazardous Waste 2. Wastewater or 0 Non-Wastewater 3. 0 TSCA Waste 4. All applicable EPA Hazardous Waste Codes and subcategones including Characteristic ("D") codes:______ F025/D040 /D039 TSCA Waste Code: 992030 Yes No Generating 5. YQea No Disposal State Regulated Material 6. State Number: T .AnnnsnRA5r)6______ 7. Ci DOT Regulated Material 8. DOT Shipping Name: HaTarrfmin ua.ot-e 9. DOT Hazard Class: 9 PGIII 10. DOT (UN/NA) No.: NA3077 Destination State Waste Code Number: 992P3Q . (.containssTricnTo~roethv solid, n.o.s and rei lItIoi ueri iv lerie) 11. RQ (lbs,):. lb G. METHOD OF SHIPMENT t KXDrums: Type/Size: DOT 21-C/55 gal Other (Please be specific):__________________ 4. E Transportation Requirements: Yes No Enclosed Vai 5. Custom r to Transport 2. Bulk: Type/Size: Yes No 6. Truck Scale at Customer Site SL 022043 CUSTOMER REVISION: Signature _ Date _ Stream No.. HO-42294 H. REGULATORY COMPLIANCE (check all that apply) Ye# NO 1. B OSHA Carcinogens (list below) .ppm -ppm -ppm 2. 3 Radioactive Material a Q TSCA Regulated PCS (fill in appropriate concentration below): < 50 ppm 0 50-500 ppm > 500 ppm 4. Q Biomedical Waste [3 Infectious Waste Yes No 5. H FIFRA Pesticides with Specific Disposal Requireme? 6. E Asbestos 7. SI Benzene 8. jt California List Regulated Waste 9. Q Solvent Regulated Waste 10. IS Dioxin Regulated Waste (F020. F021, F022, F023. F026 F027, F028) 11. 2 First. Second or Third Third Regulated Waste 1. WASTE COMPOSITION (must add up to a minimum of 100%) 1 Chemical Name and Constituent Solids (steel, fiber, polyethylene) Tetrachloroethylene Tetrachloroethane (sym & unsym) Concentration (range 10%) 45-55% 15-25% 1 <1-5% CASRN N/A 127-18-4 79-34-5 j j RQ(lbs.) N/A 1 1 Pentachloroethane 5-10% 76-01-7 , 1 Hexachlorobutadiene | Trichloroethylene Unknowns j Hexachloroethane ! i I :i1 j 1-2% 5-12% <1-10% 1-2% ' : 1 87-68-3 79-01-6 N/A 67-72-1 1 i i 1 100 N/A 1 A ~ i i TOTAL > 100% ---- J. PROPERTIES OF WASTE (write "NA" for all that don't apply) 1. Color Black 2. Odor. Strong 3. Ignitability (Flash Point): >140 F 4. pH 3-7 or Corrosivity. mm/yr 5. Melting Point:________ _____RMg 6. Boiling Point:________ UNK 7. TOC (Total Organic Carbon):, 8. Viscosity.___________ UNK 9. Vapor Pressure, M/A 10. Bromine:_____ mg/L CPS @ 253C (77F) mmHg @ J* 11. Iodine:________ 12. Fluorine: __ 13. Chlorine: _ 501 14. Sulfur:___ JLL ym No 15. E Rowable at 25JC (77 F) % % % 16. Physical state at 25C (77' F) and phases by volume (check all that apply): Powder 0 % (phase orla Gas Q__% Sludge/Semisolid G Liquid G Solid % 0^2_% 98-100 % Other _____________ _________ % I 17. % Solid by Weight: 85-95% 18. Heat of Combustion: 19. Ash:______________ 9.000 1.7 20. Scrub: 0.47 21. Specific Gravity:____ . or Bulk Density: 22. VOC (Total Volatile Organic Compounds): BTU/lb % lb. NaOH/1 [aste 7^ UNK u.ft mg/L CUSTOMER REVISION: Signature. Page 4 of 6 res-kmis r*v. V90 SL 022044 Date. Turn Page and Complete Page : Stream No. HQ-42294 K. REACTIVE CHARACTERISTICS (check all that apply) Yes No . C? Explosive 2. 3 Pyrophoric Yes No 6. G Reactive Cyanide: _ 7. Reactive Sulfide:__ mg/kq mg/kq 3. 