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COSQK3GQN (2)
Environmental Health - Public
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2500 – Emergency Response Program
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COSQK3GQN (2)
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Last modified
1/20/2023 3:55:29 PM
Creation date
1/20/2023 3:52:40 PM
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EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COSQK3GQN
PE
2546
FACILITY_NAME
PENNY NEWMAN GRAIN CO CORP
STREET_NUMBER
1805
STREET_NAME
HARBOR
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
14502005
ENTERED_DATE
3/18/2022 12:00:00 AM
SITE_LOCATION
1805 HARBOR ST, STOCKTON
RECEIVED_DATE
3/18/2022 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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Waste produced from a site remediation project:No <br />DOT hazardous:No <br />Waste Description <br />Waste description:Absorbant <br />Industrial waste:No <br />How was waste generated?:Spill clean up of 55 gallons of hydraulic oil <br />Why is this material being disposed? <br />Waste been contaminated:No <br />Contamination description: <br />Waste constituents:Absorbent :95.00-100.00% , Hydraulic Oil (Vegetable):0.00-5.00% <br />Color:Varies <br />Physical state:Solid <br />Free liquid range: - <br />pH:0.00 -0.00 <br />Odor:No Odor <br />Odor description: <br />Material reactive:No <br />Flash point:N/A <br />Shipping details <br />Event frequency:One Time <br />Anticipated number of loads:1 <br />Estimated annual quantity:1750 <br />Unit of measure:Pounds <br />Shipping frequency:One time <br />Quantity per shipment:1750 pounds <br />Container type:Boxes <br />Container type description: <br />Container size:CF <br />Signature <br />I hereby certify that all information contained herein is true and correct, and the material described is properly identified, classified, packaged, labeled, and prepared as <br />indicated. I certify that this waste is either (i) not hazardous or dangerous as defined by the U.S. EPA, or the state or province of origin; or (ii) hazardous, special or industrial <br />waste (including friable asbestos) that meets the classification of Class II waste. I certify that this waste does not contain any regulated radioactive materials and does not <br />contain PCB's regulated by TSCA or any other regulatory authority. I certify that all known and suspected hazards have been disclosed. I certify that all samples used for this <br />analysis are representative of the materials described herein. I understand that all wastes may undergo inspection upon arrival at the designated facility and may be refused if <br />the delivered material does not conforrn to the description herein. Notification will be provided immediately if there is a change in the composition of, or process generating <br />this waste stream, prior to offering the waste for shipment or management. <br />Certification signature: <br />Title: <br />Company: <br />Certified at:
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