Document 5LdEZoOKxdaND6LqMGDgDBdg4
THIS FORM HAS BEEN DEVELOPED BY AND FOR THE USE OF CHEMICAL WASTE MANAGEMENT, I AND OTHER WASTE MANAGEMENT, INC. COMPANIL.
(updated)
SALES
CODE
A- 4-1 Q-05~
WASTE PROFILE SHEET CODE Present Alabama #A-03602
GENERATOR'S WASTE MATERIAL PROFILE SHEET
GENERAL DIRECTIONS: In order for us to determine whether we can lawfully, safely and environmentally transport, store, treat or dispose of your waste stream, we must ask certain information about your waste. All of the information we seek is necessary, for our purposes and yours. Be complete in your answers: if your response is "none," so indicate. Answers must be in ink or typewritten. Information you provide will be maintained in strictest confidence. Please make a copy of this form for your records, returning the original to the location indicated below.
THIS FORM AND ANY SUPPLEMENTAL INFORMATION SHOULD BE RETURNED TO:
*Chemical Maste Management_____________________________________________________________________ P.Q. Box 55/Hwv 17. Mile Marker 163 Emelle. AL 35459 Attention: Chief Chemist
i generator name:
PPG Industries. Inc.
2. generating facility name/address/usepa facility i.d. number (if any): PPG Industries, Inc./
P.Q. Box 1000, Columbia Southern Road, Lake Charles, LA 70602
3 COMPANY CONTACTS:
general Andy P. Plauche^ title
Environ. Foreman phone (3181 491-4814
Mike DiGiqlia title
Env. Contrl Asst phone (318) 491-4370
technical Arlen L. Greathouse_________ title Sen. Env. Enqr.
phone (318) 491-4422
Mark Mood TITLE
Super. Env. Lab phone (318) 491-4450
4 wartfnamf Heavy ends from production of chlorinated hydrocarbons (solids/sludges) referred to as classifier Sludge
5 PROCESS GENERATING WASTE: --Wast.p.. organic rTa^ifipr*; 3 APT Spparatnr^ anri Plant "P"
sumps
_______
6 WASTE CHARACTERISTICS:
A. PHASES/LAYERS. BILAYERED 0
MULTILAYERED
NONE
B PHYSICAL STATE AT 70F:
SOLID
SEMI-SOLID Q
LIQUID
c. SOLIDS'
TOTAL (%):
POWDER
OTHER:
15-50 . TOTAL DISSOLVED fDDm or %):
D. SPECIFIC WEIGHT (AS # PER UNIT): =12 Ibs/aal
E. pH acidic (ghow the following as range of %)
AS: H.SO.
% h,po4
-
HC1
% NaOH
-
HF
% NH.OH
-
HNO.
% Ca(OH),
-
OTHER-
-... %
--
Unknown
.. %
% % % %
--%
F. flashpoint- variable: <100 F to >200 F G. VAPOR PRESSURE (in mm of Hg at 25C): Variable
--% (CLOSED CUP TEST ONLY)
h, btu per #:
Unknown ^
ash contentN/A%
i. characteristic color
brown to black
distinctive odor
strong, pungent
J. HALOGENATED?
___ Ybs:% SUEFONATED? _____________________ __________________________ %
K. ALPHA RADIATION AS pCi/l: N/A
FORM WMI-50-A (Rev. 11-5-80) - 1960 WASTE MANAGEMENT. INC.
SL 045859
7. WASTE COMPOSITION:
. A. ORGANIC COMPONENTS (\ rl RANGES -- INDICATE WHETHER % O
See attached spot sample analysis
__
)m)
(ATTACH ADDITIONAL PAGES IF NECESSARY)
DOES THIS WASTE CONTAIN ENDRIN, LINDANE, METHOXYCHLOR. TOXAPHENE, 2.4-D, 2,4,5-TP SILVEX. OR ANY OTHER ORGANIC COMPOUNDS LISTED BY USEPA AT 40 CFR 261.24?IF SO, PLEASE NOTE ABOVE.
