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<br /> %. NOtV C �DQ S ESTE;< �Ul ( YCCOL SQLUTIONS * PLA�gRDS REQUIRED." 'STATE1 777�
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<br /> PL ASO' 'f, ?H �IPPRC i3RiA
<br /> Thad is to certify thai•the wasteesorjbed above is properly classifjed,described packaged nnarked'and labeled;end is to proper condition'fortransportation;according'fo apphcable State '
<br /> and federal regulations.By signing below i also=hereby certify that a
<br /> ba ki , x '€a lE_ ,2 E.wr ' f Sf3 3 '3`Ct
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<br /> Nasj[ a�i�enera r j�s �e115 �1ec 0+1�txtt� foawin hr, edxes�t {
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<br /> #t ,fiave nomixed:a of the _'t
<br /> aste des fi6ed above with any othethazartlous tvasteth�totaifiande content is 1 ESS:thap 1 011D,ppm,andthgY±astetoes n tco fain art Bali hge r i
<br /> z impiied;with the:req of the applloable`Cslitornlaused oil''managatrient rsguiatfonsto determtnethislatrue.t agree to.accept the additional ah__ , rth apo 7:o this waste�' 4
<br /> ,tf the Information]have provided about this wasters incorrect
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<br /> .#2t tiave hot,mixed any of th wasto tlescribad abovervith�any'oihehaaoue ivaarthetofalhali ad�ogt8ni• �tEf6 than 1;QU pprti,an�therastdd'ea norcontainfanyi P s,1
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<br /> have provided pro :d6dumentatlontoAsbdy,EnYlr�mantal Services to�ebut',the:presuription that this`waa'te was inixed�with otherhaz rdous tives'te.!agree to acc"eot the addttionai charges j
<br /> for the disposal of t iswasteif the information i h`avepl`aPvldad ati" i this:weate to incorrect
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<br /> T
<br /> p#,4)Thiswaste Is from a ink which cotlects'waste oil from household"do-it-yourself'(DIYJ a6d/or con itlonally exempt small quantity generator(CESQG)sources.To the beat of my
<br /> knovl(edge,the only waste oil contained in my DIY/CES4G'collection tank is Soley from DIY andlor�E iQG sources J have not mixed'thia wasteoil with any other haiardous waste or -
<br /> wastOlojftrom other sources.1 agree'to accept the additional charges for disposal of ihis'waste if,the informati6p i hava'provided about this waste Is incorrect
<br /> (Ati`generafiors/customers'MUST r"ead:t eftiliowing text and check the ass4iciated boz.j t
<br /> It l am d large'quan)ity generato!.l certify that,!have a progkam hr place to roduce the volume and toxicity of waste generatetl to•the degree l haus determined to be economically
<br /> tacticabia and that i= v`selected the,practicablaemethod oftreatment storage,or djspo.$ai currently available to me which rjnim"izgs the resant tl future threat human iite.antl
<br /> the environmenE,Or,�arrt a srtjai�quantity generator,i have'made a good faith etforiYonlrlTmize my waste generation's erene�tat wa;e :fn ement m Shod that is available
<br /> t tp me that I can aNM 41 _
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<br /> us omer Signature - -Date KDriver Signlire date r
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