Waste Profile

Before EQ can process your waste, we ask that you complete a Waste Profile. Please complete the following Waste Characterization form for each waste stream you would like EQ to handle. If you have questions, our Customer Service staff is ready to help. In addition, you can always save your work and resume working on a profile later.

Once your information is complete, eSign the form to authorize EQ to begin the Approval process.

Form ID: (New Form), revision: 1

Form Continues...

Section 1 - Customer & Generator Information

Tracking ID:
Invoicing Company
Your Email:
EQ Customer No.
Company:
Address:
City:
State:	Zip:
Country:
Invoicing Contact
Name
Phone:
Fax:
Technical Contact
Name
Phone:
Fax:
Mobile:
Pager:
Email:
Generator
SIC/NAICS:	For a list of NAICS codes, please refer to Section 9 of the EQ Resource Guide.
EPA ID #:
Generator:
Address:
City:
State:	Zip:
County:
Generator Mailing Address
Address:
City:
State:	Zip:
Generator Contact
Name:
Title:
Phone:
Fax:

Form Continues...

Section 4 - Waste Composition and Generating Process

4.1)

Describe the physical composition of the waste
(i.e., soil, water, PPE, debris, key chemical compounds, etc.)

4.2)

Provide a detailed description of the process generating this waste (send flow diagram if available).

Form Continues...

Section 6 - Hazardous Wastes

6.1)

Does this waste exceed Land Disposal Restriction levels?
Yes No (Undo)

6.1a)	If this waste stream is greater than 50% soil, does it meet the alternative soil treatment standards of 40 CFR 268.49? Yes No (Undo)
6.1b)	Does this waste contain greater than 50% debris, by volume? (Debris is greater than 2.5 inches in size.) Yes No (Undo)

6.2)

Is the waste an oxidizer (D001)?
Yes No (Undo)

6.3)

Does this waste contain reactive cyanide > 250 ppm (D003)?
Yes No (Undo)

6.4)

Does this waste contain reactive sulfide > 500 ppm (D003)?
Yes No (Undo)

6.5)

Please indicate which constituent concentrations are below or above the regulatory level. Please indicate the basis used in the determination.
Either "Below" or "Above" MUST be checked for each constituent.

Based On:
Generator Knowledge Analysis* MSDS* (Undo)
* Please send a copy. Analysis or MSDS are required for EQ Florida Non-hazardous wastes.

Code	Regulatory Level TCLP (mg/l)
D004	Arsenic	5	Below	Above	(Undo)
D005	Barium	100	Below	Above	(Undo)
D006	Cadmium	1	Below	Above	(Undo)
D007	Chromium	5	Below	Above	(Undo)
D008	Lead	5	Below	Above	(Undo)
D009	Mercury	0.2	Below	Above	(Undo)
D010	Selenium	1	Below	Above	(Undo)
D011	Silver	5	Below	Above	(Undo)
D012	Endrin	0.02	Below	Above	(Undo)
D013	Lindane	0.4	Below	Above	(Undo)
D014	Methoxychlor	10	Below	Above	(Undo)
D015	Toxaphene	0.5	Below	Above	(Undo)
D016	2,4-D	10	Below	Above	(Undo)
D017	2,4,5-TP (Silvex)	1	Below	Above	(Undo)
D018	Benzene	0.5	Below	Above	(Undo)
D019	Carbon Tetrachloride	0.5	Below	Above	(Undo)
D020	Chlordane	0.03	Below	Above	(Undo)
D021	Chlorobenzene	100	Below	Above	(Undo)
D022	Chloroform	6.0	Below	Above	(Undo)
D023	o-Cresol	200	Below	Above	(Undo)
D024	m-Cresol	200	Below	Above	(Undo)
D025	p-Cresol	200	Below	Above	(Undo)
D026	Cresols	200	Below	Above	(Undo)
D027	1,4-Dichlorobenzene	7.5	Below	Above	(Undo)
D028	1,2-Dicholoroethane	0.5	Below	Above	(Undo)
D029	1,1-Dichloroethylene	0.7	Below	Above	(Undo)
D030	2,4-Dinitrotoluene	0.13	Below	Above	(Undo)
D031	Heptachlor	0.008	Below	Above	(Undo)
D032	Hexachlorobenzene	0.13	Below	Above	(Undo)
D033	Hexachlorobutadiene	0.5	Below	Above	(Undo)
D034	Hexachloroethane	3.0	Below	Above	(Undo)
D035	Methyl Ethyl Ketone	200	Below	Above	(Undo)
D036	Nitrobenzene	2	Below	Above	(Undo)
D037	Pentachlorophenol	100	Below	Above	(Undo)
D038	Pyridine	5	Below	Above	(Undo)
D039	Tetrachloroethylene	0.7	Below	Above	(Undo)
D040	Trichloroethylene	0.5	Below	Above	(Undo)
D041	2,4,5-Trichlorophenol	400	Below	Above	(Undo)
D042	2,4,6-Trichlorophenol	2	Below	Above	(Undo)
D043	Vinyl Chloride	0.2	Below	Above	(Undo)

6.6)

If this is a characteristic hazardous waste, does it contain underlying hazardous constituents?
Yes No (Undo)
If yes, please list the constituents in Section 11

Form Continues...

Section 7 - Non-Hazardous Wastes

For a complete list of non-hazardous waste codes, please refer to Section 7 of the EQ Resource Guide.

