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I PGu and l Company <br />PCB <br />/Oil Spill or or Leak Report <br />is <br />FINANCIAL COSTS OF CLEANUP: <br />PG&E Labor $ <br />Contract Labor $ <br />Transportation $ <br />LIST OF ATTACHMENTS <br />PG&E Equip $ <br />Contract. Equip. $ <br />Disposal $ <br />PG&E Material $ Subtotal $ <br />Contract Mat. $ Subtotal $ <br />Other $ Subtotal $ <br />Grand Total of Cleanup Costs $ <br />673685 (8/94) <br />Mstribudoa <br />Page 6 of 6 <br />❑ Pre cleanup sampling Sketch/Grid Q Post cleanup sampling Sketch/Grid ❑ Cal -EPA Written Follow-up Report <br />❑ Laboratory Analysis Reports for Fluid Identification/Classification (Lab name ) <br />❑ Pre cleanup Laboratory Analysis Reports (Lab name ) <br />❑ Post cleanup Laboratory Analysis Reports (Lab name ) <br />❑ Photograph Identification Sheets ❑ Other Documents (Describe) <br />INVOLVED EQUIPMENT (SOURCE OF SPILL) <br />TECHNICAL DATA <br />CODE(S)' <br />OPERATING NUMBER <br />MANUFACTURER <br />SERIAL NUMBERS <br />EQUIPMENT TYPE <br />AND SIZE <br />DU <br />Unit Damage (rust, tracking, etc.) <br />LI <br />Unit Failure Caused by Lightning <br />PF <br />Unit Damaged by Pole Fire <br />SF <br />Switch Failure (such as grounding switch on network transformers) <br />CH <br />Unit Damaged During Handling <br />Identify the cause of Spill from the Following <br />'Code <br />Type of Soil <br />OF <br />Unit Failure (other than by lightning) <br />CP <br />Unit Damaged by Car -Pole Accident or Other Third -Party Action <br />DU <br />Unit Damage (rust, tracking, etc.) <br />LI <br />Unit Failure Caused by Lightning <br />PF <br />Unit Damaged by Pole Fire <br />SF <br />Switch Failure (such as grounding switch on network transformers) <br />CH <br />Unit Damaged During Handling <br />UL Unit Leaking or Sweating (Bushing), Gaskets Leaking or Sweating, but Fluid no <br />Reaching Ground. <br />PLEASE NOTE: THIS RECORD MUST BE MAINTAINED FOR AT LEAST 5 YEARS <br />Report Prepared by: Phone <br />