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I CROSBY&OVERTORINC. PROFILE # <br /> PH: (562)432.5445 <br /> WASTE PRODUCT QUESTIONNAIRE FAX: (562)495.2181 <br /> GENERAL INFORMATION <br /> Generator Name: Union Pacific Railroad Billing Name: US Ecology <br /> Site Address: 1000 E.Roth Road Address: 2450 Rice Ave <br /> City I State I Zip:French Camp,CA 95231 City I State I Zip:West Sacramento,CA 95691 <br /> Contact: Mike Algots Contact:Carlos Sanchez <br /> Phone: 916-580-9999 Fax: Phone: 916-200-9869 Fax: <br /> EPA ID Number: Not Required <br /> WASTE PRODUCT DESCRIPTION AND CHARACTERISTICS <br /> Waste Product common Name: Hydraulic Oil Contaminated Absorbent and Plastic - WR003272 <br /> Generating Waste Process:Shill Clean-up <br /> A.Hazardous PropertiesB.Physical Properties <br /> U.S.EPA Hazardous Waste? Yes *N Physical State: •Solid Liquid Sludge Aerosol Empty Container <br /> Any free liquids at 707: Yes • No Color: Varies <br /> State Codes) <br /> N/A — Layers: Multi-Layered Flash Point <70°F 70-100°F 101-139°F <br /> EPA Code(s) ; ;Bi-Layered (Closed Cup Only) 140-200°F •No Flash Exact <br /> N/A <br /> Waste Product: (_;Homogenous <br /> Shock Sensitive Reactive Radioactive Viscosity: Water Honey Motor Oil •Other Solid <br /> Pyrophoric Etiological • None <br /> - - _ <br /> C.Density D.Misc.Regulatory <br /> Liquid lbs/gallon %Solids: •By Weight 100 By Volume Source Code: G32 <br /> • Solid lbs/cubic ft. pH: <2 2-5 05.1-9 Form Code: W409 <br /> 9.1-12.5 >12.5 Exact <br /> Any debris in waste? •Yes No Odor: *None Mild Strong L.A.Country Sanitation District Category: <br /> Explain:Plastic pieces Describe: Oil Organics <br /> E.Chemical Composition(account for 100%of total) RANGE METALS PESTICIDES/HERBICIDES(PPM) <br /> Absorbent 50-100 % Total(PPM) Endrin <br /> Plastic 0-50 % EP Toxicity(mg/1) Lindane <br /> % Arsenic(As) Methoxychlor <br /> % Barium(Ba) Toxaphene <br /> Cadmium(Cd) 2,4-D <br /> % Chrome(Cr) 2,4,5 TP <br /> % Copper(Cu) Other <br /> % Lead(Pb) REACTIVES/OTHER WASTES(PPM) <br /> Mercury(Hg) Cyanides <br /> % Nickel(Ni) Sulfides <br /> % Selenium(Se) Halides <br /> % Silver(Ag) Dioxin <br /> % Zinc(Zn) PCBs <br /> F.Shipping and Handling Information Phenols <br /> D.O.T.Hazardous Material: Yes •No <br /> D.O.T.ID Number:N/A Proper Shipping Name: Non-DOT Regulated Material,Solid(Absorbent and Plastic) <br /> D.O.T.Hazard Class:N/A PG: N/A <br /> Method of Shipment: Drum: 1 x DM-55 Bulk: Other: <br /> D.O.T.Shipping Container:DM-55 gal Projected Volume: Gallons: 55 Cubic Yards: RQ Amount: <br /> COMMENTS: <br /> Generator Certification Statement <br /> I hereby certify that as an authorized representative of the generator named above,all information submitted in this and all the attached documents is true and accurate. <br /> Analysis of the waste was conducted in accordance with the approved test methods in 40 CFR 261 on a representative sample as defined in 40 CFR 261.20.To the best of my <br /> knowledge,all known(40 CFR 261)and suspected hazardous components have been included in this documentation. All material and packaging will comply with all <br /> current regulations. <br /> As agent <br /> Signature: ��L foruPRR Print Name:Leah Brinson Title: Waste Coordinator Date:1/11/2021 <br /> (Print,sign and send to customer service) <br />