HAFB HWR 2021.pdf

EPA Form 8700 12, 8700 13 A/B, 8700 23 Page __ of __

United States Environmental Protec on Agency

RCRA SUBTITLE C SITE IDENTIFICATION FORM

City, Town, or Village County

State Country Zip Code

La tude Longitude

2. Site EPA ID Number

� Obtaining or upda ng an EPA ID number for on going regulated ac vi es (Items 10 17 below) that will con nue for a period of me.

� Submi ng as a component of the Hazardous Waste Report for __________ (Repor ng Year)

� No fying that regulated ac vity is no longer occurring at this Site

� Obtaining or upda ng an EPA ID number for conduc ng Electronic Manifest Broker ac vi es

� Submi ng a new or revised Part A (permit) Form

� Site was a TSD facility, a reverse distributor, and/or generator of 1,000 kg of non acute hazardous waste, > 1 kg of acute hazardous waste, or > 100 kg of acute hazardous waste spill cleanup in one or more months of the repor ng year (or State equivalent LQG regula ons)

1. Reason for Submi al (Select only one.)

7. North American Industry Classi ca on System (NAICS) Code(s) for the Site (at least 5 digit codes)

3. Site Name

4. Site Loca on Address

6. Site Land Type

� Private � County � District � Federal � Tribal �Municipal � State � Other

A. (Primary) C.

B. D.

5. Site Mailing Address

Street Address

State Country Zip Code

City, Town, or Village

� Same as Loca on Street Address

Street Address

� Use Lat/Long as Primary Address

OMB# 2050-0024; Expires 04/30/2024

✔ 2021

N M 6 5 7 2 1 2 4 4 2 2

HOLLOMAN AFB, NM

6 MILES WEST OF ALAMOGORDO

HOLLOMAN AFB OTERO

NM US 88330

32.84264 -106.07661

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

92811

1 6

First Name MI Last Name

Title

Street Address

State Country Zip Code

Email

Phone Ext Fax

City, Town, or Village

8. Site Contact Informa on

Owner Type

� Private � County � District � Federal � Tribal �Municipal � State � Other

Street Address

City, Town, or Village

State Country Zip Code

Email

Phone Ext Fax

Comments

9. Legal Owner and Operator of the Site

A. Name of Site’s Legal Owner

B. Name of Site’s Legal Operator

EPA ID Number

Full Name Date Became Operator (mm/dd/yyyy)

Operator Type

� Private � County � District � Federal � Tribal �Municipal � State � Other

Street Address

City, Town, or Village

State Country Zip Code

Email

Phone Ext Fax

Comments

� Same as Loca on Address

� Same as Loca on Address

� Same as Loca on Address

Full Name Date Became Owner (mm/dd/yyyy)

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

STEVEN JONES

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

steven.jones.17@us.af.mil

575-572-3931

UNITED STATES AIR FORCE

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

UNITED STATES AIR FORCE

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

2 6

10. Type of Regulated Waste Ac vity (at your site) Mark “Yes” or “No” for all current ac vi es (as of the date submi ng the form); complete any addi onal boxes as instructed.

A. Hazardous Waste Ac vi es

� Y � N 1. Generator of Hazardous Waste—If “Yes”, mark only one of the following—a, b, c

� a. LQG Generates, in any calendar month, 1,000 kg/mo (2,200 lb/mo) or more of non acute hazardous waste (includes quan es imported by importer site); or Generates, in any calendar month, or accumulates at any me, more than 1 kg/mo

(2.2 lb/mo) of acute hazardous waste; or Generates, in any calendar month or accumulates at any me, more than 100 kg/mo

(220 lb/mo) of acute hazardous spill cleanup material.

� b. SQG 100 to 1,000 kg/mo (220 2,200 lb/mo) of non acute hazardous waste and no more than 1 kg (2.2 lb) of acute hazardous waste and no more than 100 kg (220 lb) of any acute hazardous spill cleanup material.

� c. VSQG Less than or equal to 100 kg/mo (220 lb/mo) of non acute hazardous waste.

