Laserfiche WebLink
Land Disposal Restriction Notification <br /> Generator Name: `Cv03908 EPA NumCAROMD22971,2 <br /> Generator Address. pB5�,�est 11th Sreot Tracy CA <br /> Manifest Tracking Number, 0086792.At-L,L <br /> Instructions <br /> Column 1,-st iirtetaarOest Line rmrber of VA-fe5l Line deTT, <br /> Column 2Oerillty S EPA h� an:tous'Alaste Codes that apply to this shipmem <br /> Column 3:On the ao,0foVT',9le treXabOty qrouv.NW.Naslewaler(NW%&Il,or Wastewater NVWi <br /> Column A:-nler lie 40 C-R 26&40).4 applicable,and a1sn enter-Coqtam>naled Sal, 7 Debris J the waste will be <br /> 3&I IJS.r`q OCf*ne ilteinwvm treatment techriologies pfavidea by 268,49 te"l-soil,of 268 45 ot r* <br /> ,fer. "e <br /> Column 5:Sn,'ef!rie letlef of tne avoropriate para-graph fTOM betowisee Appendix 1 for OPI'LlIS if reede�dl <br /> column fl.;:cc c*aseen!er We F-1-iferprice Nurnt)eta)iwated beltm for Iti-ecans lituP-nts irl v <br /> ,our waste stream si,.bjest!a Ireatmen! <br /> Column 7:-cr F019 Detf-s&C cim arnmri wed SoilP,„lease list I he Reference Nim rs!Tsted:r A poert!ix 2'or any J rider ry-lq t4UWTOO,'is <br /> C',w-k One <br /> How Must This Regulated Orldetying Hazardous <br /> CDrsutuents <br /> Manifo-rl Line Number U S F-PA HaZand ftS SLib-'--ateqc,'Y I.Naste Be C,Dill tuentS for DrX1 F-)CA 3 <br /> c,%"mfev'-nne It "N*aslf Codes 1,JVV'* WW Managed'? Fu FCC1-FOO5 lmwss or <br /> '24- <br /> [7)010 Y °+gh T,;)r- qralabl(- A <br /> I t'tt w C, <br /> Column 5 Waste Management Codes <br /> Tl"S RFST" C>Fr WASTF,RFQU�RES TRFA7MFN7 TO THF APPI,,.iCARI,F STANOARD --mswaste must be treated to <br /> the a <br /> I uptocaLlp oar,forlrwxe based ftealmeni standard set forth in,40CFR Part 266 Subpart C 268 32 Subpar,0 268 40 r*, <br /> RCRA Section 3004,0 priof to lar5ci disposal <br /> Column 6 F0014005 Reference Numbers <br /> Column 7 DOOI-DO43 Reference Numbers <br /> ali mformat*n subscribed at this and al!associated documents is complete and accurate to Vie bes!of rny knoMedge ard' <br /> Generator Signature: 2-1�—j Trtie. <br /> Printed Name: Data: J'Z' z <br />