Document qmkn2d435MZOvVqLYJKyvjK7j
Waste Management, Inc.
4
r ^ERADICATION OF GENERATOR'S >*ASTt^.t/1ATERIAL PROFILE SHEti
'F
BFCERTlFteD WASTE pROF'lE sheet CODE
instructions a copy of the complete generators waste material profile sheet which is being recertified must be attached to this recertification fgm ORDINARILY THE LAST COMPLETE profile SHEET will BE ATTACHED to YOUR CONTRACT IF YOU HAYE ANY DIFFICULTY LOCATING the LAST COMPLETE PROFILE SHEET CONTACT *-E PERSON SHOWN BELOW IN ADDITION WE ASK YOU To COMPLETE THE REMAINDER OF THIS FORM AND TO HAVE IT SIGNED BY AN AUTHORIZED EMPLOYEE ANSWERS MUST BE MADE TO all QUESTIONS AND MUST BE COMPLETED I^K 'tifC&BMMlQfl Sl^LJfl^WILL BE AVUNTAIJ40P IN STRICT CONFIDENCE CONSISTENT WITH LEGAL REQUIREMENTS
ETURN THIS FORM AND ATTACHMENTS TO
i^v j*
i ^ rv^
Sv\elWrHL^4^i
A GENERAL INFORMATION
GENERATOR NAME L PP% XtJdushle
Sox, I/O."facility address
ColufAWia,
f vJesilAke- I A
La Ac dholes. La TECHNICAL CONTACT Ljaai h L. Qera^
NAME OF WASTE LJilAzlt____tit.
7*3*02._________
J title i
TRANSPORTER '.ChJM___ - Atjt-UuJAj / ~tx
/?/3j_J transporter HONE >fc7- 4772.
_j GENERATOR USEPA 1 D 1
_j GENERATOR STATE I D L
1_J PHONE | (?*s)44l-+3lo
PROCESS GENERATING WASTE
B CHANGES OR ADDITIONS SINCE LAST PROFILE SHEET PREPARATION OR RECERTIFICATION 1 HAVE YOU OBTAINED ANY LABORATORY ANALYSIS OF THIS WASTE? G YES 2*NO (IF YES PLEASE ATTACH COPIES' 2. HAVE YOU CHANGED THE RAW MATERIALS USED IN THE WASTE-GENERATING PROCESS' -- YES 2^N0 3 HAVE YOU CHANGED THE WASTE GENERATING PROCESS ITSELF' G YES S^NO
4 ARE YOU AWARE OF ANY FACTS OR CIRCUMSTANCES WHICH HAVE, OR REASONABLY COULD HAVE ALTERED THE PHYSICAL OR HAZARDOUS CHARACTERISTICS, OR CHEMICAL COMPOSITION OF THE WASTE' _ YES S'nO
5 ARE YOU AWARE OF ANY HUMAN HEALTH EFFECTS OF EXPOSURE TO THE WASTE NOT PREVIOUSLY DESCRIBED' G YES 5*NO
6 IF YOU ANSWERED -YES- TO QUESTIONS 2. 3, 4 OR 5. PLEASE PROVIDE DETAILS BELOW.
C SPECIFIC CONSTITUENTS DOES THIS WASTE CONTAIN POLYCHLORINATED BIPHENYLS' D YES I^NO
DWOVEI S THIS WASTE CONTAIN 2. 3, 7, 8 . TCDD' YES Z*NO
[ D SHIPPING INFORMATION I method of shipment C bulk liquid
i BULK SOLID n-HIB^DRUM (TYPE/SIZE) L (ss/ss) dua-&gJc
J^huTCIPATED VOLUME L
GALS.
_l CUBIC YDS. L
OTHER L <? JXi/MS
F
onetime
WEEK
MONTH
QUARTER SfvEAR
L
RECERTIFICATION. I AM AN EMPLOYEE OF THE GENERATOR AUTHORIZED TO SIGN THIS CERTIFICATION. THE INFORMATION PROVIDED IN THE RECERTIFIED WASTE PROFILE SHEET
ATTACHED HERETO. AND THE INFORMATION SUPPLIEO ABOVE, ARE COMPLETE. TRUE AND CORRECT.
::)JIAME: 0)
L Li--'pGAA.'J ,
TITLE!: ^AX iLPsxUaA +laJ4-A L___ Qj>MA*L ftyf'Xi/tllSJL.
FORM WMI-50-B (Rv. 12/84) 1984 WASTE MANAGEMENT INC.
