Phibro Animal Health Corporation
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Waste Profile Form

Waste Profile Form

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Send Samples To:

Phibro-Tech Inc.

8851 Dice Road

Santa Fe Springs, CA 90670

A. General Information
Same as above

B. Description of Waste
Generator's Common

C. Manifest and Labeling Information:
RQ

EPA Waste No

D. Characteristics of Waste:

E. Metals Total PPM:
F. Chemical Composition:

%

(Please list all constituents in the material. Ranges are ok as long as they equal a minimum of 100%)

TRI Chemical

TRI-Chemical-1
TRI-Chemical-2
TRI-Chemical-3
TRI-Chemical-4
TRI-Chemical-5
TRI-Chemical-6
TRI-Chemical-7
TRI-Chemical-8

H. Anticipated Annual Volume:
Quantity Option
Container Type (Select all that apply)

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:

  • Any amount of aqueous film forming foam (AFFF) such as fire-fighting water, fixed fire extinguishing system test water, and/or contaminated groundwater.
  • Process, rinse, and/or waste solutions containing hexavalent chromium (chrome VI or Cr(VI)) from chrome plating operations.
  • Any other waste streams that are known or suspected to contain excessive quantities of PFAS.

Does this waste contain PFAS?
Does this waste contain PFAS?

For PFAS Containing Waste, State-Certified lab results using USEPA Method 1633 analysis must be submitted to be considered for recertification. Please submit results to ptiservice@pahc.com and include a copy of this form.

This profile will be placed on hold for re-certification until analysis is received for review.

TRI-Listed Chemicals

TRI-Listed Chemicals are those that may cause cancer or other chronic human health effects, significant adverse acute human health effects, and/or significant adverse environmental effects. EPA TRI-Listed Chemicals

Does this waste contain TRI-Listed Chemicals?
Does this waste contain TRI-Listed Chemicals?

If this waste contains TRI-listed Chemicals, they should be listed and identified in the chemical composition list in Section F.

I. Special Handling or Additional Information:
Accepted file types: doc, pdf, Max. file size: 16 MB.
Accepted file types: doc, pdf, Max. file size: 16 MB.

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).
Date*

PHIBRO-TECH, INC HAS THE APPROPRIATE PERMIT(S) FOR, AND WILL ACCEPT, THE HAZARDOUS WASTE APPROVED UNDER THIS PROFILE.

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

Phibro-Tech cannot process any waste that contains PCB’s, Cyanides, Pesticides, Phenolics, Dioxins, Oils, landfill leachate, and any PFAS > 100 milligrams/liter OR wastes that have the characteristics of infectious or biological waste, organic toxicity, radioactive, explosive, pyrophoric, or shock reactivity.

Phibro Animal Health Corporation For further inquiries, contact PTIService@pahc.com
Phibro Animal Health Corporation

Corporate Office: Glenpointe Center East, 3rd Fl, 300 Frank W. Burr Blvd Ste 21, Teaneck, NJ 07666-6712 · (201) 329-7300

SEND SAMPLES TO: Phibro-Tech, Inc. 8851 Dice Road Santa Fe Springs, California 90670 · (800) 777-1850

Date: {TD}

Dear Customer,

Congratulations, the following profile has been approved for recycling at Phibro-Tech, Inc. under our Environmental Recovery Service (ERS). We appreciate the opportunity to manage this material for you.

  • Generator Name: {GeneratorName}
  • Waste Name: {WasteName}
  • ERS (Profile) Number: {ERS}
  • Expiration Date: {ExpirationDate}
  • Price Code: {PriceCode}

The following pricing will apply {Pricing}

Standard Pricing Rules:
  • 1) Resource & Recovery Fee of 20% applied to every billable order.
  • 2) All Disposal pricing is FOB Phibro-Tech Inc., 8851 Dice Rd. Santa Fe Springs, CA. 90670.
  • 3) Non standard container sizes are billed as special pricing.
  • 4) Profiles are priced at the time of profile approval.
  • 5) Pricing to be reviewed at profile renewal.
  • 6) All disposal is via Wastewater Treatment unless otherwise specified.
  • 7) $100 minimum fee per manifest.
  • 8) $35 Manifest fee per manifest.
  • 9) IBC's with < 225 gallons will be billed at 225 gallons.
  • 10) $50 surcharge per non-conforming container including totes, overpacks, and broken pallets.
  • 11) $15 per drum if not on pallets.
  • 12) $400 per drum for offsite disposal of drums with solids.
  • 13) $100 surcharge for IBC’s with significant solids.
  • 14) $100 per labor hour per person for non-standard waste off-loading work.
  • 15) $250 fee for unscheduled loads, no show for scheduled or reoccurring loads, or same day cancellation.
  • 16) $250 Emergency profile fee for new or expired wastes that need to be sampled on arrival.
  • 17) Safety Surcharge for high risk waste streams requiring extra handling or waste streams with free chlorine: Bulk $4,000 /Tote $1,000. Drums based on tiered sizes largest to smallest: $400/$300 /$200 /$100
  • 18) Spent ammonia and cupric non-conforming charge: $1.00/gallon Nickel > 50 PPM or Iron > 200 ppm.
  • 19) $250 for weekend scheduling based on PTI availability.

PHIBRO-TECH, INC HAS THE APPROPRIATE PERMIT(S) FOR, AND WILL ACCEPT, THE HAZARDOUS WASTE APPROVED UNDER THIS PROFILE.

Phibro Animal Health Corporation
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