Full Text
1 AUGUSTA-RICHMOND COUNTY LANDFILL GENERATOR’S WASTE PROFILE SHEET INSTRUCTIONS Information on this form is used to determine if the waste may be transported, treated, stored, or disposed in a legal, safe and environmentally friendly sound manner. This information will be maintained in strict confidence. Answers must be provided for all sections of this form, and must be printed in ink or typed. A response of “none” or “n/a” can be made, if appropriate. If additional space is needed, indicate on the form that additional information is attached, and attach the information to the Generator’s Waste Profile Sheet. PART A WASTE GENERATOR INFORMATION 1. GENERATOR NAME - enter the name of the facility where the waste was generated. 2. SIC CODE - enter the 4-digit Standard Industrial Classification Code for the facility where the waste is generated. 3. FACILITY ADDRESS - enter the street address (not a PO Box) of the facility where the waste is generated. 4. GENERATOR CITY, STATE, - enter the city and state where the waste is generated. 5. ZIP/POSTAL CODE - enter the generating facility’s zip or postal code. 6. GENERATOR US EPA ID - enter the identification number issued by the US EPA to the facility generating the waste (if applicable). 7. GENERATOR STATE ID - enter the identification number issued by the state to the facility generating the waste (if applicable). 8. TECHNICAL CONTACT - enter the name of the person who can answer technical questions about the waste. 9. PHONE - enter the technical contact’s telephone number. PART B WASTE STREAM INFORMATION 1. WASTE NAME - enter a name generally descriptive of this waste paint, sludge, contaminated soil, etc.). 2. PROCESS GENERATING WASTE - list the specific process/operation or source that generates the waste (i.e. paint spray booth, spill cleanup, asbestos removal, etc.) 3. ANNUAL AMOUNTS/UNITS - enter the amount of waste that will be generated and transported annually. Use appropriate units to describe this volume (i.e. cubic yards, gallons, kilograms, pounds, tons). 4. WASTE TYPE - based upon reading the landfill’s definition of Special Waste that is included in Section B5 of these instructions, determine whether your waste is a “Type A” or a “Type B” special waste. Indicate the proper response in the space provided. 5. SPECIAL HANDLING INSTRUCTIONS/SUPPLEMENTAL INFORMATION - for all wastes, describe any special handling requirements and any additional information that you feel would assist in determining the proper method(s) for transportation, treatment, storage, and disposal of the waste. For Type B Special Waste, provide the “supplemental information” requested after each applicable definition. LANDFILL’S DEFINITION OF SPECIAL WASTE A. “SPECIAL WASTE” means Type A or Type B Special waste as defined below: B. “TYPE A SPECIAL WASTE” means any waste from a commercial or industrial activity meeting any of the following descriptions: i. A waste from an industrial process. ii. A waste from a pollutant control process iii. A waste containing free liquids iv. Residue and debris from the cleanup of a spill of a chemical substance or ---PAGE BREAK--- 2 commercial product or waste listed in this definition. v. Contaminated residuals, or articles from the cleanup of a facility generating, storing, treating, recycling, or disposing chemical substances, commercial products, or wastes listed in this definition. vi. Any waste which is non-hazardous as a result of treatment pursuant to Subtitle C of the Resource Conservation and Recovery Act (RCRA). vii. Chemical-containing equipment removed from service, in which the chemical composition and concentration are unknown. C. “TYPE B SPECIAL WASTE” means any waste from a commercial or industrial activity meeting any of the following descriptions: i. friable asbestos waste from building demolition or cleaning: wall board, wall or ceiling spray coverings, pipe insulation, etc. This does not include non-friable asbestos unless it has been processed, handled or used in such a way that asbestos fibers may be freely released. Asbestos-bearing industrial process waste is a “Type A Special Waste”. SUPPLEMENTAL INFORMATION - list the source of the asbestos containing materials and the type of asbestos containing material. List the proper US EPA of Federal (and/or state) waste identification code. List the wetting agents used to wet the asbestos material before packaging and include its chemical composition or a current Material Safety Data Sheet (MSDS). List the size and type of containers that will be used to contain the asbestos. Indicate whether the asbestos has been contaminated with any other wastes, and if so, list them. ii. Commercial products or chemicals which are off-specification, out dated, unused, or banned. Outdated or off-specification uncontaminated food or beverage products in original consumer containers are not included in this category unless management of such containers is restricted by applicable regulations. Containers which once held commercial products or chemicals are included in this category unless an end has been removed (for containers larger than 25 gallons), and the container is empty as defined by RCRA, FIFRA, or other applicable regulations. RCRA considers a container to be empty when: all wastes have been removed that can be removed using