Kern County Waste Management Department

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1 Kern County Waste Management Department Douglas E. Landon, Interim Director 2700 M Street, Suite 500 Bakersfield, CA (661) (800) 552-KERN (option 6) Fax: (661) Facility Fax: (661) SUBJECT: Registration Conditionally Exempt Small Quantity Generator (CESQG) Program To be eligible for this service: Your business must generate less than 220 lbs. of hazardous waste or 2.2 lbs. of extremely hazardous waste per calendar month. Your business must be located and the waste generated within Kern County. You are required to obtain an EPA ID Number. Form 1358 is available through the DTSC website ( YOUR REGISTRATION PACKET INCLUDES THE FOLLOWING INFORMATION: Registration Forms Enclosed Action To Take Account Application (A) Page I Account Application (B) Page II Chemical Inventory Page III Example of completed Chemical Inventory Page IV Gate Fee Schedule Page V Complete and fax to or mail to address below. Complete and fax to or mail to address below. Complete and fax to or mail to address below. (Keep a copy of this form for future appointments) Use as an example when filling out your Chemical Inventory Sheet. Keep for reference. Keep for reference. Fax copies are accepted to begin the Registration process. However, to activate the account an original signature must be on file. The original signed application must be returned either at the time of your first appointment or through the mail to the address listed below. TO REGISTER: 1) Complete Pages I, II, and III 2) Return completed pages by Fax (if available) to: ) If no fax available, return by mail to: Kern County Waste Management Department Attn: CESQG 2700 M Street, Suite 500 Bakersfield, CA ) Once your completed Registration Forms have been received, our staff will contact you to set up an appointment. Business waste is accepted on Wednesdays BY APPOINTMENT only. Please call (661) should you have any questions. Sincerely, DOUGLAS E. LANDON, Director By: Lyn B. Beurmann Waste Management Supervisor Winner of local, state and national awards for innovation and efficiency.

2 PAGE I REGISTRATION PACKET ACCOUNT APPLICATION (A) Kern County Special Waste Facility Conditionally Exempt Small Quantity Generator (CESQG) Program Business Name: Tax ID #: Site Address: Telephone #: Billing Address (if different): City: State: Zip Code: Local Contact Person: Telephone #: Fax #: Number of years in business: Business Type: OW ER I FORMATIO : I DIVIDUAL Name: Social Security Number: PART ERSHIP Name: Social Security Number: Name: Social Security Number: CREDIT I FORMATIO Name: Telephone/Fax #: Account #: Contact Person: Name: Telephone/Fax #: Account #: Contact Person:

3 PAGE II REGISTRATION PACKET ACCOUNT APPLICATION (B) Kern County Special Waste Facility Conditionally Exempt Small Quantity Generator (CESQG) Program I,, certify under penalty of perjury that I (Please print name) am the Authorized Representative for. (Please print business name) Being the Authorized Representative, I also request the release of confidential credit information from the creditors listed in the Packet s Account Application (A), to the County of Kern, Waste Management and/or its Auditors. (Signature) (Title) (Date) By initialing, the Authorized Representative is in agreement with the terms and conditions of each statement: 1. The above named business generates less than 220 lbs. of hazardous waste or 2.2 lbs. of extremely hazardous waste per calendar month. And, the waste that is to be disposed, was generated by the above mentioned business. 2. A late fee charge of 1.5% per month on the principal unpaid balance If legal proceedings are initiated to handle misrepresented waste and/or collect the unpaid balance or any part thereof, the account holder will be obligated to pay any additional charges as the court deems reasonable, i.e., attorney fees, etc. If the Authorized Representative changes, this office must be notified within 15 days. Please call (661)

4 PAGE III CHEMICAL INVENTORY BUSINESS APPOINTMENT TIME EPA ID # Cost Estimate CHEMICAL INVENTORY: CUSTOMER USE OFFICIAL USE ONLY I II III IV V VI NAME OF MSDS SWF COST COST PRODUCT INGREDIENTS HAZARD L/S Y/N LBS. CAT PER LB. EST. TOTAL WEIGHT 0.0 TOTAL COST NOT ACCEPTED FOR DISPOSAL: No Medical Waste No Compressed Gas Cylinders PHONE NUMBER No Containers Over 5 Gallons In Size FAX NUMBER No Explosives Ammunitions No Radioactive Waste, Except Smoke Detectors

5 PAGE IV EXAMPLE OF CHEMICAL INVENTORY BUSINESS APPOINTMENT TIME EPA ID # Cost Estimate CHEMICAL INVENTORY: CUSTOMER USE OFFICIAL USE ONLY I II III IV V VI NAME OF MSDS SWF COST COST PRODUCT INGREDIENTS HAZARD L/S Y/N LBS. CAT PER LB. EST. Fungicide Copper Arsenate Toxic S Y 25.0 Drano Sodium Hydroxide Corrosive S Y 3.5 Paint Remover Xylene, Petroleum Distillates Flammable L N 30.5 Stump Remover Potassium Nitrate Reactive S Y 3.5 NI-CAD Battery Nickel Cadmium Corrosive S N 15.0 Oil Base Paint Petroleum Distillates Flammable L N 45.0 Thermostat Elemental Mercury Toxic L Y 1.0 Swimming Pool Acid Muriatic Acid Corrosive L N 6.5 Chrome Cleaner Sulfuric Acid Corrosive S Y 30.0 Fluorescent Tubes Mercury Toxic S Y 60.0 TOTAL WEIGHT TOTAL COST NOT ACCEPTED FOR DISPOSAL: No Medical Waste No Compressed Gas Cylinders PHONE NUMBER No Containers Over 5 Gallons In Size FAX NUMBER No Explosives Ammunitions No Radioactive Waste, Except Smoke Detectors

6 Kern County Special Waste Facility Conditionally Exempt Small Quantity Generator (CESQG) Program Registration Packet - Schedule of Gate Fees Kern County Ordinance No. G-8058 ( ) Schedule of CESQG Gate Fees For the following identifiable materials (per pound, including container) Effective August 1, 2010 Gate Fees - Hazardous Waste Gate Fees - Universal Waste Acids $1.52 Aerosol Spray Cans $2.36 Antifreeze $0.20 Batteries - Alkaline $1.45 Bases $1.52 Batteries - Auto Fire Extinguishers $0.83 Batteries - Gel Cell Flammable Liquid $0.48 Batteries - Lithium $10.00 Flammable Liquid - Resins $1.52 Batteries - Nicad $1.60 Flammable Solid $1.50 Cathode Ray Tubes Fusees $7.00 Electronic Waste $0.04 Motor Oil Fluorescent Tubes $1.73 Non RCRA, Liquid $0.28 Mercury - Articles $10.00 Non RCRA, Solid $0.88 Mercury - Compounds $15.00 Oil Filters $0.46 Mercury - Elemental $10.00 Organic Peroxides $7.60 Mercury Vapor Bulbs & HID $7.00/each Oxidizers $2.74 Sodium Vapor Bulbs $9.46/each Paint - Latex $0.87 Paint - Oil Base $1.30 Gate Fees - Additional PCB Ballasts $1.49 Special Handling $75/hr. Poison Liquids $1.80 Overload Charge ( > 220 lbs) $ Poison Solids $2.30 Compressed Cylinders Call for Pricing Spontaneously Combustible $7.20 Water Reactive $7.20

Conditionally Exempted Generator Hazardous Waste Collection Program

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