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1145 W Charter Way, Stockton Record ID PRO5145O9 6/21/2019 Hazardous Waste Land dis osal restriction form for manifest OO6O4579OGBF 8/31/2018 was not signed. .4terlcyck$hvlr"Menlel solations RCRA Land Dlapasal Resirlarkn lvatlfleoslon Form War4Order e Generator: � US EPA TO �4�'li°��'�ir�f r��of Pic Profile %. No. Menirest Na. COUbiq 0qW In accordance with 40 CFR 268.7(a),the underlying hazardous consh'tuenis must be addressed in this waste.Per 268.2(1), "underlying hazardous constituent"means any conrtimom listed in 268.48,Tabfe U7S--Universal Treatment Standard which can reasonably be expected to be present of the point of generation of the hazardous waste, at a concentration above the cnnstimenr-specific UM treatment srandwd Refer to Form-Ez(attached)for th¢waste code(s),treatability group.and subcategory applicable to this waste. In order to address underlying hazardous canstituenrs in characteristic wastes,please check the appropriate box: ❑ I have reviewed the UTS list of 268.48,and per 268.7(a),I have determined that there are no underlying hazardous constituents reasonably expected to be present in this waste. I have reviewed the CTTS list of 268.48,and per 268.7(a),I have determined that underlying hazardous constituents are present in this waste.The underlying hazardous constituents are identified as follows: _ � yornitA The determination ofunderlying hazardous constituents was based on: ~ MI Generator's knowledge of the waste -- — ❑ Analysis - I certify that I personally have examined and am familiar with the waste through analysis and testing,or throw knowledge of the waste to support this certification.I certify that as an authatized representative of the generator named above,all the information submitted in this notification is true and correct to the best of my knowledge. Printed Name Signature Date ;.: ""�»''► _ ' r COP - Form EZ ReYsed 07/31198 Tbis is a two sided form i' . - - MPC 4noiey John Alaniz, REHS Page 7 of 12