B. HEAVY METALS (WITH ppm RANGES):
TOTAL
TOTAL LEACHABLE
TOTAL
TOTAL LEACHABLE
An N/A
Hn N/A
As __ N/A
Ni N/fl
Ra N/A
Pb N/A
Cri N/A Cr N/A
Se N/A Zn N/A
C ii N/A
Other (ATTACH ADDITIONAL PAGES)
(IF YOU HAVE DETERMINED TOTAL LEACHABLES USING USEPA'S "EP TOXICITY TEST PROCEDURE" - AT 40 CFR, PART 261, APPENDIX II -- SO INDICATE BY MARKING "EP" AFTER THE RESULT SHOWN ABOVE)
C. INORGANIC COMPONENTS (WITH % RANGES):
OTHER
TOTAL CYANIDE N/A
--%
-- /o
FREE CYANIDE
N/A
--%
'o
SULFIDE AS: BISULFITE AS:
N/A N/A
--% --%
0
_%
SULFITE AS:
N/A -- %
(ATTACH ADDITIONAL PAGES IF NECESSARY)
%____
DOES THIS WASTE STREAM CONTAIN BIOLOGIC MATERIALS, PATHOGENS. OR ETIOLOGICAL AGENTS?___ NO IF SO, ATTACH ADDITIONAL PAGES DESCRIBING SUCH MATERIALS.
E. IS THE WASTE A PESTICIDE OR PRODUCED BY A PESTICIDE MANUFACTURING PROCESS? IF SO, INDICATE WHETHER IT CONTAINS:
ORGANOPHOSPHATES -- CONTAINING SULFUR CARBAMATES CHLORINATED HYDROCARBONS
YES
NO
8. HAZARDOUS COMPONENTS AND CHARACTERISTICS A. HAZARDOUS PROPERTIES (INSERT NUMBER CODES PER INSTRUCTIONS ON LAST PAGE) (1) TOXICITY RATING: INHALATION _2___ DERMAL _3_ ORAL 2 Flammability
(2) HAZARD IDENTIFICATION SYSTEM:
Health
Reactivity
Special Instructions
B. LIST ANY OTHER ACUTE OR CHRONIC HAZARDS ASSOCIATED WITH OR ALLEGED TO BE* ASSOCIATED WITH HUMAN CONTACT WITH OR EXPOSURE TO THE WASTE:
. See attached Material Safety Data Sheet for "flamnable11 material___________ __________
SL 045860
* 9. REGULATORY CLASSIFICATION OF WASTE
A. IS THIS WASTE A "HAZARDOU IATERIAL" AS DEFINED BY REGULATIC OF THE U.S. DEPARTMENT OF
TRANSPORTATION PURSUANT TO THE HAZARDOUS MATERIALS TRANSPORTATION ACT? 'e$------------------
1 (SEE 49 CFR 172.101 AND 173 FOR "HAZARDOUS MATERIALS" LIST AND CHARACTERISTICS.) IF SO, PLEASE
ADVISE OF THE FOLLOWING:
--
(1) correct shipping description- Waste flammable liquid, NOS, UN #1993
(2) hazard class(ES):Flammable liquid
(3) material i.d. no.(S) KQ18. KQ19. K02Q. K03Q (D001 if flammable)
B. DOES THIS WASTE CONTAIN ANY "HAZARDOUS SUBSTANCE" AS DEFINED BY REGULATIONS OF THE U.S. ENVIRONMENTAL PROTECTION AGENCY PURSUANT TO SECTION 311 OF THE CLEAN WATER ACT? YeS
(SEE 40 CFR 117 FOR "HAZARDOUS SUBSTANCES" AND CATEGORIES.) IF SO, PLEASE ADVISE OF THE FOLLOWING:
(1) THE NAMES OF EACH HAZARDOUS SUBSTANCE PRESENT IN THE WASTE, THE HAZARD CATEGORY
(X, A, B, C OR D) AND' TJHE APPROOXIMATE CONCENTRATION OF THE SUBSTANCE BY WEIGHT IN THE WASTE:
'1) Chloroform (D)~ ~.o %/wt
(2) Ethylene dichloride (D) -- =17.25%/wt
these and other components mav be
(3) Trichloroethylene (C) -- =3.60%/wt______ present in varvina concentrations
(ATTACH ADDITIONAL PAGES IF NECESSARY)
C IS THIS WASTE A "HAZARDOUS WASTE" AS DEFINED BY REGULATIONS OF THE U.S. ENVIRONMENTAL
PROTECTION AGENCY PURSUANT TO SECTION 3001 OF THE RESOURCE CONSERVATION AND RECOVERY ACT? Yes (SEE 40 CFR, PART 261 FOR WHAT IS A "HAZARDOUS WASTE.") IF SO, STATE:
(1) the usepa hazardous waste number(S): K018, KQ19, K02Q, K030 (D001 if flammable)
(2) DO YOU CLAIM TO BE A SMALL QUANTITY GENERATOR? Nfl (SEE 40 CFR 261.5.)