� Y � N 2. Short Term Generator (generates from a short term or one me event and not from on going processes). If “Yes”, provide an explana on in the Comments sec on. Note: If “Yes”, you MUST indicate that you are a Generator of Hazardous Waste in Item 10.A.1 above.

� Y � N 3. Treater, Storer or Disposer of Hazardous Waste—Note: Part B of a hazardous waste permit is required for these ac vi es.

� Y � N 5 Recycler of Hazardous Waste

� a. Recycler who stores prior to recycling

� b. Recycler who does not store prior to recycling

� Y � N 6. Exempt Boiler and/or Industrial Furnace—If “Yes”, mark all that apply.

� a. Small Quan ty On site Burner Exemp on

� b. Smel ng, Mel ng, and Re ning Furnace Exemp on

� Y � N 4. Receives Hazardous Waste from O site

EPA ID Number

B. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes handled at your site. List them in the order they are presented in the regula ons (e.g. D001, D003, F007, U112). Use an addi onal page if more spaces are needed.

C. Waste Codes for State Regulated (non Federal) Hazardous Wastes. Please list the waste codes of the State hazardous wastes handled at your site. List them in the order they are presented in the regula ons. Use an addi onal page if more spaces are needed.

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

D001

D002

D003

D005

D006

D007

D008

D009

D010

D018

D035

D039

F001

F003

F005

U133

3 6

� Y � N 2. Underground Injec on Control

� Y � N 4. Recognized Trader—If “Yes”, mark all that apply.

� a. Importer

� b. Exporter

� Y � N 5. Importer/Exporter of Spent Lead Acid Ba eries (SLABs) under 40 CFR 266 Subpart G—If “Yes”, mark all that apply.

� a. Importer

� b. Exporter

EPA ID Number

11. Addi onal Regulated Waste Ac vi es (NOTE: Refer to your State regula ons to determine if a separate permit is required.)

B. Universal Waste Ac vi es

� Y � N 1. Large Quan ty Handler of Universal Waste (you accumulate 5,000 kg or more) If “Yes” mark all that apply. Note: Refer to your State regula ons to determine what is regulated.

� a. Ba eries

� b. Pes cides

� c. Mercury containing equipment

� d. Lamps

� f. Other (specify) ______________________________________________

� e. Aerosol Cans

� g. Other (specify) ______________________________________________

� Y � N 2. Des na on Facility for Universal Waste Note: A hazardous waste permit may be required for this ac vity.

C. Used Oil Ac vi es

� Y � N 1. Used Oil Transporter—If “Yes”, mark all that apply.

� a. Transporter

� b. Transfer Facility (at your site)

� Y � N 2. Used Oil Processor and/or Re re ner—If “Yes”, mark all that apply.

� a. Processor

� b. Re re ner

� Y � N 3. O Speci ca on Used Oil Burner

� Y � N 4. Used Oil Fuel Marketer—If “Yes”, mark all that apply.

� a. Marketer Who Directs Shipment of O Speci ca on Used Oil to O Speci ca on Used Oil Burner

� b. Marketer Who First Claims the Used Oil Meets the Speci ca ons

A. Other Waste Ac vi es

� Y � N 3. United States Importer of Hazardous Waste

� Y � N 1. Transporter of Hazardous Waste—If “Yes”, mark all that apply.

� a. Transporter

� b. Transfer Facility (at your site)

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

4 6

12. Eligible Academic En es with Laboratories—No ca on for op ng into or withdrawing from managing laboratory hazardous wastes pursuant to 40 CFR Part 262, Subpart K.

� Y � N A. Op ng into or currently opera ng under 40 CFR Part 262, Subpart K for the management of hazardous wastes in laboratories— If “Yes”, mark all that apply. Note: See the item by item instruc ons for de ni ons of types of eligible academic en es.

