Document YGpKEZeeO8d45xx7op3LZpEJk

unemicai waste Management, me. GENERATOR'S WASTE MATERIAL PROFILE SHEET MISCELLANEOUS SPECIAL WASTE PLEASE PRINT IN INK OR TYPE (Elite, 12-pltch). CWM Location of Original:____________________ i,cn 1 U ^3631 Waste Profile Sheet Code (shaded areas for cwm use only) CWM Sales Rep. #: INSTRUCTIONS FOR COMPLETING THIS FORM ARE ATTACHED. Rgtnrn thic form tn1 Chemical Waste Management, Inc. Route 2 Box 1955 SulDhur. LA Attention: Dorothv Orteeo ZiD Code: 70663 A. GENERAL INFORMATION i Generator Name- PPG Industries, Inc. 3 Facility Address: P 0 Box 1000 Columbia Southern Road Lake Charles. LA 6. Technical Contact: . Gerald Perry 2. Generator USEPA ID: LAD008086506 _ 4. Generator State ID: 5. 7ip Code- 70602 7 Title-Env, Control Spec. a Phone-f318) 491 4370 B. MAIL CHEMICAL WASTE MANAGEMENT, INC. INVOICES TO 1.0 Generating Facility (A, above), or 2. Company Name: ----- Feme. go ahnvo 3. Phone: ( ) 4. Address: ___________________________________________________________________________________ C. 1. NAME OF WASTE EDC Contaminated Soil and Debris 2. PROCESS GENERATING WASTE Derivatives Area 5. Zip Code: D. CLASSIFICATION OF WASTE MATERIAL AND SUPPLEMENTAL INFORMATION (from instructions) __________________#13 Residue and Debris from cleanup of spills or releases* * * * 6 7 8 E. TRANSPORTATION INFORMATION 1, Is this a DOT Hazardous Material? El Yes No 2 Anticipated Annual Voinme/l Inits- 2Q0 cu yd ! year 3. Proper Shipping Name: __Ha7arrinns Wasts, solid, n.n.s 4. Hazard Class: ORM-F. 5. |.q. #: NA9189 6. Additional Description: ( TT077 7. Method of Shipment: D Bulk Liquid 0 Bulk Solid Q Drum (Type/Size): / Other: 8. CERCLA Reportable Quantity (RQ): _____]______________________ 9. RQ Units (lb/kg): --pound 10. USEPA Hazardous Waste? 0 Yes D No 11. USEPA Hazardous Waste Number(s): U077_______________ 12. State Hazardous Waste? 0 Yes D No 13. State Hazardous Waste Number(s): ______ U077_______________ F. GENERATOR CERTIFICATION By signing this profile sheet, the generator certifies that unless clearly stated above or in attachments: 1, This waste is not a Hazardous Waste" as defined by either 40 CFR 261 or the state in which the wasteis now located. This waste is not a listed solvent waste as defined by 40 CFR 261.31 (F001, F002, F003, F004, or F005). 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). This waste does not contain greater than 1000 ppm halogenated organic compounds. This waste does not contain regulated quantities of PCB's (Polychlorinated Biphenyls). 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. x\juulA j <d. ~FLq kXM Signature ___________________ Gerald Perry 9. Name (Type or Print) Env. Control Specialist 8. Title 10/30/90 10. Date Form CWM 50-A-2 1987 Chemical Waste Management. Inc SL 022134 Chemical Waste Management, Inc GENERATOR'S WASTE MATERIAL PROFILE SHEET Miscellaneous Special Waste General Instructions ______ _____________ Return the completed form to: Chemical Waste Management. Inc._______ ___________ ____________ Route 2 Box 1955 Sulphur, Louisiana 70663 __________ ______ _ _________________________ Attention: Dorothy Ortego___________________________ 1. This form is to be used only for Chemical Waste Management, Inc. defined "Miscellaneous Special Wastes." WASTES ELIGIBLE FOR USE OF THIS FORM ARE DEFINED IN THE ATTACHED INSTRUCTIONS, If after reading the instructions, you are uncertain if your waste qualifies as a "Miscellaneous Special Waste", contact the lab or technical manager at the Chemical Waste Management, Inc, facility that will be managing your waste or your Chemical Waste Management, Inc. Sales Representative for additional information. 