639695_OILY_WATER_0001.pdf

Amarillo

A. GENERAL INFORMATION

GENERATOR EPA ID #/REGISTRATION # TXCESQG

GENERATOR CODE (Assigned by Clean Harbors)

9 Mi N On Brick Plant Rd Cliffside Gas Field

GENERATOR NAME:

CITY STATE/PROVINCE

US Bureau Of Land Mgmt

ZIP/POSTAL CODE 79108

PHONE: (806) 477-1247

TXUS19175

ADDRESS

ZIP/POSTAL CODE

CUSTOMER CODE (Assigned by Clean Harbors)

ADDRESS

CUSTOMER NAME:

CITY STATE/PROVINCEDenver CO 80225

US Bureau of Land Management Building 50 , Po Box 25047 C/O Oc622- Payment Section

US19174

B. WASTE DESCRIPTION

WASTE DESCRIPTION: Oily Water

PROCESS GENERATING WASTE:

IS THIS WASTE CONTAINED IN SMALL PACKAGING CONTAINED WITHIN A LARGER SHIPPING CONTAINER ?

Spent

No

C. PHYSICAL PROPERTIES (at 25C or 77F)

PHYSICAL STATE

SOLID WITHOUT FREE LIQUID

POWDER

MONOLITHIC SOLID

LIQUID WITH NO SOLIDS

LIQUID/SOLID MIXTURE

% FREE LIQUID

% SETTLED SOLID

% TOTAL SUSPENDED SOLID

SLUDGE

GAS/AEROSOL

% BY VOLUME (Approx.)

NUMBER OF PHASES/LAYERS

TOP

MIDDLE

BOTTOM

321 50.00

0.00

50.00

ODOR

NONE

MILD

STRONG

Describe:

BOILING POINT ºF (ºC)

<= 95 (<=35)

95 - 100 (35-38)

101 - 129 (38-54)

>= 130 (>54)

COLOR

VARIES

VISCOSITY (If liquid present) 1 - 100 (e.g. Water)

101 - 500 (e.g. Motor Oil)

501 - 10,000 (e.g. Molasses)

> 10,000

TOTAL ORGANIC

CARBON

<= 1%

1-9%

>= 10%

< 140 (<60)

140-200 (60-93)

> 200 (>93)

MELTING POINT ºF (ºC)

FLASH POINT ºF (ºC)

< 73 (<23)

73 - 100 (23-38)

101 -140 (38-60)

141 -200 (60-93)

> 200 (>93)

SPECIFIC GRAVITY

< 0.8 (e.g. Gasoline)

0.8-1.0 (e.g. Ethanol)

1.0 (e.g. Water)

> 1.2 (e.g. Methylene Chloride)

1.0-1.2 (e.g. Antifreeze) pH

2.1 - 6.9

<= 2

7 (Neutral)

7.1 - 12.4

>= 12.5

BTU/LB (MJ/kg)

< 2,000 (<4.6)

2,000-5,000 (4.6-11.6)

5,000-10,000 (11.6-23.2)

> 10,000 (>23.2)

Actual:

ASH

< 0.1

0.1 - 1.0

1.1 - 5.0

5.1 - 20.0

> 20

Unknown

D. COMPOSITION

DOES THIS WASTE CONTAIN ANY HEAVY GAUGE METAL DEBRIS OR OTHER LARGE OBJECTS (EX., METAL PLATE OR PIPING >1/4” THICK OR >12” LONG, METAL REINFORCED HOSE >12” LONG, METAL WIRE >12” LONG, METAL VALVES, PIPE FITTINGS, CONCRETE REINFORCING BAR OR

PIECES OF CONCRETE >3”)?

YES NO

If yes, describe, including dimensions:

(List the complete composition of the waste, include any inert components and/or debris. Ranges for individual components are acceptable. If a trade name is used, please supply an MSDS. Please do not use abbreviations.)

CHEMICAL MIN -- MAX UOM

COMPRESSOR OIL 1.0000000 -- 89.0000000 %

DIRT 0.0000000 -- 5.0000000 %

ETHYLENE GLYCOL 0.0000000 -- 20.0000000 %

HYDRAULIC OIL 1.0000000 -- 89.0000000 %

MINERAL OIL 1.0000000 -- 89.0000000 %

MOTOR OIL 1.0000000 -- 89.0000000 %

PETROLEUM HYDROCARBON BASED OILS 1.0000000 -- 89.0000000 %

PROPYLENE GLYCOL 0.0000000 -- 20.0000000 %

WATER 11.0000000 -- 99.0000000 %

DOES THIS WASTE CONTAIN ANY METALS IN POWDERED OR OTHER FINELY DIVIDED FORM? YES NO

DOES THIS WASTE CONTAIN OR HAS IT CONTACTED ANY OF THE FOLLOWING; ANIMAL WASTES, HUMAN BLOOD, BLOOD PRODUCTS, BODY FLUIDS, MICROBIOLOGICAL WASTE, PATHOLOGICAL WASTE, HUMAN OR ANIMAL DERIVED SERUMS OR PROTEINS OR ANY OTHER

POTENTIALLY INFECTIOUS MATERIAL?