the practices commonly employed to remove materials from the type of container (pouring, pumping, aspirating, etc.) and no more than one inch (2.54 centimeters) of residue remains on the bottom of the container or inner liner, or no more than 3% by weight of the total capacity of the container remains in the container or inner liner (for containers < 110 gallons), or more than 0.3% by weight of the total capacity of the container remains in the container or inner liner (for containers > 110 gallons). Containers which once held ACUTELY HAZARDOUS wastes must be triple rinsed with an appropriate solvent or cleaned by an equivalent method. The pressure in cylinders of compressed gas and aerosol cans must be substantially equivalent to atmospheric pressure. Containers which once held pesticides regulated under FIFRA must be emptied according to label instructions. SUPPLEMENTAL INFORMATION - list the commercial product or chemical ---PAGE BREAK--- 3 and include the proper waste identification code for that material. List whether the commercial product or chemical has been banned. If so, why and by what agency. List whether the commercial product or chemical is off-specification and why. Attach copies of the most current MSDS if they exist. Indicate the current state of the waste (sludge, liquid, solid, etc.) iii. Untreated medical waste - any waste capable of inducing infection due to contamination with infections agent from bio-medical sources including but not limited to a hospital, medical clinic, nursing home, medical practitioner, mortuary, taxidermist, veterinarian, veterinary clinic, animal testing laboratory, or medical testing laboratory. Sharps from these sources must be rendered harmless or placed in needle puncture-proof containers. SUPPLEMENTAL INFORMATION - list the source from the list above. List the specific waste types and include appropriate warnings for the handling of these wastes. Indicate any special requirements for the labeling, packaging and storage of these waste types. iv. Treated medical waste - any waste from a bio-medical source including but not limited to a hospital, medical clinic, nursing home, medical practitioner, mortuary, taxidermist, veterinarian, veterinary clinic, animal testing laboratory, or medical testing laboratory which has been autoclaved or otherwise heat treated or sterilized so that it is no longer capable of inducing infection. Sharps from these sources must be rendered harmless or placed in needle puncture-proof containers. Residue from incineration of medical waste is a “Type A Special Waste”. SUPPLEMENTAL INFORMATION - list the source from the list above. Specify how the waste was treated. v. Residue/sludges from septic tanks, food service grease traps, or wash waters and wastewaters from commercial laundries, Laundromats, and car washes, unless these wastes are managed at commercial or public treatment works. SUPPLEMENTAL INFORMATION - indicate the physical state of the waste. List specific sources of the waste and indicate whether there are any industrial discharges incorporated into the waste. Indicate whether or not a commercial laundry cleans clothing that may be contaminated with chemicals from an industrial facility. List the types of vehicles cleaned at car washes. Include a statement that indicates whether the interiors of any truck or exteriors of bulk chemical or waste tank trucks are washed. vi. Chemical-containing equipment removed from service, in which the chemical composition and concentration are known (i.e. acetylene tanks, cathode ray tubes, etc). SUPPLEMENTAL INFORMATION - list the specific equipment removed from service and any additional information pertaining to the chemical contained in that equipment, including type, concentration and volume. vii. Waste removed from dismantling or demolition of industrial process equipment or facilities contaminated with chemicals from the industrial process. Chemicals or residues removed or drained from such equipment or facilities are “Type A ---PAGE BREAK--- 4 Special Wastes”. SUPPLEMENTAL INFORMATION - list the waste types and the process types from which they came. Indicate wither there are residues contained in the process equipment. Describe the process used to decontaminate the equipment and list any chemicals or mixtures of chemicals that were used in the cleaning process. Attach a copy of the most current MSDS for each of the chemicals used the original process, the end product of the process, and the chemicals or mixtures of chemicals used in the cleaning process. Indicate whether this waste is contaminated with asbestos or asbestos insulation. viii. Incinerator ash generated at a resource recovery facility that burned only non- hazardous household, commercial, or industrial waste and qualifies for the hazardous waste exclusion in 40 CFR 261.4(b). If the regulatory authority does not recognize the household hazardous waste exclusion, then ash is a “Type A Special Waste”. SUPPLEMENTAL INFORMATION - if the ash is wetted during storage or transportation, list the wetting agent(s) used and include its chemical composition or provide a current MSDS. 6. INCIDENTAL AMOUNTS OF SPECIAL WASTE - the landfill recognizes that many customers will produce some “special waste” as defined above. Incidental quantities of special waste (quantities that do not materially change the physical or chemical identity of the load or make it hazardous waste), do not require the customer to sign a Generator’s Waste Profile Sheet. However the customer must identify the type and amount of special wastes which will be provided to the landfill in incidental amounts. PART C TRANSPORATION INFORMATION 1. METHOD OF SHIPMENT - indicate the anticipated method of shipment by checking the appropriate box. 2. SUPPLEMENTAL SHIPPING INFORMATION - enter any additional shipping information. 