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FORWARD, INC. <br /> Petroleum Contaminated Soil, <br /> Waste Characterisation Form <br /> Approval. No. : <br /> SECTION A: GENERAL INFORMATION Page (1) of (2) <br /> Generating Facila.ty• , <br /> Site Contact: Jean Kulusza Phone: (909)683-3660 <br /> Facility Address- 2825--W— Washitigtrin ',t- . <br /> City. 'tocktorr State: CA zip: <br /> Generator/owner- Same as above <br /> Contact- L phone <br /> Mailing Address P.O. Box 4904 <br /> City D State: Zip. <br /> 91765 <br /> Consulting Firm Win flunter & Assoc <br /> Technical Contact Phone- <br /> SECTION D: WASTE STREAM INFORMATION <br /> Waste Description. Clay and sand soil mixture <br /> Source of Contamination. Leaking under round Fuel tarik <br /> =orted Contaminant(s) Uasollrie <br /> SECTION C: PHYSICAL CHARACTERISTICS <br /> Soil Type- %Clay %Sslt %Sand %Moisture <br /> Other (Describe) Free Liquid Yes No X <br /> h <br /> SECTION D: ANALYTICAL SUMMARY <br /> ORGANIC COMPOUNDS Maximum Average INORGANICS Total soluble <br /> ppm PPM Ppm mg/L <br /> TPH Gas Arsenic 15.5— <br /> TPH Diesel Barium28Q <br /> TPH Motor Oil lel/A Cadmium a <br /> TPH Chromium 50 <br /> TRPH Cobalt <br /> TOG N/A Copper 9 <br /> Benzene N11) Lead �— <br /> Toluene <br /> le � Mercury <br /> Ethyl4 <br /> t;thylbenzene Nickel <br /> Xylenes NI) Zinc __70Total VOC' s Other <br /> Total Semi-VOC's <br /> SECTION E: SHIPPING INFORMATION <br /> QUANTITY (Cubic Yards) : 15 to 100 D O T 55 Gal 17H Drums: <br /> Transporter Jtin Flior e Oil Inc <br /> Contact Richard Thorpe Phone: (209)462-4581 <br /> MI Mailing Address.- P.O Box 35 <br /> Cit • Lodi, State- CA. zip 95241-0357 <br /> Type of Vehicle Ftid Dwrip Estimated Number of Trucks: <br /> To be completed by FORWARD, INC. : Reviewed by. Date• <br /> - - - RECERTO <br />