3 Shock Sensitive 8. 3 Oxidizers (specify): 4. 3 Water Reactive 9. Other (specify):___ 5. C? Air Reactive L ELEMENTAL ANALYSIS (Total Metals and TCLP metals data are required for incineration waste streams.TCLP metals data are required for landfill material. For liquid wastes with less than 0.5% solids, total metals (in mg/kg) x density of waste (in kg/L) = TCLP results (in mg/L).* (Record data for all that apply). Total Metals: SJ mg/kg mg/L Antimony (Sb) Arsenic (As) Barium (Ba) Beryllium (Be) Cadmium (Cd) <1.0___________ <1.0 <0*3 <0.3 <0.3 Chromium (Cr) Chromium VI (CrVI) Cobalt (Co) --CG4----------------UNK UNK ppm (Check a Copper (Cu) Lead (Pb) Manganese (Mn) Mercury (Hg) Molybdenum (Mo) Nickel (Ni) Potassium (K) UNK 3.8 UNK <0.09 JSL5. Selenium (Se) Silicon (Si) Silver (Ag) Sodium (Na) Thallium (Tl) Vanadium (V) Zinc (Zn) <0.3 1.5 TCLP ^004. - Arsenic__ ^TO700055 Barium___ 0006 - Cadmium _ 0007 - Chromium (mg/L) <0.2 <0.02 <0.03 <0.04 TC Level 5.0 100.0 1.0 5.0 0008 - Lead____ 0009 * Mercury _ 0010 - Selenium. 0011 - Silver___ TCLP (mg/L) <0.1 <0.0002 <0.2 <0.02 *N.B. EP Toxicity Characteristic data are acceptable until 9/25/90, or 3/25/91 for small quantity generators. TC Level __ 5.0 ___ 0.2 ___ 1.0 ___ 5.0 M. ORGANIC TOXIC CHARACTERISTIC WASTE (specify EPA waste code and TCLP results (mg/L) for all that apply; see instructions for list). D028 3.56 mg/L _______________________________ ^_________________________ _____ mg/L mg/L .mg/L mg/L _ mg/L _ mg/L . mg/L .mg/L . mg/L . mg/L N. RECOMMENDED TREATMENT METHOD (check applicable box) 1. Cj} Incineration 4. Direct landfill 2. Incineration with chemical stabilization and encapsulation of residues 3. Chemical stabilization and encapsulation 5. Underground injection 6. Chemical treatment 7. Other (specify)______ O. CERTIFICATION I hereby certify and warrant that the information supplied on this form and on any attachments or supplements represents a complete and accurate identification and descnption by the generator company of this waste material, its constituents and its known or suspected hazards. ature Title- Env. Control Spec Date: April 10, 1991 CUSTOMER REVISION: Signature Page 5 of 6 RES-50-419 r* 7/90 SL 022045 Date 'prim D-g/rn jnri r'/">-->1 n*o C P. POLYCHLORINATED BIPHENYL (PCB) ITEMS Stream No. HO-42294 1. LIQUIDS: a. Name of Original Fluid:________I________ b. Name of Solvent:______________________ c. PCB Concentration:____________________ ppm d. Shipping Weight:______________________ 2. CAPACITORS: kilograms a Quantity:_____________________________ b. Shipping Weight:______________________ 3. TRANSFORMERS AND REGULATORS: kilograms a Dimensions: b. Nameplate Gallons:_________________________________________________ _ gallons c. PCB Concentration:_________________________________________________ ____ ppm d. Shipping Weight:_____________________________________________ _______ kilograms e. To Be Shipped: Full Drained Only 4. OTHER TYPES OF PCB ARTICLES (Be specific): Drained and Flushed a Name: ____________________________________________________________________ b. Quantity:Shipping