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Site Address: 2061 W. Inman - Stockton Record ID#C00044255 <br /> Date of Inspection: 09/12/2017 <br /> PHOTO 10: Shi in a ers for waste to PG&E facilit . <br /> NL <br /> PACIFIC GAS AND ELECTRIC COMPANY n Pacific Gas 0 O � <br /> HAZARDOUS WASTE SHIPPING PAPER Il�1P(�j Eleenie C '� ' <br /> SHIP FROM SHIP TO —C <br /> NAME Pontic Gaiind Fenrc ComnnnY N 7;A11P <br /> ION/AODRE55: ApOCITY <br /> Slam, CA ZI STATELEPHONE. NOD <br /> DATE GENERATED: try !x SHIPPED 7 !/2117 AgRIVFD AT CONSOLIDATION SITE I 9 Irp 11 '_ O <br /> Ives torswaste tisk el am nlenm bcaNaN Yro No (c✓%le noel LITlIgi fprl t: P5C indiv al ovKvQAJ nq,IM 844. ro <br /> if yes.1aoM1Mnameand ad3rassName of Driver: i IInnannaI JOG \ <br /> cmnmv5w cr REMOTELY GENERATED IIA7ARDOUS WASTE, cn,aw n,r.nlPy unm I'1�I5v5I <br /> 51r .m <br /> NOnJInnrMUl Wo{I.\„Iln.lin,Inn,I Je4+iu[,.nrernrnaloe wrll,llllmrla1..", d nd 1[Iw y <br /> Mrmfl Haufn,u,s Warlr Lxllrlr+ J�V,wnlp wrin llMLHAInIl gI3Pgnlr 1 12 IgafYn r, <br /> LILL Wlmlapyml•5 m1N'0 221 gdwn5 omit v <br /> SEP <br /> NM RCPrI HaLNOu{WNIe.LXuIJ.tort l.IlnO[:+Yalllrnia Sllgnl'Cnl 113 mi. 4prw1 X111 Cf <br /> F NamP[AA xaaSmausWou.LpwL Jpuue, PrvnP HlNnnrynl <br /> 2M1I <br /> IEceraxmwnm wl) Urw:.ipPm PCB Pw ianl <br /> 711 Pwyvimn lw In f O <br /> J uiXntiy ora lnrmlM lulu✓, <br /> ldJ99p npq& 715 <br /> Xg3 Iamgml <br /> ya NaM[R11 Heavewf Wlf11,50114. Jrnmm ngnP' <br /> J IimllbMSLONunlruppwtlM1 PC01 Jumnwn Erle a3sU114U 504W {V;p. 161 Aqs `ndw PFluireeWarlY amdml <br /> NmaCM Namedou5 waste.Lpmd. uinam I+pm PLB 13,9 Pqu 1al <br /> (PCBienunwluO ornallad Nnh,wl USrrmn_pµn l+CB'9BPpnq Tay 405 4uq Plpgltlebr Orr/amWM V T w <br /> u mann ❑„n5nawl nnnanum54 soJg9 mnce nl q <br /> NnnflCM rbONpus WaslL 1eIM J',.n PCB <br /> Iomwed PCBianlammarm.wav,ol ]ol5iiwn and Msumia SoJ99 num PCn 141 5q5 W'd PLwu Nranylmvli <br /> Rn.MUM..ft,ulorAiid eipllmyk, ❑daeHV dpiPNM eyrnpmenl' Fey wnpwal wlp121 _ w• <br /> Solig9,p60 Jr5ean5LMmmmmid wlN PCB d1• 2ul 495 adw el um PrB PdJPA �� <br /> Lrqu149 <br /> Pq.BNSJIS.Po1yLHIwIna15V 91phonyls, Odl-0INq 0.1'"Nquwamm Amy mnYwNrmNal ppund 4 <br /> .PGd OPCS aInlamulsM dl' Ill 595 Upud <br /> el maP B <br /> CP <br /> Cantu ors C`n1e�W selorWSMATERIAL(IN-SERVICE ELECTRICAL EQUIPMENT) Ouanlny' inns nSizmalmalequN�g l <br /> Pm Payr <br /> X ND,UNiIIS.PotycPbnniwd egnmyls, 'qui 69,PG 11 AYNy1 <br /> INm+neSNq,dr MW akcvlul eq 11.1 Win X276 gallons of un5n„un,n.,,nl 30199ppm PCB Lgz Ugaq pmaM murt wNlw of <br /> mlonPmLw ours Pca i <br /> Equlpmem manufacturer and serial# <br /> I Record keeping requirements are three years for non.PCB wastes and five years lot PCB-conlaminaledwastes, <br /> 2 REQUIRED.Department of Transportation(DOT)Emergency Response Guidebook(ERG)corresponding pages.Potentially required supporting paperwork (i)CHP Hazardous Materials _ <br /> Transportation License. (ii)DTSC Transportation Regulatory Exemption Application Variance and(ii)DISC Hazardous Waste Transporter Registration iv)DOT Hazardous Malin ials <br /> Cediricale of Registration.ERG for oiUPCBs is 171 and can be found In the Remote Waste Management Procedure. <br /> 3. Total waste per shipment per vehicle from an installed ladllty or split may not exceed 2,500 pounds or 500 gallons.See Allachmenl 4 of the Remote Waste Managementble on in e <br /> e _ <br /> 4. It the PCB concentration is unknown,you must assume the equipment and/or debris to be 50 to 499 ppm PCB Agdide for estimating the RQ and welgM OI PCB 15 availaProcedurProcedur back. <br /> It the volume of pure PCB meets or exceeds one pound in any one contains (the Reportable Quantity(RQ)for PCBS),use the shipping name with RQ 1n description,other <br /> RCRA(solid or liquid). wise use Non- <br /> _ <br /> Page 1 oft Retain this document for three years Revised 211912015 <br /> Staff Person Name, Cesar Ruvalcaba Page 10 of 10 <br />