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<br /> <br />Uncontrolled when printed - Do not use before ensuring that this document is applicable and that this is the current version. <br /> <br />Proprietary and Confidential, Tesla, Inc. | 1 <br /> <br />Document Code <br />Document Title Hazardous Waste Determination Form - CA <br />Region (NA) North America - Canada - Mexico <br />Business <br />Channel (ALL) All Channels <br />EHSS Core <br />Subject (ENV) Environmental <br />Site <br />5150 Glacier St <br />Lathrop, CA <br />95330 <br />Department EHSS <br />California Waste Determination Form <br /> Manufacturing shop, line, process: <br />A. Waste Process & Description <br />Debris generated from anti-rust metal application <br />Waste description (including chemical/ physical description): <br />Rags and wipes contaminated with metal dust (zinc) and rust inhibitor chemical <br />Description of process generating the waste: <br />After grinding on metal, surface is wiped with a rust inhibitor chemical collecting metal dust. Rags/wipes <br />are then disposed as hazardous waste <br />B. Waste Stream Determination <br />Waste determination based on: <br />☐Generator knowledge (attach process knowledge statement, SDSs, etc.) <br /> <br />☒Waste analysis (list most recent sampling date and attach analytical results): <br />Sample taken 9/10/2024 <br />Is the waste a “solid waste” according to §66261.2? <br />If no, specify exclusion or exemption by regulatory citation and describe: <br />☒Yes ☐No <br /> <br />Is the waste excluded or exempt from regulation under §66261.4 or HSC 25143.2? <br />If yes, specify exclusion or exemption by regulatory citation and describe: <br />☒Yes ☐No <br /> <br />Is the waste a listed hazardous waste? (Detail rationale, as necessary) <br />F-listed per §66261.31 ☐Yes ☒No <br />K-listed per §66261.32 ☐Yes ☒No <br />P-listed per §66261.33(e) ☐Yes ☒No