Container: c. Shipping Weight: ........._________________________________________________ kilograms d. PCB Concentration:____________________________________________________ - ____ ppm ROLLINS ENVIRONMENTAL SERVICES SALES OFFICES CORPORATE OFFICE ILLINOIS Rollins Environmental Services (SALES) Inc. Rollins Environmental Services (SALES) Inc. Mail To: One Rollins Plaza, P.O. Box 2349 Mail To: P.O. Box 88480 Wilmington, DE 19899 Carol Stream, IL 60188 (302) 479-2768 1 -800-X-WASTES Fax (302) 479-3339 Ship To: 135 East St. Charles Road Unit C Carol Stream, IL 60188 NEW JERSEY (708) 260*9566 Fax (708) 260-0358 Rollins Environmental Services (SALES) Inc. Mail To: P.O. Box 337 TEXAS Bridgeport NJ 08014 Ship To: RL 322 & 1*295 Bridgeport NJ 08014 (609)467-3105 Fax (609) 467-1040 LOUISIANA Rollins Environmental Services (SALES) Inc. Rollins Environmental Services (SALES) Inc. Mail To: P.O. Box 609 Deer Park. TX 77536 Ship To: 2027 Battleground Road Deer Park, TX 77536 (713) 930-2300 Fax (713) 930-2334 Mail To: P.O. Box 74137 Baton Rouge, LA 70807 Ship To: 13351 Scenic Highway Baton Rouge, LA 70807 (504) 778-3535 Fax (504) 778-3553 CALIFORNIA Rollins Environmental Services (SALES) Inc. Mail To/Ship To: 3777 Spinnaker Court Fremont CA 94538 (415) 226-1680 Fax (415) 490-8152 Rollins Environmental Services of LA, Inc. Mail To: Rt 2, Box 1200 Plaquemine, LA 70764 Ship To: West Sorrell Road. Grade Lane Plaquemine LA 70764 (504) 659-2434 Fax (504) 659-7870 Rollins Environmental Services (SALES) Inc. Mail To/Ship To: 1848 E. 55th Street Los Angeles, CA 90058 (213) 583-6040 Fax (213) 589-5443 ____________________________________SL 0220^ CUSTOMER REVISION: Signature Psop B of F rfs-`iO"4io 7*0 Date |MM' * * w>wwnnwiwwwwitmiynmiWB.fMi as*sos*aaesas*sas->u SOS Environmental Laboratories E90O8-038 RESULTS - TCLr TOXICITY VOLATILES SOS IDi 69008-038-4 PPG IDi 1327 P/T Heavy Still Bottona Date Extracted! 8/11/90 Data Analyzed! S/13/98 Concentration in ppb (ug/D in TCLP Extract & 8 & Q s* 1327 P/T Heavy Still Bottoae Method Detection LlBlt Benzene ND 5.0 Carbon Tetrachloride 197 S.O Chlorobanzana HD 5.0 Chloroform 346 5.0 1,4-Dichlorobenzene 41 5.0 1,2-Dlchloroethane 3,562 5.0 1,1-Dichloroethylene 88 5.0 Methylethylkatona HD 10.0 Tetrachloroethylene 105 5.0 Trichloroethylene 60 5.0 Vinyl Chlorlda ND 10.0 TCLP Blank HD ND HD HD ND ND HD NO HD HD HD Blank Detectlo Limit 5.0 5.0 5.0 5.0 5.0 5.8 5.0 10.0 5.0 5.0 10.0 Surrogate. Standard Percent Recovery (at 0.050 wa/L) 1327 P/T Heavy Still Bottoae Blank 1,2-Dichloroethane-d4 Toluene-dB 4-Broaofluorobanzane 89 % 84 % 87 % 86 % 103 % 104 % SL 0220*7 HD denotes Not Detected at a level above tha aeth d detection liait Member of the SOS Group (beoee <mmm w sunmimm* 8 sosesoseasSQ8sa8esosttQo8Qs*oos*SQO oos*sos*sos*oosesasesassos*sasV )GS-$GS*SGSSGS*SGS*SGS*SGS*SGS*SGSSGS*SGS*SGS*SGS*SGSSGS*P''S*SGS*SGS*SG$*SGS*SGS*SGS iO a CO to SGS Environmental Lab ratories E9008-038 RESULTS - Sample IDs TCLP Metals 1327 P/T Heavy Still Bottoms SGS ID: E9008-38-4 Date Extracted: 8/13/90 Date Analyzed: 3/17/90 Concentration m ppm (mg/L) in TCLP Extract EPA HW