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UNIFIED PROGRAM CONSOLIDATED FORM <br />FACILITY INFORMATION <br />BUSINESS ACTIVITIES <br />I. FACILITY IDENTIFICATION <br />FACILITY ID #1. <br />EPA ID # (Hazardous Waste Only) 2. <br />(Agency Use <br />_ <br />CAD981390073 <br />BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3. <br />PG&E - Stockton Service Center <br />Business Site Address 4040 West Lane 103. <br />Business Site City Stockton 104 <br />CA <br />I Zip Code 95204 '05- <br />11. ACTIVITIES DECLARATION <br />NOTE: If you check YES to any part of this list, <br />lease submit the Business Own er/Operator Identification page. <br />Does your facility... <br />If Yes, please complete these pages of the UPCF... <br />A. HAZARDOUS MATERIALS <br />Have on site (for any purpose) at any one time, hazardous materials <br />at or above 55 gallons for liquids, 500 pounds for solids, or 200 <br />cubic feet for compressed gases (include liquids in ASTs and <br />YES E] N04. <br />Hazardous Materials Inventory - <br />USTs); or the applicable Federal threshold quantity for an extremely <br />Chemical Description <br />hazardous substance specified in 40 CFR Part 355, Appendix A or <br />B; or handle radiological materials in quantities for which an <br />emergency Ian is required pursuant to 10 CFR Parts 30, 40 or 70? <br />B. CaIARP REGULATED SUBSTANCES <br />Have Regulated Substances stored onsite in quantities greater than <br />❑ YES® NO 4a. <br />Coordinate with your local agency <br />the threshold quantities established by the California Accidental <br />responsible for CaIARP. <br />Release Prevention Program CalARP ? <br />C. UNDERGROUND STORAGE TANKS (USTs) <br />UST Facility <br />N YES❑ NO 5. <br />(Formerly SWRCB Form A) <br />Own or operate underground storage tanks? <br />UST Tank (one page per tank) (Formerly <br />Form B <br />D. ABOVE GROUND PETROLEUM STORAGE <br />Own or operate ASTs above these thresholds: <br />N YES❑ NO 8. <br />No form required to CUPAs <br />Store greater than 1,320 gallons of petroleum products (new or <br />used) in aboveground tanks or containers? <br />E. HAZARDOUS WASTE <br />Generale hazardous waste? <br />N YES El NO 9. <br />EPA ID Number- provide at top of this <br />page <br />Recycle more than 100 kg/month of excluded or exempted <br />❑ YES® NO 10. <br />Recyclable Materials Report <br />recyclable materials (per HSC §25143.2)? <br />(one per recycler) <br />Treat hazardous waste onsite?❑YES® <br />NO 11. <br />Onsite Hazardous Waste Treatment <br />Facility <br />Onsite Hazardous Waste Treatment Unit <br />(one page per unit) <br />Perform treatment subject to financial assurance requirements (for <br />❑ YES N NO 12. <br />Certification of Financial Assurance <br />Permit by Rule and Conditional Authorization)? <br />Consolidate hazardous waste generated at a remote site? <br />N YES❑ NO 13. <br />Remote Waste Consolidation Site <br />Annual Notification <br />Need to report the closure/removal of a tank that was classified as <br />❑YESN NO 14. <br />Hazardous Waste Tank Closure <br />hazardous waste and deaned onsite? <br />Certification <br />Generate in any single calendar month 1,000 kilograms (kg) (2,200 <br />pounds) or more of federal RCRA hazardous waste, or generate in <br />Obtain federal EPA ID Number, file <br />any single calendar month, or accumulate at any time, 1 kg (2.2 <br />Biennial Report (EPA Form 8700-13A/B), <br />pounds) of RCRA acute hazardous waste; or generate or <br />(-)YES M NO 14a. <br />and satisfy requirements for RCRA Large <br />accumulate at any time more then 100 kg (220 pounds) of spill <br />Quantity Generator. <br />cleanup materials contaminated with RCRA acute hazardous <br />waste? <br />Serve as a Household Hazardous Waste HHW Collection site? <br />I ❑ YES N NO 14b. <br />I See CUPA for required forms. <br />F. LOCAL REQUIREMENTS (You may also be required to provide additional information by your CUPA or local agency.) 15 <br />UPCF Rev. 112/2007)-2/2 wee .xnidocs.org <br />