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Hazardous Waste Management Program <br />Revised 3/21/16 <br />3,&.83$1'5(48,5(''2&80(176 <br />WM - WASTE MANAGEMENT SERVICE PROVIDER 31 <br />7KH1RQ6DOHDEOH+D]DUGRXV0DWHULDO&KHFNOLVWPXVWEH¿OOHGRXWDQGNHSWLQDFOHDUSRXFKRQWRS <br />of each hazardous waste tote and on the side of the universal waste box. The UPC, manufacturer, <br />GHVFULSWLRQVL]HDQGTXDQWLW\¿HOGPXVWEH¿OOHGRXWIRU(9(5<,7(03/$&(',16,'(7+(727( <br />This form allows Waste Management to properly identify the contents of the tote during pick-up. <br />Your store will be supplied with 12 copies of this form for your initial setup which can be found in the <br />Program Binder. Additional copies can be printed from Online Resources. <br />Online Resources for Stores> Hazardous Waste Management Program> <br />Documents & Communication> Non-Saleable Hazardous Material Checklist <br />The Universal Waste Pick-up Request Form attached to the Universal Waste bin and large box and <br />PXVWEH¿OOHGRXWZKHQ8QLYHUVDO:DVWHLVUHDG\IRUSLFNXS<RXUVWRUHZLOOEHVXSSOLHGZLWK <br />copies of this form for your initial setup which can be found in the Program Binder. Additional copies <br />can be printed from Online Resources. <br />Online Resources for Stores> Hazardous Waste Management Program> <br />Documents & Communication> Universal Waste Pick-up Request Form <br />       <br />   <br />5  <br />""%1*$!/%+%(%$** $)* $#$*3 /%+- )*%)+"*& !+&%/%+("(%.% <br />$ ,()"4)*6"*(%$ )7 &")+)* )%(#3 /%+(& !+& )%(/%+(0(%+))* <br />%*)1)+)/%+("##"1%((%) ,1$%. &")+)* %$4""0(%+) *( " <br />!" )*3  <br /> <br />;3 '+)*() # <br /> <br /><3 %+(=  *%(>  *)*%(8 <br /> <br />=3 *%(.8 <br /> <br />>3 $ ,()"4)*6"*(%$ )7 4*%*"&""*)%*"(%.) <br /> <br />?3 ")&(%, * # "()) <br /> <br />@3 .* )%#&"*%(#*%B ??4 <?>4 <<>@  <br /> <br /> ($ ,()"4)*6 "*(%$ )7 5 ""%  $6 7- "".*%*)*%( )&"/ $* <br />& !+&*3")&(%, * *%*( ,(%$*/%& !+&3,(*+($4(%+$* #*%, <br />*"($ ,()"4)*6"*(%$ )7& !+& )?4A+) $))/)3")""BAA4?@A4;<@;- *  <br /> ))+)$%(%$($)3 -(, $  +"*/( $/%+/.1-- ""%(-(%&/, # "*%/%+( <br /> 3 <br />0(%+))*%*)4 %$4""0(%+) *( ")!" )*$%+$$%#&"* $ <br />$" $)%+()*2 <br />   <br />              <br />      <br />