2. Complete this "Profile" per the instructions. All questions must be answered. 3. Shaded areas on this form are for Chemical Waste Management use only. 4. Answers must be printed in ink or typed (elite, 12-pitch). 5. Complete the signature block at the bottom of the "Profile". 6. Most Miscellaneous Special Wastes" do not require sampling. However, when a sample is requested, submit this form and waste sample per the instructions on the Generator's Certification of Representative Sample which will be supplied by your Chemical Waste Management, Inc. Sales Representative or the facility requesting the sample. 7. If you have any questions regarding the use of this form, please contact your CWM Sales Representative or the office that issued this form to you. 8 This document is perforated so you can separate the form from the instructions for copying and mailing. 9. All wastes which are not "Miscellaneous Special Wastes" must be profiled on the Generator's Waste Material Profile Sheet, Form CWM-6000. 10 MAKE A COPY OF THIS FORM FOR YOUR RECORDS. SEND THE ORIGINAL AND ALL ATTACHMENTS TO THE ADDRESS SHOWN ABOVE OR TO THE ADDRESS PROVIDED BY YOUR CHEMICAL WASTE MANAGEMENT, INC. SALES REPRESENTATIVE. m CV.'M 50-A-2 9 1987 Chemical Waste Management, Inc SV 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: QP.Ca__ j <?_ 2. USEPA ID Number: t>\0 \g\S\o\ 3. Waste Profile Sheet Code:*U1A2>\f\6>\3\/ o\ B. WASTE STREAM INFORMATION 1. Is this a USEPA hazardous waste? 1 Yes Z No 2. If yes, is this waste: Characteristic 3S Listed Both a. Is this waste a nonwastewater or a wastewater? Check ONE: ^ Nonwastewater Z Wastewater b. Identify ALL Characteristic and Listed USEPA hazardous waste numbers that apply (as defined by 40 CFR 261). For each waste number, identify the subcategory (as applicable, check none, or write in the description from 40 CFR 268.41, 268.42, and 268.43). The following waste numbers have subcategories: D001, D002, D003, D006, D008, D009, F001, F002, F003, F004, F005, F025, K006, K046, K061, K069, K071, K106, and U151. USEPA HAZARDOUS WASTE NO. NONE 7X SUBCATEGORY DESCRIPTION USEPA HAZARDOUS WASTE NO. NONE ' SUBCATEGORY DESCRIPTION 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? Yes, Soil; Yes, Debris; X Yes, Both; u No, Neither C. GENERATOR CERTIFICATION--I hereby certify that all information submitted in this and all attached documents con tains true and accurate descriptions of this waste material and all relevant information regarding known or suspected hazards in the posession of the generator has been disclosed. Signature ___ L* Name (Type or Print) Title ___ ______ ________ 4. Date /a - */o Form CWM-6000-A 1990 Chemical Waste Management, Inc. SL 022136 Chemical Waste Management, Inc. ADDENDUM TO GENERATOR'S WASTE MATERIAL PROFILE SHEET FOR LAND DISPOSAL RESTRICTIONS PART A. GENERATOR INFORMATION 1. GENERATOR NAME--Enter the name of the generating facility. 2. GENERATOR USEPA ID--Enter the identical twelve character alpha-numeric descriptor issued by the USEPA to the facility generating the waste. 