Koman_profile_NLON.pdf

WASTE/MATERIAL PROFILE FORM

Profile ID: 758738

A. GENERATOR/CUSTOMER INFORMATION

1. Generator: NAVAL SUBMARINE BASE NLON

2. Site Address: CRYSTAL LAKE ROAD AND ROUTE 12 P.O. required for payment? If yes, include:

City: GROTON Phone: (860) 694-4298 State: CT Zip: 06349 Country: USA 8. Invoicing Company: KOMAN GOVERNMENT SOLUTIONS LLC

3. Mailing Address: CRYSTAL LAKE ROAD AND ROUTE 12 9. Invoicing Address : 293 BOSTON POST RD., STE. 100 City: GROTON City: MARLBOROUGH State: CT Zip: 06349 Country: State: MA Zip: 01752-4615 Country: USA

4. Technical Contact: BRIAN HENDRICKSON 10. Customer Contact: Russ McCormick

5. Phone: (860) 694-4298 Email: brian.g.hendrickson.civ@us.navy 11. Phone: (978) 460-9603 Email: rmccormick@komangs.com

6. Generator Status: SQG LQG VSQG/CESQG (If yes, complete Certification Supplement) Not Applicable

7. EPA ID #: CT4170022020 NAICS CODE: 928110 State ID #:

B. WASTE/MATERIAL STREAM

1. Common Name: (L) Groundwater

2. Generating Process: IDW contains diesel-range organics and weathered diesel product generated from groundwater in monitoring wells.

3. Source Code: Form Code:

C. SHIPPING/PACKAGING INFORMATION

1. DOT Hazardous Materials? Yes No Proper Shipping Name: Non Hazardous Liquid Waste, Not Dot Not RCRA Regulated

2. Additional Description:

3. RQ: Yes No RQ Reason: RQ Threshold: UN/NA#:

Packing Group: ERG#: Hazard Class:

4. DOT Special Permit? Yes No Permit #:

5. 24-Hour Emergency Phone: (800) 483-3718 6. DOT Inhalation Hazard? Yes No

7. Container Type: Bulk Totes Pallet Boxes Drums Cylinder Container size: 55 Gallon Drum

Lab Pack (If 40 CFR 264.316/49 CFR 173.12(b) Lab Pack Inventory lists required)

Combination Containers (e.g., inner containers) Describe:

Other, Describe:

8. Volume/Frequency: Volume: 110 Units: Gallons Frequency: Year Quarterly Monthly 1 Time Other, Describe:

D. PHYSICAL PROPERTIES

1. Physical Description (e.g. soil, water, PPE, debris, sorbent, etc. Include 100% of container content. If debris, provide dimensions & weight.)

Description Typical (%) Min (%) Max (%) Purge water generated from groundwater sampling wi 100 100 100

2. Odor: None Slight Strong Odor type: Ammonia Amines Mercaptans Sulfur Organic Acid Other Describe: Petroleum

3. Physical State: (at 70°F) Solid Dust/Powder Debris Sludge/Slurry Liquid Gas/Aerosol Varies

4. Color: BROWN 5. Liquid phases: Single Double Layer Multi-layer N/A

6. Is it solid using the paint filter test? (40 CFR Part 264.314(b)) Yes (Solid) No (Not Solid) Is there a possibility of incidental liquids from transportation? Yes No

7. pH: (If solid, provide estimated pH if mixed 50:50 with water) <=2 2.1 - 4.9 5 - 10 10.1 - 12.4 >=12.5

8. Flash Point: °F and/or <90 °F 90 - 139 °F 140 - 199 °F >=200 °F Does not flash Flammable solid BTU/lb. Value: and/or <5000 BTU >=5000 BTU

9. Are there any known handling/treatment issues involving this material? (i.e. Describe whether the waste stream has ever been the direct or suspected cause of a fire or other reaction, and whether there are any specific controls you use to prevent any adverse reactions?)

Yes No

Page 1 of 4 Profile ID: 758738 https://www.naics.com/search/

E. CHARACTERIZATION & CHEMICAL COMPOSITION (See Continuation for E.6)

1. Robstown Facility Customers - Waste/Material Type: Industrial Non-Industrial N/A TX State Code:

Pennsylvania Residual Waste: Yes No PA State Code (s):

2. State Waste Codes: MI-029L

3. RCRA Waste Codes: None

If None, is it exempt from the definition of “Solid Waste” or “Hazardous Waste”? Yes No

4. If F006-F009, F012, or F019, are Cyanides used in the process? Yes No (If yes, Total and Amenable CN (9010/9012) analysis required)

5. Knowledge is from: Lab analysis (requires attachment) SDS/MSDS (requires attachment) Process/generator knowledge

6. Chemical Composition (include all applicable UHC’s, TRI Section 313 chemicals, OSHA Hazardous Materials, PFAS Constituents, etc.)

