Non-Hazardous Waste Water Facility
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Non-Hazardous Waste-Water Facility

Waste Characterization

Non-Hazardous Waste Water Characterization


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Address of Billable Party

 

Generator Address

 

Activity or Process Producing Wastewater (Check all that apply)

 

Suspected Source of Contaminants

Does (or did) the site contain one or more underground storage thanks (UST's) for fuel?

   

Is a UST the suspected source of contamination?

   

Are you aware of any other possible sources of causes of waste water contamination at the site? If Yes, please describe

   

 

Wastewater Characterization

Please provide copies of the results of any analytical work carried out on the wastewater.

Is the pH less than 2 or greater than 12.5?

   

Is the flashpoint less than 140 F ( 60 C )?

   

Is there any reason to suspect the presence of reactive cyanides or sulfides?

   

Is there any reason to suspect that the waste water would prove toxic in a fish bio-assay test?

   

Is there separate-phase liquid present in the waste water?

   

Can you detect any hydrocarbon odor from the wastewater?

   

Is there any reason to suspect the presence of chlorinated hydrocarbons such as trichloroethylene?

   

Was the wastewater tested for chlorinated hydrocarbons?

   

Is there any reason to suspet the presence of heavy metals, such as lead?

   

Was the wastewater tested for heavy metals? If "Yes", please describe tests and attach copies of the test results.

   

Was the wastewater tested for anything other than the above contaminants? If "Yes", Please describe tests and attach copies of the test results.

   

Is there any other analytical test data ( eg soil samples ) for this site?

   

Is there any soil vapor monitoring data for this site?

   

Is there evidence of an emulsion?

   

Generator's Certification that Wastewater is Non-Hazardous

Description of water: Certify that the above named material is a liquid exempt from rcra per 40 cfr 261.4(b)(10) and does not meet the criteria of hazardous waste as describe in 22 ccr article 11 or any other applicable state law, has been properly described, classified and packaged and is in proper condition for transportation according to applicable regulations.

The information and representations presented above are true and correct to the best of my knowledge.

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