3. WASTE PROFILE SHEET CODE--Enter the identical alpha-numeric descripter issued by CWM on your existing Generator's Waste Material Profile Sheet for the specific waste generated by the facility. PART B. WASTE STREAM INFORMATION 1. USEPA HAZARDOUS WASTE--Indicate if this waste is a USEPA Hazardous Waste (40 CFR 261) 2. IF THE WASTE IS USEPA HAZARDOUS--Indicate if this waste is a characteristically hazardous (40 CFR 261 Subpart C) and/or a listed hazardous waste (40 CFR 261 Subpart D) a. INDICATE IF THE WASTE IS A NONWASTEWATER OR A WASTEWATER. The waste must be either "wastewater" or "nonwastewater." In most cases, a wastewater is defined as having less than 1 percent total filterable (or suspended) solids, and less than 1 percent TOC (Total Organic Compounds) and the remainder of the waste is water. There are a few exceptions to this wastewater definition for TOC: K001, K013, and K014 are wastewaters if they are less than 3.5 percent TOC, and K025 is a wastewater if it is less than 4 percent TOC In addition, filterable (suspended) solids is not part of the wastewater definition for F001 through F005. Any waste that does not meet the applicable definition of "wastewater" is a ' nonwastewater". b. LIST ALL APPLICABLE USEPA HAZARDOUS waste numbers, categories, and subcategories as DEFINED BY 40 CFR 261 Subpart C & D, 40 CFR 268.41, 268.42, and 268.43. USEPA WASTE No.: This is a four unit alpha-numeric code, such as D001 or F003, that identifies the hazardous waste See 40 CFP Part 261 for a complete description. SUBCATEGORY: The treatment standards for some hazardous wastes have been further subcategorized, based on specific condition or properties of the waste. These subcategories are defined in 40 CFR Part 268.42 and 268.43, Next to each number identify the corresponding subcategory by either checking "NONE" or writing in the subcategory description, Tne waste numbers that do have subcategories and the descriptions include: D001: Ignitible Compressed Gas, Ignitible Liquid, NonAtomizable Ignitible Liquid, Ignitible Reactive, or Oxidizer, D002; Acid (pH < = 2.0), Alkaline (pH = 12.5), or Other Corrosive (Corrosive to SAE 1020 steel at a rate > = 0.25 inch/year D003: Reactive Cyanide, Reactive Sulfide, Water Reactive, Explosive, or Other Reactive, D006: Cadmium Batteries, or NONE; D008: High Lead, Low Lead, or Lead Acid Batteries; 9: High Mercury (> = 16ppm). or Low Mercury (< 16ppm); * 1, F002, F003, F004, F005: (NonWastewaters: NONE), (Wastewaters: Pharmaceutical, or NonPharmaceutical), '25: Light Ends, or Filters/Filter Aids/Desicants; K006: Anhydrous or Hydrated: K046: Reactive or NonReactive; K061: Low Zinc (< 15%) or High Zinc (> =15%); K069: Calcium Sulfate or NonCalcium Sulfate; K071, K106, and U151: High Mercury (> =16ppm) or Low Mercury (< 16ppm). EXAMPLE: USEPA HAZARDOUS WASTE NO. NONE F006 D002 D003 U129 K061 D001 X X SUBCATEGORY DESCRIPTION Acid, ph < = 2.0 Reactive cyanides High Zinc Ignitable Liquid USEPA HAZARDOUS WASTE NO. NONE SUBCATEGORY .... ........ . DESCRIPTION ` Tc ust additional USEPA waste numbers ard subcategcnes. use the supplemental form attached (CWM-6000-B) and che:N' the be.-: o'ov;de: 3. USEPA WASTE NO. D005-- I L5E"A waste code D008 is listed in #2 above, indica'e the tot at concentrat.cn of leas - wc.,- ~ .ncicaie it tne waste u. sc., cOu.cr cca .s ae:in-_,, :.n :-a 42472, Eotc- '-'ZZ u: NO in tne appropriate co,. RT C. GENERATOR CERTIFICATION - j,,;:tcr;zea employee of the ger erator r ,,s: su art a aate th:s certificat. :r or, tn^ _cmp!eted Generator's Waste Materia1 ^ Disposal r.estr.cticr j - CO' -- t- r GENE-ATD- ? '.'1-ER!AL pro^'.E EPEE- LAN'S o't" . , AODzND j* -0,-. . _ ^ r,-:,1_ C wU.,, ,'YORKSE', S" 70 TrE ADDRESS PROVIDED E YOUR CHEMiC/-.. WASTE MANAGEMENT, INC. SALES REPRESENT m SL 22l