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Start putting your waste to better reuse with SGS Recovery.
Step
1
of
5
20%
A. Generator Information
Generator Name
Contact Name
Contact Title
Phone
Email
Site Location
Street Address
County
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
EPA ID #
B. Billing Information
Same Billing Information as Previous Contact Info?
Yes
No
If "No" — please provide us with all necessary billing information.
Bill to Name
Contact Name
Phone
Email
Billing Address
Street Address
County
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Need Help? Call 716-278-2000
C. Material Information
Name and Description of Material
Process Generating Material
USDOT Proper Ship Name
Material Composition
Constituants
Item 1
Minimum %
Maximum %
Add
Remove
Constituants
Item 2
Minimum %
Maximum %
Add
Remove
Constituants
Item 3
Minimum %
Maximum %
Add
Remove
Constituants
Item 4
Minimum %
Maximum %
Add
Remove
Constituants
Item 5
Minimum %
Maximum %
Add
Remove
Constituants
Item 6
Minimum %
Maximum %
Add
Remove
Physical State of Materials
Solid
Semi-Solid
Powder
Liquid
Phases
Select one
Reactivity of Materials
None
Water Reactive
Acid Reactive
Alkaline Reactive
Oxidizer Auto-Setting
Select one
Flash Point (F - Fahrenheit)
More Than 200 Degrees
Less Than 72 Degrees
Between 72-100 Degrees
Between 100-140 Degrees
Between 140-200 Degrees
NA
Select one
pH Level
Between 6-9
Less than 2
Between 2-6
Between 9-12.5
More than 12.5
NA
Select one
S.G./Density
Total Organic Halogen (TOX)
0 ppm
More than 1000 ppm
Odor
None
Mild
Strong
Select one
Describe Odor Smell
Describe Color
PCB Content
0 ppm
1-49 ppm
Equal to or More Than 50 ppm
Other
Select one Please note if any NYS B Codes Apply
Need Help? Call 716-278-2000
Shipping/DOT Information
Material Composition
Shipping Name
Method of Shipment
Annual Volume
Unit of Measure
Tons
Drums
Gallons
Totes
Frequency
Witness Distruction?
No
Yes
Special Notes
Chemical Composition
Constituent Composition & Range % (To Applicable Chemicals)
Chorine
Minimum %
Maximum %
Bromine
Minimum %
Maximum %
Fluorine
Minimum %
Maximum %
BTU/LB
Minimum %
Maximum %
Moisture
Minimum %
Maximum %
Need Help? Call 716-278-2000
RCRA Contaminants
Select Applicable Contaminants
TCLP
None
Other Analytical Attached
Please check any of your elements that are outside of the noted regulatory levels.
Arsenic > 5.0
Barium > 100.0
Cadmium > 1.0
Chromium > 5.0
Lead > 5.0
Mercury > 0.2
Selenium > 1.0
Silver > 5.0
Endrin > 0.02
Lindane > 0.4
Methoxychlor > 10.0
Toxaphene > 0.5
2,4-D > 10.0
2,4,5-TP (Silvex) > 1.0
Benzene > 0.5
Carbon Tetrachloride > 0.5
Chlordane > 0.03
Chlorobenzene > 100.0
Chloroform > 6.0
o-Cresol > 200.0
m-Cresol > 200.0
p-Cresol > 200.0
Cresol (total) > 200.0
1,4-Dichlorobenzene > 7.5
1,2-Dichloroethane > 0.5
1,1-Dichlorethylene > 0.7
2,4-Dinitrotoluene > 0.13
Heptachlor > 0.008
Hexachlorobenzene > 0.13
Hexachlorobutadiene > 0.5
Hexachloroethane > 3.0
Methyl Ethyl Ketone > 200.0
Nitrobenzene > 2.0
Pentrachlorophenol > 100.0
Pyridine > 5.0
Tetrachloroethylene > 0.7
Trichloroethylene > 0.5
2,4,5-Trichlorophenol > 400.0
2,4,6-Trichlorophenol > 2.0
Vinyl Chloride > 0.2
Please provide more clarity on the checked items above.
Need Help? Call 716-278-2000
Certification
By signing this Material Characterization Form, I hereby certify that all information submitted in this and all attached documents contain true and accurate descriptions of this material, and that all relevant information necessary for proper waste characterization has been provided. Any analytical data attached was derived from a sample that is representative as defined in 40 CFR 261 – Appendix 1 or by using an equivalent method. All changes occurring in the character of the waste will be identified by the Generator prior to delivery of the materials to SGS Recovery. If I am an agent signing on behalf of the Generator, I have confirmed with the Generator that information contained in this profile is accurate and complete.
Name
Title
Date
Company Name
Signature
For Internal Use Only
Program
Fuel
Energy
WWT
BUD
Landfill
Other
Reviewed By
Review Date
MM slash DD slash YYYY
Approved?
Yes
No
Approved Date
MM slash DD slash YYYY
Rejection Reason
Price
Notes
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Buffalo Fuel
Services
Waste Management
Waste-to-Energy
Product Desctruction
Anaerobic Digestion
Waste Transportation
Responsibility Programs
Trusted Tread
Mattress Management
Converted Commodity
Sustainability
About
Permits & Documentation
Profile
Get a Quote
