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Aaab 1 jam GENERATOR'S WASTE MATERIAL PROFILE SHEET Rfr iv PLEASE PAINT IN INK Oft TYPE (ElHa, 12-pftch' NOV 2 8 1990 CWU Location of Ortgbitf: t IIIIIIIIIIIIIIII *I17 >t * (MADED MCAS KHICWM US* ONLY) K 37932 Waste Proflte Sheet Coda CWMSateaRepgp^i3%n A GENERAL INFORMATION 1. Generator Name: PPG Industries, Inc.2. Generator USEPA ID: LAJD00Q0S6506 3. Facility Address: P 0 Box 10004 Generator State 10: Lake Charles. LA GD-019-0495 !5. Zip Code: 6. Technical Contact: Gerald L Perry7 Title; Env. Control Spec . 8 Phone: ( 31$ 491-4500 B. MAIL CHEMICAL WASTE MANAGEMENT, INC. INVOICES TO 1. 0 Generating Facility (A above), or 2. Company Name: 3. Phone: ( ) 4. Address:____________________________________________________________________________________________________ . 5. Zip Code:. C. 1. NAME OF WASTE Soil and Debris contaminated with product spills 2. PROCESS GENERATING WASTE _ Derivatives area 3. Is this waste a Dioxin listed waste as defined in 40 CFR 261.31 (e.g.. F020, F021, F022, F023, F026, F027, or F028)? G Yes EJ No If yes, DO NOT COMPLETE this form. Contact your Chemical Waste Management. Inc. sales representative for assistance. D. PHYSICAL CHARACTERISTICS OF WASTE 1. Color Brown " 2. Does the waste have a strong incidental odor? 0 No U Yes If known. ritottihM- 3. Physical State @ 70* F: 0 Solid LI Semi-Solid U Liquid U Powder Ortww ..... 4. Layers: G Multilayered G BMayered 0 Single Phased 5. Specific Gravity: "wr. i.s 6. Free Liquids: U Yes 0 No Volume: 7. pH: G<2 Q > 2-4 G 4-7 7 G 7-10 10-<12.5 G > 12.5 G Range m na 8. Liquid Flash Point < 73* F 73-99* F 100-139*F 140-199*F ^ 200* F G None 0 Closed Cup GOpenCup E. CHEMICAL COMPOSITION 1- Soil and debris RANGE Chi rinated hydrocarbons u.uui (noted below) Tetrachloroethylene Trichloroethylene Vinylidene Chloride vinyl Chloride 1,1,1-Trichloroethane Traces of C2 -Cs C1HC Ethylene Dichloride - * - - Please note: The chemical composition total in the maximum column must be greater than or equal to 100%. TOTAL 2. Indicate if this waste contains any of the following: NONE or LESS THAN or ACTUAL PCB'a Q Q < 50 ppm ppm Cyanides JjD Phenolics Q < SO ppm Q < SO ppm ppm ------ ppm Sulfides G < 50 ppm -------ppm 9b 9b 9b 9b 9b 9b 9b 9b 9b 9b 100+ ^ F. METALS Indicate if this waste contains any of the following: 1. QMK/TCLP or 2. G Total METAL LESS THAN or ACTUAL Arsenic Barium Cadmium Chromium Lead Mercury Selenium (Parte Par Million) a< 5 < 500 E< ioo H< 1 0< 100 H< 5 B< 5 < 500 0< 0.2 < 20 0< 1 Q< 10U Silver E< Chromium-Hex E< Copper Nickel E< (3< Thallium H< n<Zinc E< 5 5 < 500 5 5 0< 134 5 n< inn 5 n< < Steal of 2 TURN PAGE AND COMPLETE SIDE 2 Form CWV '-000 e 1987 Chemical Waste Management, Inc. . 022252 GENERATOR'S WASTE MATERIAL PROFILE SHEET (Continued) g~l K 37932 Waste Proflte Stoat Coda Q. OTHER HAZARDOUS CHARACTERISTICS 1. Is this waste a listed solvent waste as defined by 40 CFR 261.31 (F001, F002, F003. F004, or F005)? 2. Does this waste contain greater than 1000 ppm total halogenated organic compounds? 3. Indicate if this waste is any of the following: RCRA Reactive G Water Reactive Radioactive G Etiological Explosive G Pesticide Manufacturing Waste D Shock Sensitive Q Other__________________ Pyrophoric (3 None of the above G Yes B No O Yes E No H. COMPLETE ONLY FOR WASTES INTENDED FOR FUELS or INCINERATION Beryllium Potassium Sodium Total Bromine Total Chlorine Total Fluorine Total Sulfur LESS THAN G< 5000 ppm G< 5000 ppm G< 5000 ppm G< 2% G< 35% G< 1 % or ACTUAL ppm ppm ppm % % % % I. OPTIONAL -- RECLAMATION, FUELS, OR INCINERATION PARAMETERS Provide if information is available. Range 1. Heat Value (BTU/lb):=___________________ 2. Water% 3. Viscosity (cps): @Q_______________________ *F Q 100*F 150*F 4. Ash: _________________ % 5. Settleable solids:% 6. Vapor Pressure @ STP (mm/Hg): ------------------------------------------ 7. Is this waste a pumpable liquid? G Yes G N Type of pump? _____________________________________________ G8. Can this waste be heated to improve flow? Yes G No 9. Is this waste soluble in water? G Yes G N 10. Particle size: Will the solid portion of this waste pass through a 1/8 inch screen? G Yea G No J. TRANSPORTATION INFORMATION 1. 3. 4. 