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Crosby & Overton, I4 Internal Use Only <br /> Waste Product Questionnaire Job Number 47374 <br /> General Information <br /> enerator 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 Gasoline Vapor Condensate Collected from Truck Fueling Racks <br /> Process Generating Waste Gasoline Vapor Condensate Collected from Truck Fueling Racks <br /> A. Hazardous U.S.EPA Hazardous Waste? Yes © No ❑ <br /> Properties: State Code(s)321 EPA Code(s) D001,D018 <br /> Waste Product: Shock n Sensitive ❑ Reactive n Radioactive n Pyrophonc ❑ Etiological n None <br /> B.Physical Phys,State: Solid ❑ Liquid © Any Free Liquids at 70 F? Yes-® No ❑ " <br /> Properties at 70 F Sludge ❑ Empty Container ❑ <br /> Layers: Multilayered ❑ Flash Point <70 F [—]70-100F ❑101-139F <br /> Bi-Layered ❑ (Closed Cup Only) 140-200 F ❑No Flash ❑Exact ❑ <br /> Homogenous <br /> Viscosity Water © Haney ❑ <br /> Molar Oil Other ❑ <br /> C. Density: !Liquid - lbs./gallon %Solids By Weight E Ph <2 ❑ 9.1-12.5 <br /> ,Solid El—Ibs./cubic ft. 0-0.1% By Volume E 5-Feb ❑ >12.5 <br /> Odor: None 5.1-9 © Exact ❑ <br /> Any debris in waste: Yes ❑ Strong <br /> No © Mild <br /> Explain: Describe: Gasoline Odor <br /> D.Chemical Composition(account for 100%of total) Range Metals: Pesticides.Herbicides•PPM <br /> % Total(PPM) Endrin N/A <br /> % EP Toxicity(mg/1) Lindane N/A <br /> Waste Gasoline .0-100.0 % Arsenic(As) N/A Methoxychior N/A <br /> Water .0-1.0 % Barium(Ba) N/A Toxaphene WA <br /> % Cadmium(Cd) N/A 2,4-D N/A <br /> % Copper(CU) N/A 2, 4,5-TP N/A <br /> % Lead(Pb) <1.0% Other N/A <br /> % Mercury(Hg) N/A ReactiveslOther Wastes(PPMI- <br /> ° Nickel(Ni) N/A Cyanides N/A <br /> °h Selenium(Se) N/A Sulfides N/A <br /> % Silver(Ag) N/A HOC N/A <br /> °k Zinc(Zn) N/A Dioxin WA <br /> PCBs NIA <br /> E.Shipping and Handling Information Phenols N/A <br /> D.O.T,Hazardous Material: Yes © No ❑ <br /> Prl D.0 T.Shi2Waa Name Warta C1 coHipe 0n,71�az�rd.Classr I <br /> D.O.T.ID Number&PG UN1203/PGII Method of Shipmenl 3 x 55-gallon 1A1 Drum amdlor Drum <br /> Bulk: Est.4,000 gal Other: D.O.T.Striping Cntr 3 x 55-gallon 1A1 Projected Volume <br /> Tons: Gallons: Est 110-gal Cubic Yards: Other: <br /> KU mownPer One Time X Week <br /> Month Quarter Year Comments <br /> .enerator Certicication statement <br /> I hereby ceAfy that as an authorized representative of the generator named above,all information submitted in this and all the aftossM documents Is he andiaommax. Analysis of the waste was conducted in <br /> accordance with the approved test methods in 40 CFR 261 on a representative sample as defined in 40 CFR 261,20. To the best of my knowledge,all known(40 CFR 261)and suspected hazardous comporents <br /> have been included In this docunenlabon. All material and packaging will comply with all curtest regulations. <br /> Signature Title: Date: <br />