046170
CERTIFICATION OF REPRESENTATIVE SAMPLE
LU4 b&>9s6>3
WASTE PROFILE SHEET CODE
GENERAL DIRECTIONS: IN ORDER TO DETERMINE WHETHER WE CAN ACCEPT THE SPECIAL WASTE DESCRIBED IN THE ABOVE NUMBERED PROFILE SHEET, WE MUST OBTAIN A REPRESENTATIVE SAMPLE OF THE WASTE. WE WILL ANALYZE THE SAMPLE TO VERIFY THE INFORMATION YOU HAVE PROVIDED US, SO IT IS PARTICULARLY IMPORTANT THAT THE SAMPLE BE TRULY REPRESENTATIVE. IN MOST CIRCUMSTANCES YOU WILL BE OBTAINING THE SAMPLE. HOWEVER, IN THOSE CASES IN WHICH WE OBTAIN THE SAMPLE, WE MUST ASK THAT ONE OF YOUR EMPLOYEES BE PRESENT TO DIRECT THE PARTICULAR SOURCE TO BE SAMPLED AND TO WITNESS THE SAMPLING. IN SUCH CASE, YOUR EMPLOYEE MUST SIGN THIS CERTIFICATION AS A WITNESS.
THIS CERTIFICATION MUST BE RETURNED, WITH THE REPRESENTATIVE WASTE SAMPLE, TO:
____ CUMI__________________________ P-'O. BOX 55,r. HMY 17, MTI F MARKFR lfi3
___ emelle. al 35459
THE UNDERSIGNED CERTIFIES THAT HE/SHE OBTAINED A REPRESENTATIVE SAMPLE OF THE WASTE MATERIAL DESCRIBED IN THE "GENERATOR'S WASTE MATERIAL PROFILE SHEET' ABOVE REFERENCED, AND THAT THE FOLLOWING REPRESENTATIONS ARE TRUE AND CORRECT:
1. HOUR AND DATE OF SAMPLING:
2. SOURCE FROM WHICH SAMPLE TAKEN: ThiS.lS a tiirnarnnnH camp To A camp! a
is nnt prPSPnt.ly flVflilflhlP. A Rflmplp ran hp mit prprpHing thp novt
ghipmpnt nr it raw ho camp!pH hy you upon arriual
H-iepn^l
3. feififrMENT AND SAMPLING METHOD USED:
4. AMOUNT OF SAMPLE OBTAINED:___________________________ 5. TYPE OF CONTAINER INTO WHICH SAMPLE WAS PLACED:
6. THE SAMPUNG EQUIPMENT USED, AND THE CONTAINER INTO WHICH THE SAMPLE WAS PLACED, WERE THEMSELVES UNCONTAMINATED BEFORE USE.
7. AT THE TIME OF SAMPUNG I AFFIXED A LABEL TO THE CONTAINER IN THE FOLLOWING FORM WITH THE FOLLOWING INFORMATION (FILL IN THIS PORTION. INCLUDING YOUR SIGNATURE, JUST AS IT APPEARS ON THE LABEL YOU PREPARED):
GENERATOR: ppfi INDUSTRIES, INC.
WASTE NAME: CdAste A&e,UN SAMPLE HOUR/DATE:
PROFILE SHEET CODE: SAMPLER SIGNATURE:__________________________
WITNESS VERIFICATION: l)M(X0eBRGmMCKX)RBGG(
1 DIRECTED THE WASTE SOURCE TO BE SAMPLED; AND I VERIFY THE INFORMATION ABOVE NOTED.
SAMPLER NAME: SIGNATURE:_____
WITNESS:___ F. Annp Cnrhpl 1 n_____________ SIGNATURE:
TITLE:________ Sr. Lab Analyst__________
TITLE:_____ EMPLOYER: DATE:______
FMPIOYFR- PPfi Tnri.iQtriPg, Tnr DATE:_____ 7/2.}XL - -
KMM WMM1 (Rav. M3| IttO WASTE MAMAOBMCNT, MC
LABORATORY REVIEW OF SAMPLING PROTOCOL
BASED UPON MY REVIEW OF THE ABOVE PROFILE SHEET, I CONCLUDE THAT THE ABOVE METHODOLOGY IS:
D ADEQUATE FOR YIELDING A REPRESENTATIVE SAMPLE.
INADEQUATE FOR THE REASONS NOTED HEREON.
DATE: LAB MGR:
SL 046171
J
*b
A GENERAL INFORMATION
neratorname: , PPG Industries, Inc.