D004 D005 D006 D007 D008 D009 D010 D011 TCLP Metals Arsenic Barium Cadmium Chromium Lead Mercury Selenium Silver Result HD HD HD HD HD HD HD HD Blank HD HD HD HD HD HD HD HD Method Detection Limit 0.2 0.02 0.03 0.04 0.1 0.0002 0.2 0.02 Total Metals ! Date Analyzed: 8/14/90 ) 1 1 J) , Antimony ' Arsenic i Barium \ Beryllium ^ Cadmium \ Chromium \ Lead \ Mercury Nickel i Silver *13 Thallium Result HD ND HD HD ND 0.4 3.8 ND ND ND HD Concentration in ppm (mg/Kg) in sampl< Blank HD HD HD HD ND HD ND ND HD ND ND Method Detection Limit 1.0 1.0 0.3 0.3 0.3 0.3 0.5 0.09 0.5 0.3 1.5 0 HD denotes Hot Detected at a level above the method detection limit. " tn n in w* Cl in i9n 0 in m Cl in in Oin in cwi in Cl in in Cl in a in Cinl n Cl in in a tn in oin in a in <n a in ian ci tn iaan in a ian ii9nn Cinl 9 ain in i9n Ci9nl m Cti9nnl tCt9nnl Cl in i9n Cl in CO a in n i^ b b b b l i i S Lib a o a 'iJ U O - J U j-' ' ' Member ot tbe SGS Grouo SL 022048 Cl i9n tn Cn9l in i -_________ SQ8 environmental Laborat riaa RESULTS - TCL? TOXICITY SEHIVOLATILES SGS IDi E9008-038-4 9008-038 i PPG ID> 1327 P/T Heavy Btill Bottoms Date Extracted* 8/28/90 Dat Analyzed* 9/01/90 Concentration in ppb (up/L) in TCLP Extract o-cresol e-creeol p-eresol Creed 2 # 4-Dinitrotoluene Hexacblorobenrene Hexachlorobutadiene Hexachloroetbane nitrobenzene Pentachlorophenol Pyridine 24,5-Triehlorophenol 2,4,6-Trieblorophenol Surrogate standard 1327 p/t Heavy Still Bottn^p &U0& Method Detection MO HD 10.0 HD ND 10.0 ND HD 10.0 ND ND 10.0 ND ND 10.0 ID ND 10.0 ND ND 10.0 ND ND 10.0 HD HD 10.0 ND HD 50 ND HD 10.0 HD HD 50 HD HD 50 ant Recovery (at 8.208 ma/L) m i 8 1 2 1327 P/T Heavy still Bottom A1*J& 2-Fluorophenol Phenel-d5 2,4,6-Trlbro*ophenol Hitrobentene-dS 2-Fluorobiphenyl Terpnenyl-di4 13 I 10 % 17 % 13 % 14 % 10 \ 28 t 19 % 33 % 38 % 37 % 21 \ SL 022049 HD denote* Hot Detected at a level above the method detection limit, S 1 8 MineirofthiMlQraueitMMiMMMMi .... u iaiIQI*IQI*iaiil0l*taMQ8t808MM8IQItQ|<IQHQt80l8aS*iai*IQ$iatttattaStQS? ROLLlf ENVIRONMENTAL SERVICES UNIFORM WASTE DATA SHEET (EXHIBIT B) JOC. NO.. CONTRACT NO.. RES SALES EXEC: # . SAMPLE NO________ STREAM NO. HQ-42294 SAMPLE RECEIVED DATE. A. GENERATOR INFORMATION 1. Generator Name: * V UiJ WAJivm t i((Vl-- --- -- . Gerald Clark, Manager-Purchasing Dept. William H. Cooper - Env. 6. Emergency Contact: Shift Superintendent 8. Generator USEPA I.D.:. LAD008086506 Control Spec*. (Tine) (Title) B. PICK UP LOCATION 1. Company Name: _ 2. Address (not P.O. Box):. 3. City:_________________ Same Columbia Southern Road Lake Charles _____________________ 4. State: "DT 6. Pickup Contact: F.lton CarsonEnv Assxsrant-Rertvart^ 3. Phone No. f3* 5. Phone No. (318 7. Phone No. <318 , 491-4215 i 491-4250 j 491-4500 5. Zip Code:. 7. Phone No. ( 318) -70602491-4324 C. MANIFEST INFORMATION (if same as "B", write "SAME" but indicate Manifest Contact below if different) 1. Company Name:_____ SAME__________________________________________________________________ 2. Address: P D Rm 1 DOf) 3. city:______ Lake Charles 4. State:. 6. ManifestContart- Vicki Cormier. Env. Secretary LA (TiWT 5. Zip Code:. 