Laserfiche WebLink
State of California—California Environmental Protection Agency Department of Toxic Substances Control <br /> Orphan Appliance Monthly Report F " EIVED <br /> Please send this document on a monthly basis to DTSC by mal in to: <br /> Attn: Consumer Products Section 1 7 2017 <br /> Department of Toxic Substances Control <br /> Office of Pollution Prevention and Green Technology <br /> 1001 "1" Street, 11th Floor ENVIRONMENTAL HEALTH <br /> P.O. Box 806 DEPARTMENT <br /> Sacramento, California 95812-0806 <br /> Month: Year: 2b <br /> Name of scrap recycling facility: (�I1��v1E�75AJEG)'c�� �9 <br /> Facility address: <br /> Name of CAR: LtSR Sr� t���~d CAR # 363 <br /> Total number of"orphan" appliances received this month (as indicated by use of DTSC <br /> Form 1459) received: <br /> This information is not required, but is appreciated: <br /> Space Heaters: .Moues <br /> Refrigerators: l Boilers: -- <br /> Freezers: Furnaces: <br /> Microwaves: Water Heaters: I� T <br /> Washers: /2 `/ Air conditioners: <br /> Dryers: z c✓ Trash compacters: — <br /> Ovens/.5Tov1�: �� I <br /> Other (please specify): ER <br /> The names and addresses of each person who transported, delivered, or sold 'orphan" <br /> appliances to this scrap recycling facility is included on the following additional pages. <br /> This information has also been submitted to my CUPA. <br /> Sincerely, <br /> Universal Service Recycling, Inc. <br /> Paul Bischofberger <br /> Name l,lvl 1 Environmental Health&Safety <br /> P c IN 209•944•9555 <br /> FAX:209.944.5552 <br /> •••............................ CELL:209.855• 1715 <br /> Contact Information 3200 South EI Dorado Street,Stockton,CA 95206 <br /> E-mail:Pbischofberger@usrscrap.com <br /> DTSC Form 1468(1115/09) www.usrscrap.com <br /> Page 1 of 1 <br />