CWM - Orange, TX
J TRANSPORTER: L
FACILITY ADDRESS: P` 0~ ^OX 1000
(318) 625-9003
_l TRANSPORTER PHONE: L
, Columbia Southern Road, Westlake. LA
_J GENERATOR USEPA I.D. lL i A i D i 0 i 0 18 I Qt8,6J^0JL
, Lake Charles, LA 70602___________
_J GENERATOR STATE I.D. L m__________
',
Mi ke DiGiglia technical contact. -NAME OF WASTE: L Waste Acetone
J TITLE: L Env. Control Asst. J PHONE: L (318) 491-437S-
^PROCESS GENERATING WASTE: I GfiDgral _P 1 &P_t Psj litj ng
( / B PHYSICAL CHARACTERISTICS OF WASTE
COLOR
Clear
ODOR CD NONE
IK] MILD
D STRONG...
DESCRIBE l_
PHYSICAL STATE tp 70 *F
SOLID
n SEMl-SOUO
EX] LIQUID
POWOER
LAYERS MULTILAYERED
BI-LAYERED
E SINGLE PHASED
FREE LIQUIDS S] YES
DnO.
VOLUME i
Si
71-10 I I 10 1-12.5
> w-s
EXACT (_
SI n/a
SPECIFIC Sl< -8
GRAVITY
8:1.0
1-3 1-S-
l,-H
>,
exact II
FLASH < TO*F POINT
70*F.100*F
101 *F - 130*F
.__. 140-F 200-F
Q > 200"F
NO FLASH [yl EXACT, QF .
[X] CLOSED CUP' ' "*
OPEN CUP
1 S_ Lf.-. :
r C CHEMICAL COMPOSITION (TOTALS MUST ADD TO 100%)
METALS Q jotaL (PPM)
1001iic___________________________________ _______________ ____ _____ : . _________i 1--___ LWW !% ARSENIC (As)
N/A
EPA EXTRACTION PROCEDURE
mtk
SELENIUM <841
L.
I-U
BARIUM (Bs)
MIL
SILVER (Ag| : L
MIL
ML1
..
../V..i\*Ll `?1 .'.
CADMIUM (CO)
"r-.
wM CHROMIUM (CO L.
N/A
-r
_________________!____________ i* lIli______ i%i
MERCURY (Hg) |_
N/A
MIL1_1
LEAD (Pt>)
l_
-I
__________ i%8
______________________________ i i
,CHROMIUM-HEX (Cf + 6) l_
MIL
___________________________________________________________ ________________ 1.1l%l
E OTHER COMPONENT* - TOTAL (PPM)
--------------------------------------------- i i_____________ !% CYANIDES
m_____.I_______________
......................
i 1................ JVlSULFIOES L
N/A
_l
-MLCOPPER (Cu) L *!>. >
N/A .iLNICKEL (Nl)
<*
ZINC (Zn)
L
N/A
THALLIUM (Tl) L
MIL.
-Mr-.
o-x
_ i------ :------------------l
ROB'S
PHENOLIC*. L.
. **1A-^Tl tC
^N/AU rri
MIL -
F SHIPPING INFORMATION
HAZARDOUS CHARACTERISTICS
-iCMfJI tk TOO- ,ri'
D.O.T. HAZARDOUS MATERIAL*5
[3 YES
NO
Waste Acetone
PROPER SHIPPING NAMEL
hazard classi FI am. Liquid id. .lno. UN1090
,.n.
ISREACTIVITY:
NONE
EXPLOSIVE
PYROPHORIC WATER REACTIVE
I_l SHOCK SENSmV* OTHER l
N/A,| OTHER HAZARDOUS CHARACTERISTICS:
METHOD OF SHIPMENT: D BULK LIQUID
* D BULK SOUD
G3 NONE
RADIOACTIVE
B drum (type/size) 117-H/(55/85)overpdc
ANTICIPATED VOLUME.
PER,
L
ONE TIME
QUARTER
J GALS. L_ _________________ I CUBIC YARDS
J OTHERC 9 drums
D WEEK
Q YEAR
PESTICIDE MANUFACTURING WASTE
USEPA HAZARDOUS WASTE?
(X) YES
OTHER L NO
I-...* -
U002USEPA HAZARDOUS CODE(S> l_MUufc II I
STATE HAZARDOUS WASTE? STATE CODE(S) |_
H YES
U002
NO
K
SPECIAI HANDLING INFORMATION
l HEREBY CERTIFY THAT ALL INFORMATION SUBMITTEO IN THIS AND ALL ATTACHED DOCUMENTS IS COMPLETE AND ACCURATE. AND THAT ALL KNOWN ON . G ADDITIONAL PAGES) ATTACHEDJ
SUSPECTED HAZARDS HAVE BEEN DISCLOSED. AUTHORIZED SIGNATURI
AUTHORIZED SIGNATURE
, Environmental Control Asst. ,.