6. Is this a DOT Hazardous Material? 0 Yes _ No 2. ifWMHTProper Shipping Name: Hazardous waste, solid. Hazard Class: ___ 0RM~E Additional Description: ( U210,U228,U226,Uw0,78,wU0w43, S. I.D.: U077)___________ _ mnWroMO-SS-uaTSw,JJ0Z -------RX5IS9---------------------------- v' an: __ _________________________) 7. Method of Shipment: G Bulk Liquid G Bulk Solid E? Drum (Typa/<ti7>)- D0T17C / 55 gal Other e. CERCLA ReportabtoGum* (RQ):-------------------- '------------------------- 1" 10. USEPA Hazardous Waste? 0 Yes Q No 12. State Hazardous Waste? 0 Yes G No K. SPECIAL HANDLING INFORMATION G Additional Page(s) Attached L, GENERATOR CERTIFICATION I hereby certify that all information submitted in this and all attached documents contains true and accurate descriptions of this waste material, and all relevant information regarding known or suspected hazards in the possession of the generator has been disclosed. r\ Krv SignnitaottuiirrAe Gerald L. P rry 3. Name (Type or Print) V .""tel Side 2 of 2 F rm CWM-6000 o 1987 Chemical Waste Management Inc 2. Environmental Control Spec. * Title November 16, 1990 4. ____________________________ Date SL 022253 ------ - Chemical Waste Management Inc. Route 2 Box 1955 Sulphur, LA 70663 --Al-fpnr-inn; TWnt-hy INSTRUCTIONS FOR COMPLETING THIS FORM ARE FOUND ON THE OPPOSITE SIDE. In order to determine whether Chemical Waste Management, Inc. can accept the special waste described in the Generator's Waste Material Profile Sheet referenced above, you must obtain and supply us with a representative sample of the waste. We may analyze the sample to verify the information that you have provided to us. A representative sample is defined as a sample obtained using any of the applicable sampling methods specified in 40 CFR 261 -Appendix I or an equivalent method. Collect a representative sample of your waste and complete the form below. Apply the peel off label and ship your sample along with this form to the address noted above. If you have any questions regarding obtaining a representative sample of your waste, please refer to the instructions for this form, or contact your Chemical Waste Management. Inc. sales representative. A. SAMPLING METHOD (Indicate which method was employed) If sampling requirement has been waived by Chemical Waste Management, Inc., do not complete this Generator's Certification of Representative Sample form. D1. I have obtained a representative sample of the waste material described in the Generator's Waste Material Profile Sheet referenced above according to the sampling methods specified in 40 CFR 261-Appendix I. 2. S) I have obtained a representative sample of the waste material described in the Generator's Waste Material Profile Sheet referenced above using a method equivalent to the sampling methods described in 40 CFR 261-Appendix I. B. SAMPLE SOURCE (e.g., drum, lagoon, pit, pond, tank, vat) C. SAMPLE LABEL -- COMPLETE LABEL BEFORE REMOVING 1. Waste Profile Sheet Code: 2. Generator's Name: 3. MBM Name of Waste: 4. BH Sample Hour/Date: 5. Sampler's Signature: PPG Industries. lac. Boll and Debris ontaa. with Product O ? DO n-iH-So P i^l --,, l. i * f 1. Waste Profile Sheet Code. 2 Generator's Name: 3. Name of Waste: f Semple Hour/Data: $. Sampler's Signature: 6. Print Sampler's Name:. rv A 7. Sampler's Title: ____ 8. Sampler's Employer (if CWM, see D. below): Pre*icn />/>& n'ZF D. WITNESS VERIFICATION (if required) In most circumstances you will be obtaining the sample. However, in those cases in which Chemical Waste Management, Inc. obtains the sample, one of your employees must be present to direct the particular source to be sampl d, to witness the sampling, and to complete this Part O. 1 was personally present during the sampling described. I directed th waste source to be sampled, and I verify the information noted above. 