Laserfiche WebLink
0 <br /> EPA ID NO: I c I A 1 0 11 0 1 0 1 0 11 1 1 4 1 2 11 3 1 3 1 1 <br /> OMB#: 2050-0028 Expires 06/30/2009 <br /> 9. Legal Owner Street or P.O.Box: 4500 Dorr Street <br /> (Continued) <br /> Address City,Town,or Village: Toledo <br /> State: OH <br /> Country: US Zip Code:43615 <br /> 10. Type of Regulated Waste Activity <br /> Mark"Yes"or"No"for all activities;complete any additional boxes as Instructed. (See instructions on pages 17 to 20.) <br /> A. Hazardous Waste Activities <br /> Complete all parts for I through 6. <br /> YO NEI 1. Generator of Hazardous Waste YO NO 2. Transporter of Hazardous Waste <br /> If"Yes",choose only one of the following-a,b,or c. <br /> YEI NO 3. Treater,Storer,or Disposer of <br /> E] a.LQG: Greater than 1,000 kg/mo(2,200 lbs./mo.) Hazardous Waste(at your site) Note:A <br /> of non-acute hazardous waste;or hazardous waste permit is required for this <br /> activity. <br /> 0 b.SQG: 100 to 1,000 kg/mo(220-2,200 lbs./mo.) <br /> of non-acute hazardous waste;or YO NO 4. Recycler of Hazardous Waste(at your <br /> site) <br /> 0 c.CESQG: Less than 100 kg/mo(220 lbs./mo.) <br /> of non-acute hazardous waste YEI NO 5. Exempt Boller and/or Industrial Furnace <br /> If"Yes",mark each that applies. <br /> In addition,indicate other generator activities. E3 a. Small Quantity On-site Burner <br /> Exemption <br /> YEI NO d.United States Importer of Hazardous Waste 0 b. Smelting, Melting,and Refining <br /> YEI NO e.Mixed Waste(hazardous and radioactive)Generator YEI NO 6. Underground Injection Control <br /> B. Universal Waste Activities C. Used Oil Activities <br /> Mark all boxes that apply. <br /> YE]NO 1. Large Quantity Handler of Universal Waste(accumulate <br /> 5,000 kg or more)[refer to your State regulations to YO NO 1. Used Oil Transporter <br /> determine what Is regulated]. Indicate types of universal If"Yes",mark each that applies. <br /> mark all boxes that apply: 0 a.Transporter <br /> Manaae [J b.Transfer Facility <br /> a. Batteries 1771 YO NO 2. Used Oil Processor and/or Re-refiner <br /> b. Pesticides 0 If"Yes",mark each that applies. <br /> ❑ a.Processor <br /> c. Mercury containing equipment b.Re-refiner <br /> d. Lamps ❑ <br /> e. Other(specify) 13 YO NO 3. Off-Specification Used Oil Burner <br /> f. Other(specify) ❑ YO NO 4. Used Off Fuel Marketer <br /> g. Other(specify) O If"Yes",mark each that applies. <br /> E] a.Marketer Who Directs Shipment of <br /> Off-Specification Used Oil to <br /> YEI NEI 2. Destination Facility for Universal Waste Off-Specification Used Oil Burner <br /> Note:A hazardous waste permit may be required for this activity. 0 b.Marketer Who First Claims the <br /> Used Oil Meets the Specifications <br /> EPA Form 8700-12(Revised 7/2006) Page 2 of 3 <br />