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Generator Information
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Generator |
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| Site Address |
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| Mailing
Address (if different) |
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| U.S. EPA ID Number |
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| SIC Code: |
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| Technical Contact |
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| Title |
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| Email |
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| Phone Number |
(
)
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| Fax Number |
(
)
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| Name of Waste |
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| Process of Generating
Waste |
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| Broker
Information |
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Name |
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Address |
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City |
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State |
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| Zip |
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Contact |
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Email |
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Phone |
(
)
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Fax |
(
)
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Characteristics |
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Color |
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BTU/LB |
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Odor |
Mild
Strong
None |
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Physical State@70 |
Liquid
Semi-Solid
Solid |
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Layers |
Multilayered
Bi-layered
Single
Layered |
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Free Liquids |
No
Yes
if yes then %
|
|
Flash Point |
<70
70-100
101-139
140-200
>200
No
Flash
Exact |
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Density |
Lbs/Gal
Lbs/Ft
API Gravity |
|
PH Range |
<2
2.1-4
4.1-10
10.1-12.4
>12.5 |
|
Metals |
None
TCLP
(MG/L)
Totals(ppm)
Arsenic
Barium
Cadmium
Chromium
Lead
Mercury
Selenium
Silver
Copper
Nickel
Zinc
Cyanides
|
|
Physical/Chemical Composition |
|
|
%
%
%
%
%
All material must equal to 100%
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Shipping Information |
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Proper shipping Name |
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Hazard Class |
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UN/NA # |
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State Code |
(required if shipping as Non RCRA) |
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EPA Code |
We do not accept any EPA codes. |
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Non RCRA Hazardous |
Yes
No |
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Volume |
Drums
Boxes/Sacks
Gallons
Yards |
| |
One
Time
Monthly
Annually |
| |
Bulk
Liquids
Bulk
Solids
Drums |
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Method of Shipment |
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Special Handling Information |
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Generator
of this waste certifies, that the information above is true and
accurate. The determination of this waste stream was derived by state
certified analysis and/or generator knowledge. If the physical or
chemical composition(s) of the waste stream changes, the generator
will notify Filter Recycling Services Inc. prior to shipment. The
generator is solely responsible for the disposal of any material that
may be delivered to Filter Recycling Services, Inc. that is not
disclosed in the above profile. |
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Your Name* |
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|
Title |
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Email Address* |
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Referred by |
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Notes |
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Date |
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|
Contact Phone Number |
(
)
-
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