1. Witness'Signature: 022254 2 Witness' Name: 3. Witness' Title: 4. Witness' Employer. __________________________ 5. Date: ________________ CHEMICAL WASTE MANAGEMENT, INC. LAKE CHARLES TREATMENT CENTr- LAND ,POSAL NOTIFICATION AND CERTIFIt ION FORM SUPPLEMENTAL PAGE # 1OF I (`Count only supplemental pages) Generator Name: CWM Profile Number: mMM State Manifest No. LA This form is a continuation from Form CWM-LC-2001 -A for a waste identified by more than five USEPA waste number/subcategories groups. This page by itself IS NOT an acceptable Land Disposal Notification and Certification Form! II. Continue (from form CWM-LC-2001 -A) to identify ALL USEPA hazardous wastes that apply to this waste shipment (as defined by 40 CFR 261). For each waste number, identify the corresponding subcategory (write in the description from 40 CFR 266.41, .42 or .43. or check NONE if the waste does not have a subcategory). Identify in column 6 the applicable treatment standards. If the waste is subiect to a specified technology standard (268.42) write the five tetter treatment code(s) in the space provided. Identify in column 7 how your waste must be managed for each waste code listed. Spent Solvent and California List treatment standards are listed on the back of the first page, F039 treatment standards, if applicable, must be attached. 4 USEPA HAZARDOUS R WASTE E COD(S) F i 2 5. SUBCATEGORY ENTER THE SUBCATEGORY DESCRIP tonIF NOT APPLICABLE. SIMPLY CHECK 7ONE DESCRIPTION NONE X 6 APPLICABLE TREATMENT STANDAROS 6.* -PERFORMANCE- BASED CHECK AS APPLICABLE 6 b -SPECIFIED TECHNOLOGY IF APPLICABLE ENTER THE TABLE 1 TREATMENT COOE(S) 7 HOW MUST THE WASTE BE MANAGED' ENTER THE LETTER FROM THE LAND DISPOSAL NOTIFICATION AND CERTIFICATION FORM 268.41|al .68 43(a) 268 42 X ^S .^9X ... _. 3 4 L 6 7 8 Hs flio ii 12 13 14 15 16 17 is 19 l 2Q b To list additional USEPA waste code(s) and subcategory(s). use another supplemental sheet provided (CWM-LC 2001B) and check here: Q I I hereby certify that all information submitted in this and all associated documents is complete and accurate, to the best of my knowledge and information. Signature Title SL 022255 Date________________ FORM CWM-LC2O01-B (7 -23.901 CHEMICAL WASTE MANAGEMENT, INC. Generator Name: LAKE CHARLES TREATMENT CENTER IcLANO DISPOSAL NOTIFICATION AND CERTIFICATION FORM TT Gr -/L CWM Profile Number: BME0 .... State Manifest No.: LA iroSwiil -ui * Ftirv- ., j'j_ . ... . .j. ........... . 1, : - ~ This form is submitted to Chemical Waste Management. Inc. in accordance with 40 CFR Part 268. which restrict the land disposal of certain hazardous wastes 1. IDENTIFICATION^?^ tftA'STE' ~ ............. " `' " " " " _ ' ~ 1. Treatability Group: IsJb&yvaste a non-wastewater or a wastewater? (See 40 CFR 268.2) Chech One: Non-Wastewater JQ .Wastewater 2. If this waste is subject to any California List restrictions, enter the letter from below either (A, B.1 or B.2) next to each restnctiori that je applicable: HOCs____ PCBa >- Adds_________ Metals Cyanides. .IMS * "* Identify All USEPA hazardous.waste codes that apply to this waste shipment, as defined by 40 CFR 261. For each waste code, idertflyjly corresponding subcategory, or check NONEife the waste code has no subcategory. Also check which treatment standards apply. Spent solvent and43Sfpfns List treatment standards are listed on the back of the form. It F009. multi-source leachate applies, those standards must be attached by the generator,'or^yv- ^ SEE THE INSTRUCnONSfgGgFQR>IORE INFORMATION REGARDING THE PROPER USE OF THIS FORM. 'HOm&rsiZF 4. USEPA HAZARDOUS R WASTE E COOE(S) F 1 s. suecATEOonv . APPLICABLE TREATMENT STANOARDS ENTER THE SUBCATEGORY DESCRIPnoN- IP NOT APPLICABLE, SMPLY CHECK rONE --SA-PERFORMANCE* . ea* - 1 ; *L BASED -CHECK AS APPLICABLE *r *- J 6.6 -SPECIFIED TECHNOLOGY: IF APPLICABLE ENTER THE TABLE 1 TREATMENT COOE(S) # ~ , * DESCRIPTION "7----- NONE 266.41(a) 264430) 260.42 L- 1 UOM3 A 1 . '* "A X 7. HOW MUST THE WASTE BE MANAGED? U ENTER THE LETTER FROM BELOW '( V -* C, *5 /y i V x --'-rtfS^rW*-* -we ' 2 Ul)U 3 lio^s 4 'JPiO s 'C". *' / * < v ` * 'I -- Qllr / A 7^ - A X A 0 . 5 lv/9Z | I To list additional USEPA waste code(s) and subcategory(s); use the supplemental sheet provided (CWM-LC-2001-B) and check here N. HOW MUST THE WASTE BE MANAGED? -uu*au.