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' UNIFIED PROGRAM CONSOLIDATED FORM titULIVED <br />FACILITY INFORMATION <br />BUSINESS ACTIVITIES MAR 14 2012 <br />SA of 3 <br />I. FACILITY IDENTIFICATION Ji-HCE OF EMERGENC <br />FACILITY ID # <br />I <br />EPA ID # (Hazardous Waste Only) 2 <br />(Agency Use Only) <br />I <br />I <br />BUSINESS NAME (Same as Facility Name of DBA -Doing Business As) AT&T Mobility - WHISTLER WAY 106248 3 <br />BUSINESS SITE ADDRESS 10555 THORNTON ROAD 103 <br />BUSINESS SITE CITY STOCKTON 104 1 CA I ZIP CODE 95209 los <br />II. ACTIVITIES DECLARATION <br />NOTE: If you check YES to any part of this list, <br />lease submit the Business Owner/O perator Identification page. <br />Does your facility... <br />If Yes, please com <br />Tete these pages of the UPCF.... <br />A. HAZARDOUS MATERIALS <br />Have on site (for any purpose) at any one time, hazardous materials at or above <br />55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed <br />HAZARDOUS MATERIALS <br />gases (include liquids in ASTs and USTs); or the applicable Federal threshold <br />[DYES ❑ NO a <br />INVENTORY — CHEMICAL <br />quantity for an extremely hazardous substance specified in 40 CFR Part 355, <br />DESCRIPTION <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. REGULATED SUBSTANCES <br />Have Regulated Substances stored onsite in quantities greater than the <br />threshold quantities established by the California Accidental Release <br />[]YES ® NO 4� <br />Coordinate with your local agency <br />prevention Program (CalARP)? <br />responsible for CaIARP. <br />C. UNDERGROUND STORAGE TANKS (USTs) <br />UST FACILITY (Formerly swrtcB Form A) <br />Own or operate underground storage tanks? <br />❑ YES ONO 5 <br />UST TANK (one page per tank) (Formerly Form 13) <br />D. ABOVE GROUND PETROLEUM STORAGE <br />Own or operate ASTs above these thresholds: <br />Store greater than 1,320 gallons of petroleum products (new or used) in <br />❑ YES N NO s <br />NO FORM REQUIRED TO CUPAs <br />aboveground tanks or containers. <br />E. HAZARDOUS WASTE <br />Generate hazardous waste? <br />[]YES N NO y <br />EPA ID NUMBER — provide at the top of <br />this page <br />Recycle more than 100 kg/month of excluded or exempted recyclable <br />❑YES N NO 1� <br />RECYCLABLE MATERIALS REPORT <br />materials (per HSC 25143.2)? <br />(one perrecycler) <br />Treat hazardous waste on-site? <br />❑ YES N NO i <br />ON-SITE HAZARDOUS WASTE <br />TREATMENT — FACILITY <br />ON-SITE HAZARDOUS WASTE <br />TREATMENT — UNIT (one page per unit) <br />Treatment subject to financial assurance requirements (for Permit by Rule and <br />CERTIFICATION OF FINANCIAL <br />Conditional Authorization)? <br />❑ YES N NO 12 <br />ASSURANCE <br />Consolidate hazardous waste generated at a remote site? <br />❑ YES N NO 13 <br />REMOTE WASTE / CONSOLIDATION <br />SITE ANNUAL NOTIFICATION <br />Need to report the closure/removal of a tank that was classified as <br />❑ YES N NO 14 <br />HAZARDOUS WASTE TANK <br />hazardous waste and cleaned on-site? <br />CLOSURE CERTIFICATION <br />Generate in any single calendar month 1,000 kilograms (kg) (2,200 pounds) or <br />more of federal RCRA hazardous waste, or generate in any single calendar <br />El YES ®NO 14a <br />Obtain federal EPA ID Number, file <br />month, or accumulate at any time, 1 kg (2.2 pounds) of RCRA acute hazardous <br />Biennial Report (EPA Form 8700 - <br />waste; or generate or accumulate at any time more than 100 kg (220 pounds) of <br />13A/B), and satisfy requirements for <br />spill cleanup materials contaminated with RCRA acute hazardous waste. <br />RCRA Large Quantity Generator, <br />Household Hazardous Waste (HHW) Collection site? <br />[]YES N NO lab <br />See CUPA for required forms. <br />F. LOCAL REQUIREMENTS 15 <br />(You may also be required to provide additional information by your CUPA or local agency.) <br />UPCF Rev. (12/2007) <br />