Laserfiche WebLink
0 <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS WASTE <br /> RECYCLABLE MATERIALS REPORT - PAGE 1 <br /> FOR EXCLUDED OR EXEMPTED MATERIALS ONLY <br /> PD 7."MINI D <br /> tau_sr_. <br /> FACILITY 1139EPA ID p <br /> CAL000257516 NU'V 18 2 <br /> BUSINESS NAME(SOmra FACILITY NAME or haA-peina auslnetsk) �_iw1,4(� Eiyi HEALTH 5 <br /> TRADEWAY COLLISION CENTER, <br /> DATES OP REPORTING PERIOD BEGINNING DATE 500 ENDfNG DATE " 501 <br /> 9-1 -2002 <br /> I.TYPE OF RECYCLING ACTIVITIES <br /> If yes,please follow instructions. <br /> I. Do you recycle more than 100 kgfmanth of excluded or exempted 301 J If YES,you are both the generator and recycler. <br /> recyclable material at the same location at which the mamrial was ® YES ❑ NO Complete one Recyclable Materials Report. Do not <br /> gcncated(onsite recycling)? complete Para 11 and V. <br /> 2. Do you recycle more than 100 ky'month of non-manifested, les J If YES,you are an offsite recycles but not the <br /> excluded recyclable materials received from an oftisite location YES 0 NO generator. Complete a Recyclable Materials Report <br /> (otfsitc recycling)^ for each generator that sends you materials. <br /> —Businesses that only lend recyclable materials to an oflsitc rccyclers ore not required to rile this report.-- <br /> 11. OFFSITE GENERATOR OF RECYCLABLE MATERIAL <br /> Only cempletc when the generator is ditTcrent from the¢cycler. <br /> OFFSITE GENERATOR OF RECYCLABLE MATERIAL los OFFSITE GENERATOR EPA IDs As <br /> STREET ADORES$ soe PHONE 507 <br /> CITY soe STATE 100 1 ZIP CODE ma <br /> MAILING ADDRESS(IF DIFFERENT) set <br /> CITY 51= I STATE 511 ZIP CODE s11 <br /> III. CERTIFICATION SECTION <br /> I certify underpenafry of law that this document and all attachments were prepared uadcrmy direction or supervision in accordance with a system designed to assure <br /> that qualified personnel properly gachcr and evaluate the Information submitted. Based on my inquiry of the person or persons who manage the system,or those <br /> directly responsible for gathering the information,the information Is,to the best of my knowledge and belief,true,accurate,and complete. <br /> SIGNAT C IF R DATE ses NAME OFDOCUM NT PRREEPAREg 51e <br /> 1 -14-2002 evin J. Sturtr KJS Health <br /> NAME OFSIGNER(pdnq 1,1 TITLE OFSIGNER - ser <br /> KIRK WATSON MANAGER <br /> UPCF(1/99 revised) 179 <br /> EB 39Vd 800Id HIJId EEPE890606 T17191 L08L/91/81 <br />