70602 7. Phone No. ( 318 ) 491-4618 1VOICE INFORMATION (if same as "B" or "C" write "SAME" but indicate Invoice Contact below if different r Company Name: SAME 2. Address:______ SAME AS ABOVE 3. City:__________ 6. Invoice Contact:. __________________________ 4. State:____________ Cinger Rushy, Arrt. Payahle Clerk 5. Zip Code:. 7. Phone No. I 318 ) 491-4526 E. GENERAL WASTE DESCRIPTION 1. Name of Waste:--Trichloroethylene and Perr.hloroethylene Heavy Still Bottoms Cartridges 2. Process Generating Waste: 3. Quantity Generated:. Production of Trichloroethylene and Perchloroethylene______________ 2200 lbs. Tear* Per. lYoaror Sfonth) F. SHIPPING INFORMATION (check all that apply) Yes No Ym No 1. Gt EPA RCRA Hazardous Waste 2. Wastewater or El Non-Wastewater 3. B TSCA Waste TSCA Waste Code: 992030 4. All applicable EPA Hazardous Waste Codes and subcategories including Charactenstic ("D") codes:_______ F025/D040 /D039 Yes no Generating 5. Q Disposal State Regulated Material 6. State Number: r.AnnnflDRfiSDfi______ Yes No 7. CJ DOT Regulated Matenal 8. DOT Shipping Name: HayarHonw uasfp 9. DOT Hazard Class: 9 PGIII 10. DOT (UN/NA) No.: NA3077 Destination State . Waste Code Number: 992030 ______ _ (.contains inctiLoroethy snl i d, n. o. s. and -Perd dot'uethy fene) _______________ 11. RQ (lbs.): . 1 lb G. METHOD OF SHIPMENT fs Drums: Type/Size: DOT 21-C/55 gal Other (Please be specific): 4. B Transportation Requirements: Yes No Enclosed Van 5. 13 Customer to Transport 2. Bulk: Type/Size: Yes No 6.20 Truck Scale at Customer Site SL 022050 CUSTOMER REVISION: Signature _ Date_ Stream No. HQ-42294 H. REGULATORY COMPLIANCE (check all that apply) ys no 1. H OSHA Carcinogens (list below) --------------------------------------1---------------- ------------ ppm ------------------------------------------------------- ------------ ppm ------------------------------------------------------- ------------ ppm 2. 3 Radioactive Material 3. TSCA Regulated PCB (fill in appropriate concentration below): < 50 ppm SO 50-500 ppm > 500 ppm 4. Q Biomedical Waste (3 infectious Waste Yes No 5. E F1FRA Pesticides with Specific Disposal Requireme? 6. E Asbestos 7. C 2 Benzene 8. 5 u California List Regulated Waste 9. Q O Solvent Regulated Waste 10. m Dioxin Regulated Waste (F020. F021. F022, F023. F026 F027. F028) 11. Q First, Second or Third Third Regulated Waste I. WASTE COMPOSITION (must add up to a minimum of 100%) 1 Chemical Name and Constituent Solids (steel, fiber, polyethylene) Tetrachloroethylene Tetrachloroethane (sym & unsym) Concentration (range 10%) 45-55% 15-25% ! <1-5% CASRN N/A 127-18-4 79-34-5 RQObs.) N/A 1 1 Pentachloroethane 5-10% 76-01-7 1 Hexachlorobutadiene Trichloroethylene Unknowns Hexachloroethane ~ 1-2% 5-12% <1-10% 1-2% : ... 1 1 87-68-3 79-01-6 N/A 67-72-1 _L. . 