D. IS THIS WASTE A "HAZARDOUS WASTE" AS DEFINED BY THE ENVIRONMENTAL REGULATORY AGENCY IN
YOUR STATE? Yes
IF SO, STATE WHY IT IS SO DEFINED AND ANY STATE HAZARDOUS WASTE CODE
numbers assigned: 508-05 (La. DNR waste number)__________
ETHYLENE DICHLORIDE., TRICHLOROETHYLENE
______________
10. IS THE INFORMATION PROVIDED IN SECTIONS 6-9 BASED UPON LABORATORY ANALYSIS OF THE WASTE
MATERIAL7 YeS IF SO, PLEASE ADVISE OF THE DATE OF THE MOST RECENT ANALYSIS: 1/27/81
11 HAVE YOU OBTAINED TOXICITY STUDIES OF THIS WASTE STREAM? THE RESULTS.
No
IF SO, PLEASE ATTACH A COPY OF
12 QUANTITY/SHIPPING REQUIREMENTS:
ANTICIPATED VOLUME IS: ____ 90 ,000
GALLONS fi
TONS
CUBIC YARDS
DRUMS
OTHER
PER: DAY
WEEK
MONTH
YEAR Cl
ONE TIME
transportation equipment required: Flatbed trailer to haul DOT 55-gallon drums
service/scheduling requirements: Will contact CMMI, Alabama when needed
GENERATOR'S AUTHORIZED SIGNATORY:
CONFIDENTIALITY AGREEMENT: as consideration for the Generator's release of the above information, and any other supplemental data provided, agrees to treat such information as confidential property and will not disclose such information to others except asr is required by law. and in
uch circumstances only after first giving notice to the Generator.
Sh 004455886611
Name - Title
7. WASTE 'COMPOSITION:
A. ORGANIC COMPONENTS (V H RANGES -- INDICATE WHETHER % O. >m)
See attached spot sample analysis
___________________
(ATTACH ADDITIONAL PAGES IF NECESSARY)
DOES THIS WASTE CONTAIN ENDRIN, LINDANE, METHOXYCHLOR, TOXAPHENE. 2.4-D, 2.4.5-TPSILVEX, OR ANY OTHER ORGANIC COMPOUNDS LISTED BY USEPA AT 40 CFR 261.24?IF SO, PLEASE NOTE ABOVE.
B. HEAVY METALS (WITH ppm RANGES):
TOTAL
TOTAL LEACHABLE
TOTAL
TOTAL LEACHABLE
Ag N/A As N/A 8a N/A Cd N/A Cr N/A
CuN/A_________________________
Hq N/A
Ni N/A
Ph N/A N/A
Zn N/A
other (ATTACH ADDITIONAL PAGES)
.........
(IF YOU HAVE DETERMINED TOTAL LEACHABLES USING USEPA'S "EP TOXICITY TEST PROCEDURE" -- AT 40 CFR, PART 261, APPENDIX II -- SO INDICATE BY MARKING "EP" AFTER THE RESULT SHOWN ABOVE.)
C. INORGANIC COMPONENTS (WITH % RANGES):
OTHER
TOTAL CYANIDE N/A
--%
b
FREE CYANIDE SULFIDE AS: BISULFITE AS: SULFITE AS:
N/A %
N/A _ %
_N/A
%____
N/A
%____
(ATTACH ADDITIONAL PAGES IF NECESSARY)
"o
/o
_% _ 0/0
D. DOES THIS WASTE STREAM CONTAIN BIOLOGIC MATERIALS, PATHOGENS. OR ETIOLOGICAL AGENTS? ____ ___ NO.-.. IF SO, ATTACH ADDITIONAL PAGES DESCRIBING SUCH MATERIALS.
E. IS THE WASTE A PESTICIDE OR PRODUCED BY A PESTICIDE MANUFACTURING PROCESS? IF SO, INDICATE WHETHER IT CONTAINS:
N0
ORGANOPHOSPHATES -- CONTAINING SULFUR CARBAMATES CHLORINATED HYDROCARBONS
YES
NO
8. HAZARDOUS COMPONENTS AND CHARACTERISTICS
A. HAZARDOUS PROPERTIES (INSERT NUMBER CODES PER INSTRUCTIONS ON LAST PAGE)
(1) TOXICITY RATING: INHALATION _2___ DERMAL 3
ORAL _2_
Flammability
(2) HAZARD IDENTIFICATION SYSTEM:
Special Instructions
B. LIST ANY OTHER ACUTE OR CHRONIC HAZARDS ASSOCIATED WITH OR ALLEGED TO BE ASSOCIATED WITH HUMAN CONTACT WITH OR EXPOSURE TO THE WASTE:
.See attached Material Safety Data Sheet for "flammable11 material ________________
SI* 045862 ir
0 = No Toxicity
This designation is given to materials wlv 'all into one of the following categories:
(a) Materials which cause no harm under any conditions of normal use.
