HomeMy WebLinkAboutContract 45320 M AWL LLATM
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FORT WORTH, cw"cT
Noll
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C V OF FORT WORTH..
C -D G,ESTION FEED STOCK- DELIVERY AGREEMENT
This Agreement, is entered into this I0. day of 20 by and between, the C w .
of Fort Worth (CITY),_ a ub its duly authorized Assistant City Manager,
Fernando Costa a: � � ," "ic er, �6 Z1, C*- (Hauler), by and throw h its
duly zed i
authorized �,
'/""hr P
WHEREAS, the CITY's Village Creek Water Reclamation Facility (VCWRF)
orated at 4500 Wiima Lane, Arlington, Texas, his the capability to accept and process
orgamc waste, grease and food waste that meet the testing characteristics set by the City
(collectively referred to as Co-digestion Feed Stock) and,-
Hauler would c to dispose of its Co-digestion Feed Stock at the VC
NOW THEREFORE., cons .crat on of the mutual promises and benefits of this agreement,
the CITY and Dauer agree as -follows,
LQN1-EjS:[.QjE]:HE WA�3:E
I. For the purposes of this agreement. Co-digestion Feed Stock shall mean b.I* -w
degradable, non-toxic organic waste amenable to anaerobic digestion as
determined y the CITY
2. Hauler may only deliver - to the VCNAW Co-generafilon facHity materials as
approved and shown can the Generator Waste Prole Sheet attached, as Exhibit A tc
this agreement. Hauler shall obtain the signature of the generator on the Generator
Waste Profile sheet prior to the any disposal at the V C W F w
3. A Hauler may not discharge any material which may, for any reason contain
hazardous waste as dine by the Resource Conservation and Recovery Act, 42 USC
Section 690 etw seq, nor any hazardous substances as defined ne in the
Comprehensive Enviromnental Response, Compensationand Liability Act, 42
USC Section 960 et. seq., nor any, material that contains any amount of material
of a own origin whit may itself, or in co,m w t o with ether components ca e a
detrimental. Pact to the anaerobic digestion process. All material must be,,V capable of
being pumped t -ou h a 0.5 Inch screen. Hauler may not deliver a. atcr a s
OFFICIAL,
Clory SECRIEURY
RECEIVED
FT WORTH, *rX
which alone or in combination with, other material may cause obstruction or damage
to the facility.
4. CITY may, at its sole discretion and without prior notice, ref-use to accept at its
facility and reject for processing any materials, it deems may contain hazardous
waste, or be incompatible for processing at the VCWR-F. Acceptance of any
materials by the CITY shall in no way limit the flauler's liability for damages or
violations of any applicable laws. If waste accepted at the facility is tested and is
proved is 'incompatible with the process, the Hauler shall remove the waste from
VCWRF at the Hauler's expense. If the City deems it necessary to remove the waste,,
the CITY may remove the Waste at the Hauler"s expense.
5. For the purposes of deterrru-m"ng the chemical, physical or biolo 91 ical characteristics
of any material presented at its facility for discharging,, CITY reserves the night, at
its own expense,, to sample and analyze material prior to permitting its discharge or
F n I I I
any time thereafter. The Cl' Y has the Wight to inspect and sam pie fiac'fides associated
With the generation of accepted waste. CITY has the night to change the classification
and any associated fees for waste delivered based upon the results of laboratory
analyses performed on the waste sample.
6. No Waste Will be accepted which may cause pass-thXough or interference for the
CITY's,utility or system.
D15EUSAL HATESAND,WASIE L.LASSILICAT
HAJLS AZJD JjjLLjNjj--
7. Rates shall be set by the City Council and may be amended from time to time.
8. Hauler will receive a bill from the CITY on a monthly basis. All bills must be plaid
within thirty (30) days from the date of the invoice. If the bill is not paid within, (30)
days from the date the bill is due, the agreement will be suspended until the payment
is completed or make payment arrangements with C I T Y
TIML .Q.F. DIS!LHAR
9. The CITY shall accept Co-digestion Feed Stock at the VC)AW -for disposal Monday
through Saturday in accordance with the schedule as coordinated through the Facility
Superintendent, except as referred to in paragraph 18 or in an emergency situation as
deli ned by C I T Y-
10. It is the responsibility of-the Hauler to discharge the Co-digestion Feed Stock into
the receiving area set up to receive Co-digestion Feed Stock at the CITY facility.
