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Waste Profile
Step 1 of 11 - Generator
9%
Generator
EPA ID #
Generators Name
Missouri ID #
Profile
Haz Fuel
Haz Liquid
Haz Solid
Non-Haz Fuel
Non-Haz Liquid
Non-Haz Solid
Raw Feed Substitute
Raw Material
Solvent Wash
Synthetic Soil
Waste Water
Product
Alternate Fuel
Engineer Fuel
Fuel
Health Care
Product
Raw Material
Waste Water
Is the Generator a TSDF?
Yes
No
Street
PO Box
City
State
Zip
Tech Contact Name
Title
Phone Number
Billing
Billing Name
Street
PO Box
City
State
Zip
Tech Contact Name
Title
Phone Number
General Waste Information
Material Description
Process Description
Shipping Container
- Check all that apply
Select All
Bulk
Drums
Boxes / Bags
Shipping Method
- Check all that apply
Select All
Truck
Railcar
Shipping Volume and Frequency
Give Details
Attach MSDS for components requiring employee communication under OSHA
Also, if available, attach current analysis representative of the material.
MSDS
Analysis
Chemical Composition/Waste Constituents
List components, attach additional sheets if needed
List Metal Information in Section H
Concentration Range (Units)
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
List Metal Information in Section H
to
Typical %
Reactive Characteristics
Explosives
Yes
No
Shock Sensitive
Yes
No
Pyrophoric
Yes
No
Oxidizer
Yes
No
Water Reactive
Yes
No
Air Reactive
Yes
No
Polymerizable
Yes
No
Reactive Sulfide
If yes please give more details
Yes
No
Reactive Sulfide Details
Reactive Cyanide
If yes please give more details
Yes
No
Reactive Cyanide Details
Other Incompatibles
If yes please give more details
Yes
No
Other Incompatibles Details
EPA Information
USEPA hazardous waste?
Yes
No
USEPA Waste Codes
Select All
D001
D002
F001
F002
F003
F004
F005
List other USEPA codes
Specific Analysis of Waste
Must be completed if an analysis is not attached or a sample is not submitted
Arsenic
Selenium
Silver
Nickel
Lead
Thallium
Cadmium
Barium
Beryllium
Chromium
Antimony
Mercury
Fluorine
Chlorine
Bromine
Phosphorus
Sulfur
Iodine
Aluminum
Silicon
Heat of Combustion
Specific Gravity
pH (range)
Water
Ash
Flash point
Physical Properties
(Provide if available)
If Liquid , Viscosity
Low
Medium
High
Can waste be heated to improve flow?
Yes
No
Is waste soluble in water?
Yes
No
Is this material pumpable with centrifugal pump?
Yes
No
If varies please explain
Is waste multi-layered?
Yes
No
If Yes Describe:
Percent Solids in Liquid:
Physical State
Liquid
Sludge
Solid
Lean Water
Substances which may be in the material:
Check all of the following substances which may be in the material:
Nitrocellulose (Usually found in LACQUER DUST Streams)
DOT Corrosives, Poisons, Forbiddens, Radioactives, Explosives, or Gases
TSCA regulated materials (PCBs, PBBs, Chlorinated dibenzodioxins or furans)
Materials used exclusively as pesticides, herbicides, insecticides, etc.
Toxic components with ACGIH TLV less than 2 ppm or 8 mg/m³
CERCLA Regulated (Superfund) Waste
Water reactive components (Isocyanates, Acid Chlorides, Anhydrides, etc.)
Biological hazards (Pathogenics, Infectious agents, Etiologic agents, etc.)
None of the above
DOT Information
Proper shipping name
Hazard Class
UN/NA Number
P.G
Special Handling Information
DOT Hazardous Material
Yes
No
Signature
*
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