(b) Materials which produce toxic effects on humans only under the most unusual conditions or by overwhelming dosage.
1 - Slight Toxicity (a) Acute local. Materials which on single exposures lasting seconds,
minutes or hours cause only slight effects on the skin or mucous membranes regardless of the extent of the exposure.
(b) Acute systemic. Materials which can be absorbed into the body by inhalation, ingestion, or through the skin and which produce only slight effects following single exposures lasting seconds, minutes, or hours, or following ingestion of a single dose, regardless of the quantity absorbed or the extent of exposure.
(C) Chronic local Materials which on continuous or repeated expo sures extending over periods of days, months, or years cause only slight and usually reversible harm to the skin or mucous membranes. The extent of exposure may be great or small.
(d) Chronic systemic. Materials which can be absorbed into the body by inhalation, ingestion, or through the skin and which produce only slightly usually reversible effects following continuous or repeated exposures extending over days, months, or years. The extent of the exposure may be great or small.
In general, those substances classified as having "slight toxicity'" produce changes in the human body which are readily reversible and which will disappear following termination of exposure, either with or without medical treatment
2 - Moderate Toxicity
(a) Acute local Materials which on single exposure lasting seconds, minutes, or hours cause moderate effects on the skin or mucous membranes These effects may be the result of intense exposure for a matter of seconds or moderate exposure for a matter of hours.
(b) Acute systemic. Materials which can be absorbed into the body by inhalation, ingestion, or through the skin and which produce moderate effects following single exposures lasting seconds, minutes, or hours, or following ingestion of a single dose.
(c) Chronic local Materials which on continuous or repeated expo sures extending over periods of days, months, or years cause moderate harm to the skin or mucous membranes
(d) Chronic systemic. Materials which can be absorbed intothebody by inhalation, ingestion or through the skin and which produce moderate effects following continuous or repeated exposures extending over periods of days, months, or years.
Those substances classified as haying "moderate toxicity" may produce irreversible as well as reversible changes in the human body. These changes are not of such severity as to threaten life or produce serious physical impairment.
3 - Severe Toxicity (a) Acute local, Materials which on single exposure lasting seconds
or minutes cause iniury to skin or mucous membranes of sufficient severity to threaten life or to cause permanent physical impairment or disfigurement
(b) Acute systemic. Materials which can be absorbed into the body by inhalation ingestion, or through the skin and which can cause iniury of sufficient severity to threaten life following a single exposure lasting seconds minutes, or hours, or following ingestion of a single dose.
ic) Chrome local Materials which on continuous or repeated expo sures extending over periods of days, months, or years can cause injury to skin or mucous membranes of sufficient severity to threaten life or cause permanent impairment, disfigurement, or irreversible change.
(d) Chronic systemic. Materials which can beabsorbed intothebody by inhalation, inqestion, or through the Skin and which can cause death or serious physical impairment following continuous or repeated exposures to small amounts extending over periods of days, months, or yeais
Hazard Identification System
c!ammability
Special Instructions
The above diagram identifies the "health," ""flammability" and ``reac tivity'' (instability and water reactivity) of a chemical and indicates the order of severity of each hazard by use of one of five numerical gradings, from four (4). indicating toe severe hazard or extreme danger, to zero (0), indicating no special hazard. In the diamond-shaped diagram "health" hazard is identified at the left, `"flammability" at the top, and "reactivity" at the right. The bottom space is primarily used to identify unusual reactivity with water. A W with a line through its center W-alerts fire fighting personnel to the possible hazard in use of water.
This bottom space m- -Iso be used to identify a radiation hazard by the symbol * . Oxidiz .hemicals are identified in the bottom space by OXY.
To supplement the spatial arrangement. NFPA No. 704M recom mends the use of colored backgrounds or colored numbers to identify the hazard categories -- blue for "health." red for"flammability." yellow for "reactivity."