� 1. College or University

� 2. Teaching Hospital that is owned by or has a formal wri en a lia on with a college or university

� 3. Non pro t Ins tute that is owned by or has a formal wri en a lia on with a college or university

EPA ID Number

� Y � N Are you an LQG no fying of consolida ng VSQG Hazardous Waste Under the Control of the Same Person pursuant to 40 CFR 262.17(f)? If “Yes”, you must ll out the Addendum for LQG Consolida on of VSQG hazardous waste.

� Y � N LQG Site Closure of a Central Accumula on Area (CAA) or En re Facility.

A. � Central Accumula on Area (CAA) or � En re Facility

B. Expected closure date: ____________ mm/dd/yyyy

C. Reques ng new closure date: ____________ mm/dd/yyyy

D. Date closed : ____________ mm/dd/yyyy � 1. In compliance with the closure performance standards 40 CFR 262.17(a)(8) � 2. Not in compliance with the closure performance standards 40 CFR 262.17(a)(8)

14. LQG Consolida on of VSQG Hazardous Waste

15. No ca on of LQG Site Closure for a Central Accumula on Area (CAA) (op onal) OR En re Facility (required)

� Y � N Are you an SQG or VSQG genera ng hazardous waste from a planned or unplanned episodic event, las ng no more than 60 days, that moves you to a higher generator category. If “Yes”, you must ll out the Addendum for Episodic Generator.

13. Episodic Genera on

D. Pharmaceu cal Ac vi es

� Y � N 1. Opera ng under 40 CFR Part 266, Subpart P for the management of hazardous waste pharmaceu cals—if “Yes”, mark only one. Note: See the item by item instruc ons for de ni ons of healthcare facility and reverse distributor.

� a. Healthcare Facility

� b. Reverse Distributor

� Y � N 2. Withdrawing from opera ng under 40 CFR Part 266, Subpart P for the management of hazardous waste pharmaceu cals. Note: You may only withdraw if you are a healthcare facility that is a VSQG for all of your hazardous waste, including hazardous waste pharmaceu cals.

� Y � N B. Withdrawing from 40 CFR Part 262, Subpart K for the management of hazardous wastes in laboratories.

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

5 6

EPA ID Number

18. Comments (include item number for each comment)

19. Cer ca on I cer fy under penalty of law that this document and all a achments were prepared under my direc on or su pervision in accordance with a system designed to assure that quali ed personnel properly gather and evaluate the informa on submi ed. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gath ering the informa on, the informa on submi ed is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are signi cant penal es for submi ng false informa on, including the possibility of nes and imprisonment for knowing viola ons. Note: For the RCRA Hazardous Waste Part A permit Applica on, all owners and operators must sign (see 40 CFR 270.10(b) and 270.11).

Signature of legal owner, operator or authorized representa ve Date (mm/dd/yyyy)

Printed Name (First, Middle Ini al Last) Title

Email

Signature of legal owner, operator or authorized representa ve Date (mm/dd/yyyy)

Printed Name (First, Middle Ini al Last) Title

Email

17. Electronic Manifest Broker

� Y � N Are you no fying as a person, as de ned in 40 CFR 260.10, elec ng to use the EPA electronic manifest sys tem to obtain, complete, and transmit an electronic manifest under a contractual rela onship with a haz ardous waste generator?

16. No ca on of Hazardous Secondary Material (HSM) Ac vity

� Y � N Are you no fying under 40 CFR 260.42 that you will begin managing, are managing, or will stop managing hazardous secondary material under 40 CFR 260.30, 40 CFR 261.4(a)(23), (24), (25), or (27)? If “Yes”, you must ll out the Addendum to the Site Iden ca on Form for Managing Hazardous Secondary Material.

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

6 6

United States Environmental Protec on Agency

RCRA SUBTITLE C SITE IDENTIFICATION FORM

City, Town, or Village County

State Country Zip Code

La tude Longitude

2. Site EPA ID Number

� Obtaining or upda ng an EPA ID number for on going regulated ac vi es (Items 10 17 below) that will con nue for a period of me.

