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�s <br /> [`*anH nrIw% <br /> �a� SFr <br /> 7850 South R.�A, Bridgeford SI CESQG DATA SHEET 8 WAIVER <br /> Stockton,CA 95206 JOBB: GJ2481336 <br /> Telephonle(209)468-5670 SA000046 <br /> Fa>r(209)488-6672 <br /> Beaaraaa Nfanmaen <br /> Corp Name: Mecca E u COrt1 V°' <br /> Address; 7030 C E Dixon E-nvail' <br /> C Coact: Stockton Ca 95266 Ares Code B T hang x: 209-98344 <br /> Area Coat A Fm Numbef <br /> eusft s Walwer <br /> State and federal hamrdova waste lows limit the use of this type of waste eolleal 0n programs to Inose businesses that gerrerete <br /> lase than 100 kNgrams(27 gallons or 220 PI%da)of hazardous waste per month.BWness"that generate more tfam"a <br /> amount are rewired by law to use a OC�ed huardouswaft hauler to manifest and transport their waste.Therefore,kt order to <br /> paraclpele in this program,You must sign the fdlowing washer of IlehlstY.We reserve the fight m inview Your annual manifests or <br /> oonau*with the County Environmental""flh Da"';...a 1 to determine your elWM tY for use of this program. Than*You. <br /> I Car"its business <br /> "1 am repreadhtg is a Condibonalb Exempt Small Quan"Generator(CESQG)who generates no <br /> mora Nen 100 Wlorenn(27 galons or 220 tom)of hazardous waste per month based an an annual average and f,the <br /> represn4athe 01111M CESQG,rmdarsmnd the maxfer m Warr"of waste ac Wpted at sea time for disposal la 27 galkms or 220 <br /> pounds end arty disposal costs incurred and be the respoaeld"of the CESQG to pay at the time of disposal. <br /> Signature <br /> 9124/2009 2:53 <br /> DO NOT WRITE BELOW THIS LINE <br /> INVENTORY <br /> (To ba oaeplened by cosacaan pe nnw) <br /> Item 01 be.l Gal Nee Ura Tare) <br /> 1 <br /> EF <br /> 2 24 <br /> Subtotal $ <br /> IIrwg <br /> Fee $ ea. <br /> Total $ <br />