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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS ACTIVITIES <br /> I. FACILITY IDENTIFICATION <br /> FACILITY ID# 1. EPA ID#(Hazardous Waste Only) 2. <br /> (Agency Use — — 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 CA Zip Code 95204 105. <br /> II. ACTIVITIES DECLARATION <br /> NOTE: If you check YES to any part of this list, <br /> please submit the Business Owner/Operator Identification page. <br /> Does your facility... 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 ®YES ❑ N04. Hazardous Materials Inventory- <br /> USTs); or the applicable Federal threshold quantity for an extremely 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. CalARP REGULATED SUBSTANCES <br /> Have Regulated Substances stored onsite in quantities greater than ❑ YES® NO 4a. Coordinate with your local agency <br /> the threshold quantities established by the California Accidental responsible for CaIARP. <br /> Release Prevention Program CalARP ? <br /> C. UNDERGROUND STORAGE TANKS(USTs) UST Facility <br /> ®YES❑ NO 5. (Formerly SWRCB Form A) <br /> Own or operate underground storage tanks? UST Tank(one page per tank)(Formerly <br /> Form B <br /> D. ABOVE GROUND PETROLEUM STORAGE <br /> Own or operate ASTs above these thresholds: ®YES❑ NO 8. 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 /> Generate hazardous waste? [AYES El NO 9. EPA ID Number-provide at top of this <br /> page <br /> Recycle more than 100 kg/month of excluded or exempted Recyclable Materials Report <br /> recyclable materials(per HSC§25143.2)? [-]YES NO 10. (one per recycler) <br /> Treat hazardous waste onsite? ❑YES® NO 11. 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 /> Permit by Rule and Conditional Authorization)? ❑ YES® NO 12. Certification of Financial Assurance <br /> Consolidate hazardous waste generated at a remote site? ®YES E:1 NO 13. Remote Waste Consolidation Site <br /> Annual Notification <br /> Need to report the closure/removal of a tank that was classified as [-]YES® NO 14. Hazardous Waste Tank Closure <br /> hazardous waste and cleaned onsite? 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 Obtain federal EPA ID Number,file <br /> any single calendar month, or accumulate at any time, 1 kg (2.2 Biennial Report(EPA Form 8700-13A/B), <br /> pounds)of RCRA acute hazardous waste; or generate or [-]YES Z NO 14a. and satisfy requirements for RCRA Large <br /> accumulate at any time more than 100 kg (220 pounds)of spill Quantity Generator. <br /> cleanup materials contaminated with RCRA acute hazardous <br /> waste? <br /> Serve as a Household Hazardous Waste HHW Collection site? ❑YES® NO 14b. 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. (12/2007)-2/2 www.unidocs.org <br /> 2 <br />