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EPA ID Number I C I A I R 1 0 1 0 1 0 1 2 1 2 1 9 1 7 1 3 1 2 1 OMB#2050-0024; Expires 05/31/2020 <br /> United States Environmental Protection Agency } ` '` <br /> HAZARDOUS WASTE REPORT 2017 (reporting cycle) (;!ki <br /> WASTE GENERATION AND MANAGEMENT (GM) FORM M <br /> 1. Waste Characteristics <br /> A.Waste Description Broken Fluorescent Bulbs <br /> B. EPA Hazardous Waste Codes) D009 <br /> C. State Hazardous Waste Code(s) 181 <br /> D.Source Code G11 Management Method Code (Source Code G25 only) <br /> E. Form Code W320 F.Waste Minimization Code X <br /> G. Quantity 3.000000 UOM 1 Density ❑ lbs/gal ❑ sg <br /> 2. On-site Generation and Management of Hazardous Waste <br /> ❑Y ❑� N Was any of this waste that was generated at this facility treated,disposed, and/or recycled on-site? If yes, <br /> continue to On-site Process System 1. <br /> Process System 1 Management Method Code Quantity <br /> Process System 2 Management Method Code Quantity <br /> 3. Off-site Shipment of Hazardous Waste <br /> ❑✓ Y ❑N A. Was any of this waste that was generated at this facility shipped off-site for treatment,disposal,or recy- <br /> cling? If yes,continue to Site 1. <br /> Site 1 <br /> B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quantity Shipped <br /> CAD980884183 H141 3.000000 <br /> Site 2 <br /> B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quantity Shipped <br /> Site 3 <br /> B. EPA ID of facility to which waste was shipped C. Management Method Code D. Total Quantity Shipped <br /> 4. Comments <br /> EPA Form 8700-12,8700-13 A/B, 8700-23 GM Page 3/12 <br />