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GENERATOR CERTIFICATION (Initial he line for the appropriate certification.)e <br />RESTRICTED WASTE WHICH REQUIRES TREATMENT <br />This waste stream must be treated to meet the applicable lreatme . nt standards set forth in 40 CFR 268 <br />Subpart D, 268.32, or RCRA section 3004(d). <br />2. RESTRICTED WASTE TREATED TO PERFORMANCE STANDARDS <br />"I certify under penalty of law that I have personally examined and am familiar with the treatment <br />technology and operation of the treatment process used to support this certification and that, based <br />upon my inquiry of those individuals Immediately. responsible for obtaining this information, I believe that <br />the treatment process has been, operated and maintained properly so. as to comply with the <br />performance levels specified in: 40 CFR part . 2 . 68 Subpart D and all applicable prohibitions set forth in 40 <br />-CFR <br />.268.32.,or,_RCRA Section 3004(d) without impermissible dilution of the prohibited,waste'. I am aware <br />that _there ­­a"r_'si0'['h' ificant'penalties for submitting a false certification, including the possibility of fine and <br />imprisonment." <br />—3. RESTRICTED WASTE TREATED BY A SPECIFIED TECHNOLOGY <br />"I certifyunderpenalty of law that the waste has been treated in accordance with the requirements of 40. <br />CFR -268A2. I am aware that there aresignificant penaltles.for submitting a false certification, including <br />the possibility of fine and imprisonment." <br />4.' RESTRICTED WASTE SUBJECT TO A VARIANCE <br />This waste stream is 'subject to a national capacity variance, or a case-by-case extension, or other <br />variance. The effective date of the prohibition is (enter actual date) <br />—5. RESTRICTED WASTE WHICH MAY BE LAND DISPOSED WITHOUT FURTHER TREATMENT <br />"I certify under penalty of law that I have personally examined and am familiar with the waste through <br />analysis and testing or through knowledge of the waste to support this certification that the waste <br />complies with the treatment standards specified in 40 CFR.part 268 Subpart D and all applicable <br />prohibitions set forth in 40 CFR 268.32 or RCRA section 3004(d)..I believe that the information I <br />submitted is true, -accurate and complete. I am- aware that there are significant penalties for submitting a. <br />false certification, including the possibility of a fine and imprisonment.* <br />—6. APPENDIX IV LAB PACK WASTE -CERTIFICATION <br />NI certify urider.penalty of law that..) personally.have examined and am familiar with the waste and that <br />the lab pack contains only wastes which have not been excluded udder appendix IV to .part 268 or solid <br />wastes not subject to regulation under 40 CFR 261. 1 am aware that there are significant penalties for <br />submitting a false certification,. including the- possibility of fine -or imprisonment.* <br />7* WASTE WHICH IS NOT CURRENTLY SUBJECT TO PART 268 REGULATIONS <br />liv I .-I-1— Z <br />" i identified, newly listed, or non-RCRA waste which is not current subject to <br />is waste stream is a newly . _. d currently j <br />any 40*CFR part 268 restrictions. <br />I hereby <br />y know <br />Signatur( <br />NUMBER SUBCATEGORIES: <br />in this and all associated documents is complete, and accurate, to the best of <br />Date: A0 =/ <br />Z <br />Title.: Z"Z4?. <br />RCRA, WASTE NUMBERS WITH -SUBCATEGORIES: <br />A <br />=ANHYDROUS <br />D001CWA <br />K006A <br />CB <br />CADMIUM BATTERY <br />D001 LIQ k1l 00/*TOC <br />K006H <br />CS <br />CALCIUM 8ULFATE* <br />D001 NCWA <br />K069CS <br />CWA <br />CLEAN WATER ACTICWA-EQUIVALENTI <br />D002CWA <br />K069NCS <br />CLAS 'S I SAFE DRINKING WATER ACT <br />D002NCWA <br />K106HM:; <br />E <br />EXPLOSIVES <br />D003E <br />K1'06LM <br />H <br />=HYDRATED <br />D003R <br />P06SHM <br />,HM <br />= HIGH MERCURY <br />D003RC <br />P065LM <br />LB <br />= LEADIIATTERY <br />D003RS <br />P092HM <br />LIQ, <br />--lIQUID <br />D003WR <br />P092LM <br />LM <br />LOW MERCURY (<260mg/kg) <br />D006CB <br />U151LM <br />NCS <br />NON-CALC I`UM SULFATE. <br />D008LB <br />U151HM <br />NCWA <br />NON -CLEAN WATER ACTI <br />D009LM <br />,C <br />5N WA 5(1(11 VALENT/'. <br />D009HM <br />NON -CLASS I SAFE <br />DRINKING WATER ACT <br />SC <br />"-.REACTIVE CYANIDE <br />RS <br />= REACTIVE tULFiDE <br />TOC <br />= TOTAL ORGANIC CARBON <br />WR <br />= WATER REACTIVE <br />Rev 11/94 <br />