State of California 198 Form ARC/order no: 802390 California Integrated Waste

Collection Log page2/4 Management Board

COVERED ELECTRONIC WASTE (CEW) COLLECTION LOG
Primary Contact Name: Telephone #:
Iosefatu Aulai E-Waste Handler Christine Palas (888) 728-5712
Handler / Address (Address, City, Zip): Location of Collection Event (if different from the Collector's address):
1805 N Lemon Street Anaheim, CA 92831
Material Received From Source1 Material Received
For transfers of 5 or more units Describe Circumstances of Collection

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: Pedro Cardenas
02/12/08 Address: 1431 Falstone Ave R Non-Working 2
City / Zip: Hacienda Heights, 91745
Name: Baltazar Cervantes
02/12/08 Address: 901 S 6th Avenue., S.P. 149 R Non-Working 3
City / Zip: Hacienda Heights, 91745
Name: Oh Sukyong
02/12/08 Address: 2085 Chriske St R Non-Working 2
City / Zip: Fullerton, Ca 92833
Name: Daniel Rosales
02/12/08 Address: 822 Sunset Blvd., Apt. B R Non-Working 1
City / Zip: Arcadia, Ca 91007
Name: Betty Eskey
02/12/08 Address: 3416 Hamlin Avenue R Non-Working 3
City / Zip: Simi Valley, Ca 93063
Name: Susan Van den Brink
02/12/08 Address: 13544 Morning Mist Way R Non-Working 2
City / Zip: Chino Hills, Ca 91709
Name: Chandler Ardyce
02/12/08 Address: 14839 Hardaway Dr R Non-Working 2
City / Zip: La Mirada, CA 90638
Name: Randy Greenberg
02/12/08 Address: 14362 Mulholland Dr R Non-Working 1
City / Zip: BelAir, Ca 90077
SUBTOTALS 0 16 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

and handlers are not considered consumers or California

CEWs were accumulated by the other collectors and attached

ot elegible for SB 20/50 payment system.

lifornia local government, shall maintain a list of all consumers