...
| Approval Status | Approved |
|---|---|
| Access Code | 8DxlYVA3D1 |
| Legacy ID | 10896 |
| Top Cards | |
| A. General Information | A. General Information |
| Generator Name | Bristol Industries, LLC |
| Generator Site Address | 630 E Lambert Rd |
| City | Brea |
| ST | CA |
| Zip | 92831 |
| Generator Mailing Address: | Same |
| City | San Jose |
| ST | California |
| Zip | 95133 |
| Phone No | 714-990-4121 |
| Generator EPA ID Number | CAD067615435 |
| Generator Contact | Richard French |
| Bill to Company | ACTenviro |
| Bill to Contact | Daniel Busbee |
| Bill to Address | 967 Marbury Road San Jose CA 95133 |
| 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 | Fire Water |
| Process Generating Waste | Post Fire Collection |
| C. Manifest and Labeling Information: | C. Manifest and Labeling Information: |
| Proper DOT Shipping Name | NON Regulated Material Liquid |
| Empty HTML Block | |
| D. Characteristics of Waste: | D. Characteristics of Waste: |
| Color | Dirty Water |
| Odor | None |
| Specific Gravity@70 F | 1.0 |
| Flash Point | >200 |
| Physical State at 70 F | Single Phase Liquid |
| pH | 8 |
| E. Select Generic Waste Type that best describes Waste | Select Generic Waste Type that best describes Waste |
| Select Generic Waste Type that best describes Waste | L. NON-HAZARDOUS WASTE |
| F. Metals Total PPM: | E. Metals Total PPM: |
| % | % |
| Chemical Composition | (Please list all constituents in the material. Ranges are ok as long as they equal a minimum of 100%) |
| Percentage-1 | 100 |
| Chemical-Composition-1 | Water |
| Percentage-2 | 0-1 |
| Chemical-Composition-2 | Dirt |
| H. Anticipated Annual Volume: | H. Anticipated Annual Volume: |
| Quantity | 4500g |
| Quantity Option | onetime |
| Container Type (Select all that apply) |
|
| I. Special Handling or Additional Information: | I. Special Handling or Additional Information: |
| 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 | Dan Busbee |
| Title | MGR |
| Date | 2020/01/03 |
| PDF Footer | |
| PDF Header | |
| PDF Content | |
| Link to Edit Entry | Edit Entry |
United States
European Union
Brazil