~ . In column 7 above, enter the letter (A, B1, B2. B3, C, or D) below that describes how the waste must be managed to comply with the land disposal regulations (40CFR 268.7). Please understand that if you enter the letter B.1, B.2,8.3 or 0, you are making the appropriate certification as provided below. A. RESTRICTED WASTE REQUIRES TREATMENT ,,.. .I'Ud '_p '1 .................................... This waste must be treated to the applicable treatmentstandards set forth In 40 CFR Part 268 Subpart D, 268.32 or RCRA Section 3004{dfand LAC 33:V.2213. B.1. RESTRICTED WASTE TREATED TO PERFORMANCE STANDARDS EPA CERTIFICATION 'I certify under penalty of law that I have personally examined and am familiar with the treatment technology and operation of the treatment process used to support this certification and that based upon my Inquiry of those indvfduals Immediately responsible for obtaining this Information, I believe that the treatment process has been operated and maintained property so es to comply with the performance levels specified in 40 CFR Part 268 Subpart D and ail applicable prohibitions set forth in 40 CFR 268.32 or RCRA Section 3004 (d) without impermissible dHution of the prohibited waste. I am aware that there are significant penalties for submitting a false certification, inducting the poeslbilty of a fine and imprisonment' ------- LaDEQ Certification Iwhere anptlcabte) ------ T certify under penalty of law that I have personally examined and am familiar with the treatment technology and operation of the treatment process used to support this certification and that, based on my inquiry of those indviduals immediately responsible for obtaining this information, I believe mat the treatment process has been operated and maintained property so as to comply with the performance levels specified in LAC 33:V.Chapter 22, Subchapter B, and all applicable prohibitions set forth in LAC 33:V.2213 without dilution of the prohibited waste. I am aware that there are significant penalties for submitting a false certification." B.2. RESTRICTED WASTE FOR WHICH THE TREATMENT STANDARD IS EXPRESSED AS A SPECIFIED TECHNOLOGY (AND THE WASTE HAS BEEN TREATED BY THAT TECHNOLOGY) EPA CERTIFICATION "I certify under penalty of law mat the waste has been treated In accordance with the requirements of 40 CFR 268.42.1 am aware that there are significant penalties for submitting a false certification, Inducting the possibility of fine and imprisonment* f --- - Lepan rPPTiRCATlON (where applicable! ------- -- --- "l certify under penalty oflaw thatthe waste has been treated in accordance with the requirements of LAC 33:V.2227 of the Louisiana Hazardo**^"' Regulations I am aware mat there are significant penalties tor submitting a false certification.' ^ 022256 B.3. GOOD FAITH ANALYTICAL CERTIFICATION - FOR INCINERATED ORGANICS *1 certify under penalty of law that I have personally examined and am familiar with the treatment technology and operation of me treatment process used to support mis certification and that, based on my inquiry of those Individuals immediately responsible for obtaining mis information. I believe mat the nonwastewater organic constituents h been treated by indneration in units operated in accordance with 40 CFR Part264 Subpart O, or by combustion in fuel substitution units operating in accordan ipolicable technical requirements, and I have been unable to detect the nonwastewater organic constituents clesnite havino used host ikw* GENERATOR'S WASTE MATERIAL PROFILE SHEET R|r'v. PLEASE PRINT IN INK OR TYPE (Ellto, 12-plte NOV 2 8 1990 'TV CWM Location of Original: llllllllllllllll i(irii I KLCH 37932 Waste Profile Sheet Cod* >v/' : r ^- (WADED AREAS FOR CWM UK ONLY) . ^ CWM 6*1** Rep.#;-* A. GENERAL INFORMATION 1. Generator Name: PPG Industries, Inc.2. Generator USEPA ID: _ LAD008086506 3. Facility Address: P 0 Box 10004 Generator State ID: Lake Charles. LA______________________ GD-019-0495 6. Technical Contact: Gerald L Perry7 Title: 5. Zip Code: Env. Control Spec.H Phone; ( 31? 491-4500 B. MAIL CHEMICAL WASTE MANAGEMENT, INC. INVOICES TO 1. 3 Generating Facility (A, above), or 2. Company Name: 3. Phone: ( 4. Address: ) 5. Zip Code: C. 1. NAME OF WASTE Soil and Debris contaminated with product spills 2. PROCESS GENERATING WASTE _ Derivatives area 3. Is this waste a Dioxin listed waste as defined in 40 CFR 261.31 (e g., F020, F021, F022, F023, F026. F027, or F028)? G EJYes No If yes, DO NOT COMPLETE this form. Contact your Chemical Waste Management. Inc. sales representative for assistance. D. PHYSICAL CHARACTERISTICS OF WASTE 1. Color Brown 2. Does the waste have a strong incidental odor? 0 No G Yes If known. 