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3190435--001C !$ 4357PSG <br /> PQ•(�orrn designed•for`use on elite(12-!)itch} <br /> FOffn RPPruvett.OMB fi�v.2�5E)Df39 <br /> U{( OE21iflAR�C?tf$ 1.Ger12raXsr-ID Number <br /> ]ZP871.0f <br /> 3.EmergersscyReSR4nSePhor3eeSF1r N[FE51 CALOW391073 (a77�577-2559 �1 87435?PS�i <br /> 5.taenesa]nrs Name and Marling Addro% Ger>erakors SiteAddress Ct rerd than mailing address] <br /> BIG LOTS STORES BIG LOTS##4457 <br /> 300 PHILLIP RI),AT ,DEKA FERARIJ •': 2551 WIRACY Sf:YE3. <br /> TR <br /> COLUMBUS,OH 43228.(614)278-4614. TRAC' ,OA 95376 20488.6312 <br /> GerreraWS Phone: <br /> ma garter 1 coiPpany Name. U.5.EPA ID Number <br /> STER(GYCLI<sPP-ClALT1 WASTESOLUTIONS INC PANS4 .110924 <br /> T Transporter 2 Gon1paRY N ' U.S.EPA ID Nun&r <br /> c <br /> 8,Designated Fac*name and Site Add U.S..EPA Irl PLrmber <br /> .21st Century EnVronillental Management of Wvada LLC ttiHyC3980B95338 <br /> 2()95 Newlands Dr.East'. <br /> Eertliey NV"89408 (7751575-2760 <br /> FacrTrty'sPhvne: . <br /> 9a 9b.U.S DOT Deseuptron('u}cludq Proper SiWAg I •HazaM Class ID Number, 10.Containers 11.Total 12.Unit 13. Codes <br /> HTS and P-15"t roup ff,anyl) No. Tygc 41ianitty I4ft Nnl. <br /> 1. NON-RCRA HAZARDOUS NfASTE 0001)(WATER eAsFd PRODUCTS) 331 <br /> 1 OF 123 P <br /> 2. UN795QWZTEAER5SOLS, 1 <br /> 331 'Do04 <br /> ilk <br /> {.� X 1 DF 10 Y <br /> 3 13141993 WASTE_FLAMMABLE LIQUIDS,N,OS.(KEROSENE,DIESEL)3 PGII, 33r D001 1fl05 <br /> x 1 <br /> OF 43 P - <br /> DW7 1018 D035 <br /> 4.-UN3266 WASM CORROSIVE LIQUID,BASIC,INORGANIC,N-0.3.(SODIUM HYDROXIDE, t41 D002 <br /> -POTASSIUM HYDROXIDE)0 PGO <br /> X 1 UP 14 P ; <br /> 19:SpF Ciat handling insitrsi3s artff Additfianat lOtonnatierr <br /> (1)6WONREGLIQ 0d-ERGO$LNONsr-GLtc9K-NON-REwt ATED WASTE PRODUCTS LIQUIDS(2)BLAEROSOL$04-ERG(126)BLAEgOSDLS Dd-AEROSOLS(3)DLFLAIIALIQ O3- <br /> EftG(129)FWMMA13LE LIOLNDS(4}&-CORRSASIC-0R-ERG(154)BL,C.ORRBASIC-04-BASIC CORROStVE MUID5 <br /> 15. jaENERA1T()WS)OFFL R'SCEgnMA'fil N.thereby(fatanatfiatthecaeterNsat#riscomignmerrtaie4u�randa telydescribedaaFlarebyffrepropsrshiPRn9name.andarec(asst�ed:Rackaged. <br /> marited and labeled'R •and are in afi.respeM m proper r ai rlfm for franspod a=4ng to ap*alk international and national gavemrnenlai ragula6ans.if export shipment and Ism the Prir m <br /> Exporter,j eerllty ltretjlie tontents,of this consignment conform to the terms of the awed E,PAAeknowledgmenl of Consent <br /> I certify that tf[e waste miirirn¢afion5tatemen!identified in A4 GFtt 262.27(a)(if f am a bNe quantdy geaeratorl or(b)(41 am a$Mali quanta{gerierafor}is true" <br /> FMO . 5 :- YR we ear <br /> G-_ 5 "'29 18 <br /> .:116.frlterrtaonal Sftments <br /> Q Import to U"S. 0 Export fm U.5 Port of edfyfa)k <br /> -T=e2rter-a2aftm M ori? :- 13etelea" U.S.: <br /> O= 17:TrarsporlerAclmowtadgirrentoFfieoeiPtofMa�t� _ <br /> ransposter 1 Priv yped Natrre ear <br /> Andy �. 1 .29L <br /> 18 <br /> E 'transpo r2FrinEO I ignature td y Year <br /> 1&Dsarepansp <br /> -B {I <br /> a.Discrepancy Spade 1__.t Quanti�r ❑Type Q Ritsidus i l Partial Rgecbm �FO Necren <br /> Maullest Werer"Number: <br /> 196.Alternate pati ilY(a 6sneratar). U.S.EPAID Number <br /> u� Fadifi 5 Phone: <br /> c3l1 Bc.Signature of Aftemate Facility(or Generator) fr f>fh Day Year <br /> 19.Haxafdous Waste Report Manwrner l Method Codes(r.e.,codes forhazardouswaste 1re�mnt dispasat,and moyc'ing systerns) <br /> � <br /> 1. 2. - 3. =4kH141 H141: M141 ' <br /> 20.Designated Facility Owner or Operator:Certification of rec&ptaf hazardous materials covered by the maOestexcept as noted in Item 183 <br /> NotdTyped Name'' }) "` Sigrtalcrre , Month Day Year <br /> WAA i t <br /> EPA Fon 8700-22.(ReV,3-W PMMOLIS.-000M are ObSOieta- "� <br />