� Submi ng as a component of the Hazardous Waste Report for __________ (Repor ng Year)

� No fying that regulated ac vity is no longer occurring at this Site

� Obtaining or upda ng an EPA ID number for conduc ng Electronic Manifest Broker ac vi es

� Submi ng a new or revised Part A (permit) Form

� Site was a TSD facility, a reverse distributor, and/or generator of 1,000 kg of non acute hazardous waste, > 1 kg of acute hazardous waste, or > 100 kg of acute hazardous waste spill cleanup in one or more months of the repor ng year (or State equivalent LQG regula ons)

1. Reason for Submi al (Select only one.)

7. North American Industry Classi ca on System (NAICS) Code(s) for the Site (at least 5 digit codes)

3. Site Name

4. Site Loca on Address

6. Site Land Type

� Private � County � District � Federal � Tribal �Municipal � State � Other

A. (Primary) C.

B. D.

5. Site Mailing Address

Street Address

State Country Zip Code

City, Town, or Village

� Same as Loca on Street Address

Street Address

� Use Lat/Long as Primary Address

OMB# 2050-0024; Expires 04/30/2024

✔ 2021

N M 6 5 7 2 1 2 4 4 2 2

HOLLOMAN AFB, NM

6 MILES WEST OF ALAMOGORDO

HOLLOMAN AFB OTERO

NM US 88330

32.84264 -106.07661

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

92811

1 6

First Name MI Last Name

Title

Street Address

State Country Zip Code

Email

Phone Ext Fax

City, Town, or Village

8. Site Contact Informa on

Owner Type

� Private � County � District � Federal � Tribal �Municipal � State � Other

Street Address

City, Town, or Village

State Country Zip Code

Email

Phone Ext Fax

Comments

9. Legal Owner and Operator of the Site

A. Name of Site’s Legal Owner

B. Name of Site’s Legal Operator

EPA ID Number

Full Name Date Became Operator (mm/dd/yyyy)

Operator Type

� Private � County � District � Federal � Tribal �Municipal � State � Other

Street Address

City, Town, or Village

State Country Zip Code

Email

Phone Ext Fax

Comments

� Same as Loca on Address

� Same as Loca on Address

� Same as Loca on Address

Full Name Date Became Owner (mm/dd/yyyy)

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

STEVEN JONES

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

steven.jones.17@us.af.mil

575-904-3233

UNITED STATES AIR FORCE

550 TABOSA AVENUE

HOLLOMAN AFB

NM us 88330

UNITED STATES AIR FORCE

550 TABOSA AVENUE

HOLLOMAN AFB

NM US 88330

2 6

10. Type of Regulated Waste Ac vity (at your site) Mark “Yes” or “No” for all current ac vi es (as of the date submi ng the form); complete any addi onal boxes as instructed.

A. Hazardous Waste Ac vi es

� Y � N 1. Generator of Hazardous Waste—If “Yes”, mark only one of the following—a, b, c

� a. LQG Generates, in any calendar month, 1,000 kg/mo (2,200 lb/mo) or more of non acute hazardous waste (includes quan es imported by importer site); or Generates, in any calendar month, or accumulates at any me, more than 1 kg/mo

(2.2 lb/mo) of acute hazardous waste; or Generates, in any calendar month or accumulates at any me, more than 100 kg/mo

(220 lb/mo) of acute hazardous spill cleanup material.

� b. SQG 100 to 1,000 kg/mo (220 2,200 lb/mo) of non acute hazardous waste and no more than 1 kg (2.2 lb) of acute hazardous waste and no more than 100 kg (220 lb) of any acute hazardous spill cleanup material.

� c. VSQG Less than or equal to 100 kg/mo (220 lb/mo) of non acute hazardous waste.

� Y � N 2. Short Term Generator (generates from a short term or one me event and not from on going processes). If “Yes”, provide an explana on in the Comments sec on. Note: If “Yes”, you MUST indicate that you are a Generator of Hazardous Waste in Item 10.A.1 above.

� Y � N 3. Treater, Storer or Disposer of Hazardous Waste—Note: Part B of a hazardous waste permit is required for these ac vi es.