3. Physical State @ 70* F: CJ Solid U Semi-Solid G Liquid Powder dMerilw Other 4. Layers: G Multilayered G BMayered 0 Single Phased 5. Specific Gravity: TY . 1.5 6. Free Liquids: G Yes 0 No Volume: 7. pH: G<2 G > 2-4 4-7 O 7 G7-10 G 10- <12.5 G > 12.5 G Range ' ... fxl NA 8. Liquid Flash Point G<73*F 73-99*F 10O*139*F 140-199*F i 200*F GNone 0 Closed Cup Open Cup E. CHEMICAL COMPOSITION V Soil and debris ______________________ (ffS: Dftwi Chlorinated hydrocarbons ~0.001" (noted below) Tetrachloroethylene trichloroethylene Vinylidene Chloride vinyl Chloride 1,1,1-Trichloroethane Traces of C2 -Cs C1HC Ethylene Dichloride - - Please note: The chemical composition total in the maximum column must be greater than or equal to 100%. TOTAL: 2. Indicat if this waste contains any of the following: PCB's Cyanides Phenolic* Sulfides NONE G 3 Q Q or LESS THAN or 0 < 50 ppm G < SO ppm < SO ppm G < SO ppm ACTUAL ppm ppm ppm ppm % % % * % % % F. METALS Indicate if this waste contains any of the following: 1. Sm TBT/TCLP or 2. Total METAL LESS THAN or ACTUAL (Parts Per Million) Arsenic E< 5 < 500 Barium Cadmium E< ioo E< 1 < 100 Chromium Lead B<E< 5 5 < 500 Mercury H< 0.2 < 20 Selenium E< a<Silver a<Chromium-Hex 1 G< 10U 5 5 < 500 Copper Nickel Thallium Zinc E< 5 E< 5 < 134 B< 5 G< 130 a< 5 < < G< Side 1 of 2 Form CWM TURN PAGE AND COMPLETE SIDE 2 * 1987 Chemical Waste Management. Inc. SL 022257 GENERATOR'S WASTE MATERIAL PROFILE eHEET (Continued) nan k 37932 Waste Proflte Sheet Coda Q. OTHER HAZARDOUS CHARACTERISTICS 1. Is this waste a listed solvent waste as defined by 40 CFR 261.31 (F001, F002. F003. F004, or F005)? 2. Does this waste contain greater than 1000 ppm total halogenated organic compounds? 3. Indicate if this waste is any of the following: RCRA Reactive Radioactive Water Reactive Etiological G Explosive Pesticide Manufacturing Waste Shock Sensitive Pyrophoric Other (9 None of the above Yes 0 No Yes 0 No H. COMPLETE ONLY FOR WASTES INTENDED FOR FUELS or INCINERATION Beryllium Potassium Sodium Total Bromine Total Chlorine Total Fluorine T tal Sulfur LESS THAN < 5000 ppm < 5000 ppm < 5000 ppm < 2% < 35% < 1 % or ACTUAL ppm ppm ppm % % % % I- OPTIONAL - RECLAMATION, FUELS, OR INCINERATION PARAMETERS Provide if information is available. Range 1. Heat Value (BTU/lb):=___________________ 2. Water. _____ % 3. Viscosity (cps): @ G_______________________ *F 100*F 150*F 4. Ash: % 5. Settleable solids: _____ % 6. Vapor Pressure @ STP (mm/Hg): ____ 7. Is this waste a pumpable liquid? Yes No Type of pump? _____________________ _ 8. Can this waste be heated to improve flow? Yes N 9. Is this waste soluble in water? Yes No 10. Particle size: Will the solid portion ofthis wastepass through a 1/8 inch screen? Yes No TRANSPORTATION INFORMATION 1. Is this a DOT Hazardous Material? 0 Yes No . 3. Proper Shipping Name: Hazardous waste, solid 4. 6. 7. Hazard Class: _ ORM-E Additional Description: ( Method f Shipment: U210.U22S.U226.U078.U04-3-,--U--D-7-7-)--5-.-1-.-D-.-#-:-----------BJ5I5?---------------------------*77) Bulk Liquid G Bulk Solid G Drum (Type/Size):.D0T17C , 55 gaT fghen. -) ?.cusrep* Rr,srsras 12. State Hazardous Waste? H Y No 13. Slats HUM.U. Wul. Numb*'.): UZI07D2287U2257U07S7U0437TO77 K. SPECIAL HANDLING INFORMATION Additional Page(s) Attached L. GENERATOR CERTIFICATION I hereby certify that all information submitted in this and all attached documents contains true and accurate descriptions of this waste material, and all relevant information regarding known or suspected hazards in the possession of the generat r has been disclosed. Signature Gerald L. Perry 3. Name (Type r Print) v_ . Side 2 of 2 F rm CWM-6000 e 1987 Chemical Waste Management Inc. 2 Environmental Control Spec. ' Title November 16, 1990 4. Date SL 022258 CWMLocsttoRof^ GENERATOR S CERTIFICATION OF REPRESENTATIVE SAMPLE PtEAM PAIMT M MK OH TYPC (ENto, 12-pr I1IIIIIIIIIIII1 Jf B 155 I Kr7Q39 Waste Profile Sheet Cod* CVMMmI This completed form must be returned, with the representative sample, to: Chemical Waste ManagemeOt Inc. Route 2 Box Sulphur, LA 1955 70663 INSTRUCTIONS FOR COMPLETING THIS FORM ARE FOUND ON THE OPPOSITE