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Crosby and Overton, Inc. WASTE PRODUCT QUESTIONAIRE 57749
<br /> I. GENERAL INFORMATION
<br /> Generator Name: ST SERVICES LLC Billing Name: UNIVERSAL ENVIRONMENTAL INC.
<br /> idress: 2941 NAVY DRIVE Address: 4101 INDUSTRIAL WAY
<br /> City,State,Zlp STOCKTON CA 95206 City,State,Zip BENICIA CA 94510
<br /> Contact: BILL Contact
<br /> Phone: 209.9435662 Phone: 7077476699
<br /> Fax: 209-943-0908 Fax: 7077471927
<br /> FPA Numhar: CAT000617514 ExOlmtion nate: 5114/2008
<br /> 11.WASTE PRODUCT DESCRIPTION&CHARACTERISTICS
<br /> A. Waste Product Common Name: GASOLINE ETHANOL LUBRICANT
<br /> Process Generating Waste: AREA CLEAN UP
<br /> B. Hazardous Properties: State Code(s) EPA Code(s)
<br /> 1. US EPA Hazardous Waste? a Yes ❑ No 2 343 1 1 D001 I D016
<br /> 3. Is Waste Product: ❑Shack Sensltive ❑ Reactive ❑ Radioactive ❑ Pyrophoric ❑Etiological ❑✓ None
<br /> C. Physical Properties at 70 deg F: 2 Layers 3. Flash Point(Closed Cup Only) 4. Viscosity,similarto:
<br /> 1. Physical State: <70 deg F ,� Water
<br /> ❑ Solid ❑ Aerosol E] MultiLayered ❑ 70-100 deg F ❑
<br /> Ea Liguld El Lab Pack ❑ Bi-Layered ❑ 101-139 deg F ❑ motor Oil
<br /> ❑ Sludge ❑ Free Liquids © Homogenous ❑ 140.200 deg F ❑ Honey
<br /> ❑ Empty Container ❑ Any Free Liquids @ 70 ❑ No Flash ❑ Other
<br /> ❑ Deg F ❑ Exact c70 deo F
<br /> D. 1. Density: 4. Ph.
<br /> Liquid a 0 _ lbs/gallon 2. %Solids 3. Odor. []NIA
<br /> Solid: 0 lbs/cubic ft. ❑ By Weight ❑ None []<2❑ ❑ By Volume a Strong 2 5
<br /> Any debris in waste: Total: 0 ❑ Mild ❑
<br /> El Yes allo Describe: GAS 05.1-9
<br /> n9.1-12.5
<br /> Explain: >12.5
<br /> BExact 6.00
<br /> E. Chemical Composition(Account for 100%of total) Range Metals TTLC: Copper: rND
<br /> ETHANOL ,5 , — ,10 , % F______i Total(PPM) Lead: F4016 i
<br /> h----i h----1 , EP Toxiclty(mgvl) Mercury,
<br /> /o , -----
<br /> GASOLINE ,80 , — ,90 , --____, r--_-__1 rND----1
<br /> 1,----I r10---I ,�a Antimony: , , Nickel:
<br /> LUBRICITY(OIL) — F------1 r------1
<br /> 1-----4 _ -----I Arsenic: ND____ Selenium: ND___
<br /> Barium: FND Sliver. 11 -{
<br /> Beryllium: rND ; Zinc r9.I -�
<br /> , — , , F------1 F-----_I
<br /> Cadmium: ND____ Molybdenum
<br /> It -- r- -- f F - i F------i
<br /> Chromium: ,ND , Thallium:
<br /> Cobalt: rND �� Vandium:
<br /> Reactives,&Other Pesticides,Herbicides:
<br /> h-----I r-----I
<br /> Wastes(PPM): """ r------1
<br /> Endrin: , ,
<br /> I
<br /> r - y ------ Cyanides: 'r -
<br /> r
<br /> , , '-----1
<br /> Lindane
<br /> r-----I r-----I Dioxin: r -t Methoxychlor. , -I
<br /> Sulfides: , , r------
<br /> _-___-1 t
<br /> r-----f r-----I Toxaphene: , ,
<br /> r
<br /> h-----I r----7 PCBs: , , P24D: r------i
<br /> --- , , — , r-
<br /> -----tF------i
<br /> HOC: P245TP: , ,
<br /> F. Shipping and Handling Information: Phenols: L--_---, Pother. r
<br /> i am
<br /> 3. D.O.T.Hazard Class: 3 4. D.O.T. ID Number: UN1993 Packing Group II
<br /> 5. Method of Shipment o Drum ❑Bulk ❑Other 6. D.O.T.Shipping Container: DOT
<br /> 7. Projected Volume: 0 Tons: 0 Gallons 0 Cubic Yards 0 Other 8. RQ Amount 0 Per
<br /> Comments: RAMI
<br /> GENERATOR CERTIFICATION STATEMENT: I hereby certify that as an authorized representative of the generator named above,all imonnaton submitted in this and all the
<br /> 'Rached documents is true and accurate.Analysis of the waste was conducted in accordance with the approved test methods In 40 CFR 261 on a representative sample as
<br /> ined in 40 CFR 26120.To the best of my knowledge,all known(40 CFR 261)and suspected hazardous components have been Included In this documentation.All material and
<br /> ,ci aging will comply with all current regulations.
<br /> Generators Authorized Signature: Title Date
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