MEIMD QE DIS!LHARUL
11'. Pn"or to discharging any Co-digestion Feed Stock, the Mauler must check in and
sign a delivery ticket (the "Ticket"). The Ticket will state the:
(a) date
(b) timel
(c) name of Hauler;
(d) origin and type of Waste being offered for disposal.
(e) volume e of the truck,
(f) volume of Waste being offered for disposal
(g) name of the CITY repress tat.ve accepting the ti cl et
(h) signature of driver delivering the waste.
12. The CITE"" will supervise the discharge of Co digestion Feed Stock at the VCWRF
and instruct the Mauler as to the rate of flow at which to discharge the Co-digestion
Feed Stock. Discharge of aste from truck must be pumped using to IIauler's own
p gip. Blowing o f of waste 's prohibited sunless authorized in writing by the
CITY.
13. No Co digestion Feed Stock may be discharged into, the scptage receiving area.
Prior,to each truckload of w aste being discharge, it is the responsibility of the Mauler
to notify CITY personnel o f its intent to discharge Co-digestion Feed Stock. Hauler
will not discharge any Co-digestion Decd St ock until notified by CITY personnel to
begin discharging.
1 . The Hat.lcr •11 be responsible for the clean-gaup and removal of any Co-digestion,
Feed Stock and other materials spilled by the Hauler can CITY property as well as
Co-digestion not properly discharged by Hauler into the receiving area.
15. Pn"or to any delivery, the Mauler must attend a plant orientation class and be
familiar with and comply with all CITY rules for the VCWR ". Hauler shall
adhere to all posted speed li rn.%ts and safety rules, at all times.
I
16. Hauler er shall comply with all munl*cipal, State or Federal environmental laws for the
hauling and discharging of any and all waste.
17. A. For purposes of this agreement, the following words and phrases shall he
defined as fellows
I. Environmental Dameiges shall. mean all claims, judgments, damages, losses,
penalties, Imes., liabilities including strict liability), encumbrances, liens,
costs, and eaxp�enscs of "nvestigation and defense of any claim, whether or not
such claim is ultimately dcleatcd, and of any goad faith settlement or
IN
0
judgment, of"whatever kind or nature nngen
, cotit or otherwise, matured or
unmatured, foreseeable or unforeseeablel including without limitation
reasonable attorneyis fees and disbursements and consultant's fees, any of
which are incurred as a result of handling, collection, trans portation, storage,
disposal, treatment, recovery, and/or reuse of waste pursuant to thi's co,ntract., or
the existence of a violation of environmental requirements pertaini'ng to, and
V
including without limitation,,,
a,. Damages for personal Injury and death, or injury to property or natural
resources;
b. Fees incurred for the services of attorneys, consultants, contractors,
experts, laboratories, and all other costs 'in connection with the
investigation or remediation of such wastes or violation oi
environmental requirements including, but not limited to�, the
preparation of any feasibility studies or reports of the performance of
any cleanup, remediation, removal, response., abatement, containment.,
closure, restoration or monitoring work required by any federal., state or
local governmental agency or political subdivision, or otherwise
expended in connection with the existence of such wastes or violations
of environmental requirements, and including without limitation any
attorney's fees, costs and expenses incurred in enforcing this contract
or collecting any sums due hereunder; and
C. Liability to any third person or governmental agency to indemnify such
person or agency for costs expended in connection with the items
referenced in paragraph 2of this part.