SIDE. In order to determine whether Chemical Waste Management Inc. can accept the special waste described in the Generator's Waste Material Profile Sheet referenced above, you must obtain and supply us with a representative sample of the waste. We may analyze the sample to verify the information that you have provided to us. A representative sample is defined as a sample obtained using any of the applicable sampling methods specified in 40 CFR 261 'Appendix I or an equivalent method. Collect a representative sample of your waste and complete the form below. Apply the peel off label and ship your sample along with this form to the address noted above. If you have any questions regarding obtaining a representative sample of your waste, please refer to the instructions for this form, or contact your Chemical Waste Management, Inc. sales representative. A. SAMPLING METHOD (Indicate which method was employed) If sampling requirement has been waived by Chemical Waste Management, Inc., do not complete this Generat r*s Certification of Representative Sample form. 1. I have obtained a representative sample of the waste material described in the Generator's Waste Material Profile Sheet referenced above according to the sampling methods specified in 40 CFR 261-Appendix I. 2. K) I have obtained a representative sample of the waste material described in the Generator's Waste Material Profile Sheet referenced above using a method equivalent to the sampling methods described in 40 CFR 261-Appendix I. B. SAMPLE SOURCE (e.g,, drum, lagoon, pit, pond, tank, vat) C. SAMPLE LABEL - COMPLETE LABEL BEFORE REMOVING WIUI 1. Waste Profile Sheet Code: 2. Generator's Name: 3. Name of Waste: 4. Sample Hour/Date: 5. Sampler's Signature: LCH-I-37932 PPG Industrie*. Inc. Boll and Debris outas. with Product Dloo U- -yQ**** tz__ 7 rr l 1. Waste Profile Sheet Cod*. 2. Generator's Name: 3. Name of Waste: Semple Hour/Date: 5. Sampler's Signature: 6. Print Sampler's Namei:: sru A 7. Sampler's Title: . 7" 8. Sampler's Employer (if CWM, see D. belo*w)): A D. WITNESS VERIFICATION (if required) In most circumstances you will be obtaining the sample. However, in those cases in which Chemical Waste Management, Inc. obtains the sample, one of your employees must be present to direct the particular source to be sampled, to witness the sampling, and to complete this Part D. I was personally present during the sampling described. I directed the waste source to be sampled, and I verify the information n ted above. 1. Witness'Signature: ___________________________________________________________________________ 2. Witness'Name: 3. Witness'Title:SL 022259 ____________ 4. Witness' Employer 5. Date: Data print*! 09/06/92 chemical Waate Management Inc. o/f< Check here If this la a Recertification WASTE PROFILE LOCATION 07 ORIGINAL CWM LAKE CHARLES LCH K37932 Profile f GENERAL IKFOWttllON 1. Generator Naas: PPG INDUSTRIES 2. Generator Address: P 0 BOX 1000 LAKE CHARLES LA 70602 3. Technical Contact/Phone: GERALD L. PERRY 4. Alternate Contact/Phone: u) H 0.3 COOTS K, Generator USEPA ID: LADOO8O66506 Bi11 lnul(ddress: (VI Same 319/491-4500 cftPllling 31 SO Contact/Phone: JiP OXA/OgR. 'EMAS-Bky 3 >? - 4>S I - PROPERTIES AND COMPOSITION 5. Process Generating Waste: DERIVATIVES AREA 6. Waste Name: SOIL 6 DEBRIS CCWTD W/PRODUCT SPILLS 7A. Is this a USEPA harardous waste (40 CFR Part 261)7 Yes (X) No (_) B. Identify ALL USEPA listed and characteristic waste coda numbers (D,F,X,P,U): U043 U077 U07B U210 U226 U226 State Waste Codas: B. Physical State 0 70F: A. Solid(X) Liquld(_) Both(_) Gaa(_) B. Single Layer (X) Multilayer ( ) C. Free llq. range __ 0 to __ 0% 9A. pH: Range or Not applicable (X) ` B. Strong Odor (_) /describe 10.Liquid Flash Point: < 73F (_) 73-99F (_) 100-139F (_) 14Q-199F (_) >- 200F (_) N.A. (_) Closed Cup (X) Open Cup ( ) None (X) ~~ 11. CHEMICAL COMPOSITION: Llet ALL constituents (incl. halogenatad organics) present in any concentration and forward analysis constituents Range Unit Description 30IL AMD DEBRIS w** 99.90 to 99.99^ CHLORINATED HYDROCARBONS (NOTED BELOW) ,001-<0.10 to .01 aUS Va TETHACHLOROBTHYLENE o to S.6> TRICHLOROETHYLENE VINYLIDENE CHLORIDE VINYL CHLORIDE TOTAL COMPOSITION (MUST EQUAL OR EXCEED 100%): o