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U�, ti4t zrjuo Wj:44 ZU'38255190 AIM MAIL CENTERA..a2 <br /> PAGE 05/08 <br /> State of California-California Envitmvvental Proteolon Agency Deparilmmi:of Toxio Sulwtanc"Control <br /> Cathode Ray`rube Material Treatment[22 GCR seation 66273.83(c)or(d)]. Please fill in the information <br /> msuested below. Attach ad*&bnzf sheaft 9 necewary, lrrclucfe phafographs and diagrams if efealred <br /> 1. Describe the type of CRT materials you handle and intend to treat and/or recycle. <br /> CRT Monitors and televisions <br /> 2. Describe the treatment and/or recycling process(es)you wfli conduct. <br /> Manual Disassembly to reclaim components <br /> 3. Check the box(eT�)that best describes your treatmentfrecycling acttvities. <br /> r_-1 <br /> A. <br /> UJ Removal of CRT from CRT device Without breaking CRT glass. [Note: If this is the only <br /> treatment you perform, do not fill out this farm. Please Use Form 1382 instead.] <br /> MX CRT vacuum release without breaking CRT glass. <br /> C. M <br /> [Tt Yoke removal without breaking CRT glass. <br /> D. F] Process CRTs(CRT glass bTeakageAvithout the use of heat chemicals or water). <br /> [You must check one or more belcm.) <br /> F-1 ROMDVe nWkS/electrUn guns <br /> $eparate panel"m funnel <br /> size reduction, crushing, cutting, sawing, compacting, shredding <br /> other(e.g. manufacture of glass)please speoffy <br /> E. All of the ibllavdng documents must be submitted with this form if you have checked"0"above, <br /> 1 have attached documentation estimating the cost of facility closure lv"red pursuant to title <br /> 22, California Code of Regulations, section 66255,142- <br /> 1 have Etttached documentation demonstrating financial assurance for closure pursuant to title <br /> 22, Ca-lifornia Code of Regulations, section 08265.143. <br /> 1 have attached documentation demonstrating financial responsibility for liability pursuant to title <br /> 22, CallfDrnla Code of Regulations, section 66266.147- <br /> F. Universal Waste Electronic Device Treatment 122 COR section 66273.131.33(.d)(3)(F],(l)(a)(4)]. Please fill in <br /> the information requested below. Affach addiffonal shoots if necessary. Include photographs and <br /> _±Mmms ff desired. <br /> 1. Describe the types of UWEOs you handle and intend to treat andfor recycle. <br /> Printers, Computer Processing Units, Microwaves, radios,stereos,telephones, cell phones, answering.,machines <br /> 2. Describe the treatment and/or recycling process(es)you Will conduct. <br /> Manual disassembly to reclaim components <br /> OTSC 138$111115444) page 3 of 5 <br />