American Environmental Services, Inc.

A. General Information

*USEPA ID#		Attention
*Generator Name		*Billing Name
*Facility Address		*Billing Address
*City		*Billing City
*State		*Billing State
*Zip Code		*Billing Zip Code
*Telephone		Technical Contact
Fax		Telephone
State ID#
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B. DOT

Shipping Name Search
*Search Results:
Hazard Class
UN/NA No.
Packing Group
RQ
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C. RCRA

D. Annual Report Codes

SIC Code
Source Code
Form Code
Origin Code
System Type
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E. Other Components

*PCB's	Yes No	Total ppm:
*Cyanides	Yes No	Total ppm:
*Sulfides	Yes No	Total ppm:
*Pesticides	Yes No	Total ppm:
*Phenolics	Yes No	Total ppm:
*Dioxins	Yes No	Total ppm:
*Halogens	Yes No	Total ppm:
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F. Physical Characteristics At 70°F

*1. Infectious or Biological Waste?

Yes No

*2. NRC Regulated Radioactive?

Yes No

*3. Reactivity

None Water Reactive
Pyrophoric Shock Sensitive
Cyanides DOT Explosive
Sulfides Other

*

Gas (Cylinder)	Solid	%
Aerosol	Sludges	%
Lab Pack	Free Liquids	%
	Dust	%

*Layers

Single Layered Bi-Layered Multi-Layered

*Viscosity

Low Medium High

*Odor

None Mild Strong

Describe:

Color/Appearance

Weight Density

lbs./gal. (US, liq)

lbs./cu. foot

Dry Weight

< 1.0% 1-5%
5-20% 20-100%

*pH

< 2 2.1-4
4.1-10 10.1-12.4
>=12.5 NA

Exact

*Flash Point (liquid only)

< 73°F (23°C)
73° - 140°F (23°C-60°C)
141° - 200°F (61°C-93°C)
> 200°F (93°C)
N/A

*Boiling Point

< 95°F (35°C)
> 95°F (35°C)
N/A

*BTU/Lb.

*Dermal Toxicity LD₅₀ (Mg/Kg)

<=40
>40, <=200
>200, <=1000
>1000

*4. Material poisonous by inhalation?

Yes No

*Oral Toxicity LD₅₀ (Mg/Kg)

	<=5	> 5, <=50
Solids:	>50, <=200	>200
Liquids:	>50, <=500	>500 N/A

*5. Is this waste stored in vented drums?

Yes No

*6. Is this waste pumpable?

Yes No

*7. Is this waste polymerizable?

Yes No

*8. Is waste stream subject to the National Emission Standards for Benzene Waste Operations (40 CFR 61 Subpart FF)?

Yes No

*9. Is this waste regulated as an ozone depleting substance (40 CFR part 82)?

Yes No

*10. Does this waste contain scrap metal pieces greater than 2 inches in size?

Yes No

*11. Does this waste contain > 100 ppm VOC's?

Yes No

*NONE TCLP (MG/L) TOTAL
	Reg. Limit	Below	Above	Range
Arsenic	5 mg/L
Barium	100 mg/L
Cadmium	1 mg/L
Chromium	5 mg/L
Copper
Lead	5 mg/L
Mercury	0.2 mg/L
Nickel	134 mg/L
Selenium	1 mg/L
Silver	5 mg/L
Zinc
Others:
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H. Physical/Chemical Constituents

I. Anticipated Volume

*	Qty.	Container	Qty.	Container
		5 gl. pail		Cubic Yard Box*
		15 gl. carboy		Super Sack*
		30 gl. drum		Rolloff/Dump Trailer*
		55 gl. drum		Tanker*
		85 gl. drum		Other
*Per 1 Time Week Month Year Other
* Is this waste regulated as a Marine Pollutant (49 CFR 171.8)?				Yes No
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J. Signature

Comments:

Generator's Certification:
I hereby certify that the above and attached description is complete and accurate to the best of my knowledge and ability to determine that no deliverate or willful omissions of composition properties exist and that all known or suspected hazards have been disclosed. I certify that the materials tested are representative of all materials described by this profile.

Generator's Authorized Electronic Signature:
Name: (Full Name) | Date: (mm/dd/yyyy)

Upon submitting this electronic profile, for first time users it is required that you complete and submit the 'Online Profile Signature Verification' form listed on our Downloads page. Please complete and follow the instructions listed on the form for submittal process.

RCRA Non Hazardous/Exempt	Yes No
Process Generating
State Waste Codes
EPA Waste Codes	How many Wastes Codes?
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