Hazardous Waste Disposal Inventory
Vistamarine Shipbuilding and Ship Repair Inc.
                                                                                    Generator Information
Name:                                                                                                                       Date:                             Phone:
 Code:                                                                 Building:                                                     Room:
                                                                                         Waste Inventory
                  WASTE DESCRIPTION                   WASTE ID #         GENERATING PROCESS                       CONTAINERS                      STATE                WASTE TRAIT
Item     Describe material to be collected by its   (Provided by the Describe the work process that      Type — Describe type, e.g., drum, Check appropriate Insert appropriate code.
         specific chemical constituents or by       Environmental    made the waste, e.g., expired       plastic bottle, sealed bucket, etc. block.
         trade name.                                Office).         shelf life, cleaning paint brushes.
                                                                                                           No.        Size      Type         Gas Liquid Solid  Trait          Code
 1.
                                                                                                                                                                              CA - Corrosive Acid
 2.                                                                                                                                                                                (pH<2)
 3.                                                                                                                                                                           CB - Corrosive Base
                                                                                                                                                                                   (pH>12.5)
 4.                                                                                                                                                                           F - Flammable
 5.                                                                                                                                                                              (Flashpoint
                                                                                                                                                                                 <140F)
 6.
                                                                                                                                                                              NR - Non-Regulated
 7.                                                                                                                                                                           Ox - Oxidizer
 8.                                                                                                                                                                           Px - Peroxide
 9.                                                                                                                                                                           R     -    Reactive
                                                                                                                                                                                  (H2O, air or
 10.                                                                                                                                                                              otherwise
 11.                                                                                                                                                                              sensitive)
                                                                                                                                                                              T - Toxic
 12.
                                                                                                                                                                              Other (Specify)
                                                                                     Generator Comments
 Have you received Pollution Control Officer training within the last 12 months?                                                                Yes                      No
 Have you made a good faith effort to minimize your waste generation by considering substitutes or alternatives?                                Yes                      No
 Comments - Indicate special requirements (if any) for collection of the waste material, e.g., restricted access to an area, appointment needed, generator wishes to monitor collection, etc:
                                                                                    Generator Certification
       I hereby declare that the contents of this inventory are fully and accurately stated as described by their waste, process, and container parameters.
 Printed Name:                                                                     Signature:                                                                 Date:
VTMC waste inventory form.                                                                                                                                                                Page 1 of 1