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State of California—California Environmental Agency Department of Toxics Substances Control <br /> 8.) In an attached document, describe in detail your ability to properly remove and manage all materials that require <br /> special handling(MRSH) (HSC 25211.4(a)), found in appliances. The list below describes the level of detail that <br /> DTSC would like to see: <br /> • General Knowledge-What types of MRSH are found in specific appliances' <br /> • Training-Who will provide training to personnel responsible for removing MRSH from appliances at your <br /> facility? What are the contents of the training and what MRSH will be covered? How frequently will staff be <br /> trained?When will new staff be trained?What hard copy and electronic training and reference materials will <br /> be made available to staff? <br /> • Health and Safety-Describe your facility's health and safety plan and/or the duties of a safety officer. What <br /> personal protective equipment is used during the removal of MRSH? Provide information for spill kits <br /> available at your facility. <br /> • Proposed removal processes-List the tools and equipment you use to remove each type MRSH. Briefly <br /> describe how each MRSH is identified and the procedure used to remove each type of MRSH from the <br /> appliance <br /> • Storage'-How long do you plan to accumulate removed MRSH at your facility? Describe the containment of <br /> the MRSH. How are the containers labeled for each MRSH? Describe how materials will be packaged to <br /> avoid breakage. Describe your record-keeping system. <br /> • Disposition of Waste-What will be the disposition of each MRSH? Please provide the name of the company <br /> that picks up waste, or a description of where the waste is sent and/or how it gets there. <br /> What else should we know in order determine that you are capable of properly removing&managing MRSH? <br /> Optional: Site Information: <br /> Days and hours of operation of the facility: M-F T-30 "`-!-J' <br /> Open to the public? U Yes ❑ No <br /> Type, expected source, expected number or weight of appliances to be handled per month at your facility: <br /> 11�o/1y7. c ell ' ,r�< ar, 11;ocr��rl nA ,LArJ4JU'IF '�C I u��� rt„`` < tl�c F r%2..ti�f'6_L___. <br /> ,21U,C l a�J� t OJJ 'r��o) Y"bi,C II�C� c ' , Ci�Dl,G'nCcS cA oma.' tr<'.1.I, b1f_ i�,.S t S <br /> �i r\ 1�YZ�t �Ll,lOJl •/U /�� <br /> CERTIFICATION <br /> CERTIFICATION <br /> I certify under penalty of perjury that this document and all attachments were prepared under <br /> my direction or supervision to assure that qualified personnel properly gathered and evaluated <br /> the information submitted. Based on my inquiry of the person or persons directly responsible <br /> for gathering the information, the information submitted is, to the best of my knowledge and <br /> belief, true, accurate and complete. <br /> Signature: ti Date: <br /> Printed Name: 3aItIcC�G_ V Title <br /> Any MRSH that is a hazardous waste must be managed in accordance with Ch. 12 of 22 CCR <br /> OT SC 1426 111104/2010) page 2 of 2 <br />