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Page 1 of l <br /> ERICKSON Tank Processing JOB #: Sdp <br /> TANY, CERTIFICATION <br /> PART I -To be completed by the Customer ************************* <br /> �y �c''-'F•rv5�l'>>ST2.Qu.76o1 <br /> t'��`r✓SRr/ �uq�►c,c,,v r :,� <br /> CUSTOMER:_( : I ! n GENERATOR:_ SI APOIF' `� State-Waste Codes: <br /> LOCATION.JH PE Yy/'Ml/ �d� EPA I.D.Jt: � EPA Waste <br /> ►- Codes: <br /> U(J 9 b�4,15 O4.O-d _-.0 S' None <br /> TRANSPORTER: -7" IZ 1 nE�/tJT" MANIFESt t1: 0 See Attached <br /> :5ftlr tE S©7 TANK I TANK 2 T 3 TK S ATANK �Ls <br /> CAPACITY: 0�0,000 �D,OOv =Q0, 0Ud -20 1060 /.2,000 1_p d 6 <br /> DIAMETER: /J.�� -/ Ol . S <br /> LENGTH: .3A / / 9 <br /> STEEL/GLASS: S S s S <s <br /> LAST CONTAINED: D u6r: --�� �— <br /> C. <br /> LG = Leaded Gas, UG = Unleaded Gas,'D = Diesel, UO = 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 /> Arw® waste represented on this manifest is not generated by a chemical manufacturing plant, coke-by-product recovery plant of <br /> oleum refinery. As such, it is not regulated under 40 CFR Part 61, Subpart FF(NESHAPS for Benzene Operations). <br /> t/ Pursuant to 40 CFR 268.7 I am notifying Erickson, Inc. that the material described by the above manifest is a nonwastewater, <br /> Non-$CRA hazardous waste and not currently subject to EPA Land Disposal Restrictions. <br /> c/ <br /> Pursuant to CCR 22 66268.7 I am notifying Erickson. Inc. that the material described by the manifest is a metal containing <br /> Non-RCRA solid hazardous waste(66268.29(g)),and an organics containing Non-RCRA solid hazardous waste(66268.29(k)). The <br /> treatment standards for these wastes have been repealed. This waste is no longer subject to land disposal restrictions. <br /> I am an authorized agent/representative of the generator. I certify that all information submitted in this and associated documents <br /> is complete and accurate to the best of my knowledge. The tanks on the transport equipment have been numbered to correspond with <br /> the 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 /> rectifying the discrepancy(ies) between the tank(s) and the form. In the event that the Lank(s) contain excessive solids or liquids, I <br /> agree to pay the cost of preparation, transportation and disposal/recycling of the excess material according to the schedule of charges <br /> in 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: '. / DATE: <br /> v <br /> PRINT NAME: TITLE: E.t!zt `�ie/is'7EiV?7�G <br /> For assistance in completing this forst, please contact Karen Ruffin at (510)970-7463. <br /> ONSITE TIME TRUCK I TO <br /> TRUCK 2 TO <br />