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Sep. 3. 2010 9: 42AM GB Industrial Spray Inc. No- 4727 P. 13 <br /> Clean - W. ff3 <br /> E.Vifl01111 ll"TAL sERNIGM <br /> San J0001n Co.HHW <br /> 7850 Soutth RA- OM cESQG DATA SHEET b WAIVER <br /> Stockton.CA 95206 J0W 6J3012402 <br /> Telephone(209)468,5670 SA000046 <br /> Fox-,(209)468-5672 <br /> 6uafneea lriterA Unda <br /> Name: GB itMtrav►al <br /> Strmet Addleea: 1140■18e9demer Avenue Gone a T a 208-6 .7176 <br /> tiAa tk a,ca.9633T <br /> �oea a Fmc t+Yelhber <br /> g..Ihnscs arehr.r arwaste>x coon progratt�to V-se bust."es that <br /> State and fedatal haze-Imm waste'I—emk"use of thla Iryafar as"lous yvasbs par montth.Brhsirhesaes tVat gettarate more <br /> generate 1,6a than 100 Idigrems(27 gallons 0(220 POw49)rdcwom v hauler to martifest and lne sQott ttlalr Thetettxe, <br /> than this amount are requked DY Iar/to OW� ng Nasiw of SIpr.We rhe the A9ht f°��your annual <br /> In order to pugidpate In this Pmg�'•� ) �pep�hnerd to dWmthe your a ror use of this Pmgmm. <br /> manifests or consult with V*County <br /> Thank you. <br /> I M the business that I am representing la a CmWftnaliY Exempt Small GwuTdW Generator(CESQG)who genefstes no <br /> vvaete per month thesed on an annual average and 1,the <br /> more than loo 1d1orams(27 gallons 220 he . of h q warps lly of waste aocePWd at tie tone Ibr d%POW to yT gaIlons or 220 <br /> represantetve of tthe C G. d 1 be re6Dot 1�Y Of the CESQG to Pay at the ttrrre of d►spoaal, <br /> pounds and any NaP�B)CDM ..................................... <br /> Signature <br /> E1 1 I 6024/2010 9:14 <br /> pq HOT NII't(TE SELOW THIS UME <br /> lw4EMM RY <br /> (Co be oom9l W by-WIlon P---Cr) <br /> A I ibsj tad Pti00 Unit Tnhal <br /> Rem $28.70 <br /> 41 30.7 <br /> Fluorescent kamPs <br /> Leed Aad Baderkm -- <br /> Subtotal $26.70 <br /> 320.00 ea <br /> Fee $41.70 <br /> Tota <br />