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2128 Industrial Drive PR0521427 <br /> December 26, 2018 <br /> PHOTO 3:Waste being disposed of on a CESOG receipt. Site enerates over 100k of waste per month so it does not qualify to use this type of receipt. <br /> 4Yy °Jnr 30 ON3 NO IaSV-V,4><91nd'Nt OU.. <br /> 230tlO <br /> woo,�.,00N„� O Psn <br /> l� >3ar�a <br /> t/f 5}dYiw`w` 11855 White Rock Rd. <br /> FG"i! 4(�I,r+ Rancho Cordova,CA 95742 <br /> Cn�;rt�nrt``Yn yu;,ty$ (916)351.0980 Date: 10/14/201g <br /> Time: 0AM <br /> CONDITIONALLY EXEMPT SMALL QUANTITY GENERATOR WASTE CHECK-IIN AND CERTIFICATION <br /> RECEIPT AND CERTIFICATION STATEMENT <br /> To be completed by the generator: <br /> -I certify that the following infarmatlon is correct,and have reaI, understand there <br /> Small Quantity Gepa@tar Waste Acceptance Program. further certify that 1 ama Condk ortalN E�emf pt Smalll Qualntiry Generator als def ned byafederaVand <br /> California State R lation;and this Y Exempt <br /> quantityof wane does not exceed the sPeclfed limits for the type of waste being disotsed.If this waste k later found <br /> t0 exceed smai�fic,nits or mntain materials not accepted under this program 1 agree to mmpletea hazardous waste manifest and"amply wIUM <br /> other state regulations as appropnate. <br /> Company Name: Value Products Inc Company Rep: <br /> Company Address: 2128 Industrial Dr Doug HaV{ <br /> EPA ID# _ CAL 000 279 179 <br /> Stockton,CA 95206 Signature: <br /> Phone Number: 209-983-4000 Title: <br /> TO BE COMPLETED BYSTERICYCLE CHECK-IN ATTENDANT p <br /> General Waste Desttipteon(Chemical Haz. AH State Cof Container T-livare Total Waste <br /> Constituent,Ph,WTCJ Class Waste Code 'ACont. T o'xn <br /> vpe/Sa, laal/ft) (pounds) Mete Cost <br /> Silk Screen Ink 3 L 7 1 GAL,QT 2.5 <br /> $8.75 <br /> Silk Screen Filler NR L 2 GAL 2 $16.50 ' <br /> Sil Screen Wash 3 L 2 GAL 1 $3.50 <br /> Stencil Remover Solvent 8 L 2 QT 0.5 $4,12 !- <br /> Paint Thinner NR L 1 GAL 0.75 $6.18 \ <br /> Silk Screen Opener 2.1 - L 5 15 OZ 4.68 $6.55 <br /> Motor Oil NR L 121 19.1032.: %O..—CU _ <br /> Paint 2.1 L 4 12 oz 3 $4.20 <br /> Carburetor Cleaner 2.1 L 1 12 oz 0.75 $1.05 <br /> Lubricant 2.1 L 1 10 OZ 0.62 $0.86 <br /> Solder flux 8 i 7 12 oz 0.75 $6.18 <br /> Contact Cement 3 L 1 PINT 0.12 $0.42 <br /> 5 1 5 2812.yo <br /> 3 L l 3`loz. .25 sva-I <br /> ?JA L 2 fat. 2 s6u+5o <br /> s 2 the 8'2.60 <br /> I <br /> Processing Fee 520.00 <br /> Tota Paid:��a\,fj� <br /> Method of Pymnt: Cash Checktt 1^y t— <br /> Stericycle Check-In Attendants Initial (- Date: <br /> Initials: <br /> Lydia Baker, REHS Page 3 of 5 <br />