ADEM Form 300 XX/18 m3
SOLID WASTE PROFILE SHEET INSTRUCTIONS
GENERAL INFORMATION
Indicate if the submittal is
a new certification, recertification, or a modification to a current certification. A modification is a
request for a change to a current certification when information relative to the waste stream has changed or additional
information is added.
Enter the generating facility's name, 12-digit USEPA Identification Number (if a number has been assigned to this location),
physical address where the waste is generated, to include the county name and mailing address. Enter the name of the
facility's contact person along with their official title, telephone number and e-mail address. This should be a person whom
the Department can contact with questions regarding this certification or waste stream. Enter the name of the company and
person making the profile submission, if it is different from the generator information. Include the company's mailing
address along with the contact person's telephone number and e-mail address.
WASTE INFORMATION
Enter a description of the process generating this waste stream along with the name of the waste. The description should
be clear and include background or historical information that will enable the Department to determine whether the waste is
a hazardous or non-hazardous waste. General processes (i.e. spill cleanup, plant cleanup, decontamination, accidental
release, wastewater treatment sludge, contaminated debris) will require additional clarifications to ensure that the waste is
properly classified. For example, wastewater treatment sludge is too generic since this sludge could be hazardous
depending on how the wastewater was generated (i.e. sludge from the treatment of wastewaters from electroplating
operations could be a F006 listed hazardous waste). If the waste is subject to the corrective action regulations of 40 CFR
Part 280 (Underground Storage Tank Program), include the UST Facility Identification Number and the UST Incident
Number (if applicable). If the waste is contaminated with a petroleum product, indicate the type of petroleum. Also, indicate
if the waste contains PCBs, cyanides, sulfides, or asbestos by checking the appropriate box, and supply the concentration
and units as well. If necessary, attach Material Safety Data Sheets or other documents (i.e. laboratory analysis results) that
describe the composition of the waste. Please indicate the annual volume for disposal. Place an "X" in the box indicating if
the waste is a Remediation, CERCLA, or Process waste.
WASTE PROPERTIES
Place an “X” in the box indicating the correct physical state of the waste. If the waste is a liquid or contains free liquid,
include values for percent free liquids, pH, and flash point. Plus indicate whether or not the waste will be solidified prior to
disposal.
If the waste is to be solidified, please identify where the solidification process will occur and the product used for
solidification. Please attach a Material Safety Data Sheet for the product, if necessary.
WASTE DISPOSITION
If the waste is Foundry Waste or Wood Ash, indicate whether or not it is being used as fill material in accordance with the
requirements of ADEM Admin. Code r. 335-13-4-.26(3) and/or (6). Supply the name(s) and permit number(s) of the intended
landfill(s).
CERTIFICATION
The certification for submitted information must be signed and dated by an authorized representative of the company.
PROFILE/CERTIFICATION NUMBER
If this is a recertification or a modification to an existing certification, enter the six-digit profile number assigned to the profile
by the Department.
E-mail or mail completed form, pertinent analyses, and applicable fees (specified in Division 1, Chapter 6 (335-1-6) of the
ADEM Administrative Code) to:
wasteapprovals@adem.alabama.gov
Or mail your profile to:
Waste Disposal Approvals
Land Division
Alabama Department of Environmental Management
PO Box 301463
Montgomery, AL 36130-1463
