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Crosby and Overton, Inc . WASTE PRODUCT QUESTIONAIRE 110534 <br /> I.GENERATOR INFORMATION <br /> Generator Name: TESORO STOCKTON TERMINAL Billing Name: AMERICAN INTEGRATED SRVS"" <br /> Address: 3003 NAVY DR Address: 1502 E.OPP STREET <br /> City,State Zip STOCKTON,CA 95206 City,State,Zip WILMINGTON,CA 90744 <br /> Contact: Contact: REGGIE SANTOS <br /> Phone: <br /> Phone: <br /> Fax: Fax: 310-522-0474 <br /> EPA NUMBER: CAT000618637 <br /> Expiration Date: 19-DEC-19 <br /> II.WASTE PRODUCT DESCRIPTION&CHARACTERISTICS <br /> A.Waste Product Common Name: NON itC:RA SOL D.-.BROKEN GLASSi DEBRIS'WEIGHTTICKFI`US ECOLOGY DISPOSAL <br /> Process Generating Waste: SITE CLEAN UP <br /> B.Hazardous Properties: State Code(s) EPA Code(s) <br /> 1. US EPA Hazardous Waste? 352 <br /> 3. Is Waste Product Shock Sensitive Reactive Radioactive Pyrophoric Etiological X None <br /> C.Physical Properties at 70 deg F: <br /> 1.Physical State: 2. Layers 3. Flash Point(Closed Cup Only) 4,Viscosity,similar to: <br /> SOLID MULTILAYERED NONE SOLID <br /> D.1.Density: <br /> 1. Density 2%Solid 3,Odor 4.PH <br /> =60 LB/FT3 =100% 5.1-9 PH <br /> Any debris in waste: <br /> Explain: <br /> E.Chemical Composition(Account for 100%of total) Range Metals TTLC: Copper: <br /> CARBON1 100 % Total(PPM) Lead: <br /> CARDBOARD 1 20 % EP Toxicity (mg/I) Mercury: <br /> CONCRETE CEMENT(INPIECES) 1 100 % Antimony: Nickel: <br /> EMPTY SAMPLE GLASS JARS0 100 % Arsenic: Selenium: <br /> ----.-... <br /> GRAVEL 1 100 ° Barium: Silver: <br /> METAL DEBRIS(_STEE_L,ALUMINUMCAS�"iR 1 1$ % <br /> OIL_ ~0 10 % Beryllium: Zinc: <br /> PETROLEUM HYDROCARBON 0 - 10 % Cadmium: Molybdenum: <br /> PIASTIC PIPES,METAL PIPES, FITTING,TAN 0 - 100 % Chromium: Thallium: <br /> PPE.GLOVES RAGS-PADS,PLSKnC,WOOD, 1 100 <br /> SANDBLAST GRIT f4 1 - 100 % Cobalt: Vandium <br /> SOIL1 - 100 % <br /> Reactives,&Other Pesticides Herbicides: <br /> Wastes(PPM): Endrin, <br /> Cyanides: Lindane <br /> Dioxin: Methoxychlor: <br /> Sulfides: Toxaphene: <br /> PCBs: <br /> P24D: <br /> HOC: P245TP: <br /> Phenols: POther: <br /> F.Shipping and Handling Information: <br /> 1. D.O,T,Hazardous Material? 2,D.O.T.Shipping Name: NON RCRA HAZARDOUS WASTE SOLID <br /> 3. D.O.T.Hazard Class: 4.D.O.T. ID Number: Packing Group: <br /> 5. Method of Shipment: Drum X Bulk_Other 5.D.O.T.Shipping Container: <br /> 7. Projected Volume: <br /> Comments: <br /> GENERATOR CERTIFICATION STATEMENT: I hereby certify that as an authorized representative of the generator named above,all information submitted in this and all the <br /> attached documents is true and accurate. Analysis of the waste was conducted in a ccordance with the approved test methods in 40 CFR 261 on a representative sample as defined <br /> in 40 CFR 261.20, To the best of my knowledge,all known(40 CFR 261)and suspected hazardous components have been included in this documentation. All material and packaging <br /> will comply with all current regulations. <br /> Generator's Authorized Signature Tdfe Late: <br />