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EPA ID Number <br />OMB#: 2050-0024; Expires 11/30/2011 <br />D. Eligible Academic Entities with Laboratories—Notification for opting into or withdrawing from managing laboratory hazardous <br />wastes pursuant to 40 CFR Part 262 Subpart K <br />:• You must check with your State to determine if you are eligible to manage laboratory hazardous wastes pursuant to 40 CFR Part <br />262 Subpart K <br />1. Opting into or currently operating under 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories <br />See the item -by -item instructions for definitions of types of eligible academic entities. Mark all that apply: <br />❑a. College or University <br />b. Teaching Hospital that is owned by or has a formal written affiliation agreement with a college or university <br />© c. Non-profit Institute that is owned by or has a formal written affiliation agreement with a college or university <br />2. Withdrawing from 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories <br />11. Description of Hazardous Waste <br />A. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes handled at <br />your site. List them in the order they are presented in the regulations (e.g., D001, D003, F007, U112). Use an additional page if more <br />spaces are needed. <br />Q0 <br />'DO 0ff <br />u <br />Do b <br />'Dbe-1 <br />iDO B <br />'DO le <br />5- <br />'DO -35- <br />P 3 <br />PC) <br />-DO 40 <br />B. Waste Codes for State -Regulated (i.e., non -Federal) Hazardous Wastes. Please list the waste codes of the State -Regulated <br />hazardous wastes handled at your site. List them in the order they are presented in the regulations. Use an additional page if more <br />spaces are needed. <br />2-'r <br />Jkk <br />:.(3 <br />t) 13 <br />21 LA <br />2-2 <br />2— <br />EPA <br />EPA Form 8700-12, 8700-13 A/B, 8700-23 (Revised 11/2009) <br />Page 3 of q <br />