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CO0051960
EnvironmentalHealth
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2500 – Emergency Response Program
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CO0051960
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Entry Properties
Last modified
1/12/2021 4:09:53 PM
Creation date
6/4/2020 3:32:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0051960
PE
2546
STREET_NUMBER
1900
STREET_NAME
ROOSEVELT
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22716025
ENTERED_DATE
5/15/2020 12:00:00 AM
SITE_LOCATION
1900 ROOSEVELT AVE
RECEIVED_DATE
5/15/2020 12:00:00 AM
P_LOCATION
06
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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- NOW r�a° <br /> �0 <br /> PACIFIC GAS AND ELECTRIC COMPANY Pacific Gas and <br /> HAZARDOUS WASTE SHIPPING PAPER Electnc Company <br /> SHIP FROM _ <br /> NAME: Pacific Gas and Electric Company- SHIP TO <br /> LOCATION I ADDRESS: C NAME: Pacific Gas and Electric Company- <br /> � J2 ADDRESS: <br /> CITY: CITY: <br /> State: CA Zi STATE: CH ZIP:- TELEPHONE: <br /> DATE GENERATED: SHIPPED: <br /> ARRIVED AT CONSOLIDATION SITE 1: I 1 <br /> Was this waste held at any interim location? PesNo (circle one) Emergency Contact: RSC Industrial Outsourcing,Inc. 844.334.2468 <br /> If yes,facility name and address: L f ,,, f r� Name of Driver, J i! �: f; �f (Internal Job Number <br /> Number Of container REMOTELY GENE TED HAZARDOUS WASTE` CA Waste Quant ' units Physical Amounts requiring <br /> Containers T Code ty, State shippinq paper <br /> �✓` Non-Hazardous Waste solids(Soil and debris contaminated with mineral oil) lbs solid <br /> NOn•RCRA Hazardous Waste,Liquid U oily water with transformer ort<5 ppm PCB 222 <br /> U used transformer oil<5 prim PCB 221 gallons liquid >1 garTr, <br /> ul Non-RCRA Hazardous Waste,Liquid,(oil filled capacitors<5 ppm PCB) 223 lbs liquid >tD bs W <br /> Non-RCRA Hazardous Waste,Liquid, Ll known_ppm PCB t549 ppm) 261 �.. <br /> (I <br /> PC <br /> oil ❑known m PCB >50 m 731 Required for any amount <br /> ( ) -PP I PP 1 kgs. Liquid Q <br /> U unknown and assumed 50-499 m PC8 731 <br /> Non-RCRA Hazardous Waste,Solid, ❑known__ppm PCB 261 kgs Solid Regmred for any amount <br /> soil I debris contaminated with PCB ❑unknown and assumed 50-499 p2m PC8 <br /> Non-RCRA Hazardous Waste,Liquid, U known ppm PCB(5-49 ppml 261 <br /> q m PCB >50 m 731 k Liquid Regwred for any amount <br /> (PCB-contaminated oil-filled electrical U known_pp I PD 1 731 kgs <br /> e ui ment) U unknown and assumed 50-099 ppm PCB <br /> Non-RCRA Hazardous Waste,Solid, U known-ppm PCB Required tot any amount <br /> (Drained PCB•contaminated electrical ❑unknown and assumed 50.499 ppm PCB <br /> 261 kgs. Solid <br /> e til merit Any container"t zt Pound <br /> U drained electrical equipment' 261 kgs. Sold of re PCB <br /> RQ,UN3432,Polychlorinated Biphenyls, ❑debris contaminated with PCB oil' <br /> SOIid,9,PG II Any container wn'n zt pound <br /> O oil-filled electrical equipment' 731 kgs Liqu d o1 ure PCB <br /> RQ,UN2315,Polychlorinated Biphenyls, ]PCB contaminated oil'Liquid,9,PG 11 physical Amounts requiting <br /> Quantity' units Stare Any equgmelt`i,z1 Pound of shippi paper <br /> Number of Container Hazardous MATERIAL(IN-SERVICE ELECTRICAL EQUIPMENT) <br /> Material mPCB kgs liqud pure PCB <br /> Containers <br /> Type. RQ.UN2315,Polychlorinated Biphenyls,with i 27, gall <br /> X (Non-leaking,oil-filled electrical equipment with%210 gallons of unknown,assumed 50-099 PP <br /> concentration <br /> i CHP Hazardous 6lateda4s <br /> corresponding pages.Potentially required Supporting PaPe1W°rk: (1 <br /> Equiprrlent manufacturer and serial#: wastes <br /> Reglsiratlon,(iv)DOTHazardousMateriats <br /> enc Response Guidebook(ERG)ce and(iii)DTSC Hazardous Waste Transporter1entProcedtire <br /> requirements are three years for non-PCB wastes and five years for PCB nontaminated was e . n <br /> Record keeping req Transportation(DOT)Emergency <br /> Application Vana <br /> artment of Transp ortation Regulatory ementprocedure. <br /> 2. REQUIRED:DeP it DTSC Transportation ounds or 500 gallons.See Attachment 4 of the Remote Waste anage <br /> ill may not exceed 2,500 p m PCB A 9 tion.othervnse use Non <br /> - <br /> CBS License, (�) y g uideforestimatingtheROandweightofPCBlsavailableonlheback <br /> ration. ERG for oil/PCSs is �� anfacil ty or <br /> in the Remote babe 50 tog PP use the shipping name vnth RQ in description <br /> Certificate of Regist 3tiO per vehicle from an unstaffedui merit and/or debris RQ for PCBs), <br /> Total waste per ship ortable Quantity(Rol Revised 2I19�p15 <br /> 3 You must assume the equipment <br /> PCB meets or exceeds one pound in an one container(the Rep <br /> 4. If the PCB concentration is unknown,Y <br /> If fhe volume of pureears <br /> RCRA(solid or liquid). Retain this document for three Y <br /> Page 1 of 2 <br />
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