Constituent Units TCLP Totals Typical Min Max UHC Exceeds LDR Barium mg/l 0.205 0 0.205

Chromium mg/l 0.003 0 0.003

Lead mg/l 0.0038 0 0.0038

Mercury (all others) mg/l 0.000016 0 0.000016

Arsenic mg/l 0.005 0 0.005

Selenium mg/l 0.007 0 0.007

Cadmium mg/l 0.007 0 0.007

Silver mg/L 0.004 0 0.004 mg/L 0.019 0 0.019 mg/L Not Detect 0 0

F. ADDITIONAL PROPERTIES

1. Explosive: Yes No 2. Reactive Sulfides : 40 ppm Yes No

3. Shock Sensitive: Yes No 4. Reactive Cyanides: 10 ppm Yes No

5. Radioactive: Yes No 6. Reactive Other: Yes No

Describe:

7. Medical/Infectious/Biohazard Waste: Yes No 8. Polychlorinated Biphenyls (PCB): Yes No

9. Dioxins and/or Furans: Yes No 10. Metal Fines/Powder/Paste: Yes No

11. Pyrophoric: Yes No 12. Temperature Controlled: Yes No

13. Thermally Unstable: Yes No 14. Biodegradable Sorbents: Yes No

15. Compressed Gas: Yes No 16. Used Oil: Yes No

17. Oxidizer: Yes No 18. Tires: Yes No

19. Organic Peroxide: Yes No 20. Beryllium: Yes No

21. Ammonia/Ammonia Compounds: Yes No 22. Per-and Polyfluoroalkyl Substances (PFAS): Yes No

23. Asbestos: Yes No

24. Hazardous Secondary Material: Yes No

25. Are pharmaceutical wastes profiled under this approval subject to a prescription? Yes No N/A

Page 2 of 4 Profile ID: 758738

TCLP VOCs

TCLP SVOCs

G. REGULATORY INFORMATION

1. Volatile Organic Concentration: (Per 40 CFR Part 264.1083 & 265.1084) <500 ppmw ≥500 ppmw

2. Has the material been treated after the initial point of generation? Yes No

3. If RCRA Hazardous:

Wastewater WW=<1% TSS & TOC; 40 CFR Part 268.2 Non-wastewater TSS/TOC>WW Alternative Treatment Standards for soil? > 50% soil; 40 CFR Part 268.49 Alternative Treatment Standards for debris? 40 CFR Part 268.2(g) & (h); >50% of waste is >2.5 inch size

I confirm debris cannot reasonably be separated from non-debris by simple physical or mechanical means I confirm debris has not been mixed/diluted with non-debris as prohibited in 40 CFR Part 268.3

Waste meets LDR Treatment Standards

4. Treatment subcategory: (if applicable)

5. Is the site or waste/material, subject to NESHAP/MACT standard(s)? Yes No

6. Is the waste/material RCRA Hazardous containing Benzene and originating at a petroleum refinery (SIC 2911), chemical manufacturing plant (SIC 2800 thru 2899) or Coke by-product recovery plant (SIC 3312)?

Yes No (If yes,complete the Benzene Waste Operations Supplement and if applicable the Thermal Supplement)

H. GENERATOR’S CERTIFICATION

1. Is a specific facility or treatment technology requested? Yes No

2. Requested Technology:

3. Thermal Processing: Yes No

4. Other specific restrictions requested:

5. Requested Facility: Belleville Facility - Treatment

Certificate Statement:

I certify that all information (including attachments) is complete, factual and is an accurate representation of the known and suspected hazards pertaining to waste/material described herein. I authorize Republic Services personnel to add supplemental information to the Waste/Material Profile Form, provided I am contacted and grant permission to do so. Republic Services may require re-submittal of the Waste/Material Profile Form if substantial changes are determined necessary. I authorize Republic Services personnel to obtain a sample from any waste/material shipment for purposes of verification and confirmation and understand that waste/material that does not conform to specifications described in this Waste/Material Profile Form may be rejected by Republic Services. I certify that I am familiar with the waste/material described herein through analysis and/or process knowledge and that all information provided is true, accurate, representative and complete and that this Waste/Material Profile Form was completed in accordance with the instructions provided.

If I am an agent acting on behalf of the generator, I also certify that I have permission to sign any and all waste/material characterization paperwork on the generator’s behalf and that I can produce such certification in writing upon request.

Print Name: Signature: {{Sig_es_:signer:signature}}

Title:

Date: Company:

Page 3 of 4 Profile ID: 758738

WASTE MATERIAL PROFILE FORM - CONTINUATION (Chemical)

758738Profile ID :

E. CHARACTERIZATION & CHEMICAL COMPOSITION

Constituent Units TCLP Totals Typical Min Max UHC Exceeds LDR PFBS ng/L 20 20 20

PFDA ng/L 3.0 3.0 3.0

PFDoA ng/L 0.36 0.36 0.36 PFHpA ng/L 130 130 130

PFHxA ng/L 140 140 140

Total PFHxS ng/L 250 250 250

PFNA ng/L 28 28 28

PFOA ng/L 97 97 97

PFOS ng/L 630 630 630

PFTrDA ng/L 0.91 0.91 0.91 PFUnA ng/L 0.72 0.72 0.72

PFTeDA ng/L 0.91 0.91 0.91

4. Chemical Composition:

Page 4 of 4 Profile ID: 758738