2. Environmental requirements shall mean all applicable present and future
statutes, regulations, rules,, ordinances, codes,,, licenses, permits, orders,
approvals,,,, plans, authorizations, concessions, franchises, and similar, items, of'
all governmental agencies, departments, commissions, boards'. bureaus, or
states,, and political subdivisions, thereof
instrumentalities of the United States.,
and all applicable udicial, administrative, and regulatory decrees, judgments,
j I I
and orders, relating to the protection of human health or the environment.,
including without limitation:
a. All requi*rements, including, but not limited to, those lie rtaim*ng, to
reporting, licensing, permitting, Investigation, and remedl"ration of
discharges, releases.
emissions, or threatened releases of hazardous
materials, pollutants, contaminants or hazardous or toxic substances,
materials, or wastes whether solid, liquid, or gaseous in nature, into the
air, surface water, groundwater, stormwater, or land, or relating to the
manufacture, process-Ing, distribution, use, treatment, storage, disposal,
transport, or handling of pollutants, contaminants, or hazardous or toxic
4
substances', maten*als, or wastes, whether solid,, liquid, or gaseous in
nature, and
b�. All requirements ertai,ning to the protection of the health and, safety, of
employees or the public.
B. GENERAL INDEMNIFICATION. HAULER DOES HEREBY RELEASE,
INDEMNIFY, REIMBURSE, DEFEND, AND HOLD, HARMLESS, THE CITY,
ITS OFFICERS, AGENTS, EMPLOYEES AND VOLE TEERS, FROM AND
AGAINST ANY AND ALL LIABILITY, CLAIMS, SUITS , DEMANDS,, OR
CAUSES OF ACTIONS, WHICH MAY ARISE DUE TO ANY LOSS OR
DAMAGE TO PERSONAL PROPERTY, OR PERSONAL INJURY, AND/OR
DEATH OCCURRING AS, A CONSEQUENCE OF THE PERFORMANCE OF
THISAGREEMENT, WHEN SUCH INJURIES, DEATH., OR, DAMAGES ARE
CAUSED BY THE NEGLIGENCE OFHAULER, ITS OFFICERS', AGENTS,
OR EMPLOYEES, OR THE JOINT NEGLIGENCE OFHAULER, ITS
OFFICERS, AGENTS, OR EMPLOYEES, AND ANY OTHER PERSON OR
ENTITV.
Ce, ENVIRONMENTAL INDEMNIFICATION: HAULER DOES ICE
RELEASE, INDEMNIFY, DEFEND, FIMBURSE, AND HOLD HARMLESS
THE CITY, ITS OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS,
FROM ANY AND ALL ENVIRONMENTAL DAMAGES AND THE
VIOLATION OF ANY AND ALL ENVIRONMENTAL RFQU IRE MEN TS
RESULTING FROM THEHAULERIS TRANSPORTING OR DISPOSAL OF
WASTE ANDALL RELATED ACT IVTIES UNDER,'THIS AGREEMENT.
18. CITY may in its sole discretion and \"ithout prior notice, refuse to accept the
d'Ischarge of Co-digestion feed s,toick from Hauler at times of treatment plant upset,
high 'Influent flow conditions or for any other good, cause as determined by CITY
personnel,.,
:[LM A
:LUbMATION,
ull and
19. The to of this Agreement shall be for five (5) years, from 'the date of f
complete execution. U on mutual written amendment, this Agreement may be
P
renewed for up, to five (5)one(I) year term.
g 0
20. Either party may term1nat(-,,% this agreement by, 'vmgtfurty (30) days written notice
to the other party. All indemnifilcablon provisions in the Agreement shall survive
termination.,
INURANLE RLQUEEMENIS
21. The Hauler shall at its own cost and expense maintain, and shall cause its
subcontractors to maintain insurance in the minimum amounts as set Earth below.
The Hauler shall name the City as an additional insured 'n its policies for the
insurance coverage regUired herein and a certificate of insurance evidencing The
required *i ance coverage shall he filed by the Hauler With the CITY. The CITY
shall he given 30 days written notice prior to ter -nation or reduction of such
insurance. The Hauler shall keeps in force the following types of insurance in a
company or comperes acceptable to the CITY.
A) Comprehensive lanes Liability Insurance
Minimum Policy Limits of ,000,000.00 per occurrence/ $2,000,000.00.
Aggregate and must include Completed Operations Liability. Policy must
be endorsed to slow CITY as additional Named Insured.
