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<br /> WASTE DIPQSA 1NFQ1?N�ATION
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<br /> 1�= » HA7 RD 7 W . S , LI° IIID i�lSED 01OMI ED Oi � S} " 10 PLI CARDS (2EQUIRED* S7`AT1= CODE 221 411,
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<br /> GCCO : SOUTIONSj "NOPLACAf2DS REQUIRES* " ' STATE CODE
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<br /> ty MIGNATED TSOF:
<br /> AIf LIdERIN
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<br /> " ll W RECYCLING ` :S32i0�Western AVeti ` 16- eft tatty, GAf945$7=" 1-51fl-X87; 9277' , r . ylIN
<br /> DANMJ` EMPTY pRUMS FACI<-ITY ,__ ___ SSC
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<br /> % # 1 x1 ` : -_ ' GENERATtOR WAS lyx� CERTIFICATION !yyve
<br /> PLEASE% -ICHECKaTH.EAPPROPRIAT :Cc IBOX° . ..
<br /> This is to certify that the wasto described"above Is properly classified, described, packaged, marked and labeled, and is in proper condition for transportation, according to applicable State
<br /> and federal regulations By signing below i also hereby, certify that
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<br /> (Waste oil 9eneratorJcustomer 'MUS i check ONE of the following three poxes]
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<br /> i] #1 f i havo no mixed an of.the""waste described above With any othe"trhazardous waste, the total halide content is LESS than 1,000 ppm, and the waste does not contain any.PCBs 1 have
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<br /> complied"withltia requirements of the ap"pl'cable cali'fornia used`oil.management regulation$ to'determine this Is true. l agree to accept the additional chs ges7orthe` disposatof this�yiaste �
<br /> k , , c? I Intomiation' t nave provided about this waste Is incorrect
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<br /> ❑=#2) have not mixod any of the waste described above With aii&thsr fiaia(doue viAiii, the tfital "halide cootent:lsiGREAT,gRthan :1,000,ppmv and,th@ waste does nofcontaitl anyPCBs. l
<br /> hav�providedprope�d"ocutpentation to Asbury Enylronmentai Sorvlces to rebut the presumption that this waste vias mixed with other hazardous .waste. I agree to accept the additional charges
<br /> IN
<br /> for the disposal of th s waste It the Information I have provided About this waste Is Incorrect
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<br /> #9) ft#1$ wasto'ia from a tank which collects waste oil from household 'do•lt•yourselr"(DIY) and/or conditionally exempt small quantity generator (CESQG) sources. To the beat of my
<br /> < = knowledge, the Doty Mta:to oli conteinad'in my DIYI CESQG collection tank Is soley, from DIY'andlor CESQG sources; l have not mixed this waste oil with'any other hazardous waste or
<br /> waste oil from other 'sourees. l a8rea to accept the additional charges (ordisposal of this waste if the information have provided about thiawaste is incorrect .
<br /> (Ail generatorsJcustomerstMUST read the following text and check"the 'associated box,)
<br /> [ U pa}. Jf1 am a, large quantity 8ensrator, l certify that i havaja proerarn tIT place to reduce the volume and toxicity of waste generated to the, degree I have determined to be economically
<br /> x",practicgble and=that i havo selected the practicable method of treatment storage, or dtaposa) currently available tome which minimizes the,present and future threat to human lite and
<br /> ! the env[ronment, or, if I am a $Mali quantity generators i have made a'good at effort to minimize my waste generation and select the best waste management method that " vailable
<br /> to me;thatl 4an aWord _
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