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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3725
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2900 - Site Mitigation Program
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PR0528359
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Last modified
5/8/2020 3:20:07 PM
Creation date
5/8/2020 2:48:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0528359
PE
2950
FACILITY_ID
FA0019146
FACILITY_NAME
SHELL OIL PRODUCTS US
STREET_NUMBER
3725
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95304
APN
21217030
CURRENT_STATUS
02
SITE_LOCATION
3725 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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FORWARD INC. <br /> WASTE CHARACTERIZATION FORM:'Complete both sides and attach or submit all California Certified <br /> laboratory analyses. <br /> RETURN TO FORWARD INC. <br /> ATTN: Environmental Compliance Officer <br /> P.O.Box 6336 <br /> Stockton,California 95206 <br /> SECTION A. GENERATOR/TRANSPORTER INFORMATION r <br /> Waste Generator. Compan Name: <br /> Contact Person: CkJA e Phone: ?Q0 — If S/ -Z7 7 9 <br /> Generating Facility. City 1 r<< State_C_A_.. Zip <br /> Transporter. Company Name: <br /> Contact Person: Phone: <br /> Consultant: Company Name: , <br /> Contact Person: Phone: <br /> SECTION B: WASTE STREAM IDENTIFICATION <br /> General description of waste: S0; f cd Qa e d , ✓ '�'�e<< <br /> Process generating waste: e- �� <br /> SECTION C: PHYSICAL CHARACTERISTICS <br /> Color. Physical State. �(Solid ❑ Liquid ❑ Slurry ❑ Paste ❑ Powder Free Liquids: ❑ Yes P�No <br /> pH: Odor. ❑ Strong n Mild ❑ None <br /> I <br /> SECTION D: WASTE COMPOSITION (see SECTION E for asbestos) ac�5 U-. SU�-U (.ef C4 ffecf <br /> (Include range of concentrations for multiple samples) fQS <br /> Total Petroleum Hydrpcarbo Metals: i ' Total Soluble(Cal. WET) <br /> as gasoline <U°S"�� ppm cma/ka} (mill} <br /> as diesel +=_ ppm Antimony <br /> as motor olI ppm Arsenic <br /> other. ppm Barium <br /> Aromatic Hydrocarbons: Beryllium <br /> Benzene ppm Cadmium <br /> Toluene d.D ppm Chrom.(total) <br /> Xylenes(total) �'y� ppm Chrom:VI k <br /> Ethylbenzene O.O Z ppm Cobalt I <br /> Copper <br /> Other Components(list)- lead <br /> ppm Mercury <br /> ppm Manganese <br /> ppm Molybdenum <br /> ppm Nickel <br /> i f <br /> ppm Selenium <br /> ppm Silver <br /> ppm Strontium <br /> ,I ppm Thallium <br /> ppm Vanadium <br /> ppm Zinc <br /> ppm Others(list): <br /> ppm <br /> ppm <br /> i <br /> ppm <br /> (attach or submit additional sheets if necessary) <br /> w <br />
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