Temarry Recicling
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Waste Profile

Before Temarry Recycling Inc. 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 Temarry Recycling Inc. 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, e-sign the form or you can print the form for customer signature and your file and sign it and scan and e-mail to: info@temarry.com or fax to 619-270-9453 to authorize Temarry Recycling Inc. to begin the Approval process. You should have and approval within 48 hours or you need it expedited, please call 619-270-9453.

  I.- BILL TO INFORMATION
Customer name:
Send email profile to:
Address:
City:
State: Zip:
Technical contact name:
Phone number:
  II.- GENERATOR INFORMATION
Generator name.:
Address:
City:
State: Zip:
Contact # 1:
Phone #: Email:
Contact # 2:
Phone #: Email:
24 Hours Emergency #:
Fax #:
Manifest Attention To:
Special Pick up instructions:
   III.- WASTE INFORMATION
Method of Shipment:
Qty:
Per:
Waste is:
Waste Name:
Description of process generating waste:
Source Code:
Form code:
   
Color(s): Odor: pH:
No. Phases: BTU´s: Flash Point °C:
% Liquid: % Solid: % Sludge:
     
  IV.- CHEMICAL COMPOSITION
Constituents: % Min. % Max.
Total % %
   V.- MAJOR SOLID COMPOSITION - Click to fill information
Urethane Waste Oil Soil Nitrocellulose
Epoxy Rags/Filter Vinyl Oil Absorbents
Other
  VI.- OTHER COMPONENTS
Cyanides Amines Sulfides Reactive PCB´s
Phenolics Sulfides    
   VII.- HAZARDOUS PROPERTIES
None Pyrophoric Water Reactive Pesticide Insecticide
Shock Reactive Etiological Radioactive Explosive
Corrosive Polymerizable Dioxins Pathogen
Benzene Neshap Biological Air Reactive  
   OTHER
MSDS Other Analytical Data Attached
  VIII.- RCRA CHARACTERISTICS
1.- Is this material "Hazardous Waste" under 40CFR 261.3?
  Yes No
2.- If this is a "Characteristic Waste" please select
3.- If this is an "F" or a "K" waste mixed with one, please give waste codes from 40CFR 261.31 and/or 261.32:
 
4.- If this a commercial chemical product or spill cleanup that would carry "U" or "P" waste code under 40CFR 261.33 (e) or (f), please give waste codes
 
5.- If thisis a state regulated waste , please give codes
 

   IX.- ORGANIC CHARACTERISTIC - Click to fill information
   Analythical report (ppm or mg/lt)
    Max Limit Actual     Max Limit Actual
D012 Endrin 0.02 D013 Lindane 0.4
D014 Methoxychlor 0.02 D015 Toxaphene 0.5
D016 2,4 Dichlorophenioxyacetic Acid 10.0 D017 2,45-TP(Silvex) 1.0
D018 Benzene 0.5 D019 Carbon Tetrachloride 0.5
D022 Chlorform 6.0 D023 o-Cresol 200.0
D024 m-Cresol 200.0 D025 p-Cresol 200.0
D026 Cresol 200.0 D027 1,- Dichlorbenzene 7.5
D028 1,2-Dichloroethane 0.5 D029 1,1- Dichloroethylene 0.7
D030 2,4-Dinitrotoluene .13 D031 Heptachlor (and it´s epoxide) 0.008
D032 Hexachlorbenzene 0.13 D033 Hexachlorbutadiene 0.5
D034 Hexachloride 3.0 D035 Methyl Ethyl Ketone 200.0
D036 Nitrobenzene 2.0 D037 Pentachlorophenol 100.0
D038 Pyridine 5.0 D039 Tetrachloroethylene 0.7
D040 Trichloroethylene 0.5 D041 2,4,5-Trichlorophenol 400.0
D042 2,4,6-Trichlorophenol 2.0 D043 Vinyl Chloride 0.2
  X.- INORGANIC CHARACTERISTICS - Click to fill information
  Analythical report (ppm or mg/lt)
    Max Limit Actual     Max Limit Actual
D004 Arsenic 5.0 D005 Barium 100.0
D006 Cadmium 1.0 D007 Chromium 5.0
D008 Lead 5.0 D009 Mercury 0.2
D010 Selenium 1.0 D011 Silver 5.0
  Copper 100.0   Zinc 500.0
  XI.- DOT CHARACTERIZATION
If this a "Hazardous substance / Marine Pollutant" as defined in 49CF D.O.T, please give proper D.O.T. shupping description from 49CFR 172.101.
Proper shipping name Hazard Class UN/NA # Packaging Group
Two primary Hazardous Constituents RQ #


  XII.- CUSTOM RECYCLE - SAMPLE REQUIRED - Click to fill information
Coating Type: Ink Paint Other
How Cured: Ultraviolet Catalytic Heat (Temp.)
Shipping Instructions: Drums Bulk
Are return specification attached?: Yes No
Special Instructions::
  XII.- SAMPLE BEING SUPPLIED - Click to fill information
Data Collected:
Time Collected: AM PM
Place Collected:
Collected By:
Signature:
  XII.- CUSTOMER PROCEDURES FOR WASTE SHIPMENTS
1. All containers are to be labeled BEFORE pick-up.
2. The proper waste manifest, bill of lading, and Land Disposal Notification form must be filled out as required by RCRA and D.O.T. and must include the Temarry Profile Number.
3. All waste material ,must be shipped in containers that conform with D.O.T. U.N. Shipping regulations. Regulations require that no hazardous material may remain on the outside of the package after filling. Containers should not exhibit excessive structural disintegrity such as denting, leaking, excessive rust, or improper closure.
4. All services provided by Temarry are subject to the terms and conditions printed on the back of this page.
  XV.- CERTIFICATION STATEMENT
I hereby certify that all the information, to the best of my knowledge, on this and any attached documents, is complete, correct, and that all known hazards are accurate and have been disclosed. If this waste changes in any manner, Temarry will inmediately be notified in writing.
_______________________ _______________________    
Print Name Signature Date PO #
I have read and understand the TERMS AND CONDITIONS OF SALE.
Please note: EMAILING OR FAXING THIS FORM TO TEMARRY established that you have read and understand the TERMS AND CONDITIONS OF SALE.
Need more information about Temarry Recycling?
Download brochures or fact sheet
Use our Information Request form and a representative will assist you.
If you need an immediate response, contact us by phone.
Visit www.recicladoratemarry.com
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