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® ® Page I of j <br /> ERICKSON Tank Processing JOB : <br /> TANK CERTIFICATION <br /> PART I -To be completed by the Customer ************************* <br /> S)�•.c'1E�x�1'eST2,.Qw76owJ ��-t_-SAr.! , '' <br /> CUSTOMER: i P ( GENERATOR: S State Waste Codes: <br /> LOCATIONS/i /-9 r-P� Y 1!'ml/ Led0d-f EPA-I7.D.#: 2 a EPA Waste Codes: <br /> q b 4/5 J? 0 - '/ ' O e <br /> Non <br /> TRANSPORTER T I?Lj �/VT MANIFEST lt: p See Attached <br /> Sr1Wov- .�"D7r� ��I Tc�Z� �,K�� .4 aff <br /> KS l� K 6 <br /> TANK 1J: ` � <br /> CAPACITY: 000 �D,60(3 _:W 6U6 -20j 060 /.2,060 j2,o 6 d <br /> DIAMETER: 0/ . S i a, S'� l� <br /> LENGTH: 3�, 32- 3z, 3A <br /> STEELIGLASS: S 5 S -S J <br /> LAST CONTAINED: D <br /> iA-LG = Leaded Gas, UGd=Unleaded Gas, D Diesel, UO = Used Oil, F—O�-- 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 /> AM 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 Operatioas). <br /> Pursuant to 40 CFR 268.7 I am notifying Erickson. Inc. that the material described by the above manifest is a nonwastewater, <br /> Non-BCRA hazardous waste and not currently subject to EPA Land Disposal Restrictions. <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 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 treatment standards for these wastes have been repealed.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 /> 1 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 is <br /> .cctifying the discrepanry(ies) between the tank(s) and the form. In the event that the tank(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 /> :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 /> kUTHORIZED REPRESENTATIVE <br /> 31GN.ATURE: DATE: <br /> ?RINT NAME: TITLE: t-C-AJ,.r+'' ie//�7Eit/%?1L <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 />