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HAZARDOUS WASTE COLLECTION STATION <br /> Required Documents <br /> HAZARDOUS TOTE LABELS AND CHECKLIST <br /> Hazardous tote labels and checklist will need to be filled out for the initial set up of your hazardous <br /> waste collection station, each time an item or bagged clean-up is placed in a tote and after each <br /> Waste Management pick up. Refer to page 30 for instructions on how to properly fill out the labels. <br /> HAZARDOUS US <br /> STATE AND FEDERAL LAW PROHIBIT IMPROPER DISPOSAL. <br /> IF FOUND,CONTACTTHE NEAREST POLICE OR PUBLIC SAFETY <br /> AUTHORITY,THE U.S.ENVIRONMENTAL PROTECTION AGENCY. <br /> GENERATOR INFORMATION: <br /> NAME <br /> ADDRESS PHONE I <br /> CITY STATE_ZIP 1 <br /> MANIFESTTNACKING NO. <br /> EPA ID N0. <br /> EPA ACCUMULATION <br /> WASTE N0. START DATE <br /> CONTENTS,COMPOSMON: CONTENTS <br /> PHYSICAL STATE: I HAZARDOUS PROPERTIES: ❑FLAMMABLE ❑ TOXIC <br /> ❑SOLID ❑LIQUID ❑COHROSIVF ❑REACTIVITY ❑OTHER <br /> l ACCUMULATION START DATE <br /> J SHIPPER <br /> ADDRESS <br /> HANDLE WI RURE! CITY STATE,ZIP <br /> NONSALEABLE HAZARDOUS MATERIAL CHECKLIST P"er BigLOTS.. vim, <br /> UNIVERSAL WASTE PICK—UP REQUEST FORM <br /> wremasrrmaces,r..e�ewomw..eas-_.m"ares' amrorraareenasae <br /> Ts.VaueseN.p„�b101anriYydyMg.rrp,o,e•W.bl,r4mrroxrylrYaWq,rr• UMv,[hankyou Waste <br /> Management.if You wish to schetlule the pickup of yourlargWaste <br /> 9m;�' A �f Unlversal E-Waste lElectronlcslpl srdse chis fl—e yourpickup isforyour...rd..Waste <br /> TIUM TotJ such as your Flammable,Corrosive,and Toxic please use the Non-SaleaEle HaxarEous Material <br /> Checklist. <br /> 1. Requesters Name <br /> Will YfOR1111710N <br /> iCawa.r0 �est.� Osf/TIOM t0 mT 2.Your 3 digit 114 dlglt store# <br /> ri 3.Store Faxp <br /> 4.Universal E.Waste l Electronlcsl-total pallets ofthe large boxes C <br /> 5.Please provide the DTLemailaddress <br /> 6.Fax this completed form 1.855-254-2246 <br /> Large Uri,ersal E-Waste(Electronlcsl-N BIII of Lading(BOL)will be faxed to the smre...playing tre <br /> pickup date.Please provide the BOL to the driver on the day.f pickup.The avemge1urn-around timet.have. <br /> the large Universal E-Waste(electronics)picked up Is 7 business days.Please ca11877-567-1261 with 80L <br /> and or co ns.if we are having diffcultyreaching you by fax,we will forward a copy via email to your <br /> Hazardous Waste Totes-The—Seleeble Hazardous Materiels Checkllrt can be found end completer n <br /> Online Res.urces a[: <br /> ��giTN{ httP✓/storeveD.cnzcom/Drtralning/Nazard.usWasteYrogram/N.nSellableHazMatCherkllztpol <br /> B16LOTsa► Hazardous Waste Management Program <br /> Revised 3/21/16 <br />