Hazardous Waste Tracking Form

Monthly Status: VSQG SQG LQG

VSQG = <220 lb./mo. SQG = 220 -2200 lb./mo. LQG = >2200 lb./mo.

Please notify Operations if VSQG status is exceeded in any month.

Facility Name:
Address:
Month:

Generation Date	Material	Qty. (Lbs.)	Disposal Date	NDOT#
Total (lbs.)

Common Material Density Reference Sheet

Material	Density (lb./gal.)
Aerosol Can (empty) – if not punctured and managed as scrap material	.25 lb. each
Antifreeze	8.9
Citrol	7.1
Diamond Vogel Orange Paint	7.9
Parts Washer Solvent	6.4 to 6.7
Pine-o-Cleaner	8.3
Windshield Washer Fluid	7.9

EXAMPLE:

Situation: 3 gallons of antifreeze from a vehicle.

Example Calculation: 3 gal. x 8.9 lbs./gal. = 26.7 lbs.