� Y � N 5 Recycler of Hazardous Waste

� a. Recycler who stores prior to recycling

� b. Recycler who does not store prior to recycling

� Y � N 6. Exempt Boiler and/or Industrial Furnace—If “Yes”, mark all that apply.

� a. Small Quan ty On site Burner Exemp on

� b. Smel ng, Mel ng, and Re ning Furnace Exemp on

� Y � N 4. Receives Hazardous Waste from O site

EPA ID Number

B. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes handled at your site. List them in the order they are presented in the regula ons (e.g. D001, D003, F007, U112). Use an addi onal page if more spaces are needed.

C. Waste Codes for State Regulated (non Federal) Hazardous Wastes. Please list the waste codes of the State hazardous wastes handled at your site. List them in the order they are presented in the regula ons. Use an addi onal page if more spaces are needed.

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

D001

D002

D004

D005

D006

D007

D008

D009

D010

D018

D035

D039

F001

F003

F005

U133

3 6

� Y � N 2. Underground Injec on Control

� Y � N 4. Recognized Trader—If “Yes”, mark all that apply.

� a. Importer

� b. Exporter

� Y � N 5. Importer/Exporter of Spent Lead Acid Ba eries (SLABs) under 40 CFR 266 Subpart G—If “Yes”, mark all that apply.

� a. Importer

� b. Exporter

EPA ID Number

11. Addi onal Regulated Waste Ac vi es (NOTE: Refer to your State regula ons to determine if a separate permit is required.)

B. Universal Waste Ac vi es

� Y � N 1. Large Quan ty Handler of Universal Waste (you accumulate 5,000 kg or more) If “Yes” mark all that apply. Note: Refer to your State regula ons to determine what is regulated.

� a. Ba eries

� b. Pes cides

� c. Mercury containing equipment

� d. Lamps

� f. Other (specify) ______________________________________________

� e. Aerosol Cans

� g. Other (specify) ______________________________________________

� Y � N 2. Des na on Facility for Universal Waste Note: A hazardous waste permit may be required for this ac vity.

C. Used Oil Ac vi es

� Y � N 1. Used Oil Transporter—If “Yes”, mark all that apply.

� a. Transporter

� b. Transfer Facility (at your site)

� Y � N 2. Used Oil Processor and/or Re re ner—If “Yes”, mark all that apply.

� a. Processor

� b. Re re ner

� Y � N 3. O Speci ca on Used Oil Burner

� Y � N 4. Used Oil Fuel Marketer—If “Yes”, mark all that apply.

� a. Marketer Who Directs Shipment of O Speci ca on Used Oil to O Speci ca on Used Oil Burner

� b. Marketer Who First Claims the Used Oil Meets the Speci ca ons

A. Other Waste Ac vi es

� Y � N 3. United States Importer of Hazardous Waste

� Y � N 1. Transporter of Hazardous Waste—If “Yes”, mark all that apply.

� a. Transporter

� b. Transfer Facility (at your site)

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

4 6

12. Eligible Academic En es with Laboratories—No ca on for op ng into or withdrawing from managing laboratory hazardous wastes pursuant to 40 CFR Part 262, Subpart K.

� Y � N A. Op ng into or currently opera ng under 40 CFR Part 262, Subpart K for the management of hazardous wastes in laboratories— If “Yes”, mark all that apply. Note: See the item by item instruc ons for de ni ons of types of eligible academic en es.

� 1. College or University

� 2. Teaching Hospital that is owned by or has a formal wri en a lia on with a college or university

� 3. Non pro t Ins tute that is owned by or has a formal wri en a lia on with a college or university

EPA ID Number

� Y � N Are you an LQG no fying of consolida ng VSQG Hazardous Waste Under the Control of the Same Person pursuant to 40 CFR 262.17(f)? If “Yes”, you must ll out the Addendum for LQG Consolida on of VSQG hazardous waste.

� Y � N LQG Site Closure of a Central Accumula on Area (CAA) or En re Facility.

