|
D � X 0 N OF r-K-
<br />t. : r- .... r ..:
<br />GENERATOR WASTE TPCA Mq (PLEASE 0HECK THE APPROPHUAi E C )
<br />By signing bQ ow 1 hereby cerliry that:
<br />(Taste od generatorlicustarnev MUST check 01I of &�e NAI 0- ,im, Fg Tnree bol;I.P-
<br />i. Yj) P have no! mixed 9ny of $he,,a SEB descrited aboV[ MV) any oche, haz&'dou5 v,'3,St. rhe Y),3E ha ({� COf'-t^_aF 4F ! °iS F ,ar , ",Jc N'F. <:nr - e .jas°.c .e,.
<br />! omol ie.d Zvi{tT the requirements of the app€iGaok, California "C- 031 r;l,inaC'ement 4Odere mrr.'„ .!_'s _ c , � _P 6 ,he „i r , a ,,60t,
<br />ff?e tniormalkm I brave pro° iped about fhis u`-aste is incorrect
<br />I_...t 2 1 have not mixen any of the w<tst0 descr;6ed above wall -,Try other rntzIrdoos the ¢ata; haii e i_s (;Ri"d 7E -
<br />half!prc,-,Getz P,0Per+.7OCiln1£-»ta;'.O-^-i�Vcrlci 0r3 serviep.810 ebut?he ,re5t1E"pf;0:: Ih?.t ibis �asie"vas i.:Q
<br />rharge,� fpr lyre (1*f)osa1 of lhls waute if Me. EnfoPmMion ; h1vC provided <)bciuf thifi',v8, f% it ir-orrect
<br />�-. 4,) This waste is frory a tllnif which COKeM, waste dri frOM hor.ISehord "dD-it ypfirScir" 'D!Vy and'or ccnditioa,al;y e>•A'F'( s- aii C, [fat - ,crier ..]. , , .. , ..E_, _ -1e o -t oI
<br />rnowledge, the on€y v,raste oil contained in ray 13 W CESQG co€lecncn lank is soley from MY addict, CESOG seances 1 hale ,ret m€red ti ,.:xie ., , , . - ",v�. ;n,:.> a< r ;�i ..U.,,
<br />from o.he, s,�L,ces. f a�3,ec i❑ .rcu pl the additio,aT Oiargz, for di spc of of this wn3S 6 it the intcirm Ali#yup 1 have p ro,idcd aboU. fr =. Yol_ _c:oh'E,,'
<br />(All generator ' customers MUST nead the, following text
<br />1 ezftiiy ih3 t i have a frogsm m place tq reduce fhe rfA ume. and bt} i itV pf WvWo generated to the dogrbt f ,in,e d',M, rr"r3:;ef Pn hC ef,.. �„ Y :'., .y'�iy t , ,E G, �... h:;r
<br />prac.tic,iHe method of irEatmC={Ti, storUSe, or dispoU 1 CU-enl4 y avaifafsleto me U'+'"3i.-h iYi i¢Zh*:=-e5 titf Pre lent and foTwcr ih.rf,,_ i<. r .:Train _ F':nr,1 the
<br />This int�ividuaf signing iar tine space se4 f0nh belew on beh"i f of clistomer represems and warrants thn! hc; Ifie has ihtt �a. is
<br />and marCHalg aYe fru© and aCCdrpte as packaged, nlarkedi and labcler13 are reFdv for!ralxspoMahon � and -i aP abrdE:
<br />by thf) 81-3atdard ±mals and Con d€!ions ee the Teverse side of this servlee Grdtr.
<br />Service Girders ti•, ith an assot>iated waste manifest (elfht:r site specific or cn;`soLris"ea; a:e s=.rt,;ev± to ;art FPA n _. ees.»e• r a _. c r ,�r ue 's,; ,rr:-.
<br />of the 00anifest program. These fees vary based on Mani`est type. A€zplicaf'Ia fees Uri€i rppem on your b,!hng in,c2iee.
<br />Customer DHe€gtuSiar 3e D a4=
<br />..........
<br />Print Name Print Dr'ive� Name
<br />
|