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CLEAN HARBORS ENVIRONMENTAL SERVICES, INC. LAND DISPOSAL RESTRICTION FORM LDR-1 MANIFEST NO. 000276707DAT SECTION III. CALIFORNIA LIST WASTES COLUMN 1 : COLUMN 2: COLUMN 3: COLUMN 4: LINE ITEM WASTE CODE / SUBCATEGORY WASTEWATER/ HANDLING CODE SEE MANIFEST NON-WASTEWATER Hazardous waste containing one or more ❑ WW ❑ Non-WW ❑l 02 03 04 ❑5 ❑6 of the following California List constituents: ❑ ALL CALIFORNIA LIST CONSTITUENTS ❑ Liquids with nickel greater than or equal to 134 mg/I ❑ Liquids with thallium greater than or equal to 130 mg/I ❑ Liquids with PCB's > or = 50 ppm ❑ Waste containing HOC's > or = 1 ,000 mg/kg SECTION IV OTHER LISTED WASTES (F006-12 F019-F028 F037-38 F039 K- U- AND P-CODES) COLUMN 1 : COLUMN 2: COLUMN 3: COLUMN 4: LINE ITEM WASTE CODE / SUBCATEGORY WASTEWATER/ HANDLING CODE SEE MANIFEST NON-WASTEWATER ❑ WW ❑ Non-WW 03 04 ❑s ❑6 ❑ WW ❑ Non-WW ❑3 ❑4 05 06 ❑ WW ❑ Non-WW 03 04 ❑s ❑6 ❑ WW ❑ Non-WW 03 [14 O5 06 ❑ WW ❑ Non-WW 03 04 ps 06 ❑ WW ❑ Non-WW 03 ❑4 Os ❑6 ❑ WW ❑ Non-WW 03 04 ps 06 ❑ WW ❑ Non-WW ❑3 04 ❑s ❑6 ❑ WW ❑ Non-WW 03 04 ps 06 ❑ WW ❑ Non-WW 03 04 ❑s E16 ❑ CHECK HERE IF ADDITIONAL LISTED WASTE CODES ARE PRESENT. COMPLETE AND ATTACH LORA CONTINUATION SHEET. ❑ CHECK HERE IF WASTE CODE F039 (MULTISOURCE LEACHATE) IS PRESENT, IDENTIFY F039 CONSTITUENTS BY COMPLETING SECTIONS II AND IV OF CHI FORM LDR-1 ADDENDUM AND ATTACH COMPLETED ADDENDUM TO THIS FORM. SECTION V. CONTACT NAME AND DATE Print Name: Signature: Date: KEY TERMS/DEFINITIONS CLASS I SDWA SYSTEM means a Class I deep well facility regulated under the Safe Drinking Water Act (SDWA). CWA SYSTEM means a centralized wastewater treatment facility discharging under a Clean Water Act (CWA) permit. For example, a CWA facility would treat organic or inorganic aqueous wastes and discharge the treated effluent to the local sewer system. Examples of CWA treatment systems owned and operated by Clean Harbors include the wastewater treatment operations at Baltimore (including the CES system), Bristol, Chicago, Cincinnati and Cleveland. CWA-EQUIVALENT SYSTEM means a "zero discharge system" that engages in "CWA-equivalent" treatment before land disposal. Zero- discharge facilities treat hazardous wastes using "CWA-equivalent" treatment methods, but do not discharge the treatment effluent to a sewer or water body (e.g., spray irrigation land farm). "CWA-equivalent" treatment methods means biological treatment for organics, alkaline chlorination, or ferrous sulfate precipitation for cyanide, precipitationt sedimentation for metals, reduction of hexavalent chromium, or other treatment technology that can be demonstrated to perform equally or greater than these technologies. HIGH TOC IGNITABLE LIQUIDS SUBCATEGORY means an ignitable liquid hazardous waste (waste code D001 ) which contains greater than or equal to 10% total organic carbon (TOC). Pursuant to 40 CFR 268.40, such wastes must be treated using organic recovery (RORGS) or combustion (CMBST) technology. Examples of RORGS technologies include the CES unit at Clean Harbors of Baltimore. Examples of CMBST technologies include hazardous waste fuel blending and subsequent reuse at a cement kiln, or destruction at a RCRA incinerator. WASTEWATERS are wastes that contain less than 1% by weight total organic carbon (TOC) and less than 1 % by weight total suspended solids (TSS). [See 40 CFR 268.2(1)1 CHI Form LDR-1 , Page 4 of 3 [Effective 12/07/05]