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OIFIED PROGRAM CONSOLIDATED F <br /> FACILITY INFORMATION <br /> BUSINESS ACTIVITIES <br /> Pae 1 of_ <br /> I. FACILITY IDENTIFICATION <br /> FACILITY ID# 1 EPA ID#(Hazardous Waste Only) <br /> BUSINESS NAME(Same as Facility Name of DBA-Doing Business As) 3 <br /> ConocoPhilli s Company#255417/5417/30877 <br /> II. 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 2730). <br /> Does your facility... If Yes,please com Tete 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 ®YES ❑ NO 4 CHEMICAL DESCRIPTION(OES 273 1) <br /> quantity for an extremely hazardous substance specified in 40 CFR Part 355, (This is repoerted with the HMMP.) <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 swRCB Form A) <br /> 1. Own or operate underground storage tanks? ®YES ❑ NO 5 UST TANK(one page per tank)(Formerly Form B) <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 Form C) <br /> 3. Need to report closing a UST? ❑YES ❑ NO 7 UST TANK(closure portion—one page per tank) <br /> C. ABOVE GROUND PETROLEUM STORAGE TANKS(ASTs) <br /> Own or operate ASTs above these thresholds: <br /> ---any tank capacity is greater than 660 gallons,or ❑YES ® NO 8 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 ❑ 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 MATERIALS REPORT(one <br /> recyclable materials(per HSC 25143.2)? ❑YES ONO 10 perrecycler) <br /> 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE <br /> ❑YES ® NO I 1 TREATMENT—FACILITY(Formerly Disc Forms <br /> 1772) <br /> ONSITE HAZARDOUS WASTE <br /> TREATMENT—UNIT (one page per unit)(Formerly <br /> DTSC Forms 1772 A,B,C,D and L) <br /> 4. Treatment subject to financial assurance requirements(for ❑YES ONO 12 CERTIFICATION OF FINANCIAL <br /> Permit by Rule and Conditional Authorization)? ASSURANCE(Formerly DTSC Form 1232) <br /> 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE/CONSOLIDATION SITE <br /> ❑YES ONO 13 ANNUAL NOTIFICATION(Formerly DTSC Form <br /> 1196) <br /> 6. Need to report the closure/removal of a tank that was classified as ❑YES ONO 14 HAZARDOUS WASTE TANK CLOSURE <br /> hazardous waste and cleaned onsite? 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 /> UPCF(1/99) 5 <br />