For a detailed description of the hazard identification system used here, see "Recommended System for the Identification of the Fire Hazards of Materials, NFPA No. 704M. 1969 Edition."
The following paragraphs summarize the meanings of the numbers in each hazard category and explain what a number should tell fire fighting personnel about protecting themselves and how to fight lires where the hazard exists.
Health
4 A few whiffs of the gas or vapor could cause death, or the gas. vapoi. or liquid could be fatal on ponetratinq the lue fighters' normal lull protective clothing which is designed for resistance to heat For most chemicals having a Health 4 rating, the normal full protective clothing available to toe average fire department will not provide adequate protection against skin contact with these materials Only special protective clothing designed to protect against the specific hazard should be worn
3 Materials extremely hazardous to health, but areas may be entered with extreme care. Full protective clothing, including self-contained breathing apparatus,'rubber gloves, doois and bands around legs arms and waist should be provided No skin surface should be exposed
2 Materials hazardous to health, but areas may be entered freelv with self-contained breathing apparatus,
1 Materials only slightly hazardous to health It may be desirable to wear self-contained breathing apparatus
0 Materials which on exposure under fire conditions would offer no health hazard beyond that of ordinary combustible material
Flammability
4 Very flammable gases, very volatile flammable liquids, and materials that in the form of dusts oi mists readily form explosive mixturi-s when dispersed in air. Shut off flow of gas or liquid and keepcoolmq water streams on exposed tanks or containers Use water sprnv carefully m the vicinity of dusts so as not to create dust clouds
3 Liquids which can be ignited under almost normal temperature con ditions. Water may be ineffective on these liquids because of thmi low flash points. Solids which form coarse dusts, solids in shredded or fibrous form that create flash fires solids that burn rapidly usually because they contain their own oxygen and anv material that ignites spontaneously at normal temperatures in air
2 Liquids which must be moderately heated before ignition will occur and solids that readily give off flammaDle vapors Water spray mav be used to extinguish the fire because the material can be cooled to below its flash point
1 Materials that must be preheated before ignition can occur Water may cause frothing of liquids with this flammability rating number if it gets below the surface of the liquid and turns to steam However water spray gently applied to the surface will cause a frothing which will extinguish the fire. Most combustible solids have a flammable rating of 1.
0 Materials that will not bum
Reactivity
4 Materials which m themselves are readily capable of detonation or of explosive decomposition or explosive reaction at normal temper atures and pressures. Includes materials which are sensitive to mechanical or localized theimai shock If a chemical with this hazard rating is in an advanced or massive fire, the area should be evacuated
3 Materials which in themselves are capable of detonation or of ex plosive decomposition or of explosive reaction but which require a Strong initiating source or which must be heated under confinement before initiation. Includes materials which are sensitive to thermal or mechanical shock at elevated temperatures and pressures or which react explosively with water without requiring heat or confinement Fire fighting should be done from an explosion-resistant location
2 Materials which in themselves are normally unstable and readily undergo violent chemical change but do not detonate. Includes materials which can undergo chemical change with rapid release of energy at normal temperatures and pressures or which can undergo violent chemical change at elevated temperatures and pressures Also includes those materials which may react violently with water or which may form potentially explosive mixtures with water or generates toxic gases, vapors or fumes when mixed with water In advanced or massive fires, fire fighting should be done from a protected location,
1 Materials which in themselves are normally stable but which may become unstable at elevated temperatures and pressures or which may react with water with some release of energy but not violently. Caution must be used in approaching toe fire and applying water.
0 Materials which are normally stable even under fire exposure conditions and which are not reactive with water. Normal fire fighting procedures may be used.
