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corn 2LTEr LT1ztr7: PF:clf:c Gas au! trr.:77.; LI 0 .(,--)7 E - STATE: OA ZIP: c=1 '-5TLC:tct TELEPHONE: 2f.5 -- d (DI r-) 1 1 c1. I 7 ARRIVED AT CONSOLIDATION \I (r) ; 2 1 Emergency Contact: P7 1nstriaI Outsourcing, Inc. aoo-se-14.SS Name of Driver* ERG Page for ODA PCBs: Quantly, SHP FROM NAME: Pac Gas and Electric Company- LOCATION/ADDRESS: PAGFIC. GAS AM ELECTRIC CePORA HAZARDOUS WASTE SHIPPiNG PARER CITY: '5714.. State: CA Zip: DATE GENERATED: / I / a Was this waste held at any Interim location? Yes If yes, facility name and address: Number of Container Containers Type ' S SHIPPED: circle one) NAME: ADDRESS: CITY: "S1-11? 7 REMOTELY GENERATED .HAZARDOUS WASTE2 Non-RCRA Hazardous Waste, Solid, (S.111 Clean u. - soil and debris contaminated with transformer all <5 ..m PCB Non-RCRA Hazardous Waste, Liquid olly water with transformer oil < 6 ppm PCB 0 used transformer oil < 5 . m PCB Non-RGRA Hazardous Waste, Liquid, (oil filled capacitors <5 ppm P08) (PCB-cOntamlnated oil) CB known ppm PCB pso ppm) Non-RCRA Hazardous Waste, Liquid, 0 known ppm PCB (649 ppm] unknown and assumed 50-499 ppm PCB Non.RCRA Hazardous Waste, Solid, known, ppm PCB soli /debris contaminated with PCB) 0 unknown and assumed 50-09 ppm PCB I Non-RCIZA Hazardous Waste, Liquid, (PCB-contaminated oil-filled electrical / equipment) 1 Non-RCRA Hazardous Waste, Solid, 0 known _ppm PCB ' . (Drained PCB-contaminated electrical 0 unknown and assumed 50-499 ppm PCB . equipment RQ, Waste Polychlorinated BlOhenyls, 9, 0 drained electrical .egtopment)4 11142315, PG III - 0 debris contaminated with PCB 01{)4 known ppm PCB [5:49 ppm] 0 known _ ppm P08 is50 .PPm1) 0 unknown and assumed 150:499 pm PCB) RQ, Waste Polychlorinated Blphenyls, 9, LIN2315, PG III o oil-filled electrical equipment, 2 PCB contaminated oil' 291 731 kes- 731 261 • 261 731 \ Lirtflid . Requited for am/ eMount \ • Pectited tor any entbtliit , MATERIAL (IN-SERVICE ELECTRICAL EQUIPMENT) Quantity3 RQ., Polychlorinated Blphenyls, 9; LIN2315, PG III (Non-leaking, oll-filled electrical equipment with 270 gallons of unknown, assumed:504p ppm PCB con ontrallon -.Number of Container Containers T a' Hazardous Material x. ; Physical ' Amounts requiting t State shl oin a or Any eckulpmentsailh> pound purePO .. . Equipment manufacturer and serial #: t•--) A Record keeping requirements are three years for non-PCB wastes and five years for PCB-contaminated wastes (archive permanently) . Potentially required supporting paperwork: CHP Hazardous Materials Transportation License *,DTSC Transportation Regulatory Exemption Application \latiarice an( DTSC.', Hazardous Waste Transporter Registration * DOT Hazardous Materials Certificate of Registration Total waste shipment per vehicle may not exceed 2,500 pounds/shipment or 500 gallons/shipment-with the exception of PCB wsteb 5 ppm•PCE (no kveit maY)t if the PC r:l cent;entration is unknown, you must assume the equipment and/or debris to be 50 to 499 ppm PCB. A guide for estimating the RQ and 1\1\g\-\k 019n \s available the back. If the volUme of pure PCB meets or exceeds one pound In any one container (the Reportable Quartty RforlDC2s), use te sh#lng RQ cie=c;rip-flon„ otherwise use Non-RCRA (solid or liquid). gation > tr-q-ny aittont.' Solid "Plegutrad for any tchlwrit 223 I lbs. 261 731 731 251 Solid An/cm-Wainer-with 1 • ; .ol pits PCB' containema151?_:ilkaidlin t of otoPGS- • Iga• tcqs. 3154 McAllen Rd, Stockton, CA Record ID COOSAOWHZ 7/17/2021 CUPA — ER PHOTO #3 PG&E hazardous waste shipping paper for the five drums of non-RCRA hazardous waste solids, transported to PG&E facility at 4040 West Ln in Stockton. Elianna Florido, REHS Page 3 of 3