1 100 N/A 1 A W TOTAL > 100% ! -- J. PROPERTIES OF WASTE (write "NA" for all that don't apply) 1. Color Black 2. Odor Strong 3. lanitabilitv (Flash Point):__ >14QF____ 3F 4 nH 3-7 or Corrosivity mm/yr 5. Melting Point 6. Boilina Point: TINY UNK 3F 3F 7. TOC (Total Organic Carbon): 8. Viscositv: _ . UNK ______________ ^ CPS @ 253C (77F) 9. Vapor Pressure 10. Bromine: M/A 0 mmHg @ C % 11. Iodine: 0 % 12. Fluorine: 0 % 13. Chlorin : 30% % 14. Sulfur <1 Yes No 15. Flowable at 252 C (77 F) % 16. Physical state at 25 C (77" F) and phases by volume (check all that apply): Powder 0--. % (phase or layer) Gas Sludge/Semisolid Q Liquid 3 Solid 0 0-1 % 0-2 % 98-100 at, Other 17. % Solid by Weight 85-95%________ 18. Heat of Combustion:______ 9,000______ 19. Ash:____________________ LI_________ 20. Scrub:___________________ 0 47_______ % ____ % BTU/lb % lb. NaOH/1 21. Specific Gravity:or Bulk Density: 75 22. VOC (Total Volatile Organic Compounds):. UNK mg/L CUSTOMER REVISION: Signature Page 4 Of 6 RE&50~419 Rev. 7VB0 SL 022051 Date Turn Page and Complete Page Stream No. HQ-42294 * K. REACTIVE CHARACTERISTICS (check all that apply) Yes No . C? Explosive Yes No 6. G xji Reactive Cyanide:mq/kt 2. 3 Pyrophoric 7. E3 Reactive Sulfide:mg/kc 3. 3 Shock Sensitive 8. 3 Oxidizers (specify): . 4. 3 Water Reactive 5. l? Air Reactive 9. Other (specify): L ELEMENTAL ANALYSIS (Total Metals and TCLP metals data are required for incineration waste streams.TCLP metals data are required fc landfill material. For liquid wastes with less than 0.5% solids, total metals (in mg/kg) x density of waste (in kg/L) = TCLF results (in mg/L).* (Record data for all that apply). T tal Metals: ID mg/kg mg/L Antimony (Sb) Arsenic (As) Barium (Ba) Beryllium (Be) Cadmium (Cd) Chromium (Cr) Chromium VI (CrVI) Cobalt (Co) <1.0 <1.0 <0.3 . <0.3 <0.3 Q.A___________ UNK UNK ppm (Check appropriate unit) CooDer (Cu) UNK Lead (Pb) Manganese (Mn) Mercury (Hg) 3.8 UNK <0.09 Molybdenum (Mo) Nickel (Ni) <0.5 Potassium (K) Selenium (Se) Silicon (Si) Silver (Ag) Sodium (Na) Thallium (Tl) Vanadium (V) Zinc (Zn) <0.3 1.5 TCLP ^004 - Arsenic (mg/L) <0.2 TC Level 5.0 D008 Lead TCLP (mg/L) <0.1 - Barium DOOfi - Cadmium D007 - Chromium <0.02 <0.03 <0.04 100.0 1.0 5.0 D009 Mercury . D010 - Selenium DO11 - Silver <0.0002 <0.2 <0.02 *N.B. - EP Toxicity Characteristic data are acceptable until 9/25/90, or 3/25/91 for small quantity generators. TC Level 5r r 5.C M. ORGANIC TOXIC CHARACTERISTIC WASTE (specify EPA waste code and TCLP results (mg/L) for all that apply; see instructions for list). DO 28 3.56 mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L N. RECOMMENDED TREATMENT METHOD (check applicable box) i- Q Incineration 4. Direct landfill 2. Incineration with chemical stabilization and encapsulation of residues 3. Chemical stabilization and encapsulation 5. Underground injection 6. Chemical treatment 7. Other (specify)______ O. CERTIFICATION I hereby certify and warrant that the information supplied on this form and on any attachments or supplements represents a complete and accurate identification and description by the generator company of this waste material, its constituents and its known or suspected hazards. ature ________ -fidg. Env. Control Spec Date: April 10, 1991 CUSTOMER REVISION: Signature Page 5 of 6 res-so-419 r*v 7ao SL 022052 Date________________ TufTl PSCI*1 jmH Cmmnlofo C P. POLYCHLORINATED BIPHENYL (PCB) ITEMS Stream No. HO-A2294 1. LIQUIDS: a. Name of Original Fluid:________1________ b. Name of Solvent:______________________ c. PCB Concentration:____________________ d- Shipping Weight: .... 