A. � Central Accumula on Area (CAA) or � En re Facility

B. Expected closure date: ____________ mm/dd/yyyy

C. Reques ng new closure date: ____________ mm/dd/yyyy

D. Date closed : ____________ mm/dd/yyyy � 1. In compliance with the closure performance standards 40 CFR 262.17(a)(8) � 2. Not in compliance with the closure performance standards 40 CFR 262.17(a)(8)

14. LQG Consolida on of VSQG Hazardous Waste

15. No ca on of LQG Site Closure for a Central Accumula on Area (CAA) (op onal) OR En re Facility (required)

� Y � N Are you an SQG or VSQG genera ng hazardous waste from a planned or unplanned episodic event, las ng no more than 60 days, that moves you to a higher generator category. If “Yes”, you must ll out the Addendum for Episodic Generator.

13. Episodic Genera on

D. Pharmaceu cal Ac vi es

� Y � N 1. Opera ng under 40 CFR Part 266, Subpart P for the management of hazardous waste pharmaceu cals—if “Yes”, mark only one. Note: See the item by item instruc ons for de ni ons of healthcare facility and reverse distributor.

� a. Healthcare Facility

� b. Reverse Distributor

� Y � N 2. Withdrawing from opera ng under 40 CFR Part 266, Subpart P for the management of hazardous waste pharmaceu cals. Note: You may only withdraw if you are a healthcare facility that is a VSQG for all of your hazardous waste, including hazardous waste pharmaceu cals.

� Y � N B. Withdrawing from 40 CFR Part 262, Subpart K for the management of hazardous wastes in laboratories.

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

5 6

18. Comments (include item number for each comment)

19. Cer ca on I cer fy under penalty of law that this document and all a achments were prepared under my direc on or su pervision in accordance with a system designed to assure that quali ed personnel properly gather and evaluate the informa on submi ed. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gath ering the informa on, the informa on submi ed is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are signi cant penal es for submi ng false informa on, including the possibility of nes and imprisonment for knowing viola ons. Note: For the RCRA Hazardous Waste Part A permit Applica on, all owners and operators must sign (see 40 CFR 270.10(b) and 270.11).

Signature of legal owner, operator or authorized representa ve Date (mm/dd/yyyy)

Printed Name (First, Middle Ini al Last) Title

Email

Signature of legal owner, operator or authorized representa ve Date (mm/dd/yyyy)

Printed Name (First, Middle Ini al Last) Title

Email

17. Electronic Manifest Broker

� Y � N Are you no fying as a person, as de ned in 40 CFR 260.10, elec ng to use the EPA electronic manifest sys tem to obtain, complete, and transmit an electronic manifest under a contractual rela onship with a haz ardous waste generator?

16. No ca on of Hazardous Secondary Material (HSM) Ac vity

� Y � N Are you no fying under 40 CFR 260.42 that you will begin managing, are managing, or will stop managing hazardous secondary material under 40 CFR 260.30, 40 CFR 261.4(a)(23), (24), (25), or (27)? If “Yes”, you must ll out the Addendum to the Site Iden ca on Form for Managing Hazardous Secondary Material.

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

6 6

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material, ignitable

D001

G06

W002 ✔

0 1

ARD981057870 H061 141

Source / Form Comments:

Absorbent material with fuel. These pads and absorbent material has all types of fuel on them from small spill clean up

1 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material, ignitable

D001

G09

W002 ✔

781 1

ARD981057870 H061 463

AZD081705402 H141 438

Source / Form Comments:

SATURATED ABSORBENT PADS WITH FUEL, WIPING DOWN AND SPILL CLEANUP

2 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material, ignitable

D001

G09

W119 ✔

0 1

ARD981057870 H061 34

Source / Form Comments:

Metal Chip Detection process with Alcohol. Process is used to detect chips in the metal

3 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material, ignitable

D001

G09

W319 ✔

45 1

ARD981057870 H061 204

Source / Form Comments:

