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Page 1 of P <br /> ERICKSON Tank Processing JOB #: '51'7 S00 7 -- <br /> TANK CERTIFICATION <br /> *********************** PART 1 -To be completed by the Customer ************************* <br /> CUSTOMER:-e"�-/'� � �_ GENERATOR: State Waste Jf°' <br /> LOCATION:'s 14 igr Pk-- Armt, LV6 tPA I.D-#.r EPA Waste Codes: <br /> - 3- el ti- o S- 0/ None <br /> -T / OI - S'yaad <br /> TRANSPORTER: IFEST <br /> #: ❑ See Attached <br /> S"PR-Pr- '� �' TANK 3 TANK 4 TANK 5 TANK 6 <br /> TANK I1: o7�a�E, �� " <br /> CAPACITY: �D 6 d � <br /> DIAMETER: <br /> LENGTH: <br /> STEEUGLASS: S S <br /> LAST CONTAINED: �/�Sr� — <br /> 1;+/GkT:Ee <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 /> waste represented on this manifest is not generated by a chemical manufacturing plant, coke-by-product recovery plant of <br /> petroleum refinery. As such, it is not regulated under 40 CFR Part 61, Subpart FF(NESHAPS for Benzene Operations). <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-RCRA 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 /> 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 treatment standards for these wastes have been repealed.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 keen 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 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 /> 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 /> PRINT NAME: � r <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 />