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HAZARDOUS WASTE PROFILE SHEET01012 4

"'I/"I - ' ( "EXHIBIT A TO Contract Dated

As prescribed by the Resource Conse rvation and Recove ry Act (Public Law 98- 580 Sec . 3004), a detailed chemical and physical analysis must be submittedbefore we can handle your waste stream . This information is necessa ry to help us evaluate whether we can safety and economically transport and dispose ofyour controlled industrial wastes in an environmentally sound manner. Be as complete as possible . If an area is not applicable , mark as such . Should a laboratoryanalysis be available , please attach it to this form . We can arrange analytical laboratory services , if neded, for an appropriate fee . All information we receivewill be held in strictest confidence to protect your interests . SAMPLE WILL NOT BE PROCESSED UNLESS ALL AREAS OF THIS SHEET ARE PROPERLYFILLED IN. (~, c

Purchase Order No, Sales Representative & IL . 'I Ser. 1

1 . Generator information QeCJCeJElt t. ii.frf~ i JdATONA(~ ( ) Check if small quantity Generator per CFR-4 0

Name of Company QOe cETDY~1t ~~wStewJ US EPA ID

- -_Facility Address C.~OOSL$q C .D .% G Invoicing Information QISPCSAt_ _m.,7Tf_L_C, SQZCVt_ir

Stn,t {-l,L'_s , CA 136QL W. iii Srtet rC. Ar.3061t A%sy sUMailing Address Ill VPIANC , G L1118~et~~ ~~

GraoGei 0%a CA °lt-3o3

Technical Contact L Title ~• 1 L i fir/ Phone l/Pl '7c C - rf. f

General Contact 1~_ le T Title lr-Li!-r'c. PHone (l / r - C- /fl

II . Waste Stream General Information

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ANTICIPATED VOLUME T er yearrrE~ `7or L

Waste NameCpw,,,~r . rt .~tr► per month per week one time onl y

Process Producing Waste e- I ' - Li p Color r/' Odor 1 ~r o ~~ yrn

Na< AIll . Waste Prope rt ies Layers Free Liquids NormalitypH (X) Organi c

Physical State (I 25°C (>Q Single Phase Yes Type Acid Type ( 7C) Inorgani c

) Liquid ( ) Powder ( ) Bi-layered (}~1 No Density Caustic Flash Point

()q Solid ( ) Sludge Multi-layered F

Chemical Composition ( %)% ( ) PPM Metals-EP Tox Test

t/a

Mg/I or PP M

(List all known) Range Arsenic (As) ( ) Lead (Pb) L_ ) Nickel (Ni)

Lower Upper Barium (Ba) ( ) Vanadium (V) (__) Zinc (Zr) (_=) (IruEflT SOrL (it) (rte Cadmium (Cd) ( - ) Selinium (Se) ( - ) Thallium (Ti)

VCVf;rS /Tna►bM ( 0) ( L Chromium (Cr) ( - ) Silver (Ag) ( - ) Cobalt (Cc) (_=J

r7' r (Q) (~) Mercury (Hg) ( - ) Copper (CU) ( "' ) )

- (-) (-)Possible Component (include un it of measure) a~ /J~Cyanides

rA2 . 4. D Dioxin

Sulfides Phenolics Organic Chlorides N

JqIV . PCE Oil : Type Concentration % /a ppm PCB Equip: Type Concentration °h % pp m

PCB Solids : Type Concentration °ro % ppm Has equipment been drained anc flushed according 1 0 40 CFR Pan 7617 N~A

Attach information for dimensions, weight and nameplate capacity for all eouipment

V . Hazardous Characteristics (From CFR-40)RSA NeN- REGuc. a~'CaD

U .S . EPA Hazardous Code(s )Is the waste ( ) Pyrophoric ( ) Infectious ( ) Water reactive ( ) Radioactive ( ) Pathogenic

Explosive ( ) Pesticides/ Herbicides ( ) Biological ( ) Shock sensitive ( ) Etologica l

VI . Shipping Information (From CFR-49) ~1 ~~-77e KM Lr(11=011 i "/'fl "Cie C rt-YVQI r_Proper DOT Shipping Name

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DOT H az ard Class /VC___ UN/NA Number a~A Reportable Quantity _ NONE )

Method of Shipment ) Bulk Liquids (A Bulk Solid s

)Drums ( ) Othe r

Git Oa%j # (O"LES P ccr r1 uEraGSpecial Handling and Safety Instructions

I cerily, and warrant that the above information , the information attached , and the waste stream as desedbed is true sna correct to the Deal of MY knowledge and abilityand not willful or deliberate omissions exist and that all known and/or suspected hazards have been disclosed, and a sample representative of the weeks stream has beenor is being aeri to the proper facility . Further, I certify the samples have been collected using the appropriate EPA sampling guideinea and acknowledge that the currentsample p Ia We will be charged by U .S

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. / lution Control . Inc_,and be pair .by generator.

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