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IED PROGRAM CONSOLIDATED FOID <br />FACILITY INFORMATION <br />BUSINESS ACTIVITIES <br />Pae 1 of 1 <br />L FACELITY IDENTIFICATION <br />FACILITY ID # <br />1 <br />EPA ID # (Hazardous Waste Only) 2 <br />(Agency Use Only) <br />BUSINESS NAME (Same as Facility Name of DBA -Doing Business As) <br />GI Trucking DBA - Estes West <br />3 <br />BUSINESS SITE ADDRESS 7611 S Airport Way 103 <br />1n" <br />CA <br />ZIP CODE toy <br />BUSINESS SITE CITY Stockton <br />95206 <br />H. ACTIVITIES DECLARATION <br />NOTE: If you check YES to any part of this list, <br />lease submit the Business Owner/Operator Identification page. <br />Does your facility... <br />If Yes, Please com lete 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 />HAZARDOUS MATERIALS <br />55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed <br />EYES ❑ NO 4 <br />INVENTORY - CHEMICAL <br />gases (include liquids in ASTs and USTs); or the applicable Federal threshold <br />DESCRIPTION <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. REGULATED SUBSTANCES <br />Have Regulated Substances stored onsite in quantities greater than the <br />threshold quantities established by the California Accidental Release <br />❑ YES ENO 4. <br />Coordinate with your local agency <br />prevention Program (CalARP)? <br />responsible for CalARP. <br />C. UNDERGROUND STORAGE TANKS (USTs) <br />UST FACILITY (Formerly SwaCB Form A) <br />Own or operate underground storage tanks? <br />E YES ❑ NO 5 <br />UST TANK (one page Per tank) (Fomealy <br />Forma <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 />0-YESNO s <br />46" <br />NO FORM REQUIRED TO CUPAs <br />aboveground tanks or containers. <br />baa <br />E. HAZARDOUS WASTE <br />Generate hazardous waste? <br />❑ YES E NO 9 <br />EPA ID NUMBER- provide at the <br />top of this page <br />Recycle more than 100 kg/month of excluded or exempted recyclable <br />RECYCLABLE MATERIALS <br />materials (per HSC 25143.2)? <br />❑ YES E NO to <br />REPORT (ooeper r«yel r) <br />Treat hazardous waste on-site? <br />❑ YES E NO it <br />ON-SITE HAZARDOUS WASTE <br />TREATMENT -FACILITY <br />ON-SITE HAZARDOUS WASTE <br />TREATMENT -UNIT (ore page per unit) <br />Treatment subject to financial assurance requirements (for Permit by Rule and <br />Conditional Authorization)? <br />❑ YES E NO 12 <br />CERTIFICATION OF FINANCIAL <br />ASSURANCE <br />' Consolidate hazardous waste generated at a remote site? <br />REMOTE WASTE / <br />❑ YES E NO 13 <br />CONSOLIDATION SITE ANNUAL <br />NOTIFICATION <br />Need to report the closure/mmoval of a tank that was classified as <br />❑ YES E 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 />Obtain federal EPA ID Number, <br />more of federal RCRA hazardous waste, or generate in any single calendar <br />❑ YES ENO 14. <br />file Biennial Report (EPA Form <br />month, or accumulate at any time, 1 kg (2.2 pounds) of RCRA acute hazardous <br />8700-13AB), and satisfy <br />waste; or generate or accumulate at any time more than 100 kg (220 pounds) of <br />requirements for RCRA Large <br />spill cleanup materials contaminated with RCRA acute hazardous waste. <br />Quantity Generator. <br />Household Hazardous Waste (HHW) Collection site? <br />❑ YES E NO 14b <br />See CUPA for required forms. <br />F. LOCAL REQUIREMENTS is <br />(You may also be required to provide additional information by yaw CUPA or local agency.) <br />