to 5.G -p-prf*# 0 to 33 -p-PAO^ p to 33 TPM ** 100.000000 See attachment 2 12. OTHER: PCBe if yea, concvitratlon < 50 ________ ppm, PCBe regulated by *0 CTR 761 (_). Pyrophoric (_) Explosive (_) Radioactive (_) Bansene if yes, concentration _ ppa. Shock Sensitive (_) CKldlxar ( ) Carcinogen ( ) Infectious ( ) Other ~____________________________________ ~ 13. If waste subject to the land ban 6 meets trestment standards, check here: C supply analytical results where applicable. SHIPPING INFORMATION 14. PACKAGING: Bulk Solid Bulk Liquid (_) Drum Type/Sire: DRUMS /s5 &-Al~ Other 15. ANTICIPATED ANNUAL VOLUME I 250 Units: TONS Shipping Frequency: YEAR Data Printed 09/08/92 LCH K37932 18. Chack ORE: This la a _ waatewater _ Nonweatawatar- Proflla * 19. if tbla waata la aubject to any California Hat raatrlctiona antar tha lattar froa below (either A. B.l or B.2) next to each raatrictlon that la applicable: ___ BOCa, ___ PCBa, ___ Acid, ___ Matale, ___ cyanidaa 20. Identify ALL Charactarlatlc an<f Litad USEPA hazardoua waata nunbera that apply (aa daflnad by 40 CPU 261). For each waata number. Identify tha eubcategory (aa applicable, chack none, or write In the description from 40 CFR 268.41, 268.42, and 268.43). 1I1 1 111 t A. US SPA HAZARDOUS 1 1 1 REP WASTE CGDE(S) I 1I I #I 11 1 I1 I 11 I B. SUBCATBGORY 1 1 Entar tha aubcatagory daacrlptlon. j C. APPLICABLE TREATMENT STANDARDS If not applicable. aiaply check none 1 PERFORMANCE- SPECIFIED TECTNOLOGY: I BASH): Check aa applicable If applicable antar the 40 CFR 268.42 DESCRIPTION _______ 1 table 1 treatment coda(a) lNONE|268.41(a)1268.43(a)i 268.42 ! i! U043 1 I tx ; 1xi 4-""2 r 3 i 41 U077 U078 U210 1 | I | 1 I !x ! !x I !x 1 1Xj !x ! 1XI ! si 11 II ! 6, U226 U228 1I | _L_ !x ! iJ X 1i 1x 1 11 1x! D. HOW MUST j THE WASTE BE MANAGED? 1 Entar lattar 1 froa below ! 1 D O O jiP D cUf | D cfrP' ---8- \-----------?! j 10! 1 I 1 1 11 1 1 1 -...... 1 1 1 1 I 1 1 11 1 1 11 1 1 I| 1 1 1 11 1 1 11 1 1 11 11 1 1 11 t 1 11 1 llmnijaaant under tha land dlapoeal raatrlctiona: A. RESTRICTS) WASTE ESQUIRES TREATMENT I 1 1 1 1 1 1 I I I B.l RESTRICTED WASTE TREATED TO PERFORMANCE STANDARDS B.2 RESTRICTED WASTES FOR WHICH THE THIA3MEHT STANDARD IS EXPRESSED AS A SPECIFIED TECHNOLOGY (AMD THE WASTE BAS BEER TREATED BY THAT TECHNOLOGY) B.3 OOOO FAITH ANALYTICAL CERTIFICATIOH FOR INCINERATED ORGANICS C. RESTRICTED WASTE SUBJECT TO A VARIANCE D. RESTRICTED WASTE CAR BE LARD DISPOSED WITHOUT FURTHER TREUMBT E. NOT CURRENTLY SURIECT TO LAND DISPOSAL RE8TRICTI0BS 21. Ia tbla waata a aoll and/or dabria? No: _ Yaa, Soil: Yas, Dabrla: Yaa, Both: 22. Spaelfic Gravity Range: 1.100 to 1.500 23. Indicata tha range of each: Unita Cyanidaa: non* to Type (free, total. aaenable, etc.) Cyanldea: Nona to Type (free, total. aaanable, ate.) Sulfldee: Nona to Type Optional Pbeoolice: Nona to Identify tha waata color BROWN , DOT phyalcal atate SOLID SL 022261 Data Printed 09/08/92 25. COMPLETE ORLY FOR WASTES IETKHDED FOR FUELS OR INCINERATION Barylllua aa Be Potaaaiua aa X Sodluu aa Na Bromlna aa Br Chlorine aa Cl Fluorine aa F Sulfur aa 3 TOTAL LCH K37932 26. RECLAMATION, FUELS or INCINERATION PARAMETERS (Provlda If Information la available) Profile # RAMOS ppa A. Hast Valua (Btu/lb): ppa B. Watar: PPM C. Viscosity (cpa): ____ 100 F 150 F % D. Aab: % E. Sattlaabla aolidai % F. Vapor Praaaura SSP (nm/Bg) i _____ 1 a. la thla waata a punpable liquid? Yaa No B. Can thla waata ba haatad to ia^irovn flow? Yaa No I. la this waata aolubla in watar? Yaa _ No J. Partlcla alia: will tbs solid portlaa of this waata pass through a 1/8 Inch soraan? Yaa No 27. TRANSPORTATION INFORMATION A. la this a DOT Hazardous Matarial? Yaa X No B. Proper Shipping Nanai HAZARDOUS WASTE SOLID, NOS (.TCTfenCrtUFKAfiTHariK, /,& - DZCMU>'K0e.THA**-)*O** jg- (wat7 waasi vaasr mbib, boo., ua?7) c DOT Regulation*: North Anarlca Hazard Class< om-1 I.D. NA9189 D CKRCLA Raportahla Quantity (RQ) and units (Lb, Kg)t 28. SPECIAL HANDLING INFORMATION (l&g M.L. T^O-Pgft.'PKOTg^TT.va; ff^mPAIgWT ffP-R. H-AWDkJhK^ ttAgft*.POU*S naJ ___ _ _ Matarial Safety Data Shaata Attached 29. OTHER IMFOIMATION 30. CHEMICAL WASTE MARAflMENT CERTIFICATION Chemical waata Management, Inc. haa all tha nacaaaary permits and licensee for the waata that haa bean charactarlsad and identified by thla approved profile. SL 022262 1 Data Printed 09/08/92 LCH K37932 31. CTISKR HAZARDOUS CHimtinB Indicata If tha waM contains any of tha following. 