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Land Disposal Restriction Notification <br /> GeneratorNaraw. CVS. -.. A Number <br /> Generator A IM West 11th Strad Tracy, <br /> ng Numben. 010177074FLE <br /> ✓�'t E#1'iS <br /> Column 1:List the Manifest Lits numtw or Mangnt Une Rem, <br /> Column 2:identify all U.S.EPA hazardous Waste to die 5 ` <br /> Column 3:Choose the ropri ilYl gr ( or W! . <br /> column 4:Enter the approlmiste Su (per 40 CFR .40),if and 8"Gntsr'C Salt'or'Debris'If the vain be <br /> t of the n by .49(cr ;i,or . debris. <br /> Column 5:Enbeir the letter of the see Appendix 1 for adver Whom if needed} <br /> Cokunn 6:For 1`0011-FIX6,please enter the Relbrance Num s)kr4ted below for the=mMuens in your waste stream subfeCt to treatment, <br /> Column 7:For F039,D001-13043,Debris&Conteminslad :pkme fist the ftfavence Numbers rated in Appoft 2 for any <br /> C . <br /> Ch t7ne <br /> Underlying Hs <br /> HOW Must This RegulatedConstituents <br /> Manifest Line Number U.S.EPA Hazardous Sub-CWaste Be Constituents for D00143043, <br /> or Mardest Lite IWn Waste G For 1-FW5 Debris l <br /> NWW WW <br /> 1-101062 0034 Yes A <br /> Column 5Wages Management Codes <br /> A THIS RESTRICTED WASTE REQUIRES TREATMENT TO THE APPUCABLE STANDARD.This weeks must be trailed to <br /> the applicable pargmance based standard set f6fth in 40CFR Part 268 sulpart C,268.32,Subpart Do 266.40 or <br /> RCRA Section d)prior to land disposal. <br /> Column 6FWI-FOOS Reference Numbers <br /> Column <br /> I hereby carlify that all inf u at this and al associated docurroft is=npide and accursta to the best of my WOMISCIP and <br /> information. no <br /> t"' <br /> C3 r re: <br /> Title: �' <br />