B) Worker's Compensation and Employee's Liability Insurance covering all
employees engaged directly and indirectly in the,disposes of Waste at the
CITY facility. Coverage l's to comply with Texas Statutes ,end include
coverage for proprietors, Partners and/or Executi^ve Offices. E L µ`RS
LIABILITY ii 'ts of'$500,000.00 for each accident/disease rewired.
C) Automotive and Other Vehicle Liability Insurance covering,all.
Combined Sing ie ,Limit (CSL)owned,, non-owned, and hired veucies in
the n i murn amounts:
. Bodily Injury- M
Di) Property Insurance
The Hauler is required to insure his/her own Prop rty. The CITY shall not
prr v*de any insurance on the uler's property.
E Additional Insured.
The Hauler shall name the CITY as an additional insured on the Certificate of
Insurance.
COSI OF LNEQJJCFMN'j,
2., The Hauler shall reimburse CITY for all costs, Including reasonable attorneys' fees
and costs
of suit incurred by CITY in enforcing this Agreement as a result of the
,at .er's violation of any provision of this Agreement.
TI.CE
23. All invoices, notices, requests, demands and other communications herein shall be
in writing and shall be deemed to have been duly given, I*f delivered via fax, in
person or mailed by first class U.S. mail, postage pre-paid.
of For Worth 1NSERTgPM NY NAME
Mir. erry Freed (company Name) 131,177 Z C-
Village Creek water Reclamation Facility (Address) 5 0 OA'a a t 0
Fort Worth Water Department (Phone)
4500,Wilma Lane
Arlington,Texas 760112
Phone: 817-392-4,9126,
VCWRF phone: 817-3,912,-4920,
T 1NG..i[D-.,HONLTOMG
24. The Hauler warrants that acquired and shall maintain, all required State and Federal
licenses and permits to haul waste. "rhe Hauler shall be solely responsible at its own
cost and expense for requirements mandated by the Texas Commission on
Environmental Quality (TCEQ) and the 'United States Environmental Protection
Agency (USEPA), or pursuant to any other local, municipal, State or Federal
environmental law. Copies of any waste analysis reports or any other documentation
sent to or fro the TCEQ and USEPA shall be filed with the CITY.
ENTIRE AIJILEMEN1
I "
25. This Agreement represents the entire agreement oetween the parties and supersedes
and nullifies any prior agreement. Any modification,or addition to the agreement
must be 'in writing signed by both parties.
26. Venue and jurisdiction of any suit, n*ght1,,or cause 01 action ansing under, or in
connection With this Agreement shall.,lie exclusively in Tarrant County,Texas.
IN WIT' SS W I uted this Agreement this
,..,,H]EREOF, the parties hereto have made and exec
dav of vi" A.D., 20
CITY OF FORT WO
we
City ." Mr. Fernando Costa
f oRr I itle.- Assistant City Manager
0 "
Rec,. ode . b
Ink
o ,
w
i �
astia i hers .
Title-., Asst. Dir. Water Resource covert'
Fort Worth Water Department
pproved as to Form and Legal* .
Date:
Ms. Christ Reynolds
Title: Sr. Assistant City Attorney
(INSERT MPA.NY AME Witness
1,
C,V,/I
Title.,
Date: Date:
OFFICIAL RECORD
CITY SECRETARY
WORTHv TX
Policy Number-. Date Entered:1/9/2014
AC<:>Rf> CERTIFICATE OF LIABILITY INSURANCE DATE(MNVDD/YYYY')
1/9/2014
THIS CERTIFICATE IS ISSUED AS A MATTER, OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HIOLDE,R. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AM.END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITIJTEI A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND;THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,, the policy(iesl must be endorsed. If SUBROGATION IS WAIVED,, subject to
the terms and conditions of the policy,certain poli�cies may require an endorsenwnt. A staternient on this certificate does not confer rights tothe
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Nelson Insurance Agent ,AM,E"":-,"" L,I"SA_HULL
- ,
H
PONE (8�117)27'4-1445 FAX 817)795-7881
,_: I—,.........
