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`4 ExpertSUSTAINABILITY-- <br /> ` °{�'" Land Disposal Restriction Notification <br /> Generator Nan ms: Dollar General#14130 EPA Number: CAL000376262 <br /> Generator Address: 4115 N EL DORADO ST STOCKTON,CA <br /> Manifest Tracking Number: 010740496FLE <br /> ftsftcbons <br /> Column 1:List the Manifest Line number or Manifest Line ilem. <br /> Column 2_Identify all U.S.EPA hazardous Waste Codes that apply to this shipment <br /> Cokann 3:Choose the appropriate treefabiiy group:Non-Wastawater(NW W)or Wastewater(WW)- <br /> Column <br /> W W)_Column 4:Eater the appropriate Subcategory(per 40 CFR 268.40),if applicable,and also enter'Contaminated Soir or'DebrW if the waste wig be <br /> treated using one of the alternative treebmrent technologies provided by 268.49(c)-soil,or 268.45•debris. <br /> Column 5:Eater the letter of the appropriate paragraph from bebow(see Appendix 1 for other options if needed) <br /> Column S.For F001-F005,please enter the Reference Number(s)located below far the constituents in your waste stream subject to treatment <br /> Column 7:For F039,D001-D043,Debris&Contaminated Soil:please list the Reference Numbers Bated in Appendx 2 for any Underlying Hazardous <br /> Constituents. <br /> Check One <br /> Underlying Hazardous <br /> Manifest Line Number U.S.EPA Hazardous How Must This Regulated Constituents <br /> or Manifest Line Item Waste Codes Sub-Category Waste Be Constituents for D001-D043, <br /> Managed? For F001-F005 <br /> NWW WW Debris or Sod <br /> 1-110517 D002 Yes A <br /> 2-110528 13007,D010,13027.U07 Yes A <br /> 2,U248 <br /> Column 5 Waste Managemerd Codes <br /> A THIS RESTRICTED WASTE REQUIRES TREATMENT TO THE APPLICABLE STANDARD.This waste must be treated to <br /> the applicable performance based treatment standard set forth in 40CFR Part 268 Subpart C,268.32,Subpart D,268.40 or <br /> RCRA Section 3004(d)prior to land disposal. <br /> Colunn 6 FW1-F006 Reference Numbers <br /> Column 7 00094)043 Reference Numbers <br /> I hereby certify that all infformation subscribed at this acrd atsociaded documents is complete and accurate to the best of my knowledge and <br /> information. �Q <br /> Generator Skpwtuufe: Title: LCA <br /> a� <br /> Printed Name: Data: <br />