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LAND DISPOSAL NOTIFICATION AND CERTIFICATION FORM PHASE IV Page 1 of 1 Generator Name: LKQ Auto Parts 2041 Navy Drive EPA ID# CAL000268997 State Manifest No. 015971 997JJK 1.If waste is a wastewater(see 40CFR 268.2)place"w'next to the applicable code(sl Profile# 750654 CODES WITH SUB CATEGORIES(place appropriate letter from section 8 before each code that applies)(See 40 CFR 268 for details) D001 HI-TOC _ D008 Lead Acid batteries K069 Not vinic um Sulfate _P065 Lo RMERC Res. U151 Hi Hg D001 E&cept HI-TOC D009 Organic Hg>260 ppm K071 Rmerc Res. P065 Not IncJRMERC Res. U240 2.4 D D003 Reactive Cyanide D009 Inorg.Hg>260ppm _K071 Not Rmerc Res. _P065 Hi IncJRMERC Res. U240 2,4 esters&Satts DD03 Reactive Sulfide _D009 Hg[260 _K10B Lo Rmerc Res. _P092 Lo Inc.Res. D003 Explosive F025 Light ends K106 Not Rmerc Res. _P092 Lo RMERC Res, D003 Water Reactives _F025 Spent filter ___ K1 U6 >260 ppm Hg _P092 Not IncJRMERC Res. D003 Ur=-xp Ord.Emg _K006 Hydrated P047 Salts P092 Hi IncJRMERC Res. D003 Omar Reactives _K006 Anhydrous P047 Nonsalts U151 Lo RMERC Res. D006 Batteries _ K069 Calcium Sulfate P065 Lo Lr; Res. U151 Lo Not RMERC Res. The subcategory for D018-DG43 waste is"treated in nonCWAI nonSDWA facility"unless the following box is checked: ❑ "treated in CWAISOWA facility' 3.COMMON CODES(Place appropriate fetter from section 8 before each code that applies) D002 P012 P030 __Post P098 P105 P205 _ F006 _ F007 _ F008 _F009 _ F010 _F011 F012 F019 F039 D004 - D005 —DD06 D007 D006 D009 D010 X011 D012 _ D013 D014 _ D015 _D016 D017 Y D018 D019 D020 - D021 D022 D023 D024 D025 _DG26 D027 D028 D029 D030 _D031 D032 _D033 0034 D035 D036 D037 D038 D039 D040 D041 D042 D043 F001 F002 F003 _ F004 FOOS 0002 0003 0005 0007 U044 U061 U072 - U080 U108 _U117 U122 _ U123 _U136 _U154 U188 _U213 0220 U226 U279 Kn61 ADDITIONAL,CODES(Enter all codes not identified above which are associated with waste) 4.USEPA HAZARDOUS WASTE 5.TREATMENT STANDARDS FOR NON-PHASE II STATES(INDICATE THE APPLICABLE 6.HOW MUST THE WASTE BE CODE(S) TREATMENT STANDARD 268.41,268.43 OR SPECIFIED TECHNOLOGY BELOW MANAGED?ENTER THE LETTER FROM BELOW Qoa1 D018 214 To identify FU39 or UHCs manage in non-CWA,use the'F0391Undedying Hazardous Constituents Form'provided and check here: ❑ If no UHCs are present upon generation check here:12 Check here if disposal facility will check for ali OHCS ❑ (i.e no UHC form required) To list additionniI EPA waste code(s),use the supplemental sheet and check here: ❑ In lieu o'supplemental sheet you may use multiple copies of this form. 7.SOLVENTS CONSTITUENTS(F001-F005)Check here if disposal facility will check for all spent solvents Acetone Benzene n-Butyl alcohol Carbon disulfide Carbon Tetrachloride Chlorobenzene O-Cresol Cresols(m&p) Cyclohexanons o-Dichlorobenzene 2-Ethoxyethanal Ethyl acetate Ethyl benYene Ethyl ether isobutanol Methanol Methylene chloride _Methyl ethyl ketone Methyl isabutyl ketone Nitrobenzene 2-Nitroprovane Pyridine Tetrachloroethylene Toluene 11,1-Tncriloroethane 1,1,2-Trichloroethane 1,1,2-Trichloro,1,2,2-tnfluoroethane Trichloroethylene Tnchloromonoduoromethane Xylenes 8 (States authorized by EPA to manage the LDR program may have regulatory citations different from the 40 CFR citations listed below.Where these regulatory citations differ, your certification will be deemed to refer to those state citations instead of the 40 CFR citations,) A.o RESTRICTED WASTE REQUIRES TREATMENT This waste must be treated to the applicable treatment standards set forth in 40 CFR Part 268.40 [] For Hazardous Debris:"This hazardous debris is subject to the alternative treatment standards of 40 CFR 268.45.' B.1 RESTRICTED WASTE TREATMENT TO PERFORMANCE STANDARDS N t eniy under penalty of law that I have personally examined and am familiar with the treatment technology and operation of the treatment process used to support this certification. Based on r- inquiry of those individuals immediately responsible for obtaining this information,I believe that the treatment process has been operated and maintained properly so as to comply with the treatment standards specified in 40 CFA 268.40 without impermissible dilution of the prohibited waste.I am aware that there are significant penaltles for submitting a false certification including the possibility of a fine and B2 (CERTIFICATION REMOVED BY PHASE IV) B.3 GUM I-AITH AND ANALYTICAL CERTIFICATION-FOR INCINERATED ORGANICS "I cerlly under penalty of law that I have personally examined and am familiar with the treatment technology and operation of the treatment process used to support this cerlifrcauon. Based on my inquiry of those individuals immediately responsible for obtaining this information.I believe that the nonwastewater organic constituents has been treated by combustion units as specified in 268.42.Table 1.1 have been unable to detect the nonwastawater organic cons6tuonts,despite having usad best good faith efforts to analyze for such constituents.I am aware that there are significant penalties for submitting a false B-4 DECHARACTERIZED WASTE REQUIRES TREATMENT FOR UNDERLYING HAZARDOUS CONSTITUENTS "I,.ertiy under penalty of law that the waste has been treated in accordance with the requirements of 40 CFR 268.40 to remove the hazardous characteristics.This decharacterized waste contains underlying hazardous constituents that require further treatment to meet universal treatment standards.I am aware that there are significant penalties for submitting a false certification including the pos5ibility of a fine and imprisonment." C. RESTRICTED WASTE SUBJECT TO A VARIANCE This waste is subject to a national capacity variance,a Treatability variance,or a case-by-case extension.Enter the effective date of prohibition in column 5 above, ❑ For Hazardous Debris:'This hazardous debris is subject to the alternative treatment standards of 40 CFR 268.45." D. RESTRICTED WASTE CAN BE LAND DISPOSE WITHOUT FURTHER TREATMENT '1 certify under penalty of law that I have personally examined and am familiar with the waste through analysis and testing or through knowledge of the waste to support this corlifcabon that the waste complies with the troatment standards specified in 40 GFR Pad 268 Subpart D I believe that the information I submitted is true,accurate and complete.I am aware that there are significant pehalbes for submitting a false certification,including the possibility of a fine and impnsonment.' E. WASTE NOT CURRENTLY SUBJECT TO PART 268 RESTRICTIONS r. This waste is a newly identified waste final is not currently subject to any 40 CFR Part 266 restrictions. i hereby certify Thal ell to ation in this and ss ieled documents is complete and accurate,to the best of my knowledge and information. Signatur Title ` Gj�"�' /lJ`7Gjz Date FORM#OES-78B C.� V90LIA GENERATOR COPY