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Hazardous Waste Management Program <br />Revised 3/21/16 <br />All states require one or two pick ups per year. These pick ups are prescheduled through Waste <br />0DQDJHPHQW8SRQDUULYDOWKHSURSHUO\LGHQWL¿HG:DVWH0DQDJHPHQWUHSUHVHQWDWLYHZLOOFRQWDFWWKH <br />Manager on Duty to pick up the hazardous waste your store has collected in the hazardous waste <br />totes. <br />The Waste Management representative will transfer the materials in your tote to the appropriate <br />hazardous waste collection drums that Waste Management will bring with them. The following items <br />on these forms are to be completed by the Store Team Leader when placed on the collection tote at <br />the start of each new collection period. <br />During hazardous waste pick-up, the Waste Management representative will assess the store’s <br />FRPSOLDQFHZLWKWKHSURJUDPFRPSRQHQWV HJHQVXUHZDVWHVDUHSURSHUO\EDJJHGDEVRUEHQWLV <br />XVHGZKHQQHFHVVDU\HWF 6KRXOGWKH:DVWH0DQDJHPHQWUHSUHVHQWDWLYHGHWHUPLQHWKHVWRUH <br />is not following the required elements of the program, the Waste Management representative will <br />FRPPXQLFDWHWKHVHGH¿FLHQFLHVWRWKH0DQDJHURQ'XW\,QVRPHFDVHVWKHVHGH¿FLHQFLHVZLOODOVR <br />EHFRPPXQLFDWHGEDFNWRWKH%LJ/RWV*HQHUDO2I¿FH <br />3,&.83$1'5(48,5(''2&80(176 <br />WM - WASTE MANAGEMENT SERVICE PROVIDER 30 <br />Complete the Store <br />Name and Number, <br />Address, Phone, City, <br />State and Zip <br /> Start date when the <br />new label is placed on <br />the tote <br />Check the box that <br />is appropriate to the <br />items being collected <br />in the tote this will be <br />adhered to <br />Provide your EPA ID # <br /> ,IDSSOLFDEOH <br />Always check SOLID <br />7KH02'PXVWFRPSOHWHDQHZODEHODQGDGKHUHWRWKHDSSURSULDWHFRQWDLQHULPPHGLDWHO\IROORZLQJ <br />SLFNXS7KH0DQLIHVW7UDFNLQJ1RDQGWKH'HVFULSWLRQZLOOEHSURYLGHGIURPWKHZDVWHSUR¿OHWKDWLV <br />JHQHUDWHGIURP:DVWH0DQDJHPHQW <br />Big Lots 4347 <br />2495 Sycamore Ave.216-555-9665 <br />Sun Valley CA 43228 <br />CAL000379463 8/12/16 <br />Oxidizer