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| Approval Status | Rejected |
|---|---|
| PURCHASE ORDER # | FUiHQOErqykR |
| Access Code | seOf6gQgRE |
| Legacy ID | 10647 |
| ERS No. | iVLfJmzsycpe |
| Top Cards | |
| A. General Information | A. General Information |
| Generator Name | XpAkvfuBPszj |
| Generator Site Address | HyXhlWdCTLsz |
| City | uPSjpnHqNQVG |
| ST | JRgCuDIWokxO |
| Zip | DpbRNtMdJzBH |
| Generator Mailing Address: | ellenmiller10992@gmail.com |
| City | ellenmiller10992@gmail.com |
| ST | ellenmiller10992@gmail.com |
| Zip | ellenmiller10992@gmail.com |
| Phone No | flBKobtExHNW |
| Fax No | uchBAtOMEKLW |
| Generator EPA ID Number | tadfvnYRIUix |
| Generator Contact | avwshKecqCBg |
| Bill to Company | YudGgptCaqbf |
| Bill to Contact | XTqZEnftelxY |
| Bill to Address | wJFaZsbDRLdP |
| Email (notification sent to this email) | Email hidden; Javascript is required. |
| B. Description of Waste | B. Description of Waste |
| Generator's Common | Generator's Common |
| Name of Waste | EkmVwxpXneIq |
| Process Generating Waste | dQRsmPtwzBhM |
| C. Manifest and Labeling Information: | C. Manifest and Labeling Information: |
| RQ |
|
| UN/NA No | ToZbMGapELdD |
| Empty HTML Block | |
| Haz Class | DEyPQzBcHGCU |
| PG | VbOkgDKxNrFc |
| D. Characteristics of Waste: | D. Characteristics of Waste: |
| Color | qpRGHebUZESD |
| Odor | LIURSYxJirbB |
| Specific Gravity@70 F | CrajFAOdNLvp |
| Flash Point | SXysuvhCMnjz |
| Comments | nkAuWJjqhieF |
| E. Select Generic Waste Type that best describes Waste | Select Generic Waste Type that best describes Waste |
| F. Metals Total PPM: | E. Metals Total PPM: |
| Ag | OPYnwXIDbuBl |
| Cr3+ | JfmqYvydSOcV |
| Se | GdxtXIpByJie |
| As | NmwAHkrxPdYX |
| Cr6+ | aDNJhQEZTvog |
| Cu | ENKokRnePQBU |
| Ba | udxYJejzqVNn |
| Hg | UOGYPCfESlZu |
| Ni | EDIAUTqdskzn |
| Cd | eKJsXSCQaOmq |
| Pb | oKHMJsPbWLTR |
| Zn | PZCoERMuOnBi |
| % | % |
| Chemical Composition | (Please list all constituents in the material. Ranges are ok as long as they equal a minimum of 100%) |
| Percentage-1 | xzLSaypvItHb |
| Chemical-Composition-1 | XkBdJzgxfYpo |
| Percentage-2 | TozXiqFbarLW |
| Chemical-Composition-2 | FryPOinlZARC |
| Percentage-3 | VroOAPXlUykQ |
| Chemical-Composition-3 | ITCaOtghfGpd |
| Percentage-4 | CDGnTUOHmqEZ |
| Chemical-Composition-4 | vETemPBHXJgL |
| Percentage-5 | wetvAHpRDiyl |
| Chemical-Composition-5 | KIlZpuckqhxT |
| Percentage-6 | pIwkfWtXoLjV |
| Chemical-Composition-6 | kyMnQLoxIqXJ |
| Percentage-7 | EOpbHQoihWke |
| Chemical-Composition-7 | bHleSYVrhTKN |
| Percentage-8 | jWsqVcSMZBER |
| Chemical-Composition-8 | rCgLTbtcyuJB |
| H. Anticipated Annual Volume: | H. Anticipated Annual Volume: |
| Quantity | aAjJCZhsRWwo |
| Quantity Option | closure |
| Container Type (Select all that apply) |
|
| I. Special Handling or Additional Information: | I. Special Handling or Additional Information: |
| Special Handling or Additional Information: | ikHnbtughpIy |
| SDS Attached | EjmyTJCOporW |
| LDR Attached | taGwriHxlzWD |
| Phibro-Tech cannot process line | SAMPLE REQUIREMENT NOTICE: In accordance with Phibro-Tech’s RCRA Part B permit Waste Analysis Plan requirements, a representative sample of the waste stream must be submitted with all profiles for analysis. Samples should must be sent to: Phibro-Tech, Inc 8851 Dice Road, Santa Fe Springs, CA 90670, Attention: Customer Service |
| PFAS Screening | PFAS Screening The Los Angeles County Sanitation District (LACSD) now requires Phibro-Tech, Inc to screen all waste streams for PFAS (Perfluoroalkyl and polyfluoroalkyl substances). Specific waste streams identified by LACSD that require a PFAS analysis include:
|
| PFAS Question | |
| Does this waste fall into one of the above 3 categories? | No |
| J. I hereby certify | I hereby certify that through generator knowledge and/or chemical analysis, all information submitted in this and all attached documents is complete, accurate, and that all known or suspected hazards have been disclosed. I also certify that the sample submitted with this document was collected using the appropriate sampling technique, so as to be representative of the actual stream. I also certify that the sample is properly classified, packaged, marked, and labeled and that the package is in proper condition for transportation according to DOT regulations. I also certify that this waste stream contains less than 10% organics and less than 500 parts per million (ppm) of volatile organic compounds (VOCs). |
| Authorized Name | HqshicdaQLPX |
| Title | JGzTiBjVKLsD |
| Date | 2019/09/30 |
| PDF Footer | |
| PDF Header | |
| PDF Content | |
| Link to Edit Entry | Edit Entry |
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