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+ <br />Spill/Waste Tracking Loguj zF <br />\ , ujc <br />Notify VeederRoot 1-800-997-7725 (Press Option 4, Option 4) to report ALL spills over a % Gallon. All j Z <br />fuel/surface spills, hose replacements, and filter changes are required to be documented on the log beN0.. <br />Fuel Station #-Lt 4-1 <br />M <br />M <br />s <br />4- <br />4 - <br />It <br />P <br />O <br />N <br />A <br />A <br />It <br />0 <br />10 <br />m <br />ti <br />It <br />a <br />0 <br />N <br />ti <br />0 <br />r` <br />N <br />a <br />s <br />d <br />w <br />m <br />P <br />00 <br />N <br />O <br />I <br />0 <br />N <br />Date/Time <br />of Spill or <br />Waste <br />sposal: <br />Estimated Quantity/ <br />Type of waste: I.E. 1 cup, <br />lgal, 2 absorbent pads, <br />1 hose, 12 filters <br />How Spill/Waste was <br />created: I.E. Customer <br />Fueling Error, Drive- off, <br />Maintenance <br />Actions taken to clean up the spill: I.E. <br />used FM186 {Include the name of the <br />person who cleaned up the spill, added <br />waste to the barrel} <br />Hazardous Waste <br />Type: I.E. Solid or <br />Liquid <br />Haz Waste <br />Accumulation <br />Start Date <br />Haz Waste <br />pick up <br />date <br />i40-1�( <br />I(te oL n( .64'0 <br />CIE i.�( <br />cc.4a^-a-loco! <br />NameU %V.e.., ci,Q��✓D��� <br />�+'i FM.+wib.ub5a[a&n� d5 <br />V061c{ <br />oz/z0lfc <br />Name: <br />Name: <br />Name: <br />Name: <br />Name: <br />Name: <br />Name: <br />If the estimated quantity of the spill is unknown, then insert unknown in the "Estimated Quantity" column. <br />