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<br /> LAND DISPOSAL RESTRICTION NOTIFICATION
<br /> Manifest Manifeat Manifest
<br /> Line# A roval f Line 1F AoPraval# Line Approml#
<br /> 9bl 27b2 27b
<br /> Pacific3150 EAST PIC BLVD, 9b2 27b3 27b8
<br /> ��a� � LOS ANGELES,ICA 90023 9b3 27b4 27b
<br /> PHONE: 800.4`9,7145 9b4 27b5 27b10
<br /> ReCOVery FAX: 323.780. 78 27b1 127b6
<br /> 'I t
<br /> This notification form shall be ompleted by the generator and shall accompany each shipment of restricted waft sl�bj�ct�g�
<br /> the land Disposal Restrictions(40 CFR 268 Subpart C). V L 1
<br /> *Complete all information i Section 1.
<br /> >Check mark all appropriat Regulated Constituents in Section 11, additional applicable Sections aEWL9 WW"HEALTH
<br /> )1.-Sign and date Section IV. U'ARTMENT
<br /> r Y a�,R �'435�'� �",y,•'�i'a � us 1S1"s^� �r9" K "4
<br /> ' a�4°�> �e �1 • '{u.'�i u�� ��# 5�y 3 ''�3 Rv� ? 1 5 1 y.
<br /> .r 1" Hf•LF.° .SiM' JCS ti,1. J {: t._-.i f- K��
<br /> GENERATOR'S NAME NatlQnfRefroleurn;
<br /> EPA l.).NUMBER :'CAI;�O.t93992T..
<br /> MANIFEST NUMBER `ai'2�97030JIC:
<br /> TREATABILITY GROUP Check one DWastewater r� Non-Wastewater
<br /> HAZARDOUS DEBRIS CIYes No
<br /> EPA HAZARDOUS WASTE CC DE(S)-r f
<br /> f
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<br /> :.:.:.:.�..-..,..:_:..:.� J-.i i.::._...w•w-::'n': tri..•:._.._.:..:..._.i •_,'.:... ...n...:i'. ,c�i,.'.d
<br /> ' ^.L'1\J `meq':; r.71 �,`...k:• k:,� .N'� ''.f:�l
<br /> "lir^ •'t:, T< 1 !'� ,a :+n'.. :.{':
<br /> i" •.
<br /> iV1.
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<br /> There are no underlying hazardous constituents of concern,or 'I
<br /> There are underlying hazardous constituents of concern which do not meet the treatment standards of 40 CFA 268.48,Table
<br /> UTS-Universal Treatment(Standards(see Section 11).
<br /> I have used the following to make the above determination:
<br /> Knowledge of the waste pr ducing process,raw materials used and reaction products,or
<br /> i
<br /> Q Results of analysis for the stituents in Table UTS.
<br /> Waste analysis data attache ? ❑ Yes CI Na
<br /> I
<br /> NONxRCRA WASTE F-1 LIIUID 0 SOLID (Check alt that apply) ❑9b1 09b2 Q 9b3 D 9b4
<br /> Eflectfm 1131/96-
<br /> PursvaW to Sectlon 25179.6 of the Heatth and Sefoty Code,NON-RCRA other(27bl-27b10) i
<br /> aqusous and solid waste containing organks has been repealed from
<br /> Land Disposal Restriction Noriflcatidn requirements.
<br /> 6NIVERSAL TREATMENT STANDARDS
<br /> .M ti.c'-.y r: %'7,y '!%.)',.i'.v t:Y:4?i 'vLti, "b" ..�L.�' f.:• v�..�K,},. qct..Yv.,;:�.T �,{:,.+�',P�x..+i,�;t';t'e;�i; \il':a.,•NI'S,i�blV 4�i:4R.._ �r.fl�lY�•4�?'�M�:f,�l k.".1..:,,j' tilt
<br /> nv° �^ d Kc a a b�c•, ;1.,., ' ..,..N '+:
<br /> ,'rte. '`•,,;• �1 ' .;i�M.;'•in5,. .,' o, c. ;f✓,•z. i
<br /> t,�'• ...� rot. 'yY.r.;�',,,,::. +.:�•.b.., .,,,.7 :,:fit:,: ..r, ,.4': .;,.,•.[:a „'i;t�` / 's.,.,,`ea �"y
<br /> !4rRi1. X ,�c;..�, l' if•:,� t,� . 1 .'r4x: .tf!%t,.,ob7nk5c31Y1f
<br /> 1 C c rf ;e i� I r! N�..i •,ai :f•-nt, Se ..A:•, F.., t flw:f:.I:a,:C'3Yar•,•
<br /> The lhrderyiny Hamrnfners Carr must be identlNed for waste streams which carry the EPA Waste Codes F007-F17tl5, ,
<br /> D007(orrfy X7001
<br /> not treated by PORGS,CMBST or Yit't�0005-DO43(only D005'DO43 if tri in Non-C WA,Non-CWA egtnPvR AW or Nand�f!A fatilifie8).
<br /> The wastes identified ort the aforementioned manifest document number and bearing the EPA Hazardous Waste Number(s)ident}fi in Secdon I are
<br /> subject to tho Lancs Disposal Restrictions of 40 CrD 268 Subpart C.The wastes do not meet the applicable treatment standards sp clfted In 40 CFR 268
<br /> Subpart D or exceeds the applicable prohibition levels specified in 40 CFR 268-32(Callfomla list wastes)or RCRA Section 8004(d)r In compliance wtth
<br /> the requirements of 40 Ct=R 268.7 and 268.9 we are indicating below the applicable constituents of concern. I
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