RAGS AND DEBRIS WITH FUEL

4 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material, ignitable

D001

G32

W310 ✔

67 1

ARD981057870 H061 29

AZD081705402 H141 38

Source / Form Comments:

5 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste adhesives, ignitable

D001

G11

W210 ✔

11 1

ARD981057870 H061 11

6 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste adhesives, ignitable

D001

G11

W409 ✔

20 1

AZD081705402 H141 13

OHD980610541 H040 7

Source / Form Comments:

Adhesive organic peroxide

7 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste chemical product, ignitable

D001

G11

W004 ✔

24 1

OHD980610541 H040 24

8 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste chemical product, ignitable

D001

G11

W005 ✔

16 1

ARD981057870 H061 16

9 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste chemical product, ignitable

D001

G11

W209 ✔

1986 1

AZD081705402 H141 38

ARD981057870 H061 1948

Source / Form Comments:

DS 108 Solvent, 10P20-13 High Solids Epoxy Primer

10 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste chemical product, ignitable

D001

G22

W001 ✔

26 1

ARD981057870 H061 26

Source / Form Comments:

USED WRIGHT STAINING KIT

11 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste filters, ignitable

D001

G16

W310 ✔

45 1

ARD981057870 H061 45

12 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste adhesives, ignitable, corrosive

D001

D002

G11

W209 ✔

501 1

OHD980610541 H040 501

13 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste coatings and related materials, toxic (listed spent solvent)

D001

D004

D005

D007

D008

D010

D035

F003

F005

G06

W219 ✔

919 1

ARD981057870 H061 444

AZD081705402 H141 475

Source / Form Comments:

coatings and solvent

14 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste coatings and related materials, toxic

D001

D005

D007

D010

D018

D035

G06

W219 ✔

487 1

ARD981057870 H061 487

Source / Form Comments:

PAINT RELATED MATERIALS

15 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste coatings and related materials, toxic

D001

D005

D007

D035

G11

W209 ✔

469 1

ARD981057870 H141 203

AZD081705402 H141 266

Source / Form Comments:

Expired or unused paint material

16 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material w/ cadmium (listed solvent)

D001

D006

F003

F005

G09

W002 ✔

1354 1

ARD981057870 H061 786

AZD081705402 H141 500

Source / Form Comments:

Wiping

17 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material w/ cadmium (listed solvent)

D001

D006

F005

G09

W002 ✔

1564 1

ARD981057870 H061 982

AZD081705402 H141 338

Source / Form Comments:

Rags, Adhesive, Fuel, Debris w Solvents.

18 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste absorbent material, ignitable w/ chromium & MEK (listed spent solvent)

D001

D007

D035

F001

F005

G09

W002 ✔

1146 1

ARD981057870 H061 485

AZD081705402 H141 436

Source / Form Comments:

RAGS, PAINT FILTERS & DEBRIS

19 74

United States Environmental Protec on Agency

HAZARDOUS WASTE REPORT ______ (repor ng cycle)

WASTE GENERATION AND MANAGEMENT (GM) FORM

1. Waste Characteris cs

A. Waste Descrip on

2. On site Genera on and Management of Hazardous Waste

� Y � N Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site? If yes, con nue to On site Process System 1.

3. O site Shipment of Hazardous Waste

� Y � N A. Was any of this waste that was generated at this facility shipped o site for treatment, disposal, or recy cling? If yes, con nue to Site 1.

4. Comments

C. State Hazardous Waste Code(s)

B. EPA Hazardous Waste Code(s)

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 1

Process System 1 Management Method Code Quan ty

Process System 2 Management Method Code Quan ty

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 2

B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quan ty Shipped

Site 3

H. Quan ty UOM � lbs/gal � sgDensity

D. Source Code Management Method (G25) Country Code (G62)

E. Form Code F. Waste Minimiza on Code G. Radioac ve Mixed � Y � N

N M 6 5 7 2 1 2 4 4 2 2 OMB# 2050-0024; Expires 04/30/2024

Waste coatings and related materials,…