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1145 W Charter Way, Stockton Record ID PR0514509 <br /> 6/21/2019 Hazardous Waste <br /> Photo 5: Land disposal restriction form for manifest 006148673GBF (3/25/2019) was not signed. <br /> _ ;ues��ee�r,either tSarr <br /> ,��myapsdremedia0ely fdl � <br /> aboravatfon from rabl,i Sterievele Envirotnttental3afuitons HI <br /> pa RCRA Laud Disposal Restriction Notification Form <br /> ys Worlt Order 4 "LfsC of <br /> ptrrp lNe r <br /> ,,+Y�y1 ,.ygadan dorms,barrels.4,gs5 Generator: U6 EPA .�Q Q r, cxqM <br /> or4ondolacars Ya. L-�b <br /> era;F, <br /> W3J35��� <br /> PSC Profile rr aa <br /> fF_ ;etanks. No. ���J J—Q`J tManifes���� rf <br /> _pi.r 'b'rk`(tank Wcksl, Hoar. <br /> �93ig,yF <br /> In accordanee with 40 CFR 26&.7(ai,the underfytny hazardons consrouents must be addiwixed to this waste.Pei• 00cl I) F . <br /> �oaEwi6 to the nearest ogsaev , <br /> 'rte .V0report 9rranuHea 268.2(r), "underiyFng hazardous constituent"rueans any constituent fisted in 168.48,Table UMS U;ntversat Treatmexr Whir ar r <br /> r ,'. with precision Standard whtch can reasonably be expected to be piwenr at the point of generation of the hazardous waste, at a oo3371 c <br /> f �'p or reasonably <br /> cancentration above the constituent-specific UT•S h•ewment siandard Refer to Form-E2(attached)for the waste oU337?1 F <br /> errcasanably aoCuratg code{s),ti a•ov,and subcate w applicable to this Wane. Qs3nrese c� <br /> .5E _ �ndycceptahYeases5ngtea p S 9 FP a¢3saanrw <br /> rags ry9aw)for the utitot In order to address undo-lying haear dous constituents in characteristie wastes,please check lite appropriate box: <br /> r,..r✓ ooar3ast� cot <br /> - Q I have reviewed the UT5 fist of 268.48,and pez 268.7(a),I have determined that there are no ° +! <br /> �A`l�actteos, underlying hazardous constituents reasonably expected to be present in this waste, <br /> rrr iii h7aBT Pow ds1 I have reviewed the UTS list of 268.48,and per 268.7(a),I have determined that underlying -hazardous constituents constituents are resent in this waste.The underlying hazardous constituents are <br /> tre,nrtedforrery p .----- - -- <br /> i <br /> identified <br /> hnas�fo�Flroywls: A .L� b <br /> JA YT <br /> nuslbeentsredhere, <br /> , iiimAe properties of l 7y <br /> e�reeorrrra V t} <br /> . "4 <br /> s:� .wM�t+iRaEicinfwtrtatbn necessar: <br /> -YY��'1�� s 'S'egercerators or ether -- <br /> ' vfes;,�nfarrercedes,be.- <br /> MINWNSM tenter `✓ t-"'^ _ <br /> e�Fe ���sarc5aschemicsl <br /> �1:- _4'3My ofwaslra idenelfie� <br /> i±Ari, Phe determination of underlying hazardous constituents was based on: <br /> ' 1e1urmation for <br /> eta ae4arility IM Gernwatot's knowledge ofthe waste y -- <br /> .4��!! e�d�relec�wastes - <br /> serncedaol'aret ❑ Analysis _ <br /> I certify that I personally have exarnined and azo familiar with the waste through analysis and testing,or through <br /> R y n staff - knowledge ofthe waste to support this certification.I certify that as an authorized representative of the generator -- -- - - —(.-, <br /> e peialon wra have: named above.all the information submitted in this notification is true and correct to the best of my knowledge. <br /> — <br /> Mtica, td der have _,.. <br /> „¢. anoeataaren;, ted Name 5ignattue Date <br /> rroruacn�r.., � arsinptopEv... -- <br /> ft of ting <br /> na i <br /> ..4'WBrgtipPngo- W� --- <br /> sr <br /> �a;r gt°�t�3ttne ' <br /> • „'0�3merR bTQ Revised 1117131f96 <br /> This is a two sided form <br /> �in•AR ' <br /> Is . <br /> John Alaniz, REHS Page 5 of 12 <br />