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I/ 9b.2/ 9b.3 /9b.4 Constituent <br />Acetone <br />Benzene <br />n -Butyl Alcohol <br />— — _ Carbon Tetrachloride <br />Carbon Disulfide <br />Chlorobenzene <br />_ — ® Cresol Mixed Isomers <br />— — — Cresol, p -isomers <br />— — Cresol, m -isomers <br />— — _ o -Cresol <br />9b.1/ 9b.2/ 9b.3 /9b.4 Constituent <br />®_ Cyclohexanone <br />o -D <br />E" Acuate <br />— — — ` Ethyl Benzene <br />— — Ethyl Ether <br />isobutyl Alcohol <br />Methanol <br />— — _ — Methylene Chloride <br />_ — — — Methyl Ethyl Ketone <br />— _ Methyl Isobutyi Ketone <br />Underlying Waste Constituents for, Characteristics Wastes <br />(From 40 CFR 268.48, not applicable for Lab Packs) <br />9b.1 <br />9b.2 <br />9b.3 <br />9b.4 <br />9b.1/ 9b.2/ 9b.3 /9b.4 Constitue <br />® — _ Nftrobenzene <br />--- Pyridine <br />_ Tetrachloroethylene <br />— — —.- a Toluene <br />--� 1,1,1 Trichloroethane <br />---_ 1,1,2 -Trichloroethane <br />1,1,2 Tric hWro-1,2,2-Trifluoroethane <br />— — _ Trichloroethylene <br />-- Trichloromonofluoromethane <br />Xylenes (rotaq _ <br />Certifications <br />., Does Not Meet.. - Treatment <br />K"M M F 1 Waste does not meet applicable treatment standards in 40 CFR 268.40 or exceeds applicable prohibition <br />141 111Y level's of <br />c CFR 268.32RCRA Section 3004(d). <br />Waste or Contaminated Soil Meets Treatment Standard At Original Point of Generation <br />I cer*.under penalty of law that I personally have examined and am familiar with the waste through <br />® ❑ ❑ ❑ analysis and testing or through knowledge of the waste to support this bertific ation that the waste complies <br />with the treatment standards specified in 40 CFR part 268 subpart D and in CCR, Title 22, Division 4.5, . <br />Chapter 18, Article 4. i believe that the information I submitted is true, accurate, and complete. I am <br />aware that there are significant penalties for submitting a false certification, including the possibility of a <br />fine and imprisonment. <br />Contaminated Soils Certification (Mark appriopriate answers in certification statement.) <br />I certify under penalty of law that I personally have examined this contaminated soil and it [DOES / DOES <br />NOT] contain listed hazardous waste and [DOES / DOES NOT] exhibit a characteristic of hazardous waste <br />and requires treatment to meet the soil treatment standards as provided by 40 CFR 268.49(c) and CCR <br />Title 22 §66268.49(c). <br />Lab Pack Alternate Treatment Standard Certification <br />I certify under penalty of law that I personally have examined and am familiar with the waste and the lab <br />pack contains only wastes that have not been excluded under appendix IV to 40 CFR part 268 and that <br />this lab pack will be sent to a combustion facility in compliance with the alternative treatment standards for <br />lab packs at 40 CFR 268.42(c). I am aware that there are significant penalties for submitting a false <br />certification, including the possibility of fine or imprisonment. <br />I hereby certify that all inform o su is complete and accurate to the best of my kno d e and i194rmation. <br />Si natur . v° <br />g Printed Name: <br />Title: Date: �' �� <br />