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3250 East Pico Blvd. Los Angeles,CA 90023 <br /> 9-7145 <br /> Pacific Resource flecoverq PhFaxone(323)780-0078 <br /> Fax(323)780-0078 <br /> baa CLIENT AND ENVIRONMENTAL PROTECTION www.paciPtiesoutestecovery.com <br /> , <br /> This notification form shall be completed by the generator and shall <br /> accompany each shipment of restricted waste subject to the Land 9b1 ► <br /> 1 l 1 27b2 2767 y <br /> Disposal Restrictions(40 CFR 268 Subpart C). ��tLC4 _ _------ <br /> Y Complete all information in Section I 9b2_ + 2763 27b8 <br /> Check mark all appropriate Regulated Constituents in Section II, 9b3 _ 27b4 27b9 <br /> additional applicable Sections andlor complete Section Ill. 9b4 27b5 f 27b10 — <br /> Sign and date Section IV. 2. <br /> 2761 2766 <br /> tt � <br /> GENERATOR'S NAME Ramos 011 Co. <br /> EPA I.D.NUMBER CAL000420961 -- <br /> MANIFEST NUMBER 018144622JJK - ._,• <br /> TREATABILITY GROUP ❑ WASTEWATER Q tION-WASTEWATER <br /> HAZARDOUS DEBRIS ❑ YES No K <br /> EPA HAZARDOUS WASTE CODE(S) <br /> D001 I 1)018 ) I I 1 I <br /> There are no underlylne bazardous eunzrtlucnls of concern,or <br /> There are underty g harardous caa mnuents of concern which do not meet the treatment standards of 40 CFR 266.48,Table LITS—Universal Treatment Standards <br /> [see Secticmt ll). <br /> I have used the following to make the above determination,- <br /> Knowledge <br /> etermination;Knowledge of the waste producing process,raw materials used and reaction producls,or <br /> ❑ Results of analysis for the constituents in Table UTS. <br /> Waste analysis data attached? ❑ YES Ef NO <br /> NON-RCRA WASTE ❑I.IQUID ❑SOLID (Check all that apply) <br /> Effective 1/37196— ❑ 9b1 ❑962 ❑ 9b3 ❑ 9b4 <br /> Pursuant to Section 25179.6 of the Health and Safety Code,NON-RCRA <br /> aqueous and solid waste containing organics has been repealed from ❑ olller(2761 27610) <br /> Land Disposal Restriction Nolificalien requirements. <br /> IN:10 <br /> The Underlying Hazardous Constituents must be identified for waste streams which carry the EPA Waste Codes F0014005,F038,D001(only D001 <br /> not treated by RORGS;CMBST or POLYM),D005-DO43(only D005-DO43 if treated in Non•CWA,Non-CWA equivalent or Non•SDWA facilities). <br /> The wastes identified on the aforementioned manifest document number and bearing the EPA Hazardous Waste Number(s)identified in Section I are <br /> subject to the Land Disposal Restrictions of 40 CFR 268 Subpart C.The wastes do not meet the applicable treatment standards specified in 40 CFR 268 <br /> Subpart D or exceeds the applicable prohibition levels specified in 40 CFR 268.32(California list wastes)or RCRA Section 3004(d). In compliance with <br /> the requirements of 40 CFR 268.7 and 268.9 we are indicating below the applicable constituents of concern. <br /> PM ram WaN-17na <br /> Page r o14 <br />