3. INDICATE IF THIS WASTE IS A USDOT (see 49 CFR 171) - if so, answer questions 4, 5, and 6 below. 4. HAZARD CLASS/ID - enter the proper USDOT hazard class/enter the proper USDOT identification number. 5. REPORTABLE QUANTITY (RQ)/UNITS (lb/kg) - enter the RQ established by 40 CFR 302.4 of this waste. Indicate the appropriate units of the RQ. 6. SHIPPING NAME - enter the appropriate USDOT shipping name for this waste. PART D TECHNICAL MANAGER DECISION To be completed by Landfill staff only. PART E PHYSICAL CHARACTERISTICS OF WASTE If Part B4 was checked “Type B” go directly to Part I 1. COLOR - describe color of waste 2. ODOR - DO NOT SMELL THE WASTE! If the waste has a known incidental odor, then describe it (acrid, pungent, sweet, etc) 3. PHYSICAL STATE - if the four boxes provided do not apply, a descriptive phrase may be entered after “other”. 4. LAYERS - check all applicable boxes. Multi-layered means more than two layers (ex. Oil/water/sludge). Single phased means the waste is homogeneous. 5. SPECIFIC GRAVITY - indicate the range. The specific gravity of water is 1.0. Most organics are ---PAGE BREAK--- 5 less than 1.0. Most inorganics and paint sludge are greater than 1.0. 6. FREE LIQUIDS - check “yes” if liquid is usually present when packaging for shipment and estimate the percent of liquid volume. Check “no” if there are no free liquids as determined by the Paint Filter Test (method 9095 of SW-846) or direct observation. 7. pH - Indicate for liquid portions of the waste. Check the appropriate boxes which cover the pH of the waste. Use the “range” space if appropriate. For solid or organic liquid wastes, indicate the pH of a 10% aqueous solution of the waste if applicable. Check “NA” for non-water soluble materials (e.g. foundry sands). 8. FLASH POINT - indicate the flash point obtained using the appropriate testing method. PART F CHEMICAL COMPOSITION 1. List all organic and/or inorganic components of the waste using special chemical names. If trade names are used, attach MSDS or other document which adequately describe the composition of the waste. For each component, estimate the range (in percent) in which the component is present. In addition, indicate whether any of the TCLP constituents are present in the waste. The total of the maximum values of the components must be greater than or equal to 100% including water, earth, etc. 2. If this waste contains PCBs, cyanides, of sulfides, indicate the concentration(s). If this waste does not contain these constituents, indicate by checking the “no” boxes which apply. If the concentration of these constituents is unknown, please indicate “UNK” under “ACTUAL”. 3. Indicate whether the method used to determine the chemical composition in G.1 was the TCLP method. An analysis to determine the total concentrations, or another method. Specify the other method. PART G SAMPLING SOURCE Describe exactly where the sample was taken (drum, pond, tank, etc.) PART H REPRESENTATIVE SAMPLE CERTIFICATION This section only needs to be completed when providing a waste sample to contractor for testing. Some Special Wastes require analytical data to determine their chemical composition, regulatory status, and if they are acceptable for transportation, treatment, or disposal. The sample should be collected in accordance with “Test Methods for Evaluation of Solid Waste, Physical/Chemical Methods” SW-846, US EPA, and/or 40 CFR 261.20(c), or equivalent rules. A suitable sample container for most wastes is a wide mouth glass bottle with a plastic cap having a non-reactive liner. Plastic containers are recommended for strong caustics or fluorides. Fill to approximately 90% of capacity to allow for expansion during transportation. The sample must be packed and shipped in accordance with US DOT regulations and any specific requirements imposed by the carrier. Improperly packaged samples may be disposed of upon receipt. 1. PRINT SAMPLER’S NAME – enter the sampler’s name 2. SAMPLE DATE – enter the date the sample was collected. 3. SAMPLER’S TITLE – enter the sampler’s title 4. SAMPLER’S EMPLOYER – enter the sampler’s employer 5. SAMPLER’S SIGNATURE – the sampler must sign in the space provided PART I GENERATOR CERTIFICATION By signing this Generator’s Waste Profile sheet, the Generator certifies that the statements in numbers 1-6 are true and accurate with respect to the waste streams listed. 1. SIGNATURE – an authorized employee of the Generator must sign this Generator Waste Profile Sheet. 2. TITLE – enter the employee’s title 3. NAME – enter the employee’s name ---PAGE BREAK--- 6 4. DATE – enter the date signed KEEP A COPY OF THIS GENERATOR’S WASTE PROFILE SHEET FOR YOUR RECORDS. SEND THIS ORIGINAL AND ALL ATTACHMENTS TO: AUGUSTA-RICHMOND COUNTY LANDFILL ATTENTION: HEALTH AND SAFETY 4330 DEANS BRIDGE ROAD GEORGIA 30805