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gun 21 44 11;328 Son Bienvemu 713- -5050 <br />'naw tUlaamwry wore Manite n <br />F439 Xaft=Qcrts to be--xtcpd mm Le m&11,4 tlao l=oan WRN-1 Aj <br />FW 14'005- DM 1 (otlyx th m -id— r -M RORW ar CMESTJ DW2, Do i2-DO4� <br />5a o& An m4edying aoastitu_( ixlvdes MYconstitucat =fisted i. 368. 8. Table 1175 iJur ND&dYTT1 � M= be ortiw�+t Ctsr Fi oei tbgy et �1 <br />end to be pl slhi aY me pov, o(6atCCa[ian vl the hanedOelT waSYe d dao <br />above tbt o�iba� C SWW-k S[]'�$ F � Wth baa ��Y h, <br />>� <br />_ the waste is a charactar istic hazardous tvaAy DWI er D002 wixic is iatrndrd farkcatoncnVdispasal in a CWA sygtq <br />CWAtquivslnit systrT4 lx Class I 5D WA ".m- Undalying Hazardous CaWan UMLS (tMC"s) M= NOT requircj to tm <br />Itlt� � tx( <br />_ tvaaic <br />T1x ser a chamcbWistio haz"Ous Wia's DW 1 ,KS); TOC 1plitabte Liquids Svbcategory (i.e.. greater than err equal to <br />i 0°!a TOC). Pursuant to 40 CFR 268.44. the waste must be trcatcd use Wga & rcrovery (RORGS) err combustion techmolog.. <br />UM's arc NOT required to be i l=Ued. <br />_ Check here if the Ovate is u DOI 2.17 sen- tvasxe vow or a DO 18-43 that is intended to treated in a CLIA system, CWA_ <br />scli ivalest rystwa, or Class I SDWA, syst= if so. the W&A0 is E.'K3?'WT f ora tie LDR rcguEatiaw, and no fiehe r k&armatiou is <br />-Txkcd. <br />Deadline Extensions and Varlapccl <br />CzCtaia wast= may t>c subject to a deadibe extmsioa or variance (c.g, treatability variance, e= -by -c sc Gxtmmon). Dcam-be Wow <br />any =t=sion that applies to a waste in this waste shipment (include dates End waste wcies). <br />NOTICE: ThiS s ediorl must be completed (attach aciditiocW sheets ifn©c_—,Sy) <br />Ba=sis for OHS CM-tificxtion. rbc the lnowic* upon which the =t fiication is made_ <br />A2E T RE ANY CONS M [TENTS WHICH DO NOT MEET l?rUCA.BLE "R TREA TMNT STANDARDS? If <br />lease list the coiisiWents which x fieher treatme=nt. <br />Wsate Gods I Constkuent(s) <br />Signature Printed Name Datil <br />x ors <br />C 'd 9HO '°N AV : 6 ti006 16 ''1 n f <br />