B125_Black_Beauty_BM_Profile.pdf

HAZARDOUS WASTE PROFILE SHEET

NOTE: Explosives, Shock Sensitive, Pyrophoric, Radioactive, and Etiological Waste are not normally accepted by the DRMO

Contact your DRMO for further guidance if your waste meets any of these categories.

A. GENERAL INFORMATION

1. GENERATORS NAME

WASTE PROFILE NO.

2. FACILITY ADDRESS

3. ZIP CODE

4. GENERATOR USEPA ID

5. GENERATOR STATE ID

6. TECHNICAL CONTACT 8. PHONE7. TITLE

B. WASTE INFORMATION

B125BLASTMEDIA v3

Part I

Environmental ContactJOHN GULLOCK

31098

(478) 327-4214

ROBINS AFB

BUILDING 359

ROBINS AFB GA United States

GA1570024330

1. NAME OF WASTE: BLAST MEDIA RESIDUE

402 AMXG 900I - C-5 SHEETMETAL SHOP

ORGANIZATION NAME SHOP NAME OFFICE SYMBOL

4. PROJECTED ANNUAL VOL

(If yes, Enter Reference Standards in Part 3, Block 6)

X6. IS THIS WASTE A DIOXIN LISTED WASTE AS DEFINED IN CFR 261.31?

NO

5. MODE OF COLLECTION

NO

HAS AN EXEMPTION BEEN GRANTED? X

(40 CFR 268)

NO

YES

DOES THE WASTE MEET APPLICABLE TREATMENT STANDARDS ALREADY? YES NOX

X

YES

3. PROCESS GENERATING WASTE

YES

7. IS THIS WASTE RESTRICTED FROM LAND DISPOSAL?

DRUM

OTHER CHARACTERISTICS

COLOR:

CYANIDE REACTIVE

PHYSICAL STATE

IGNITABLE REACTIVE(D003)

ph:

LAYERING

DENSITY:

LIQUID

2. RCRA CHARACTERISTICS

Flash Point:

GASSEMI-SOLID

SULFIDE REACTIVE

NON-WASTEWATER

X

X

SINGLE

1. MATERIAL CHARACTERIZATION

OTHER

(Optional - Not Required Data)

Part II

SOLID

WATER REACTIVE

WASTEWATER

MULTILAYERED

TREATMENT GROUP:> X

BTU/LB:

BILAYERED

TOTAL SOLIDS: ASH CONTENT:

HIGH TOC ( 10%)

CORROSIVE (D002)

LOW TOC (<10%)

2A. USEPA WASTE CODE

2B. STATE/LOCAL/HOST-NATION WASTE CODES

D008

HAZARDOUS WASTE PROFILE SHEET (Continued) WASTE PROFILE NO.

B125BLASTMEDIA v3

3. CHEMICAL/MATERIAL COMPOSITION List all components and contaminants, including PCB's, and any applicable F-Listed and underlying Hazardous Constituents.

CAS # COMPONENT

(Be as descriptive as possible.

Chemical names, as well as generic descriptions. e.g., 'sludge', 'paint solids', 'water' etc. are acceptable)'

CONCENTRATION RANGE

CADMIUM = .17 PPM .0 %

BEAD BLAST RESIDUE = 100 % 100.0 %

LEAD (TCLP) = 71.5 PPM .0072 %

ACETONE = 12.9 PPM .0013 %

RANGE TOTAL MUST EQUAL AT LEAST 100%

3. MATERIAL COMPOSITION / UNDERLYING HAZARDOUS CONSTITUENTS

CAS # COMPONENT

(Be as descriptive as possible.

Chemical names, as well as generic descriptions. e.g., 'sludge', 'paint solids', 'water' etc. are acceptable)'

CONCENTRATION RANGE

RANGE TOTAL MUST EQUAL AT LEAST 100%

HAZARDOUS WASTE PROFILE SHEET (Continued) WASTE PROFILE NO.

B125BLASTMEDIA v3

4. SHIPPING INFORMATION

DOT HAZARDOUS MATERIAL? X YES NO

PROPER SHIPPING NAME

HAZARD CLASS U.N. or N.A. NO. PACKING GROUP

ADDITIONAL DESCRIPTION

METHOD OF SHIPMENT BULK X DRUM OTHER

EMERGENCY RESPONSE GUIDE EDITION EMERGENCY RESPONSE NUMBER(YR)

5. SPECIAL HANDLING INFORMATION

6. GENERATOR CERTIFICATION

X CHEMICAL ANALYSIS (ATTACH TEST RESULTS) USER KNOWLEDGE (ATTACH SUPPORTING DOCUMENTS)

EXPLAIN HOW AND WHY THESE DOCUMENTS COMPLY WITH RCRA REQUIREMENTS

III

HAZARDOUS WASTE, SOLID, N.O.S.

Hazardous waste, solid, n.o.s.

NA30779

CERTIFICATION

I, __________________________ HEREBY CERTIFY THAT ALL INFORMATION SUBMITTED IN THIS AND ALL ATTACHED DOCUMENTS IS TO THE BEST OF MY KNOWLEDGE AN ACCURATE REPRESENTATION OF THE

WASTE TURNED IN TO THE DRMO. ALL KNOWN OR SUSPECTED HAZARDS HAVE BEEN DISCLOSED.

Signature of Generator's Representative

Date