YES NO

I acknowledge that this waste material is neither infectious nor does it contain any organism known to be a threat to human health. This certification is based on my knowledge of the material. Select the answer below that applies:

The waste was never exposed to potentially infectious material. YES NO

Chemical disinfection or some other form of sterilization has been applied to the waste. YES NO

I ACKNOWLEDGE THAT THIS PROFILE MEETS THE CLEAN HARBORS BATTERY PACKAGING REQUIREMENTS. YES NO

I ACKNOWLEDGE THAT MY FRIABLE ASBESTOS WASTE IS DOUBLE BAGGED AND WETTED. YES NO

SPECIFY THE SOURCE CODE ASSOCIATED WITH THE

WASTE.

SPECIFY THE FORM CODE ASSOCIATED WITH THE WASTE.G32 W205

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Profile No. 639695

WASTE MATERIAL PROFILE SHEET

If based on knowledge, please describe in detail, the rationale applied to identify and characterize the waste material. Please include reference to Material Safety Data Sheets (MSDS) when applicable. Include the chemical or trade-name represented by the MSDS, and or detailed process or operating procedures which generate the waste.

TestingKnowledgeAre these values based on testing or knowledge?

E. CONSTITUENTS

OTHER CONSTITUENTS MAX UOM NOT

APPLICABLE

BROMINE

CHLORINE

FLUORINE

IODINE

SULFUR

POTASSIUM

SODIUM

AMMONIA

CYANIDE AMENABLE

CYANIDE REACTIVE

CYANIDE TOTAL

SULFIDE REACTIVE

VOLATILE COMPOUNDS

D018 BENZENE 0.5

D019 CARBON TETRACHLORIDE 0.5

D021 CHLOROBENZENE 100.0

D022 CHLOROFORM 6.0

D028 1,2-DICHLOROETHANE 0.5

D029 1,1-DICHLOROETHYLENE 0.7

D035 METHYL ETHYL KETONE 200.0

D039 TETRACHLOROETHYLENE 0.7

D040 TRICHLOROETHYLENE 0.5

D043 VINYL CHLORIDE 0.2

SEMI-VOLATILE COMPOUNDS

D023 o-CRESOL 200.0

D024 m-CRESOL 200.0

D025 p-CRESOL 200.0

D026 CRESOL (TOTAL) 200.0

D027 1,4-DICHLOROBENZENE 7.5

D030 2,4-DINITROTOLUENE 0.13

D032 HEXACHLOROBENZENE 0.13

D033 HEXACHLOROBUTADIENE 0.5

D034 HEXACHLOROETHANE 3.0

D036 NITROBENZENE 2.0

D037 PENTACHLOROPHENOL 100.0

D038 PYRIDINE 5.0

D041 2,4,5-TRICHLOROPHENOL 400.0

D042 2,4,6-TRICHLOROPHENOL 2.0

PESTICIDES AND HERBICIDES

D012 ENDRIN 0.02

D013 LINDANE 0.4

D014 METHOXYCHLOR 10.0

D015 TOXAPHENE 0.5

D016 2,4-D 10.0

D017 2,4,5-TP (SILVEX) 1.0

D020 CHLORDANE 0.03

D031 HEPTACHLOR (AND ITS EPOXIDE) 0.008

HOCs

NONE

< 1000 PPM

>= 1000 PPM

PCBs

NONE

< 50 PPM

>=50 PPM

IF PCBS ARE PRESENT, IS THE

WASTE REGULATED BY TSCA 40

CFR 761?

YES NO

Please indicate which constituents below apply. Concentrations must be entered when applicable to assist in accurate review and expedited approval of your waste profile. Please note that the total regulated metals and other constituents sections require answers.

Customer knowledge

ADDITIONAL HAZARDS

DOES THIS WASTE HAVE ANY UNDISCLOSED HAZARDS OR PRIOR INCIDENTS ASSOCIATED WITH IT, WHICH COULD AFFECT THE WAY IT SHOULD BE HANDLED?

YES NO (If yes, explain)

DEA REGULATED SUBSTANCES EXPLOSIVE FUMING

NONE OF THE ABOVEPOLYMERIZABLE RADIOACTIVE REACTIVE MATERIAL

RCRA REGULATED METALS REGULATORY

LEVEL (mg/l)

TCLP

mg/l

TOTAL UOM NOT APPLICABLE

D004 ARSENIC 5.0

D005 BARIUM 100.0

D006 CADMIUM 1.0

D007 CHROMIUM 5.0

D008 LEAD 5.0

D009 MERCURY 0.2

D010 SELENIUM 1.0

D011 SILVER 5.0

CHOOSE ALL THAT APPLY

OSHA REGULATED CARCINOGENS

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G. DOT/TDG INFORMATION

DOT/TDG PROPER SHIPPING NAME:

NON DOT REGULATED MATERIAL, (OIL AND WATER)

NON D.O.T. REGULATED, (OIL AND WATER)

F. REGULATORY STATUS

YES NO IF THIS IS A US EPA HAZARDOUS WASTE, DOES THIS WASTE STREAM CONTAIN BENZENE?

