Document 9wdgaxgQexLQVvQp8ypDLz4R

UNIFORM WASTE CHARACTERIZATION SUMMARY SHEET ALL QUESTIONS MUST BE ANSWERED BEFORE WASTE CAN BE ACCEPTED FOR DISPOSAL. MSDS OR EQUIVALENT MUST BE ATTACHED. 1. LA. WASTE TYPE # 2. LA DEQ NON-HAZ CODE 3. TX WASTE STM NO. 4. MICH EVS NO. 5. T"C CODE 6. RCRA/EPA HAZARDOUS CODE hOOl. FOZ^__ 7. PLANT CONTACT Pk,U,fS 8. PHONE # (-> '5'7 9. ALTERNATE di If >/*-**{._______ 10. PHONE # \ 11. PLANT/DIV VJfAMfl JC-______________ 12. ACCOUNT # X Is this a new waste type? Yes ____ No If existing waste type enter type #. 13. Enter the WASTE NAME commonly used to describe the waste. F&cA To Tn-ftOX Uaj\T__________________________. 14. DESCRIBE source of the waste. INCLUDE "where" and "how" waste was generated. STATE what happened to cause the waste, i.e. spill, process upset, tank or sump cleaning. INDICATE listed solvents and purpose for which they were used and whether or not they are spent at the "point of generation" of this waste. REFERENCE specific tank(s) and function of the tank(s). IS THE WASTE; a. Solids from a process unit (e.g. tank sludge, carbon, coke, polymers, refractory, packing etc.)? Yes _____ No b. Solids from a process sump, shot pond, trench, etc?' Yes _____ No c. Solids from a RCRA unit (e.g. TOX/THROX refractory or packing, RCRA tank sludge, etc.)? Yes _____ NO ^ d. Excavated dirt. Yes _____ No ___ e. Asbestos containing gaskets? Yes No (If yes. gaskets must be decontaminated first.) f. Solids from a tank, sump or trench in which^plant neutralization was done? Yes No g- Contaminated clothing, filter media, etc? Yes h. Cleanup from a spill? Yes _____ No -- No i. Other (describe) _____________________________ "P49-.Q FeeK To Tf+nQ^ uiOiT DO A 03235? CONFTDFNTTAI 1 COMPONENT NAME Tetrachloroethylene (Per) 1,1,2 Trichloroethane (B-tri) 1,1 Dichloroethylene 1,2 Dichloroethane (EDC) Carbon Tetrachloride Chloroform (CCI3) Hexachlorobutadiene Trichloroethylene (TCE) Vinyl Chloride (VCM) 1,1,1 Trichloroethane (Atri) 1,1 Dichloroethane 1,3 Dichloropropylene (cis) 1,3 Dichloropropylene (trans) 2 Chloro 1,3 butadiene 3-Chloropropylene Chloroethane (Etd) Pentachloroethane Trans 1,2 Dichloroethylene (Trans) TOTAL (approximate) T420 WASTE COMPOSITION TYPE # 3778 CAS# 127-18-4 79-00-5 75-35-4 107-06-2 56-23-5 67-66-3 87-68-3 79-01-6 75-01-4 71-55-6 75-34-3 10061-01-5 10061-02-6 126-99-8 107-05-1 75-003 76-01-7 156-60-5 HAZ.WASTE CODE D039 F025 F025 F025 F025 F025 F025 F025 F025 UHC UHC UHC UHC UHC UHC UHC UHC UHC CON. % AS PKGD. 1 40 10 40 3 1 5 PROCESS KNWLG. X X X X X X X X X X X ANALY. DATA X X X X X X X 100% * T420 HAZXLS DO A 032353 CONFIDFNTTAI 17. If your waste is liquid and contains any Toxicity Characteristic constituents above the regulatory level, ENTER Y next to the constituent. INDICATE by check whether the determination is by prodess knowledge or analysis.ATTACH analytical data if analysis is checked. COMPLETE tabl below. 18. If your waste is solid and contains any Toxicity Characteristic constituents above the regulatory level in TCLP extract, ENTER Y next to the constituent. INDICATE by check whether the determination is by process knowledge or analysis. ATTACH analytical data if analysis is checked. COMPLETE table below. D004 D005 D006 D007 D008 D009 D010 D011 D012 D013 D014 D015 D016 D017 D018 D019 D020 D021 D022 D023 D024 D025 D026 D027 D028 D029 D030 D031 D032 Regulatory Level (mg/1) 5.0 100.0 1.0 5.0 5.0 0.2 1.0 5.0 0.02 0.4 10.0 0.5 10.0 1.0 0.5 0.5 0.03 100 6.0 200.0 200.0 200.0 200.0 7.5 0.5 0.7 0.13 0.008 0.13 Constituent Arsenic Barium Cadmium Chromium (Total) Lead Mercury Selenium Silver Endrin Lindane Methoxychlor Toxaphene 2,4-D 2,4,5-TP Silvex Benzene Carbon Tetrachloride Chlordane Chlorobenzene Chloroform o-Cresol m-Cresol p-Cresol Cresols 1,4 Di chlorobenzene 1,2 Dichloroethane 1,1 Dichloroethvlene 2,4-Dinitrotoluene Heptachlor (and eDOXide) Hexachlorobenzene Present Above Regul. Level y y y y Indicate Process Analysis Knowledge . i-"" - DO A 032354 3 CONFIDENT I Al h. Density pounds/gal or ____ pounds/cubic foot i. If liquid, does it corrode steel greater than .25"/year ( ) Yes ( ) No (If yes waste is D002 hazardous) j. If aqueous liquid, enter pH ') (amenable to pH measurement and at least 10% water) (If <2.0 or >12.5 waste is D002 hazardous. k. Is this waste an oxidizer per 49 CFR 173.151? 1. Does this waste react,violently with water or form potentially explosive mixture when mixed with water, or 2. When mixed with water, does it generate toxic gases, vapors, or fumes in a quantity sufficient to present a danger to human health or environment, or 3. Is it a cyanide or sulfide bearing waste which, when exposed to pH conditions between 2 and 12,5, can generate toxic gases, vapors, or fumes in a quantity sufficient to present a danger to human health or environment or 4. Is it capable of detonation or explosive reaction at standard temperature and pressure, or if it is subjected to a strong initiating source, or if it is heated under confinement { ) Yes ( ^No (If yes waste is D003 hazardous) . 22. Handling and Spill Procedures 1. Is personal protective equipment required? ( ) Yes If "yes" specify. ( ) No Goggles Face Shield Air Supply Mask Scott Ovista Resp. Self Contain etc. () () () (tr" () Rubber Suit Rubber boots Rubber Gloves Air Supply Hood Saranac Suit Other (-r" (-r <-r" () () 2. Suitable absorbents: Sand Sawdust Silkwick Corn Cobs () () 2orball Clay Other () (> () 3. List any special precautions or procedures: DO A 032355 CONFTDFNTTAl.