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RECEIVED BY SJCEHD (EF) on 10/1/19 <br /> Stericycle Envirojunetttal Soltttiofts <br /> RCRA Land Disposal Restriction Notification Fortar <br /> Work Order ; <br /> Generator: US <br /> C 16 J �✓ 1 PA ID �..��4r.110 <br /> ��a. <br /> PSC Profile <br /> No. �[ 3 ` — j r' Manifest <br /> No. SU <br /> Ira accordance with 40 CFR 268.7(,7), the underlying haiardous catastituents tnust be addressed in this waste. per <br /> 268.2(1), "W'derlying hazardozas constituent"tlseans any constituent listed in 268.48, Table UTS—Universal Treatment <br /> Standard which can reasonably be expected to be pt^eserit at the poitzt of generation of the hazardous tivaste, at a <br /> concentration above the constituent-speck UTS tt-eattnent standard. Refer to Form-EZ (attached)for the waste <br /> code(s),treatability group, and subcategory applicable to this-waste. <br /> Itz order,to address underlying hazardous constituents in characteristic wastes,please check the appropriate box: <br /> ❑ I have reviewed the UTS list of 268.48, and per 268.7(a),I have determined that there are no <br /> underlying hazardous constituents reasonably expected to be present in this waste. <br /> I have reviewed the UTS list of•268.48, and per 268.7(a), I have determined that underlying <br /> hazardous constituents arc present in this waste. The underlying hazardous constituents are <br /> identified as follows: <br /> 1 <br /> The determination ofunderlying hazardous constituents was based on: <br /> 21 Generator's knowledge of the waste <br /> Cl Analysis <br /> I certify that I personalty have examined and am familiar with the waste through analysis and testing, or through <br /> knowledge of the waste to support this certification.I certify that as an authorized representative of the generator <br /> turned above,all the information submitted in this.notification is true and corzect to the best of my knowledge. <br /> Printed Name Signature Date <br /> Form U Revised 07131198 <br /> This is a two sided form <br />