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r <br /> t <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS ACTIVITIES <br /> Page 1 of <br /> I. FACILITY IDENTIFICATION <br /> FACILITY ID# A1 EPA ID#(Hazardous Waste Only) 2. <br /> (Agency Use Only) F 0 0 1 3 5 3 5 <br /> BUSINESS NAME(Same as Facility Name or DBA-Doing Business As) 3. <br /> LEVEL3 COMMUNICATIONS LLC <br /> It. ACTIVITIES DECLARATION <br /> NOTE: If you check YES to any part of this list, <br /> please submit the Business Owner/Operator Identification page(OES Form 2734). <br /> Does your tacili If Yes,please com lete these pages of the UPCF... <br /> A. HAZARDOUS MATERIALS <br /> Have on site(for any purpose)hazardous materials at or above 55 gallons for <br /> liquids, 500 pounds for solids, or 200 cubic feet for compressed gases HAZARDOUS MATERIALS INVENTORY <br /> (include liquids in ASTs and USTs); or the applicable Federal threshold BYES ❑ NO 4. --CHEMICAL DESCRIPTION(OES 273 1) <br /> quantity for an extremely hazardous substance specified in 40 CFR Part 355, <br /> Appendix A or B; or handle radiological materials in quantities for which an <br /> emergency lan is required pursuant to 10 CFR Parts 30,40 or 70? <br /> B. UNDERGROUND STORAGE TANKS USTs UST FACILITY(Formerly SWRCa F.A) <br /> 1. Own or operate underground storage tanks? ❑YES 0 NO 5 UST TANK(one page per tank)(Formerly Form H) <br /> 2. Intend to upgrade existing or install new USTs? ❑YES ® NO 6. UST FACILITY <br /> UST TANK(one per tank) <br /> UST INSTALLATION-CERTIFICATE OF <br /> COMPLIANCE(one page per tank)(Formerly Farm C) <br /> 3. Need to report closing a UST? ❑YES ® NO 7. UST TANK(closure portion—one page per tank) <br /> C. ABOVE GROUND PETROLEUMSTORAGE TANKS(ASTs) <br /> Own or operate ASTs above these thresholds: <br /> ---any tank capacity is greater than 1,320 gallons,or EYES ❑ NO a. NO FORM REQUIRED TO CUPAs <br /> ---the total capacity for the facility is greater than 1,320 gallons? <br /> D. HAZARDOUS WASTE <br /> 1. Generate hazardous waste? ❑YES M NO 9. EPA ID NUMBER—provide at the top of this <br /> page <br /> 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT(one <br /> materials(perH&SC§25143.2)? ❑YES ® NO to, perrecycler) <br /> 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE <br /> ❑YES ® NO 11 TREATMENT—FACILITY(Formerly DTSC <br /> Forms 1772) <br /> ONSITE HAZARDOUS WASTE <br /> TREATMENT—UNIT (ane page per unit)(Formerly <br /> DTSC Forms 1772 AB,C,D and L) <br /> 4. Treatment subject to financial assurance requirements(for Permit by CERTIFICATION OF FINANCIAL <br /> Rule and Conditional Authorization)? ❑YES ONO 12. ASSURANCE(Formerly DTSC Form 1232) <br /> 5. Consolidate hazardous waste generated ata remote site? REMOTE WASTE/CONSOLIDATION <br /> ❑YES ONO 13. SAT-ANNUAL NOTIFICATION(Formerly <br /> DTSC Form 1]96) <br /> 6. Need to report the closure/removal of a tank that was classified asHAZARDOUS WASTE TANK CLOSURE <br /> hazardous waste and cleaned onsite? as []YES ® NO 14. CERTIFICATION(Formerly DTSC Form 1249) <br /> E. LOCAL REQUIREMENTS 15 <br /> (You may also be required to provide additional information by your CUPA or local agency.) <br />