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s <br /> ) <br /> EPA ID Number C A L 0 0 0 2 9 9 4 1 4 OMB# 2050-0024 ; Expires 05/31 /2020 <br /> i <br /> F <br /> 10. Type of Regulated Waste Activity (at your site) <br /> Mark "Yes" or "No" for all current activities (as of the date submitting the form ) ; complete any additional boxes as instructed . <br /> A. Hazardous Waste Activities <br /> E <br /> N 1. 'Generatar4. . Qf Haiardous Waste . If:"Yes", mark. only pne of tl� e following—.a, b, c <br /> a . LQG -Generates, in any calendar month ( includes quantities imported by importer site) € <br /> 1,000 kg/mo ( 2,200 Ib/mo) or more of non-acute hazardous waste; or <br /> - Generates, in any calendar month, or accumulates at any time, more than 1 kg/mo <br /> (2 . 2 Ib/mo) of acute hazardous waste; or i <br /> - Generates, in any calendar month or accumulates at any time, more than 100 kg/mo <br /> (220 Ib/mo) of acute hazardous spill cleanup material . <br /> E <br /> b . SQG 100 to 1,000 kg/mo (220-2, 200 Ib/mo) of non-acute hazardous waste and no more than s <br /> 3 kg (2 .2 Ib) of acute hazardous waste and no more than 100 kg ( 220 ib) of any acute <br /> hazardous spill cleanup material . <br /> c. VSQG Less than or equal to 100 kg/mo ( 220 lb/mo) of non -acute hazardous waste. } <br /> 1 <br /> ®Y �N . 2 . Short Term Generator (generates from a short-term or one-time event and not from on -going <br /> processes) . If "Yes", provide an explanation in the Comments section . Note: if "Yes "I you MUST Indicate <br /> that you area Generator of Nazardous .Wasre in Item . 10.A. 1 above. <br /> ®y n : : 3 . Treater, Storer or Disposer of Hazardous Waste- Note : Part B .of a hazardous waste permit is .required <br /> for these. activities . <br /> Y . . , N <br /> 4:. .Receives . Hazardous .W.aste,from .gff-site : : : '. <br /> �/ <br /> I <br /> 5 Recycler.of Hazardous Waste . : <br /> DY . . NF € <br /> ❑ a . Recycler who stores prior to recycling <br /> ) <br /> b . Recycler who does not store prior to recycling <br /> . .. . . .. <br /> Y ,/ N 6. Exempt Boiler :and or ndustrial .Furnace- lf "Yes"; mark. all that apply. <br /> a . Small Quantity On-site Burner Exemption i <br /> x <br /> b . Smelting, Melting, and Refining Furnace Exemption <br /> f <br /> B. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes <br /> handled at your site . List them in the order they are presented in the regulations ( e . g. D001, D003, F0071 U112 ) . Use an <br /> additional page if more spaces are needed . <br /> F003 D018 <br /> F005 IF <br /> D001 <br /> D005 <br /> i <br /> D006 <br /> i <br /> C. Waste Codes for State Regulated (non-Federal ) Hazardous Wastes. Please list the waste codes of the State hazardous <br /> wastes handled at your site . List them in the order they are presented in the regulations. Use an additional page if more <br /> spaces are needed . s <br /> 281 213 <br /> s <br /> 223 133 <br /> EPA Form 8700 12, 8700-13 A/B, 8700-23 Page 3 ofFIF <br /> 6 <br />