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" <br /> Pa 'int Dro <br /> p f� <br /> Log (for businesses and or <br /> anizations) <br /> Eligibility : A business or organization may use the PaintCare program to manage program-eligible hazardous waste products (e .g ., unwanted oil- <br /> based paint, varnishes, solvents) only if it provides the information below and certifies that all hazardous waste it provides to the PaintCare <br /> program qualifies as exempt under federal (40 CFR § 262 . 14) and analogous state/local hazardous waste generator rules for very small quantity <br /> generators . Among other criteria, each business/organization responsible for generating waste at a site must, at that site, (1) generate no more <br /> than 100 kilograms (about 25 gallons or 220 pounds) of hazardous waste per calendar month , ( 2) generate no more than 1 kilogram (about 2 .2 <br /> pounds) of acute hazardous waste per calendar month, and ( 3 ) accumulate no more than 1,000 kilograms of hazardous waste at any given time . <br /> Because generator status can vary from month to month , your organization must sign and date this log sheet each time that it seeks to manage <br /> hazardous waste through the PaintCare program . <br /> ' tCare program qualifies as exempt <br /> being provided to the Pain p i; q <br /> Certification Statement: By signing this document, I certify that all hazardous waste g p <br /> waste under applicable federal and state/local laws . My organization releases and holds harmless the entity accepting this waste, as well as <br /> PaintCare Inc., its sole member and related companies, and their agents, employees, member companies, officers, directors, successors, and <br /> I Is assigns from any liability, claim , injury, losses or damages arising from my organization' s provision of any materials to the PaintCare program . <br /> [This log sheet may be provided to state agencies upon their request.] <br /> Oil -Based Phone <br /> Paint Name of Address of Name of Person <br /> Date Gallons Business/Organization Business/ Organization ' Dropping-Off Paint Si ature Number <br /> ft <br /> 3 3/- Y z <br /> 5 (4ZO Lo <br /> PalNr* , , (0 / <br /> is <br /> /07 <br /> Ks so <br /> Updated Oct 2017 <br />