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EPA ID NO: I c I A 1 0 11 0 1 0 1 0 11 1 1 4 1 2 11 3 1 3 11 <br /> OMB#: 2050-0028 Expires 06/30/2009 <br /> 9. Legal Owner Street or P.O.Box: 4500 Dorr Street <br /> (Continued) <br /> Address City,Town,or Village: Toledo <br /> State: OH <br /> Country: US Zip <br /> Code:43615 <br /> 10. Type of Regulated Waste Activity <br /> Mark"Yes"or"No"for all activities;complete any additional boxes as instructed. (See instructions on pages 17 to 20.) <br /> A. Hazardous Waste Activities <br /> Complete all parts for I through 6. <br /> YO NO 1. Generator of Hazardous Waste YO NO 2. Transporter of Hazardous Waste <br /> If"Yes",choose only one of the following-a,b,or c. <br /> YEI NEI 3. Treater,Storer,or Disposer of <br /> 0 a.LQG: Greater than 1,000 kg/mo(2,200 lbs./mo.) Hazardous Waste(at your site) Note:A <br /> of non-acute hazardous waste;or hazardous waste permit is required for this <br /> activity. <br /> b.SQG: 100 to 1,000 kg/mo(220-2,200 lbs./mo.) <br /> of non-acute hazardous waste;or YO NO 4. Recycler of Hazardous Waste(at your <br /> site) <br /> 0 c.CESQG: Less than 100 kg/mo(220 lbs./mo.) <br /> of non-acute hazardous waste YO NEI 5. Exempt Boller and/or Industrial Furnace <br /> If"Yes",mark each that applies. <br /> In addition,indicate other generator activities. Ll a. Small Quantity On-site Burner <br /> Exemption <br /> YO Ni]d.United States Importer of Hazardous Waste E3 b. Smelting,Melting,and Refining <br /> YO NED e.Mixed Waste(hazardous and radioactive)Generator YO NO 6. Underground Injection Control <br /> B. Universal Waste Activities C. Used Oil Activities <br /> Mark all boxes that apply. <br /> YO NO 1. Large Quantity Handier of Universal Waste(accumulate <br /> 5,000 kg or more)[refer to your State regulations to YO NO 1. Used Oil Transporter <br /> determine what Is regulated]. Indicate types of universal If"Yes",mark each that applies. <br /> mark all boxes that apply: 0 a.Transporter <br /> Manage 0 b.Transfer Facility <br /> a. Batteries 171 YO NO 2. Used Oil Processor and/or Re-refiner <br /> b. Pesticides 0 If"Yes",mark each that applies. <br /> 0 a.Processor <br /> c. Mercury containing equipment 0 0 b.Re-refiner <br /> d. Lamps ❑ <br /> e. Other(specify) ❑ YO N ED 3. Off-Specification Used Oil Burner <br /> f. Other(specify) F-3 YO NEI 4. Used Oil Fuel Marketer <br /> g. Other(specify) 0 If"Yes",mark each that applies. <br /> 0 a.Marketer Who Directs Shipment of <br /> Off-Specification Used Oil to <br /> YO NO 2. Destination Facility for Universal Waste Off-Specification Used Oil Burner <br /> Note:A hazardous waste permit may be required for this activity. 0 b.Marketer Who First Claims the <br /> Used Oil Meets the Specifications <br /> EPA Form 8700-12(Revised 7/2006) Page 2 of 3 <br />