SL 045863
ANALYSIS RESULTS OF PREVIOUS ORGANIC CLASSIFIER CLEANING*
COMPONENT
Chloroethane Cis 1,2-Dichloroethylene 1,1-Dichloroethane Chloroform Ethylene Dichloride Tetrachloromethane T richloroethylene 1,1,2-Trichloroethane Perchloroethylene 1,1,1,2-Tetrachloroethane 1,1,2,2-Tetrachloroethane Pentachloroethane Hexachloroethane Hexachlorobutadi ene
Total Volatiles unknown
Total Volatiles
+ Non-volatile residue + Tars + solids (sand/dirt)
Total Weight Percent
WEIGHT PERCENT
0.50 % 0.12 8.27 0.05 17.25 0.07 3.60 1.46 14.09 0.77 8.34 0.87 0.37 0.59 3.81
60.16
12.15 1.60
26.09
100.00%
SL 045864
A GENERAL INFORMATION
C,ol atoll Southern Road
Lake Charles, LA
70602
TECHNICAL CONTACT: L Andy P. Pltuche*
NAME OF WASTE: L classifier Sludge
_J GENERATOR USEPA I D. It iA iD iQ iQ 181O18161 Si Oi 61
J GENERATOR STATE I.D. L
M-- .j
J TITLE: L Pit. Env. Foreman J PHONE: l (318) 491-4014
PROCESS GENERATING WASTE: L Production of chlorinated hydrocarbons
PHYSICAL CHARACTERISTICS OF WASTE
*
COLOR
Brown to Black
pH. < ^
G 7-1-10
010.1-12.5
ODOR CD NONE CD MILD
STRONG
describe' Pungent
,
Q N/A
SPECIFIC G< 8
GRAVITY
G-8-1-0-
PHYSICAL STATE a 70*F
Q SOLID
ixl SEMI-SOLID
CD LIQUID CD POWDER
LAYERS MULTILAYERED
m BI-LAYERED
G SINGLE PHASED
FREE LIQUIDS
H YES
G NO
vnmuF 1 SA-Jtffcti
Ij^l 1-3-1.4 E 1.5-17
FLASH SI < 70 "F
POINT
70*F 100*F
> 200 *F NO FLASH
G CLOSED CUP
OPEN CUfU^
| 1 4 1-69
> 12-5
Ql-M2
G> 1-7
Q 101`F - 139*F
EXACT,_______
GY
EXACT | ------- 1
EXACT t_
C CHEMICAL COMPOSITION (TOTALS MUST ADD TO 100%)
See attached- analysis----------------
140`F-200*F
D METALS Q TOTAL (PPM) O EPA EXTRACTION PROCEDURE (mg/L)
ARSENIC (As)
None_
SELENIUM ($a)| __ Hone
BARIUM (Ba)
tione
HoneSILVER (Ag) I________
<
_% CADMIUM (Cd)
CHROMIUM (Cr) L
Hone None
COPPER (Cu) U NICKEL (Ni) I
Hung
None
MERCURY <Hq) ^
,% LEAD (Pb)
L-
1%
Hone Hone-
zinc (zn) . 1
THALLIUM (Tl) L.
Hone Hone
11 1 F SHIPPING INFORMATION
1 1 _____ 1/. E OTHER COMPONENTS - TOTAL (PPM)
CYANIDES 1
None
1 1 -J SULFIDES 1
-Nam------- 1
Q HAZARDOUS CHARACTERISTICS
PCR*fi
i_
PHENOUCS 1--
D.O.T. HAZARDOUS MATERIAL? E YES
LJ NO
REACTIVITY: lg] NONE
G PYROPHORIC
O SHOCK SENSITIVE
PROPER SHIPPING NAME iFlamable Liquid, NflS
HAZARD CLASS L Flaw. I -iquid LD. NO. L UN-1393 iRQ.h^g
METHOD OF SHIPMENT Ijj] BULK LIQUID
O BULK SOLID
I
tXl DRUM (TYPEfSIZE) U S5 gallon,
ANTICIPATED VOLUME: L -80,000 _J GALS. II CUBIC YARDS
PER: O ONE TIME
_J OTHER WEEK
O MONTH
EXPLOSIVE
G WATER REACTIVE
OTHER I__________
OTHER HAZARDOUS CHARACTERISTICS:
m NONE
O RADIOACTIVE
O ETIOLOGICAL
HD PESTICIDE MANUFACTURING WASTE
HD OTHER i
USEPA HAZARDOUS WASTE?
[gl YES
CD NO
USEPA HAZARDOUS CODE(S) l024-,.. ,11
STATE HAZARDOUS WASTE?
Cx) YES
NO
QUARTER
YEAR
l______
STATE CODE(S) L 024___________________________
1
H SPECIAL HANDLING INFORMATION .
SL 045865
. jADDITIONAL PAGE(S) ATTACHED
HEREBY CERTIFY THAT ALL INFORMATION SUBMITTED IN THIS AND ALL ATTACHED DOCUMENTS IS COMPLETE AND ACCURATE. AND TF|AT ALL KNOWN OR SUSPECTED HAZARDS HAVE BEEN DISCLOSED.
AUTHORIZED SIGNATURE
TITLE
DATE
->--M-
:>p
_l L Plant Ewr. Liaison Forman J L
i-S'