TITLE
DATE
-tH#
.
CERTIFICATION OF REPRESENTATIVE SAMPLE
SALES
CODE
LCH D 69563
WASTE PROFILE SHEET CODE
GENERAL DIRECTIONS: IN ORDER TO DETERMINE WHETHER WE CAN ACCEPT THE SPECIAL WASTE DESCRIBED IN THE ABOVE NUMBERED PROFILE SHEET, WE MUST OBTAIN A REPRESENTATIVE SAMPLE OF THE WASTE. WE WILL ANALYZE THE SAMPLE TO VERIFY THE INFORMATION YOU HAVE PROVIDED US, SO IT IS PARTICULARLY IMPORTANT THAT THE SAMPLE BE TRULY REPRESENTATIVE. IN MOST CIRCUMSTANCES YOU WILL BE OBTAINING THE SAMPLE. HOWEVER, IN THOSE CASES IN WHICH WE OBTAIN THE SAMPLE, WE MUST ASK THAT ONE OF YOUR EMPLOYEES BE PRESENT TO DIRECT THE PARTICULAR SOURCE TO BE SAMPLED AND TO WITNESS THE SAMPLING. IN SUCH CASE, YOUR EMPLOYEE MUST SIGN THIS CERTIFICATION AS A WITNESS.
-- THIS CERTIFICATIC^I I^LJS^^RERJRNED, WITH THE REPRESENTATIVE WASTE SAMPLE, TO:
Chemical Waste Management P. 0. Box 55 Erne!1e, A1abama 35459
THE UNDERSIGNED CERTIFIES THAT HE/SHE OBTAINED A REPRESENTATIVE SAMPLE OF THE WASTE MATERIAL DESCRIBED IN THE "GENERATOR'S WASTE MATERIAL PROFILE SHEET" ABOVE REFERENCED, AND THAT THE FOLLOWING REPRESENTATIONS ARE TRUE AND CORRECT:
1. HOUR AND DATE OF SAMPLING:3:30 D.m.8/1/84 2. SOURCE FROM WHICH SAMPLE TAKEN: Pfum
3. EQUIPMENT AND SAMPLING METHOD USED: Siphon, Grab
4. AMOUNT OF SAMPLE OBTAINED: 1 Qt.___________________________________ 5. TYPE OF CONTAINER INTO WHICH SAMPLE WAS PLACED: 1 Qt. jar
6. THE SAMPLING EQUIPMENT USED, AND THE CONTAINER INTO WHICH THE SAMPLE WAS PLACED, WERE THEMSELVES UNCONTAMINATED BEFORE USE.
7. AT THE TIME OF SAMPLING I AFFIXED A LABEL TO THE CONTAINER IN THE FOLLOWING FORM WITH THE FOLLOWING INFORMATION (FILL IN THIS PORTION, INCLUDING YOUR SIGNATURE, JUST AS IT APPEARS ON THE LABEL YOU PREPARED):
generator: PPG Industries, waste name: Waste Acetone
SAMPLE HOUR/DATE:
8/1/84
PROFILE SHEET CODEn
9563
SAMPLER SIGNATURE:
WITNESS VERIFICATION: I WAS PERSONALLY PR ENT DURING THE SAMPLING DESCRIBED; I DIRECTED THE WASTE SOURCE TO BE SAMPLED; AND I VERIFY THE INFORMATION ABOVE NOTED.
sampler name: J Mi kg, DiGigl i a
SIGNATURE:
witnESS: Andy P. Plauche*1 2 3 4 5 6 7
title: Environmental Control Foreman
SIGNATURE:
EMPLOYER: PPG Industries, Inc.
title: . Plant EnvironmentaUForeman
DATE: -8/1/84_________________________________
employer:. PP_G. Industries. Inc.
DATE:___ 8/1/84________1________________
LABORATORY REVIEW OF SAMPLING PROTOCOL.
BASED UPON MY REVIEW OF THE ABOVE PROFILE SHEET, J CONCLUDE- THAT THE ABOVE METHODOLOGY IS:
ADEQUATE FOR YIELDING A REPRESENTATIVE SAMPLE.
FORM WM1-51 (Rev. 8/83)
inr
a INADEQUATE FOR THE REASONS NOTED HEREON.
DATE:____ LAB MGR:
SL 046173