2. CAPACITORS: kilnnrsam*; a. Quantity: h Shinnina Weiaht: 3. TRANSFORMERS AND REGULATORS: kilnnrams a. Dimensions: b. Nameplate Gallons: gallons; c. PCB Concentration: d. Shipping Weight: nom kilograms e. To Be Shipped: Full Drained Only 4. OTHER TYPES OF PCB ARTICLES (Be specific): Drained and Rushed a. Name: b. Quantity: Shipping Container: w c Shipping Weight: kilograms d. PCB Concentration: ppm ROLLINS ENVIRONMENTAL SERVICES SALES OFFICES CORPORATE OFFICE ILLINOIS Rollins Environmental Services (SALES) Inc. Rollins Environmental Services (SALES) Inc. Mail To: One Rollins Plaza. P.O. Box 2349 Wilmington, DE 19899 Mail To: P.O. Box 88480 Carol Stream, IL 60188 (302) 479-2768 1 -800-X-WASTES Fax (302) 479-3339 Ship To: 135 East St Charles Road Unit C Carol Stream. IL 60188 NEW JERSEY (708) 260-9566 Fax (708) 260-0358 Rollins Environmental Services (SALES) Inc. Mail To:. P.O. Box 337 Bridgeport NJ 08014 Ship To: Rt. 322 & 1*295 Bridgeport NJ 08014 (609)467-3105 Fax (609) 467-1040 LOUISIANA Rollins Environmental Services (SALES) Inc. Mail To: P.O. Box 74137 Baton Rouge, LA 70807 Ship To: 13351 Scenic Highway Baton Rouge, LA 70807 (504) 778-3535 Fax (504) 778-3553 TEXAS Rollins Environmental Services (SALES) Inc. Mail To: P.O. Box 609 Deer Park, TX 77536 Ship To: 2027 Battleground Road Deer Park, TX 77536 (713)930-2300 Fax (713) 930-2334 CALIFORNIA Rollins Environmental Services (SALES) Inc. Mail To/Ship To: 3777 Spinnaker Court Fremont CA 94538 (415) 226*1680 Fax (415) 490-8152 Rollins Environmental Services of LA, Inc. Mail To: Rt 2. Box 1200 Plaquemine, LA 70764 Ship To: West Sorrell Road, Gracie Lane Plaquemine LA 70764 (504)659-2434 Fax (504) 659*7870 Rollins Environmental Services (SALES) Inc. Mail To/Ship To: 1848 E. 55th Street Los Angeles. CA 90058 (213) 583-6040 Fax (213) 589-5443 CUSTOMER REVISION: Signature Pane 6 of 6 res-scmi9 rw 7/ao Date _ SL 022053 308 Envtronmsntal UboratorfM E9008-038 S RESULTS. - TC1F- TOXICITY VOLATILES SOS ID I B9008-038-4 PPG IDi 1327 P/T Heavy Still Bottom* Date Extractedi 8/11/90 Date Analyzadi 8/13/98 Concentration in ppb (ug/L) In TCLP Extract 3 8 & o ?s 1327 P/T Heavy atm Bottoms Method Detection Limit Benzene Carbon Tetraehloride Chlorobenzene HD 5.0 197 S.0 HD 5.0 chloroforn 348 5.0 1,4-Dlchlorobensene 41 5.0 1,2-Dlchloroethane 1,l-Dlchloroethylene Methylethylketone 3,562 88 HD 5.0 5.0 10.0 Tetrachloroethylene 105 5.0 Trichloroethylene 60 5.0 Vinyl Chloride HD 10.0 TCLP Blank ND ND HD HD ND ND ND ND ND HD ND Blank Detactlo: Limit 5.0 5.0 5.0 5.0 5.0 5.0 5.8 10.0 5.0 5.0 10.0 surrogate Standard Percent Reaovsgv _ (at_0.050 ig/_L) 1327 P/T Heavy Still Bottom Blank 1,2-Dichloroethane-d4 Toluene-dB 4-Broaofluorobenzene 89 \ 84 % 87 % 86 % 103 % 104 \ SL 022054 HD denotes Not Detected at a level ab ve th a thod deteotlon liait Mameer of the eoa Group *IQSiaMOStOI*MI*IQI*iaiQMOMQ| MM0lIQIIQIiail0l*IQI40|T