2340 W. Interstate 20, Suite #2012 E-MAJL lisa@rniagenay.com
ADDRESS,
Ax1ington, Tx 761017
�NSURER(S)AFFORDING COVERAGE Na IC#
.ESSEX INSURANCE CO:.
INSURER A.
MSURED Bio Liquid Materials Trucking,, LILC INSURER B'Carolina Casualty
DBA BIX Trucking INISURERC.Texas Mutual Tnsurance Co.
114 Shady Brook C INSURER,D:
Joshua, TIX 76058
IN E.'
INSURER F
ry
COVE RAGE$ CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERIM OR CONDITION OF ANY CON TRAM:1' OR OT R DOCIUMENT WITH RESPECT TO WHICH Tl-ilS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED, HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOW14 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
....... ..... tu �POLICY EF F I—_POLXY"EXP
LTR o TYPE OF IN IN SR VAO POLICY NUMBER (MWDDIYYYY) (MWDDNYW) LIMITS
GENIERAL LIABILITY E-',ACFi 0CC1JRREf,1CF_ 1 0 0 0,0,0 0
01 1 06/10/2013 36/i.0/203A LjAQW�E T()'AtNTEb ..........
A COMMERC4AL GENE RK,UABILITY X 3DK417 9 4 11010,000
>
0_AIMS-MADE X IOC,CUR r MED E7XP'(Any one person) 51000
PERSONAL&,I'kDV INJURY �$I/"Of000 m.. � � GENERAL X3,GREGSATE S2,0100,000 e..... . ......... -----------
GEN:111..A1GG)*f`ZEGATE I-IMIT APPLIES PER. PRODLr,,TS-COMP/OP AGG, S INCLUDED
f PRO.
o POLILL jE-C;T L 0C
r"Im- Sl OL LIM111i
AUTOMOBILE LIABILITY
(E2 ncrtdent) S10,0 1 00,000
3 ANY ALSO CBP344728 6/10/2013 06 1 0/2014 1 BI OILY INJURY(Per person)
Al-L OWNED S'04EDULED B001 LY�N JILJ RY(Peir acci dent)
AUTOS AL.11"OS
NONOWNED PR,<)Pii� i:JAMAGE
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xHIRED MffOS AUTOS j (Per act;ilden
UMBRELLA LAB
OCCUR EACH CCCURRE141Cf
I :-:
EXCESS LIAB -AIM&MADE A(GGREGATE s,
...............
DED RETENPON S $
WORKERS COMPENSATION W'C SI'ATU- dfA_J_l
AND EMPLOYERS'LIABILITY
14
ANY PROPRIEl'ORtPARTNER�/E-.XECU'T'I'VE Y I N 1i/',i.i,/2013 11/11/20714 _A slf000r000
TSF-000121'7940 E-L F -i ACCIDE34T
A
C OFFICERIMEMBER EXCL.UDED? N I 0 1 100,0"0010
(Mandatory in NH)
desciiib e u nde r POLICY LIMIT 1 0100 1000
D RiPTION OF IPM ATIO(IIS below f 6/10/20 El.DISEASE
F
B �CARGO CBP344728 13 )6/10/2014 BROAD FORM 100 f 000
DEDUCTIBLE, 11000
DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES (Attach ACOI 101,Additional Remarks S hedulle,If more space is requiredi)
DESCRIPTION OF OPERATIONS - TRUCKING
CERTIFICATE HOLDER IS LISTED, AS ADDITIONAL INSURED ON GENERAL LIABILITY AUTO LIABILITY POLICIES
30 DAY NOTICE OF CANCELLATION (OTHER THAN NON P.A_Y1xZNT, 10 DAYS) OR. MATERIAL CHANGE ON ALL POLICIES IN
11 AVOR (,)F, CERTIFTCAr", HO PER POLICY 'PRC)VTSI(XI4.9/ENDOR,.1-3F�IE14TS.
CERTIFICATE HOLDER CANCELLATION
CITY OF FORT WORTH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES,BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF OTICS WILL, BE DELIVERED 1-1
