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Type of
Source1
provide Contact Person & Phone and/or Attach Source Information of CRTs Other CEWs3
Date Name and Address of Source of Material:
see 18660.20(j)(1)(C) CEWs if Received from Other
(m/d/y) Collectors and Handlers.2 Weight Units Weight Units
Name: Elizabeth Navarrete
3/2/2008 Address: 14612 Danbrook Drvie R Internal use 1
City / Zip: Whittier, CA 90604
Name: Howard Shinedling
3/2/2008 Address: 1271 Brass Lantern Dr. R Internal use 1
City / Zip: La Habra, CA 90631
Name: Arthur Doing
3/2/2008 Address: 7000 La Palma Ave. R Internal use 1
City / Zip: Buena Park, CA 90620
Name: Johnnie Warren
3/2/2008 Address: 9518 10th Ave R Internal use 1
City / Zip: Inglewood, CA 90305
Name: Maria Gonzales
3/2/2008 Address: 1032 N Rosemont ST. R Internal use 1
City / Zip: Anaheim, CA 92805
Name: William Shaw
3/2/2008 Address: 17310 Sierra Sunrise Ln R Internal use 1
City / Zip: Santa Clarita, CA 91387
Name: Steve Collins
3/2/2008 Address: 14553 Emerald Canyan St. R Internal use 1
City / Zip: Corona, CA 92880
Name: Bobby Parkinson
3/2/2008 Address: 14130 Fonseca Ave R Internal use 1
City / Zip: La Mirada, CA 90638
SUBTOTALS 0 8 0 0
1
Consumer: Indicate the type of California Consumer discarding the material. Use categories of consumers such as: R - Residential; B - Business; G - Government; NP - Non
Institution
(schools). Also enter O.C. if CEWs are received from another collector and attach appropriate collection logs. Note that other collectors and handlers are not considered cons
sources.
2
Sources: When an Approved Collector accepts discarded material from other collectors, the Approved Collector must describe how the CEWs were accumulated by the other
required
source information. The approved collector must also document the name and location of those other collectors.
3
Other CEWs: Other CEWs eligible for recovery payment within the SB 20/50 payment system.
Other Electronic Devices: Other materials managed as Universal Waste Electronic Devices (UWEDS) that are not covered by or are not elegible for SB 20/50 payment syst
4
NOTE: 18660.20 (i)(1)(B) states, "Approved collectors that are not California local governments, nor entities acting as an agent for a California local government, shall main
who
transfer CEWs to the approved collector, including the name and address of the consumer and the number of CEWs transferred."
Business; G - Government; NP - Non-profit; E - Educational