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Material Profile Sheet

Please fill in the form below and sign certifying you have read and understand the following:

I hereby certify that the below and attached information is true and accurate to the best of my knowledge. I certify that the information and sample submitted is representative to the waste stream being considered. I understand that the determination made by AOC regarding the acceptance and pricing of this waste is based on the information and sample I provided and is subject to change if the incoming stream changes.

    Your Email*

    Company Name*

    Facility Address*

    City,State,Zip*

    Technical Contact

    Position

    Telephone

    Generator EPA ID No.

    DOT Shipping Name & Placard

    Are there any levels of PCB's

    Is this waste mixed with hazardous (RCRA) waste?

    Describe the process that generates this waste

    Type of waste

    Used OilVirgin productWastewaterGasoline tank bottomsDiesel tank bottomsSump sludgeOil dryOily dirtGasoline contaminated dirtDiesel contaminated dirtAbsorbent rags for used oilAbsorbent rags for virgin productUsed Oil Filters (uncrushed)Used Oil Filters (crushed)Speciality Filters

    Shipping Method

    AOC bob tail truckAOC tanker truckAOC vacuum truckGenerator's tanker truckGenerator's vacuum truckThird party tanker truckThird party vacuum truckDrums picked up by AOC truckDrums shipped by generator

    Physical Constituents

    Arsenic ppm

    Cadmium ppm

    Chromium ppm

    Copper ppm

    Lead ppm

    Nickel ppm

    Zinc ppm

    Flash Point

    Gravity

    Viscosity

    pH

    * Certification Signature

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