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Paye <br /> b 1 of 1 <br /> ERICKSON Tank Processing JOB Sd� <br /> TANK CERTIFICATION <br /> PART 1 -To be completed b the Customer ************************* <br /> 'C�:ia'�s'ta•.Q�..-7ioa – . <br /> :USTOMER:— l n CJ GENERATOR: S t,�1°� S[:71'� State Waste Codes. �/'' <br /> .0CATIONJf C=101 &e2V_ LeJQ6 t EPA I.D-#: � . fmi doiat -EPA Waste Codes: <br /> qy 41S yJv0 'dl - 0 -��-6q.%6 S @' None <br /> (� <br /> TRANSPORTER: -F I 1 OnJT" MANIFEST l! 0 See Attached <br /> TANK I TAN 2 T 3 TANK 4 K 5 K 6 <br /> $rr's�tE ..T®V A <br /> g� O c�?�" j L3 )8 `d� }�ffLsc�� j..(TANK a: � a7y J <br /> CAPACITY: <br /> ,_6010 _26,600 .Qv_. 060 a20_)060 /.21060 <br /> DIAMETER: <br /> LENGTH: 3a� .312 3;:L 1 9 <br /> STEEUGLASS: S S 5 -S S Is <br /> LAST CONTAINED: u4- _ �_ �_ <br /> LG = Leaded Gas, UG = Unleaded Gas, D = Diesel:-G-0-1 Used Oil, FO = Fuel Oil <br /> Specify the material Last Contained if other than above. <br /> ERICKSON. INC. TANK PROCESSING FACILITY <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM <br /> waste represented on this manifest is not generated by a chemical manufacturing plant, coke-by-product recovery plant of <br /> >ctroleum refinery. As such, it is not regulated under 40 CFR Part 61, Subpart FF(NESHAPS for Benzene Operations). <br /> l/ Pursuant to 40 CFR 268.7 I am notifying Erickson, Inc. that the material described by the above manifest is a nonwastewater, <br /> Jon-BCRA hazardous waste and not currently subject to EPA Land Disposal Restrictions- <br /> V, Pursuant to CCR 22 66268.7 I am notifying Erickson. Inc. that the material described by the manifest is a metal containing <br /> Jon-RCRA solid hazardous waste(66268.29(g)),and an organics containing Non-RCRA solid hazardous waste(66269.29(k)). The <br /> reatment standards for these wastes have been repealed. This waste is no longer subject to land disposal restrictions. <br /> am an authorized agent representative of the generator. I certify that all information submitted in this and associated documents <br /> s complete and accurate to the best of my knowledge. The tanks on the transport equipment have been numbered to correspond with <br /> he information provided above. In the event that the tanks do not correspond to the form, I will pay any and all costs incurred in <br /> -ectifying the discrepancy(ies) between the tank(s) and the form. In the event that the Lank(s) contain excessive solids or liquids, I <br /> igree to pay the cost of preparation, transportation and disposal/recycling of the excess material according to the schedule of charges <br /> :n effect at the time of receipt of the tank(s). Further.I will not hold Erickson,Inc. responsible for any damage to tanks which occurs <br /> after the tanks are removed from the ground. <br /> AUTHORIZED REPRESENTATIVE <br /> SIGNATURE: � i ,l G ' DATE: <br /> PRINT NAME: TITLE: <br /> TITLE: <br /> For assistance in completing this form, please contact Karen Ruffin at (510) 970-7463. <br /> ONSITE TIME TRUCK 1 TO <br /> TRUCK 2 TO <br />