Laserfiche WebLink
leanHarbare <br /> ENVIRONMENTAL SERVICES <br /> San Joaquin County Permanent HHW Collection Facility <br /> 7850 South R-A Bridgeford Street u i <br /> Stockton, CA 95206 JUN 0 4 200 <br /> Direct : 209-468-5670 <br /> Fax: 209-468-5672 <br /> CESQG 0W1'5ir&WAIVER <br /> Business Information <br /> �� Cs A <br /> Business 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 kilgram (27 gallons or 220 pounds)of hazardous waste per month. Businesses that generate more <br /> than this amount are required b 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 consu t 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 r presenting 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, L nderstand the maximum quantity of waste accepted at the tirne fo disposal is 27 gallons or <br /> 220 pounds and any disposal costs incurred shall be the responsiblitity of the CESQG to pay at the time of disposal. <br /> 6/5/2008 Signature <br /> DO NOT WRITE BELOW THIS LINE <br /> INVENTORY <br /> (To be completed by collection personnel) <br /> Item Gallons Pounds #of Cont. Price Total <br /> Fuel Filter 2 2 $1.00 2.00 <br /> Flammable Solid 17 1 1.50 25.50 <br /> Sub total 2750 <br /> Process fee - $20.00 <br /> Total - $47.50 <br /> Comments: <br />