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Crosby and Overton, Inc. WASTE PRODUCT QUESTIONAIRE 57749
<br /> I. GENERAL INFORMATION
<br /> Generator Name: ST SERVICES,LLC Billing Name: UNIVERSAL ENVIRONMENTAL INC.
<br /> ,ddress: 2941 NAVY DRIVE Address: 4101 INDUSTRIAL WAY
<br /> City,State,Zip STOCKTON CA 95206 City,State,Zip BENICIA CA 94510
<br /> Contact BILL Contact:
<br /> Phone: 209-943.5662 Phone: 7077476699
<br /> Fax: 209-943.0908 Fax: 7077471927
<br /> PPA Numher: CAT000617514 Exoimtlon Date: 5/14/2008
<br /> It.WASTE PRODUCT DESCRIPTION&CHARACTERISTICS
<br /> A. Waste Product Common Name: GASOLINE,ETHANOL.LUBRICANT
<br /> Process Generating Waste: AREA.CLEAN UP
<br /> B. Hazardous Properties: State Code(s) EPA Code(s)
<br /> 1. US EPA Hazardous Waste? Q Yes ❑ No 2 343 1 1 1 D001 I D018
<br /> 3. Is Waste Product: [I]Shock Sensitive ❑ Reactive ❑ Radioactive ❑ Pyrophoric ❑Etiological Q None
<br /> C. Physical Properties at 70 deg F: 2 Layers 3. Flash Point(Closed Cup Only) 4. Viscosity,similar to:
<br /> 1. Physicalltate:
<br /> Solid
<br /> ❑ Mu16Layered O <70 deg F Q Water Aerosol
<br /> ❑✓ 1
<br /> Liguid E] 0
<br /> Lab Pack ❑ Bi-Layered & t039 deg F
<br /> gF ❑ Motor Oil
<br /> ❑ Sludge ❑ Free Liquids O Homogenous ❑ 140-200 deg F ❑ Honey
<br /> ❑ Empty Container ❑ Gas Free Liquids @ 70 ❑ No Flash ❑ Other
<br /> ❑ Deg F ❑ Exact <70 deo F
<br /> D. 1. Density: 4. Ph.
<br /> Liquid 0 0 Ibslgallon 2. %Solids 3. Odor: []N/A
<br /> Solid: 0 lbs/cubic it [3By Weight ❑ None 0<2
<br /> ❑ ❑ By Volume © Strong o2-5
<br /> Any debris in waste: Total: 0 _ ❑ Mild ❑
<br /> ❑ Yes ©No Describe: GAS 25.1-9
<br /> ❑9.1-12.5
<br /> Explain: 12.5
<br /> &Exact 6.00
<br /> E. Chemical Composition(Account for 100%of total) Range Metals TTLC: Copper: N6 1.
<br /> r____� r_____� r______1 r______{
<br /> ETHANOL ,5 , - ,10 , % F______i Total(PPM) Lead: F4f 6___i
<br /> r----1 F-D---H , , , EP Toxicity(mgfl) Mercury: , ,
<br /> GASOLINE ,80 , - ,9 , / r______1 ------{
<br /> —F5---' _ r-----I ,yo Antimony: , , Nickel: ,ND ,
<br /> LUBRICITY(OIL) r------{ r------1
<br /> - ----a _ w----� Arsenic NDSelenium: N_D____
<br /> h'---- Barium: IND , Silver. ,ND I-i F -
<br /> r-----I I
<br /> r--'-H r-----I Beryllium: ,ND , Zinc ,9.86 ,
<br /> , r------{ r------1
<br /> r-----I t-----I Cadmium: FND....i Molybdenum r------I
<br /> Chromium: IND Thallium: ,
<br /> Cobalt ,ND , Vandium:
<br /> --
<br /> , Reactives,&Other Pesticides,Herbicides:
<br /> r-----1 r-----I Wastes(PPM): "•• r------t
<br /> - , , _____ Endrin: ,
<br /> -r-----I h-----I Cyanides: ; '
<br /> r------{
<br /> r------1 F------{
<br /> --r-----I h-----I Dioxin: Methoxychlor.
<br /> Sulfides: F------{
<br /> r -- Ir-----I Toxaphene:
<br /> PCBs: r______{
<br /> P24D: r______{
<br /> r------t h------i
<br /> HOC: P245TP: ,
<br /> F. Shipping and Handling Information: Phenols: , t pother: r -1
<br /> PP 9 9 I
<br /> 1. D.O.T. Hazardous Material? Ld YesLj No 2. D.O.T Shipping Name: Flammable liquids,n.o.s.
<br /> 3. D.O.T.Hazard Class: 3 4. D.O.T. ID Number. UN1993 Packing Group II
<br /> 5. Method of Shipment:Z Drum [-]Bulk ❑Other 6. D.O.T.Shipping Container. DOT
<br /> 7. Projected Volume: 0 Tons: 0 Galllons 0 Cubic Yards 0 Other 8. RQ Amount 0 Per
<br /> Comments: RAMI
<br /> GENERATOR CERTIFICATION STATEMENT: I hereby certify that as an authorized representative of the generator named above,all Information submitted in this and all the
<br /> 'cached documents is the and accurate.Analysis of the waste was conducted in tpidaOca�Kbke2ppr d-teslmelhodsinAo-CPP261.owa.represantathe mple-a: -- -
<br /> fine In 40 C R 261.20.To the best of my knowledge,all known(40 CFR 261)and suspected hazardous components have been included in this documentation.All material and
<br /> rackaging will comply with all current regulations.
<br /> Generator's Authorized Signature: Title Date
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