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Crosby & Overton, IL Internal Use Only <br /> Waste Product Questionnaire Job Number 48691 <br /> General Information <br /> ^inerator Name Valero Billing Name DECON Environmental Services,Inc. <br /> dress 2941 Navy Drive Address 23490 Connecticut Street <br /> City,State,Zip Stockton,California 95206 City,State,Zip Hayward,California 94545 <br /> Contact Mr.Von Crites Contact Mr.Jason M.Costello <br /> Phone (209)943-5662 Fax Phone (510)732-6444 Ext.20 Fax (510)782-8584 <br /> EPA Number CAT000617514 <br /> WASTE PRODUCT DESCRIPTION AND CHARACTERISTICS <br /> Waste Product Common Name Diesel UST Accumulation Water with Trace Diesel and Lead Contamination(Analytical Provided) <br /> Process Generating Waste UST Closure and Removal <br /> A. Hazardous U.S.EPA Hazardous Waste? Yes © No ❑ <br /> Properties: State Code(s) 141 EPA Cade(s) Non-RCRA <br /> Waste Product: Shock n Sensitive n Reactive ❑ Radioactive 0 Pyrophoric ❑ Etiological None <br /> B.Physical Phys.State: Solid ❑ Liquid ©. Any Free Liquids at 70 F7 Yes ® No ❑ <br /> Properties at 70 F Sludge ❑ Empty Container ❑ <br /> Layers:: Multilayered ❑ Flash Point <70 F ❑70-100 F ❑101-139 F <br /> Bi-Layered ❑ (Closed Cup Only) 140-200 F No Flash ©Exact <br /> Homogenous <br /> Viscosity Water Q Honey ❑ <br /> Voter Oil Other ❑ <br /> C.Density: Liquid IbsJgallon %Solids By Weight Ph s2 ❑ 9.1-12.5 <br /> Solid Ej _Ibs.lcubicft. 0-1% By Volume 5-Feb ❑>12.5 <br /> Odor. None 5.1-9 © Enact ❑ <br /> Any debris in waste: Yes ❑ Strong <br /> No © Mild <br /> Explain: Describe: Diesel Fuel Odor <br /> D.Chemical Composition(account for 100%of total) Range Metals: Pesticides.Herbicides:PPM <br /> % Total(PPM) Endrin NIA <br /> Water .0-100.0 % EP Toxicity(mg/1) Lindane NIA <br /> Diesel Fuel .0-1.0 °/a Arsenic(As) N/A Methoxychior NIA <br /> Lead 0.001 °/a Barium(Ba) N/A Toxaphene N/A <br /> °/a Cadmium(Cd) N/A 2,4-D N/A <br /> % Copper(CU) N/A 2, 4,STP N/A <br /> % Lead(Pb) N/A Other N/A <br /> % Mercury(Hg) N/A Reactivesl0ther Wastes(PPM): <br /> °/a Nickel(Ni) WA Cyanides NIA <br /> °/a Selenium(Se) N/A Sulfides N/A <br /> Silver(Ag) N/A HOC N/A <br /> 5/6 Zinc(Zn) N/A Dioxin N/A <br /> PCBs N/A <br /> E.Shipping and Handling Information Phenols N/A <br /> D.O.T.hazardous Material: Yes ❑ No <br /> Proper n n T Shipping Name Wacta Flammable I igiid NOR In 0.T Ha72nd r3£S:.. <br /> D.O.T.ID Number&PG Method of Shipment 1xTanker Truck Drum amd/or <br /> Bulk: Est.4,000 gal Other. D.O.T.Striping Cntr 1xTanker Truck Projected Volume <br /> Tons: Gallons: Est.4,000 gal Cubic Yards: Other: <br /> RQ Amount Per One Time ONETIME Week <br /> Month Quarter Year Comments <br /> Generator Certiacation 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. Analysis of the wasle was,conducted in <br /> accordance with the approved test m dxAs in 40 CFR 261 on a representative sample as defined in 40 CFR 251,20. To the best of my knowledge,all known(40 CFR 261)and suspected hazardous components <br /> have been indudw in this documentation. All material and packaging will comply w)Ih all current regulations. <br /> Signature Title: Date: <br />