4900 WILMA LANE ACC01RDANCE WITH THE POLICY PROVISIONS.
ARLINGTON.. Tx 76012
T
AUTHORIZED REPgtE SENT ATIVE
@Y9 8-2010 ACORD CORPORATION. All rights reserved.,
ACO:RD 25(20101051 The ACORD name and folgo are registered marks of ACORD
Iroduced using Fxms 8oss Plus software.wvvw.FormsBoss.com*0 Impressive Publishing
EXHIBIT A
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Fol""I'll""I'll",'ll""I'll""I'll",'ll""IlI R,111111111111111111 r WO R, I
GENERATOR'S WASTE PROFILE SHEET
FOR THE CO-�DIGESTION PROCESS
AT VILLAGE CREEK WATER RECLAMATION FACILITY'
PLEASE PRINT IN INK OR TYPF
Service Agreement on File? YES, 'NO P ffl Number:
I., Generator Name-, Renewable Fuels I,I,C
2., SIC Code. 2869
3. Phone.-
4. Facility Street Address: —3102.-Windmi'll Rd
5. Facility City: Cleburne
6. State/Province: Texas
7. Zip/Postal Code
8. State: 'I"exas
9. Contact information (Nat and Phone number)–Frank Roy
817-558-9255
10, Billing Address-, Same as above
11. What is the main operation, overall purpose of the site or facillity?
Biodiesel Production
,lo
is "escrl*p%fion (This must be completed for each type of waste)
a. Nature of the Waste-,
Slop Oil fro�m Biodiesel Production
b. What is the process that generates the waste stream
Wash water used to purify the 'Incoming Tats and oils and finished biodiesel
c. Physical state (Circle) .- ui d Sludge
d. Layers (Circle) -, Si nle Multilayer
e. Free liquid range : 4 /? to %
f What are the Inputs into the process generating the waste?' 'What chemical solutions if any)
have been added during the waste generation processes? Wliat%concentration of clievvileal
solutions exists 16n the waste generated? Please prolvide the appropriate Material Safety,, Oata
Sheets.
Animal Fats,Vegetable olils, glyceri n, water and sodium hydroxide
g. What are the constituents of concern(e.g., pH,, COD, metals, hydrocarbons,etc)? Submit
,appropnate laboratory test results:
...........
Parameter Acceptable range in mg/f, Result in mg/L
COD > 60.P00
Total Solids, 4%, to pump,able at room
temperature
Volatile Solids High volatile/low residuals
Arsenic <0.25
.......... .......... ............
-Cadmium < 0.15
Chromium < 5.00
CoPper
... ............
Lead .2.9
Nickel < 2.00
leer < 1.00
7
Mercury
Zinc < 5.00
Cyanide < 1.0
Sulfate <500 mg/L
Coed ucti,vity, Reporting the data is required
TPH ( SGTHEM) Reporting the data is required
H* 5: to
� 8
P ............ ........... ................................j
*low PH for the waste will be cons]",dered I*f the to PH is due to the presence of organic
acids in the waste (Examples-, 1 Lactic acid, Acefic acid, Formic acid, Citn*c acid)