YES NO DO ANY CANADIAN PROVINCIAL WASTE CODES APPLY?

YES NO IS THE GENERATOR OF THE WASTE CLASSIFIED AS A VERY SMALL QUANTITY GENERATOR (VSQG) OR A STATE EQUIVALENT

DESIGNATION?

YES NO IS THIS WASTE STREAM SUBJECT TO THE INORGANIC METAL BEARING WASTE PROHIBITION FOUND AT 40 CFR 268.3(C)?

Pharmaceuticals production (subpart GGG)Hazardous Organic NESHAP (HON) rule (subpart G)

YES NO IS THE WASTE SUBJECT TO ONE OF THE FOLLOWING NESHAP RULES?

YES NO IS THIS MATERIAL GOING TO BE MANAGED AS A RCRA EXEMPT COMMERCIAL PRODUCT, WHICH IS FUEL (40 CFR 261.2 (C)(2)(II))?

Texas Waste Code TXEXEMPT

YES NO DO ANY STATE WASTE CODES APPLY?

YES NO USEPA HAZARDOUS WASTE?

NO IS THIS WASTE PROHIBITED FROM LAND DISPOSAL WITHOUT FURTHER TREATMENT PER 40 CFR PART 268?

LDR CATEGORY:

VARIANCE INFO:

YES NO IS THIS A UNIVERSAL WASTE?

YES NO DOES TREATMENT OF THIS WASTE GENERATE A F006 OR F019 SLUDGE?

YES NO

YES NO DOES THE WASTE CONTAIN GREATER THAN 20% OF ORGANIC CONSTITUENTS WITH A VAPOR PRESSURE >= .3KPA (.044 PSIA)?

YES NO DOES THIS WASTE CONTAIN AN ORGANIC CONSTITUENT WHICH IN ITS PURE FORM HAS A VAPOR PRESSURE > 76.6 KPA (11.1 PSIA)?

NO IS THIS CERCLA REGULATED (SUPERFUND ) WASTE ? YES

YES

DOES THIS WASTE CONTAIN VOC'S IN CONCENTRATIONS >=500 PPM?

Not subject to LDR

Megagram/year (1 Mg = 2,200 lbs)

Describe the knowledge :

Knowledge TestingThe basis for this determination is: Knowledge of the Waste Or Test Data

What is the TAB quantity for your facility?

YES NO Is the generating source of this waste stream a facility with Total Annual Benzene (TAB) >10 Mg/year?

YES NO Does the waste stream come from a facility with one of the SIC codes listed under benzene NESHAP or is this waste regulated under the benzene NESHAP rules because the original source of the waste is from a chemical manufacturing, coke by-product recovery, or petroleum refinery process?

YES NO IS THIS WASTE STREAM "USED OIL" WHICH IS TO BE MANAGED UNDER 40 CFR PART 279 - STANDARDS FOR THE MANAGEMENT OF USED OIL?

H. TRANSPORTATION REQUIREMENTS

CONTAINER TYPE:

STORAGE CAPACITY:

CONTAINERS/SHIPMENT

CONTAINERIZED

0-0

DRUM

OTHER:

CUBIC YARD BOX

BOX|CARTON|CASEPORTABLE TOTE TANK

DRUM SIZE:

BULK LIQUID

GALLONS/SHIPMENT: GAL.500.00 Min -1000.00 Max

ESTIMATED SHIPMENT FREQUENCY .OTHERYEARLYQUARTERLYMONTHLYWEEKLYONE TIME

TONS/YARDS/SHIPMENT:

SHIPMENT UOM: TON YARD

BULK SOLID

0 Min - 0 Max

I. SPECIAL REQUEST

COMMENTS OR REQUESTS:

Please approve for SKVS using the 279 exemption.

GENERATOR'S CERTIFICATION

I certify that I am authorized to execute this document as an authorized agent. I hereby certify that all information submitted in this and attached documents is correct to the best of my knowledge.I also certify that any samples submitted are representative of the actual waste.If Clean Harbors discovers a discrepancy during the approval process, Generator grants Clean Harbors the authority to amend the profile, as Clean Harbors deems necessary, to reflect the discrepancy.

AUTHORIZED SIGNATURE NAME (PRINT) TITLE DATE

John Litchfield Facility Manager

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Addendum

D. COMPOSITION

F. REGULATORY STATUS

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