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STATEMENT OF WASTE DESIGNATION <br /> Representative samples were submitted, tested and reviewed in accordance with parameters set <br /> forth in 40 CFR part 261 for hazardous waste characterization and designation. According to 40 <br /> CFR part 262.11 (2) and based on specific generator knowledge of this material, supporting <br /> documentation provided from analytical laboratory analysis, review of applicable Material Safety <br /> Data Sheets and other supporting documentation, the Generator has designated this material as; <br /> (circle one) - <br /> Non-RCRA ERM (25143.2 1Noin-Hazardou <br /> I certify that all information submitted in this a emen of Waste Designation and attached <br /> documents is, to the best of my knowledge and belief, complete and accurate, and that all known or <br /> suspected hazards have been disclosed per California Title 22, part 66260.200. <br /> SFO-16-005 Blast Media <br /> Project Number Project Name <br /> B & C Painting Solutions ry o 9 <br /> Company Address <br /> ;7��Authc��ze Signature Print Wame Title Date <br /> C 1Users1QC%ppDatallocalWlicrosott4WndowslTemporary lntemet FileslContentOutlook%UOl%A07MFO-1"05.doc <br />