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California Land Aposal Restriction Notic and Certification Generator Name Manifest Number ' Califomia Hazardous Waste Codes) CWM Profile Number This forth Is submitted to Chemical Waste Management, Inc.In accordance with the requirements of CCR Trtle 22,Chapter 30,Amide 40 which restricts the land disposal of certain hazardous wastes. I have marked the appropriate box (boxes A. through D.) below to Indicate how my waste must be managed to conform to the land disposal restrictions. A oopy of all applicable treatment standards and waste analysis data, where available, is maintained at the Chemical Waste Management facility identified on the manifest referenced above. I have entered the appropriate California Waste Code and checked the appropriate box In the table below to indicate the applicable non-RCRA hazardous waste listing from 22 CCR § 67702. Prohibition State of California Effective Corresponding V Restricted Waste Description Usted In 22 CCR § 67702 Date Treatment Standard 1 Metal- ontaining aqueous waste that contains any of the metals or metal compounds 1/26/90 22 CCR§ 67760(b)(1) Identified in 22 CCR (b). 2 Wastes containing po lorinated biphenyls (PCBs). 1/27/90 22 CCR§67780 3 Auto shredder waste. 1 5/8/91 22 CCR§67755(b)(1) 4 Nonwastewater solvent 4ste. 3/27/91 22 CCR§67760(b)(2) 5 Hazardous waste foundrV sand. 1/1/91 22 CCR §67755(b)(2) 6rsservedj 7 Metal-oontaining solid waste that contains any of the metals or metal compounds 5/8/92 22 CCR§67755(b)(3) identified in 22 CCR 666s 9(b). 8 Fly ash, bottom ash,retort ash or baghouse waste from sources other than foundries 1/1/91 22 CCR§67755(b)(4) that contains any of the metals or metal compounds Identified In section 66699(b). 9 Baghouse waste from foundries that contains any of the metals or metal compounds 1/1/91 22 CCR§67755(b)(5) identified in section (b). 10 Aqueous and liquid orgy 'c wastes that contain any organic compound measured by 5/8/92 22 CCR§67785 EPA Test Methods 8080140,8150,8240,and 8270 described in Test Methods 16r Evaluating Solid Wastes,Physical/Chemical Methods, SW-846,Third Edition. 11 Solid hazardous wastes that contain any organic compound measured by EPA Test 5/8/92 22 CCR§67786 Methods 8080, 8140,8150,8240,and x270 described in Test Methods for Evaluating Solid Wastes, Physical/Chemical Methods, SW-846,Third Edition. A. RESTRICTED WASTE REQUIRES TREATMENT I am the generator of the waste identified above which must be treated to meet the applicable treatment standards set forth in CCR Title 22, Chapter 30,Article 41 prior to land disposal. BA RESTRICTED WASTE TREATED TO PERFORMANCE STANDARDS 7 certify under penalty of law"I h ve personally examined and am familiar with the treatment technology and operation of the treatment process used to support this certification an that,based upon my inquiry of those individuals immediately responsible for obtaining this information,I believe Mat the treatment process has beeen operated and maintained property so as to comply with the performance levels specified in CCR Tide 22, Chapter 30,Article 41 without dilution of the prohibited waste. I am aware that there are significant penalties for submitting a false certification, Including the possibility of a fine anti imprisonment.' C. RESTRICTED WASTE SUBJECT TO A VARIANCE The waste Identified above is subjept to a capacity variance which expires on D. RESTRICTED WASTE CAN BE LAND DISPOSED WITHOUT FURTHER TREATMENT 7 certify under penalty of law that/ftva personally examined and am familiar with the waste through analysis and testing or through knowledge of Me waste to support this certification that the waste complies with the treatment standards specified in CCR Tide 22,Chapter 30,Division 4,Article 41. /believe that the Information I s�bmitted is true,accurate,and complete. 1 am aware that there am significant penalties for submitting a false certification, including the possibility of a fine and Imprisonment.' I hereby oerbly that all Information submitted in this and all associated documents is complete and accurate to the best of my knowledge and information. SignatureTitle Date Copyright 0 1990 Chemical Waste Mange ent, Inc. Revised: 5/15/91