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HAZARDOUS MATERIALS/WASTE REGISTRATION FORM <br />(Individual quantities less than state Hazardous Materials Business Plan reporting require f WC E I VE D <br />For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br />Authority Cited: California Fire Code; Hazardous Materials Storage Ordinance <br />MAY 21 2009 <br />A. General Information SAN JOAQUIN COUNTY <br />OFFICE OF EMERGENCY SERVICES <br />This registration form is to be completed and returned to the appropriate local agency if your facility has hazardous materials and none <br />of the individual hazardous materials quantities equals or exceeds 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for <br />gases. If, at any time, any of your individual hazardous materials quantities equals or exceeds the above amounts, a Hazardous <br />Materials Business Plan (HMBP) may be required (pursuant to Chapter 6.95 of the California Health & Safety Code). If you must <br />submit a HMBP, this registration form is not required. <br />B. Facility Information <br />Business Name: AT&T Mobility - HWY 88 - E TOKAY COLONY RD (47625) Type of Business: Telecommunications <br />Site Address: 9303 EAST LIVE OAK ROAD City: STOCKTON Zip: 95212 <br />Mailing/Billing Address: 4430 Rosewood Drive City: Pleasanton, CA Zip: 94588 <br />If different from site address <br />Business Owner/Contact Person: Ellen Magnie <br />Property Owner: New Cingular Wireless PCS, LLC dba AT&T Mobility <br />EPA ID Number (if applicable): <br />C. Non -Waste Inventory Information <br />Phone No.: (510) 305-2553 <br />Phone No.: (510) 305-2553 <br />SIC Code: 4812 <br />Complete the table below for all non -waste inventory. Use additional pages if necessa . <br />Hazard <br />Chemical/Common Name <br />Max. Qty. <br />Container Size <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />318 ® lbs. <br />39.8 ® lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />❑ gal. <br />❑ gal. <br />❑ lbs. <br />❑ lbs. <br />❑ cu. ft. <br />❑ cu. ft. <br />Additional Information Required On Back <br />UN -012 - 1/18 http://www.unidoes.org Rev. 05/31/00 <br />