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Hazardous Waste Inventory Statement Date: 07/01/2018 For use by Unidocs Member Agencies or where approved by your Local Jurisdiction Business Name: Quality Express Lube and Smog Type of Report on This Page: Page of (Same as Facility Name or DBA) ❑Add; ❑Delete; ❑Revise (One page per building or area) Chemical Location: EPCRA Confidential Location? ❑Yes; ®No Facility ID# (Building/StorageArea) Trade Secret Information? ❑Yes; ®No I (Agency useo"N " 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Map and Hazardous Components Type Quantities Storage Codes Grid or and Annual d ° Tax. —Average Lar W-ash torage Storage d Class Code Waste Stream Name Name Wt. EHS CAS No. State Daily Daily Cont. Amount Units Pressure Temp. Cate ones Base Lubricating Oils 75 El Mixture ®gallons ®amhim ®ambient ®fire Waste Oil ®waste 250 125 250 3000 Elpounds El>� 11>amb 11teat - Detergent Inhibitor Sys. 10 ❑ Mixture Curies: Days On Stora a State ❑•'feet ❑<amb. ❑<amb. ❑pressttrerelease Management Method: Viscosity Index Improver 15 ❑ Mixture ❑solid � ❑ ®Shipped Off-site ❑ ®liquid �rad1O�) Site: Container.* Waste Code: El tons ❑cryogenic acute health [I Recycled On-site ❑ 365 A CA-221 El chronic health ❑Treated On-site El gas— radioactive Ethylene Glycol Solution 50 El107-21-1 ®gallons ®ambient ®ambient ®fire Coolant Waste Water 50 El ®waste 120 50 120 750 ❑Pounds ❑>amb. ❑>amb. ❑reactive Manaeement Method: ❑ ❑solid Curies: Days On Storage State ❑•'feet ❑<amb. ❑<amb. ❑pressure release ®Shipped Off-siteEl ®11gUld (�rad'w`t—) Site: Contain er.• Waste Code: El tons ❑cryogenic Elaauehealth ❑Recycled On-site ❑gas 365 A 343 ❑chronic health ❑Treated On-site ❑ ❑radioactive Used Oil Filters ❑❑ ®waste 200 100 200 800 El gallons ®ambient El®ambient ®fire ®pounds ❑>amamb. >amb. ❑reactive Manaeement Method.• El ®solid Curies: Days On Storage State ❑a.feet ❑<amb. ❑<amb. ❑pressure release N Shipped Off-site 9 ❑liquid (lfred'oacme) Site: Container.* Waste Code: ❑tons ❑cryogenic ❑acute health ❑Recycled On-site ❑gas 365 D ❑chronic health ❑Treated On-site ❑ ❑radioactive ❑ ®waste ❑gallons ❑ambient ❑ambient ❑fire ❑ ❑pounds ❑>amb. ❑>amb. ❑reactive Management Method: ❑ ❑solid Curia: Days On Storage State ❑ar.feet ❑<amb. ❑<amb. ❑pressure release ❑Shipped Off-siteEl [:1liquid (ifradtmcme) Site: Container:- waste Code: EI tons, Eltoncryogenic Elaanehealth ❑Recycled On-site ❑gas ❑d nic health ❑Treated On-site ❑ ❑radioactive ❑ ®W�te El gallons Elambient ❑ambient Elfire 1:1 ❑pounds ❑>amb. ❑>amb. ❑reactive Management Method.• ❑ ❑solid Curies: Days On storage State ❑•.f®<a'nb_ ❑<amb. ❑pressure release ❑Shipped Off-siteEl ❑liquid (Rradmaarve) Site: Container:* Waste Code: ❑tons El cryogenic Elaartehealth ❑Recycled On-site ❑gas ❑chronic health ❑Treated On-site ❑ ❑radioactive ❑ El all gons ❑ambient ❑ambient ❑fire ®WaStC ❑ ❑pounds ❑-amb, ❑>amb. ❑reactive Management Method: ❑ ❑solid Curies: Days On sto,;,e state El..feet El<amb. ❑<amb. 1:1 press=release El Shipped Off-site El ❑liquid (brad radioactive) Site: Container: \afire Code: ❑tons 11cryogenic ❑sate health ❑Recycled On-site ❑gas ❑chronic health ❑Treated On-site ❑ ❑radioactive rk Code Storage Type Code Storage Type Code StorageType Code Storage Tvoe Code Storage Type If EPCRA,sign below: A Aboveground Tank D Steel Drum G Carboy J Bag M Glass Bottle or Jug P Tank Wagon B Belowground Tank E Plastic/Nonmetallic Drum H Silo K Box N Plastic Bottle or Jug Q Rai)Car C Tank Inside Building F Can I Fiber Drum L Cylinder O Tote Bin R Other UN-020 www.unidocs.org 9/17-Rev.12/14/10