Document Eqjq6416yj1ww4aOgj2oVVqxn
Chemical Waste Management, Inc.
GENEh-fOR'S WASTE MATERIAL PROFIL.. JHEET
MISCELLANEOUS SPECIAL WASTE
PLEASE PRINT IN INK OR TYPE (Elite. 12-pitch).
CWM Location of Original:
7E5~^ U 08737
(SHADED AREAS FOR CWM USE ONLY)
Waste Profile Sheet C de CWM Sales Rep. #:
INSTRUCTIONS FOR COMPLETING THIS FORM ARE ATTACHED. Return this form to: Chemical Waste Management P Inc.___
Rt. 2. Box 1955 Sulphur. Louisiana Attention;___Dorothy Ortego
. Zip Code:_20&3-
A. GENERAL INFORMATION i Generator Name: PPG Industries. Inc. 3.Facility Address: PQ_Box 1000_________
Lake Charles Louisiana
3 Technical Contact: Gerald L. Perry
2. Generator USEPA ID: T,AnQQ&Q865Q64. Generator State ID: __________ mm____
7, Title: Fnvi r Print- . Spar
5. Zip Code: -Z06028. Phone: (318 ) 491 -4370
3. MAIL CHEMICAL WASTE MANAGEMENT, INC. INVOICES TO 1 2 Company Name: -------------------------------------------------------------------4, Address: --------------------------------------------------------------------------------
Generating Facility (A, above), or _________________ 3. Phone: (
5. Zip Code:
C. 1. NAME OF WASTE__ Heavy Ends from Ethyl Chloride ProHnrtion 2. PROCESS GENERATING WASTE Production of Ethyl Chlrn-M*
D. CLASSIFICATION OF WASTE MATERIAL AND SUPPLEMENTAL INFORMATION (from instructions) _______________Residue and debris from cleanup of spill a nr rFUacss (#13)
E. TRANSPORTATION INFORMATION
Is this a DOT Hazardous Material? [jg Yes -- No
2. Anticipated Annual Volume/Units: 6 tons
3. Proper Shipping Name: Hazardous Waste, solid n.o.s., 0RM--E.NA9189. RO (K0181
Hazard Class: ____ ORM-E-------------------------------------------------
5 | q #
NA9189
Additional Description- ( EPA Waste Code - K018
Method of Shipment: O Bulk Liquid 0 Bulk Solid Drum (Type/Size):
/55 gal Other:,
CERCLA Reportable Quantity (RQ):
1
9. RQ Units (lb/kg): JIl
'0 USEPA Hazardous Waste? [jj Yes No
11 USEPA Hazardous Waste Number(s):
K018-
'2. State Hazardous Waste? 0 Yes No
13. State Hazardous Waste Number(s): _
-KQ18-
year
F. GENERATOR CERTIFICATION By signing this profile sheet, the generator certifies that unless clearly stated above or in attachments: : This waste is not a `Hazardous Waste" as defined by either 40 CFR 261 or the state in which the waste is now located. 2 This waste is not a listed solvent waste as defined bv 40 CFR 261.31 (FOOl, F002, F003. F004. or F005). J This waste is not a Dioxin listed waste as defined by 40 CFR 261.31 (e,g., F020, F021. F022, F023, F026. F027, or F028). 4 This waste does not contain greater than 1000 ppm halogenated organic compounds.
5. This waste does not contain regulated quantities of PCB's (Polychlorinated Biphenyls).
6. This sheet and its attachments contain true and accurate descriptions of this waste material. All relevant information regarding known or suspected hazards in the possession of the generator has been disclosed.
Environmental Control Special!:
Signature
Gerald L. Perry
9. Name (Type or Print)
Form CWM 50-A-Z 1987 Chemical Waste Management, Inc
10. Date
31, iqtQ
SL 046362
Chemical Waste Management, Inc.
ADDENDUM TO GENERATOR'S WASTE MATERIAL PROFILE SHEET FOR LAND DISPOSAL RESTRICTIONS
CWM Location of Original
(shaded area for CWM use only)
A. GENERATOR INFORMATION--INSTRUCTIONS FOR COMPLETING THIS FORM ARE FOUND ON THE OPPOSITE SIDE OF THIS PAGE.
1 Generator Name: ^Industries, Inc.
2. USEPA ID Number i~j[~ ij Q Q ^ Q fl 6 5 H 3. Waste Profile Sheet Code:| xj fj ai 71 ll~7i
5. WASTE STREAM INFORMATION 1. Is this a USEPA hazardous waste? ^ Yes _ No
2. If yes, is this waste: Z Characteristic _X Listed Z Both s. is this waste a nonwastewater or a wastewater? Check ONE: X] Nonwastewater J Wastewater
o. identify ALL Characteristic and Listed USEPA hazardous waste numbers that aoply (as defined by 40 CFR 261). For eacn waste numoer. identify the subcategory (as applicable, check none, or write in the description from 40 CFR 268.41. 268.42. ana 268.43). The following waste numbers have subcategories: D001, D002. D003. D006 D008 0009 F001, F002. F003. F004, F005. F025. K006. K046, K061, K069. K071, K106. and U151.
USEPA HAZARDOUS WASTE NO. NONE
K018
SUBCATEGORY DESCRIPTION
USEPA
HAZARDOUS WASTE NO. NONE
SUBCATEGORY DESCRIPTION
1 i
i
!
!
i
To list additional USEPA waste number(s), and subcategories, use the supplemental sheet provided (CWM-6000-B). If an addi tional page (CWM-6000-B) is used, please check here: _
3. If the waste is identified as USEPA Waste No. D008. identify the total concentration of lead: 4 Is this waste a soil and/or debris? Z Yes, Soil: Z Yes, Debris; %} Yes, Both; Z No, Neither
C. GENERATOR CERTIFICATION--I hereby certify that all information submitted in this and all attached documents conams true ana accurate descriptions of this waste material and all relevant information regarding known or suspected hazards in the posession of the generator has been disclosed.
1 -T-\ Signature
d, -
J
?Environmental Control Specialist
"Title ~
~
3. Gerald L. Perry________________ Name (Type or Print)
SL 046363
Form CWM-6000-A
1990 Chemical Waste Management, Inc.