Laserfiche WebLink
18C <br />E-SQG DATA ; WAIVER <br />San.Joaquin CountyHousehold Hazardous Waste Collection Facility <br />7850 South R. A Bridgeford Street, Stockton, CA 95206 <br />Phone: 209-468-3066 Fax: 209-468-3078 <br />your <br />City/State/Zip Code Area Code & Telephone Number I9/04 <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 kilgrams (27 gallons or 220 pounds) of hazardous waste per month. Businesses that generate more <br />than this amount are required by 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 waiver of liability. We reserve the right to review <br />your annual manifests or consult 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 representing is a Conditionally Exempt Small Quantity Generator (CESQG) who <br />generates no more than 100 kilograms (27 gallons or 220 pounds) of hazardous waste per month based on an annual <br />average and 1, the representative of the CESQG, understand the maximum quantity of waste accepted at the time fo <br />disposal is 27 gallons or 220 pounds and any disposal costs incurred shall be the responsiblitity o the CESQG to <br />pay at the time of disposal. <br />(Date j ITime 5 ISign re <br />Item <br />DO NOT WRITE BELOW <br />INVENTORY <br />(To be completed by collection personnel) <br />Gallons Pounds # of Cont. Price Total <br />Comments: <br />