7 METALS TCLP Information: Chack only an for aach coostituant Usa units: ppm, mg/1 , 1 TC |Equal| Lass 1 Ragulatad . or i Wasta Than . Laval .Mora . No. 4| | | - TCLP Data TCLP Actual 1 TCA or TOTAL 1 Usa units: ppm, mg/1, mg/kg 1 or pargant j California List j |j jEqual! Actual .Lass Ragulatad . or . !Than! Laval iMOra ' 1Arsonic as As X 5.0 mg/1 Bariiia as Ba X 100.0 mg/1 0004 j D005 1 1 1 1 500 mg/1 11 |...] i i i i Cadmium as Cd jChrcaiua tot Cr X! 1.0 mg/1 ! X J5- |_?/!_{ ! 0006 | D007 i 1 1 1 100 rng/l ! 11 |1 i } ! i 1 iLaad as Pb X! 5.0 mg/1 1 ! 0008 | 1 1 1 | 500 a/i ,Marcurv as Bq X 2 ng/1 0009 | 1 i 1 | 20 -g/i j ! Salanium as Sa ISilvar as Ag X! X 1.0 mg/1 ! 5.0 mg/1 j ! 0010 j 0011 1 j 1 I 100 -g/i ! 11 j| i i i i iHlckal as Hi X 1 1 11 11 1 | 1 1 1 1 134 mg/l | | .Thallium as T1 !Chromium Bax X 1 1j 11 1 | _____ i ii X J1______________________ L 1 1 1 | 1 | 130 1 l ___ 1 L 500 mg/i 8/1 !_________________________ {Antimony!|!__________________________________________ _________ |_________ !!!___________________________ _! Profll* # iBaryllium !Coppsr X jj Vanadiumj!ji ij !i 1 11 1j | i ii J1______________________ L 1 | 1 1 'zinc X1 11 1L. 1 1 i ii iii i ii i i i ii iii i iii i ii iii i ii iii i ii iii iIIIIIi 11 .1 | 11 1- ______ L Ii 11 1 ______ L ii ii ii ii ii 11 ii iI 11 11 i... i ................. .... i i ii ii ii >i ii ii ii 11 ii SL 022263 * Data Print*! 09/08/93 LCH K37933 32. otBSR HAZARDOUS COHSTITOXHTS Indicata if tha waata contain* any of tha following. Profil* * 1" CROANXCS i I 1 TCLP Inforaation: . TCLP Data i1C---h--a--c-k----o- nr-l*y---O--H--S---f--o--r---a--a1c-b c,oinatltuant 1--------- I Equal TCLP Analytical 1 Lava . Ragulatad or Waata . Taat Raaulta i Than j Laval iMore j No. | Ua* units: pi* or ag/1 | TCA or TOTAL -- -tUa* units: ppa, ag/1 or % 1 1 1 1 i Banian* I X ! 0.5 ag/1 i 1 1 DO 18 1 1 1 1 i i Carbon Tatrachlorld* 1 | Chlordana 1 L Chlorobanlana i i Chloroform i X . *5 | i X ! 0.03 ag/1 ! ! X 1 100.0 ag/1 ! i X ! 6,0 ag/1 i 1 1 D019 1 U 1 1 D020 1 1 1 1 0021 1 1 1 1 D022 1 | 1 I 1 1 i i i i 1 L m-Craaol i 11- o-Craaol i 11 - p-Craaol l L Craaol l l 2,4-0 i 1,4 Dichlorobaniana ! X ! 200 ag/1 ! 1 x ' 200.0 ag/1 j I X ! 200.0 m/l 1 I x 1 200.0 ag/1 I 1 x ! 10.0 ag/1 ! | 7.5 ,/l | 1x 1 ! 1,2-Diehloroathana ! x ! 0.5 ag/1 ! 1 1 1,1-Diehloroathylana 1 X ! 0.7 ag/1 ! 1 11 - 2,4-Dinitrotoluana I x ! 0.13 m/l ! 1 Endrln ! x ! .02 ag/1 ! # Saptacblor, 8 Hyriroxld* i x ! 0.008 m/l I 1 | D024 1 1 1 1 0023 1 1. 1 1 D025 1 1 1 1 D026 1 1 1 1 0016 1 1- 1 j 0027 1 I 1 1 0028 1 | ... . I 1 0029 1 1- 1 I 0030 1 1 11 | 0012 I 1 1 0031 1 1 i i i i i i i j i i i i i 1 i i i i i i i i 1 1 Haxachloro-1,3 Butadlaoa 1 1 Bacachlorobansana x ! 0.5 ag/1 ! 1 --. | 0033 1 | . ! 0.13 ag/1 ! 1 1 D032 1 | 1 I i 4 1 1 Hwxachloroatbanw I 1 Linda* 1 1 Matboxycblor I x ! 3.0 ag/1 1 1 I 0034 1 l I x i 0.4 ag/1 ! ... 1 1 0013 1 | I x ! 10.0 ag/1 ! 1 1 0014 1 I 1 | 1 I i i 1 I Matbyl Btbyl Raton* 1 X ! 200.0 *i/l ! 1 \ 0035 1 L- i i 1 1 Nltrobansana 1 ! Pantacblorophanol 1 1 Pyridina ! 2.0 ag/1 i i X I 100.0 ag/1 1 ! 5.0 ag/1 iX 11 1 0036 I 1 l D037 1 1 1 l D038 1 1 1 1 i i i i 1 1 Tatracbloroatbylan* ! x ! 0.7 ag/1 ! 1 1 D039 1 1 i i 1 i Ttscapbao* i x ! 0.5 ag/1 ! 1 l 0015 1 1 i i 1 l 2,4,5-TP Silva* ! x ! 1.0 ag/1 ! 11 1 0017 1 i i i1 1 Trichlorowtbylana 1 X ! o.s m/l ! 1 1 2,4,5-Tricblorophaool ! 400*0 M3/1 ! * 1 1 2,4,6-TrlcblorophaDol !x 2.0 ag/1 1 1 0040 1 l 11 l 0041 L 1 1 0042 1 L i i i i i i 1 i vinyl Chlorida ! X i 0.2 ag/1 ! 11 1 _l--------------1----------------------- 1 . 1 1 0043 1 l 1 ------ (_ 1 -1-------- i i i _i------------------------------------- J________ I__________________________I---------------------------------------1 SL 022264 i Data Printed 09/08/92 A^nananx 2 CHEMICAL COMPOSITION: Addition*! constituent* NOT included on page 1 of the w*et* Prof11* Constituent* Rang* Unit Description TRICHLCKanSAHB O toS.4 TPM ***** TRACES OF C2 C' C1HC O to<iOfin T^PaI ** ETHYLENE DICSLROIDE NO FREE LIQUIDS/FCPT ___ O " "7.a. "PPM ^ i1 O s 0 LCH K37932 Proril* f