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ieanHarbor [R FE Ego <br /> AVIRONMENTAL SERVICES' JUL 4 d 2008 <br /> ;an Joaquin County Permanent HHW Collection Facility <br /> 850 South R.A Bridgeford Street EP RONME:N NEPIL TH <br /> aockton,CA 95206 PERMIT/SERVICES <br /> sired: 209458-5670 <br /> 'ax: 209-468-5672 <br /> CESQG DATA SHEET Sr WAIVER <br /> Business Information <br /> B & B Equip Co Richard or John <br /> P O Box 31600 <br /> Stockton Ca 95213 209-942-3131 <br /> Buslness Waiver <br /> State and federal hazardous waste laws limit the use of this type of waste collection programs to those businesses that <br /> generate less than 100 kilgrams(27 gallons or 220 pounds)of hazardous waste per month. Businesses that generate more <br /> than this amount are required by law to use a licensed hazardous waste hauler to manifest and transport their waste. <br /> Therefore, in order to participate in this program, you must sign the following wasiver of liability.We reserve the right to review <br /> your annual manifests or consult with the County Environmental Health Department to determine your eligibility for use of this <br /> program. Thank you. <br /> I certify the business that I am representing is a Conditionally Exempt Small Quantity Generator(CESQG)who generates no <br /> more than 100 kilorams(27 gallons or 220 pounds)of hazardous waste per month based on an annual average and I, the <br /> representative of the CESQG, understand the maximum qu ti of waste accepted at the time fo disposal is 27 gallons or 220 <br /> pounds and any disposal costs incurred shall be the res siblit y of the CESQG to pay at the time of disposal. <br /> 7/10/2008 1:00 PM Sig ure <br /> DO NOT WRITE BLOW THIS LINE <br /> INVENTORY <br /> (To be completed by collection personnel) <br /> Item Gallons Pounds S of Cont. Price Total <br /> Flammable Solid(Asphalt with oil 71 2 1.50 106.50 <br /> Fluorescent Lamp 4 1 0.60 2.40 <br /> Flammable Solid Metal Shavin 2 1 1.50 3.00 <br /> Sub total 111.90 <br /> Process fee $20.00 <br /> Total $131.90 <br />