PmserWng natural rescur'ces in a chmVing war d"* � I 0
TA' EM, 1J'N"- 'C*
C.) b r&
Enm ental Chemistry
ANALYTICAL REPORT
d
Compliance Specialists- w
(Draft Report) T1047042 7-13-8
TALE TALEM ENVIRONMENTAL TAL SE ICES Date of Dra,ft Report: 111702014
610 SOUTH JENNINGS AVENUE
POINT WORTH,TX 76104
4
TEL ( 36- 1
FAX:(81 ) 335-9830 � � 11
TALE TALEM Project 1O. 1401 0002
Attention Gary Lee
BLM Trucking
114 Shady Brook Ct. 2i'?
v
Joshua,TX 76055
Client Acct o 5533 Customer Project-. Write Profile
TALEM Lab ID No 140110002-001 Customer Sample Ili: Wet/Glycerin
Sample Matrix: Liquid Coll By: Gary Lce/Cst.. CollectDate/"l ime 1/101201 4 9:20
Dltn Test Test QC Ref
Ana1yte Result Unit Fete Procedure MDL P !L Art Date/Time Number
u'ffate mg/L 1 AS v1l C51 6-90 2.5 2
Arsenic mg/L 1 EPA 60 11C 0.006 0.050
Cadmium leg 1 EPA+501'01C 0.0016 0.010,25
Chromium mg/L 1 EPA 501 OC 0.0022 0.010
Copper mg/L 1 EPA 60100 0.00112 0.010
Lead mg/L 1 EPA 501 OC 0.0068. 01.050
Nickel mg/L 1 EPA 601 OC 0.008 0,050
Silver mg/L 1 EPA 601 OC 0.0017 0,01
Zinc mg/L 1 EPA,601 OC 0.050
Mercury L 1. EPA 7470A 0,...15 0.20
Speck Conductance @ 25C 2000 Ira hos/cm 1 EPA 9050a 25 jvl! 1/1512014 C-140115025
Cyanide Total mg/L 1 Lachat 10-204- 0.0021 0,020
Taal Volatile Solids mg/L 1 SM 2540E 5
pH 5.75 pH Units 1 Sly'4500!H+B 4.o 5.� /15/20143,-00,*OOPNQC-140'1160011
Chemical 4 gen Demand 4600010 mg/L 1000 Sl l 51220D 5900 25000 h rt 1/14/2014 C-140114023
TPH to 012) mg/'L 1 TX 1005 5.0
TPH C>12 to C23 mg/L 1, TX 1005 5.0
TPH(C>28 to C35) mglL. 11 TX 1005 5.0
TP HI 5 to 035)"Total TPH mg/L 1 TX 1005 5.' .
Test results contained within-this data package--meet thee-requirements of the'Natfonal Labor tmr Meted/ io
Conference EL r+ unless otherwiswindicated. Page 1 of 1
Are,asterisk * denotes test.1 arameters-which are not-ccver+ed'bar the scope of our NE LAC accreditation.
r1%
h. What is the current and or past method of disposal for this waste,stream!
Material has been cornin 9 to Village Creek :for past 7 months
i Do you use Quater ,,iry Ammoni um Sanifixer SOILIti-ons, a to?t your facill
Yes, No Not Sure
Please ,list all the sanitizers used at the facility and provide MSDS for each., if it has
riot been provided as a part of Pretreatment Permit Application:
Nose--
2. Quantity of Waste (This must e completed for each type of waste)
a. Estimated Annual Volume:
5 00,000 gallons/year___
b. Estimated volume in a weekly basis'.,
30,000 gallons/week.-
must Shipping Information (��hi$I s must oc completed for each type of waste),
a. Method of shipment (circle! applicable melbod):
• Contract Hauler
• City of Fort Worth Permitted I lauler Trucks
• Facilities own trucks
b. Estimated volume r shipment.- ---.5000 gallons
c. Shipping frequency,* (01'rcle) 1.) Weekly Bi-weekly Other:
4. Generator Certifficaflon
By signing this profile sheet, the generator, (or the generator"s authorized representative)
certifies that all information submitted on this profile and attached documents are true and
correct. In addition, the generator certifies that-. 1) The waste being delivered, is not
hazardous waste or material as defitied by any and all local, state and federal laws, with the
exception for waste with a low pH due to the presence of organi I c acids; 2) this profile sheet
and its attachments contain true and accurate descriptions of the waste maten*al- 3) All
relevant information regarding known or susplected hazards have been disclosed; 4) that the
generator will immediately notify the CITY of any mater l change in the composition of
the waste which, could result in the waste otherwise being characterized, as hazardous, 5)
that the generator shall not deliver or arrange for delivery., waste material to the CITY that
does not conform to the description in the profile; and 6) that the generator shall
INDEMNIFY AND HOLD THE CITY OF FORT WORTH HARMLESS FROM
ANY AND ALL DAMAGES, EXPENSES, FINES OR PENALTIES R-ESULTING
FROM ANYWASTE DELIVERED TO TEL VCWRF,
-.11" "111"r 00-* '001
Signatum,.'- ................. Date
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