Laserfiche WebLink
I rb01' <br /> EU MONMEUTAL SERWCES- <br /> San Joaquin Co.HHW <br /> 7850 South R.A.Bridgeford St CESQG DATA SHEET&WAIVER <br /> Stockton,CA 95206 <br /> Telephone(209)468-5670 JOB#: 6JZ770981 <br /> Fax:(209)468-5672 SA000046 <br /> Business Information <br /> Com Name: Sart Joa uin Co Park and Rec oro R e: Charlie <br /> Street Address: 4520 N 8 Mile Rd E-mail: <br /> Gfty/StRW4 Code: Stockton Ca 95209 rea Code&Telephone x 209-953-8802 <br /> CAH31000318 krea Code&Fax Number 209.331-2012 <br /> Business Waiver <br /> State and federal hazardous waste laws limit the use of this type of waste collection programs to those businesses that <br /> generate less than 100 kilograms(27 gallons or 220 pounds)of hazardous waste <br /> Per month.Businesses that generate more <br /> than this amount am <br /> required by law to use a licensed hazardous waste hauler to manifest and transport they waste.Therefore, <br /> in order to participate in this program,you must sign the following waiver of liiabirdy.We reserve the right to review your annual <br /> manifests or consult with the County Environmental Health Department to determine your eligibility for use of this program. <br /> Thank you. <br /> I certify the business that I am representing is a Conditionally Exempt Small Quantity Generator(CESQG)who generates no <br /> mom than 100 kilograms(27 gallons or 220 pounds)of hazardous waste per month based on an annual average and 1,the <br /> representative of the CESQG,understand the maximum quantity of waste accepted at the time for disposal is 27 gallons or 220 <br /> Pounds and any disposal costs incurred shall be the responsibility Of the CESQG to pay at the time of disposal. <br /> 2010 1.32 Signat(i <br /> DO NOT WRITE BELOW THIS LINE <br /> INVENTORY <br /> (To be completed by collection personnel) <br /> Rem <br /> #/Ibs.l Gal Price Unit Total <br /> Latex Paint 53. 455 $5.3 al $283.71 <br /> Flammable Liquid 23.1 196 $5.3 at <br /> $122.21 <br /> Flammable Solid 50 $1. lbs $80.00 <br /> Lead Acid Batteries 40 $0.0 lbs. $- <br /> ProcessingSubtotal $485.92 Fee $20.00 ea. "000 <br /> Tota <br /> $505.92 <br />