7.1)	Is this a Michigan non-hazardous liquid industrial waste? Yes No (Undo) Comments:
7.2)	Is this a Universal waste? Yes No (Undo)
7.3)	Is this a Recyclable Commodity? (e.g.: computer monitors, free mercury, etc.) Yes No (Undo)
7.4)	Is this waste a recoverable petroleum product? Yes* No (Undo)
7.5)	Is this waste used oil as defined by 40 CFR Part 279? Yes* No (Undo)

Waste Profile Addendum

Analysis must be conducted in conformance with U.S. EPA SW-846 or 40 CFR 136.

Evaluation based on:
Generator Knowledge Analysis (Please send for review) (Undo)

Wastewater and Recoverable Petroleum Products

Constituent	mg/l	Actual Concentration
Organics
Bis (2-ethylhexyl) phthalate	<0.158
Carbazole	<0.233
o-Cresol	<0.561
p-Cresol	<0.205
n-Decane	<3.31
Fluoranthene	<0.393
n-Octadecane	<0.925
2,4,6-Trichlorophenol	<0.106
Phosphorus	<500.0
Total Chlorinated Phenolics 2-Chlorophenol 2,4-Dichlorophenol 2,4,6-Trichlorophenol 4-Chloro-3-Methyl Phenol Pentachlorophenol	<0.5
Total Organic Carbon	N/A
Total PCB's	<0.00006 (nd)
Acidity/Alkalinity	>5 & < 11.5

FOG (Fats, Oils & Greases)	<2,000.0
TSS (Total Suspended Solids)	<10,000.0
BOD (Biological Oxygen Demand)	<10,000.0

Metals
Total Antimony	<0.141
Total Arsenic	<0.104
Total Cadmium	<0.0962
Total Chromium	<0.487
Total Cobalt	<0.124
Total Copper	<0.301
Total Cyanide	<2.0
Total Iron	<1,000.0
Total Lead	<0.172
Total Mercury	<0.000739
Total Nickel	<1.45
Total Silver	<0.0351
Total Tin	<0.12
Total Titanium	<0.0618
Total Vanadium	<0.0662
Total Zinc	<0.641

Priority Pollutants
Volatiles (8240)	Analysis	Non-Detect	(Undo)
Semi-Volatiles (8270)	Analysis	Non-Detect	(Undo)
Pesticides (8080)	Analysis	Non-Detect	(Undo)
Herbicides (8150)	Analysis	Non-Detect	(Undo)

Used Oil

Used oil is regulated under 40 CFR 279 if it is (1) a used oil, (2) has been refined from crude oil, and (3) as a result of use is contaminated by physical (e.g., solids) or chemical impurities (e.g., metals). Is this waste a used oil?
Yes No (Undo)

Has the waste oil been mixed with listed and/or characteristic hazardous waste?
Yes* No (Undo)
If yes, what is the hazardous waste code(s) with which it has been mixed?

*If yes, the waste is regulated as a hazardous waste rather than a used oil (40 CFR 279.10(b)(1)).

Is the total halogen content of the used oil waste stream greater than 1,000 ppm?
Yes* No (Undo)
*If yes, what is the source of the halogen content?
This is a metalworking oil/fluid containing chlorinated paraffins.
This is used oil contaminated with chlorofluorocarbons from refrigeration units.
This oil contains halogenated solvents.

List specific solvents:

Other

Describe:

(Undo)

Form Continues...

Section 10 - Fuel Blending Information

10.1)

Is this waste intended for fuel blending?
Yes* No (Undo)
*If you answered 'yes',

Heat value (BTU/lb.)
Chlorine (%)
Water (%)
Solids (%)

10.2)

Is this waste intended for reclamation?
Yes* No (Undo)
(5-Gallon Sample required for all reclaim waste streams)

Form Continues...

Section 11 - Constituent Information

Please identify your waste constituents from these four categories: Underlying Hazardous Constituents (UHC's), Volatile Organic Hazardous Air Pollutants (VOHAP's), Volatile Organic Compounds (VOC's) and Toxic Release Inventory Constituents (TRI)

Concentration
Constituent	Amount	Unit	UHC?

Please see Section 11 of the EQ Resource Guide for a list of UHC's, VOHAP's and VOC's. For a complete list of TRI constituents, please refer to 40 CFR 372.65.

5.1)	Is this an EPA RCRA listed hazardous waste (F, K, P or U)? Yes No (Undo) Comments:
5.2)	Is this an EPA RCRA characteristic hazardous waste (D001-D043)? Yes No (Undo) Comments:
5.3)	Do any State Hazardous Waste Codes apply? Yes No (Undo) Comments:
5.4)	Is this waste intended for wastewater treatment? Yes* No (Undo)

8.1)	What is the concentration of PCBs in the waste? None 0-5 ppm 6-49 ppm 50-499 ppm 500+ ppm (Undo)
8.2)	Does the waste contain PCB contamination from a source with a concentration >50 ppm? Yes No (Undo) If you answered "none" to 8.1 and "no" to 8.2, please skip to Section 9.
8.3)	Has this waste been processed into a non-liquid form? Yes No (Undo) If yes, what was the concentration of PCBs prior to processing? 0-499 ppm 500+ ppm N/A
8.4)	Is the non-liquid PCB waste in the form of soil, rags, debris, or other contaminated media? Yes No (Undo)
8.5)	Are you a PCB capacitor manufacturer or a PCB equipment manufacturer? Yes No (Undo)
8.6)	Has the PCB Article (e.g., transformer, hydraulic machine, PCB-contaminated electrical equipment) been drained/flushed of all PCBs and decontaminated in accordance with 40 CFR 761.60(b)? Yes No N/A

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