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(-40 k)o CROSBY&OVERTON,INC. PROFILE # 141007 <br /> ENVIRONMENTAL SERVICES <br /> PH: (562) 432.5445 <br /> WASTE PRODUCT QUESTIONNAIRE FAX: (562)495.2181 <br /> GENERAL INFORMATION <br /> Generator Name:TESORO STOCKTON TERMINAL Billing Name: Patriot Environmental Services <br /> Site Address: 3003 NAVY DRIVE Address: 5108 Luce Ave,Bay 250M <br /> City I State I Zip:STOCKTON,CA 95206 City I State I Zip:McClellan,CA 95652 <br /> Contact: RUTHANNE WALKER Contact:Ambrose Kong <br /> Phone: (209)466-8800 Fax: Phone: 562-676-2330 Fax: <br /> EPA ID Number: CAT000618637 <br /> WASTE PRODUCT DESCRIPTION AND CHARACTERISTICS <br /> Waste Product Common Name: DEBRIS W/TRACE PETROLEUM HYDROCARBONS <br /> Generating waste Process:aeneral faciltv maintenance <br /> A.Hazardous Properties B.Physical Properties <br /> U.S.EPA Hazardous Waste? Yes *No_] Physical State: CSolid OLiquid OSludge OAerosol OEmpty Container <br /> State Codes) <br /> Any free liquids at 70°F: OYes (�)No Color: VARIOUS Layers: •Multi-Layered Flash Point <70°F 70-100°F _101-139°F <br /> EPA Code(s) Bi-Layered (Closed Cup Only) 140-2007 *No Flash Exact <br /> Waste Product: Homogenous <br /> Shock OSensitive 0Reactive Radioactive Viscosity: Water Honey Motor Oil •Other SOLID <br /> 0Pyrophoric OEtiological !None J <br /> C.Density D.Misc.Regulatory <br /> Liquid Ibs/gallon %Solids: •By Weight 100 OBy Volume Source Code: <br /> • Solid 60 Ibs/cubicft. pH: <2 v2-5 *5.1-9 Form Code: <br /> An debris in waste? •Yes No 9.1-12.5 0>12.5 OExact <br /> y Odor: •None OMild Strong L.A.Country Sanitation District Category: <br /> Explain:PAPER. PLASTIC.PPE Describe: <br /> Oil Organics <br /> E.Chemical Composition(account for 100%of total) RANGE METALS PESTICIDES/HERBICIDES(PPM) <br /> absorbent(Dads, boom,sweep) 50-99 % Total(PPM) Endrin <br /> debris(PPE,raps,plastic sheeting) 1-50 % EP Toxicity(mg/1) Lindane <br /> TRACE (diesel/petroleum) 0-1 % 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: Proper Shipping Name: NON-HAZARDOUS WASTE,SOLID(debris w/trace petroleum hydrocarbons) <br /> D.O.T.Hazard Class: PG: <br /> Method of Shipment: Drum: DM/DF Bulk: Other: <br /> D.O.T.Shipping Container: Projected Volume: Gallons: Cubic Yards: RQ Amount: <br /> COMMENTS: REFER TO ANALYTICAL DATA <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 /> Signature: Print Name: Ruthanne Walker Title: Sr. EnvtlSpclst Date: <br /> (Print,sign ands nd to Gusto er service) <br />