GALCO Oily by liaoqinmei


									GALCO                           GENERATOR’S WASTE PROFILE                                             Waste Stream #
10201 Bay Area Boulevard
Pasadena, Texas 77507
PHONE: (281) 474- 2861 FAX: (281) 474-2328

 Generator Name:                                                                 Gustomer Name:
 Address:                                                                        Address:
 City:                                      State:         Zip                   City:                                      State      Zip
 Contact Person                                                                  Contact Person
 Phone                                 Fax                                       Phone                               Fax

 EPA ID #:                       TCEQ Generator ID #:                            State Waste Code                         SIC Code:

 A.                                                   WASTE DESCRIPTION

 Name of Waste:

 Process Generating Waste:

 Anticipated Volume:                    gallons per       year       month          week      day       one time event
 Shipping Method

 B.                                      PHYSICAL CHARACTERISTIC OF WASTE

 pH                Specific Gravity    Flash Point (F)                        Solids
        <2                 < .8               < 80                                % suspended                    BOD:
        2-5                .8 - 1.0           80 - 100                            % settleable                   TOC:
        5-9                1.0                101 - 140                           % dissolved                    COD:
        9 - 12.5            1.0 - 1.2         141 - 200                   Free Liquid Range 98 to 100%           Color:
         > 12.5             > 1.2             > 200                       Solids: % Total by Volume:
          exact               exact           no flash        exact       HOC <1000 ppm         or > 1000 ppm
 Layers:           multilayered:                        bi-layered:                             single phase:                 Odor:
                            Top Layer                          Second Layer                        Bottom Layer
  Viscosity              high (syrup)                           high (syrup)                          high (syrup)            Oil :          %
     by                   medium (oil)                          medium (oil)                         medium (oil)
   Layer:                 low (water)                           low (water)                          low (water)              Rag
                          solid                                 solid                                solid                    Layer:         %

 C.                                      CHEMICAL COMPOSITION OF WASTE
 Constituents                       Range                   Units    Constituents                          Range              Units

Is this Waste Hazardous as Defined by 40CFR 261?            Yes       No      If Yes, list the EPA Waste Codes:

Is this waste subject to Benzene NESHAP? (If YES, subject to Notification and Control Requirements?                        )     Yes        No
Is this waste subject to RCRA subpart CC controls?                                                                         Yes         No
Is this waste an oily waste under 40CFR437.2(r):                                                                           Yes         No

GALCO                             GENERATOR’S WASTE PROFILE                                            Waste Stream #

 D.                                        REGULATORY INFORMATION

 ARSENIC              BARIUM                              CADMIUM                CHROMIUM                               CHROMIUM-
 THALLIUM             LEAD                                MERCURY                SELENIUM                               HEX
 SILVER               COPPER                              NICKEL                 ZINC
 CYANIDES             SULFIDES                                PCB’S                                     PHENOLICS
 CHLORIDES            FLUORIDES                               PHOSPHATES                                NA+/K+
 Does this waste or generating process contain regulated concentrations of the following pesticides and/or herbicides:            Yes    No
 Chlordane, Endrin, Heptachlor, (and its expoxides), Lindane, Methoxychlor, Toxaphene, 2,4-D, or 2,4,5-TP Silvex as defined in 40CFR261.33?
 Does this waste contain regulated concentrations of hazardous wastes per 40CFR 261.31, 261.32, 261.33;                        Yes     No
 including RCRA F-listed Solvents?
 Does this waste contain regulated concentrations of 2,3,7,8-Tetrachlorodibenzodioxin (2,3,7,7,8-TCCD) or any other            Yes     No
 dioxin as defined in 40CFR 261.31?
 Is this a regulated Toxic Material as defined by Federal and/or State regulations?                                  Yes  No
 Is this a waste material generated at/associated with a Federal Superfund Clean Up Site?                            Yes  No
  Is this waste material regulated Medical and/or Infectious Waste as defined by State and/or Federal Regulations? Yes     No     _
 Is this waste subject to Marine Pollutant Regulations?                                                              Yes   No     _
 Used Oils:      Yes     No                   Oil/Water Emulsion: Yes      No                  Off-Specification Fuels:       Yes     No
 Bilge Water: Yes        No                  Interceptor Wastes: Yes       No                  Non-Contact Used Glycols:      Yes     No
 Lubricants: Yes         No                   Coolants:            Yes     No                  Used Petroleum Products:       Yes     No
 Contaminated Groundwater clean-up from Petroleum Sources: Yes             No       Underground Storage Remediation Waste: Yes        No
 Rinse Wash Waters from Petroleum Source:                          Yes     No      Oil-Water Emulsions or mixtures:           Yes     No
 Tank clean-out from petroleum/oily wastes:                         Yes    No      Oil Spill Clean-up:                        Yes     No
 Aqueous & oily mixtures from parts cleaning procedures:            Yes    No      Waste Water from oil bearing paint wastes: Yes     No

 E.                                        D O T PROPER SHIPPING NAME

 Shipping Name
 Hazard Class                                          UN/NA No.                            PG                                                   lb.

I hereby certify under penalty of law that all information submitted in this and all attached documents contains true and accurate
descriptions of this waste. Any sample submitted is representative as defined in 40 CFR 261 - Appendix I or by using an equivalent
method. All relevant information regarding known or suspected hazards in the possession of the generator has been disclosed. I
authorize sampling of any waste shipment for purposes of recertification.

 Date:                                                                      Representing:


Profile Reviewed By:                                                                Date:

Accepted for:

Rejected for:


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