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:lean Harbors Environmental Services, Inc. California Land Disposal/Restriction Information Notification/Certification Form his form is submitted in accordance with the requirements of 22 CCR 662687(a) Chapter 18 which restricts land disposal of certain hazardous wastes. The Dpropnate California waste code(s)and applicable non-RGRA hazardous waste listings from CCR 66268.29 are noted below.Complete all portions of Part I. If the 'sate is non-hazardous or not restricted then complete only the applicable portions in Part I and sign/date the Foos at the bottom of page. Otherwise complete Part II,and III,and sigNdale the Form at the bottom of page.(For RCRA wastes,use Clean Harbors RCRA FORMS) GENERAL INFORMATION REGARDING GENERATOR&WASTE STREAM GENERATOR'S NAME DTE Stockton LLC PHONE: 209-3263714 SITE LOCATION:2526 W.Washington Street Stockton,CA 95203 PROFILE NUMBER. CHU1753B IS THIS WASTE NONHAZARDOUS? XNO ..YES (if YES, stop hem and slgs bate form at the bottom ofpage) GENERATOR'S EPA IDM: CAL000359102 MANIFEST*Qf Vy0Zj Ea CA WASTE CODE(S): 571 IS THIS WASTE RESTRICTED? XYES NO(f NO,stop here and sigNdale form at Ne bottom ofpage) THIS NOTIFICATION&CERTIFICATION IS BASED ON THE FOLLOWING WASTE STREAM INFORMATION: ` (A)CHEMICAL/PHYSICAL'ANALYSIS OF THE WASTE: (B)GENERATOR KNOWLEDGE OF THE WASTE-,OR _(C)BOTH :heck the appropriate boxes in Parts II and Ill.If only one applies,then Ilf(A)is not required.For multiple cerificationsinotifications.the appropriate choices from Part (t-3)may be marked in Part III(A)to indicate how waste is to be managed to conform with Land Disposal Restrictions. By selecting an item in Part III(A), 1-3,you re making the certification I notification noted in Part II. TYPE OF LDR NOTIFICATION I CERTIFICATION 1.> NOTIFICATION ONLY: WASTES THAT CURRENTLY REQUIRE TREATMENT TO MEET THE 22 CCR ARTICLE I I TREATMENT STANDARDS:>22 CCR§66268.7(a)(1) X 2.,NOTIFICATION&CERTIFICATION:WASTE THAT MEETS THE 22 CCR ARTICLE 11 TREATMENT STANDARDS,NO ADDITIONAL TREATMENT REQUIRED:� 22 CCR §66268.7(a)12k I certify underpenalty of law that l personally have examined and am familiar with the waste through analysis and testing through knowledge of the are to support this certification, that the waste complies with the treatment standards specified in CCR Title 22,Division 4.5, Chapter 18, Articles 4 and 11 and all applicable prohibitions set forth in CCR Title 22, Section 66268.32 or RCRA Section 3004tdi142 U.S.C. Section 6924(d)). l believe that the'idlormation l submitted is true,accurate and complete.l am aware that there are significant penalties for submitting a false comiication,including the possibility of a fine or imprisonment. 3.>NOTIFICATION is CERTIFICATION: NON-RCRA WASTE THAT HAS BEEN TREATED AT AN OFF-SITE TREATMENT FACILITY SO AS TO MEET ALL APPLICABLE 22 CCP ARTICLE 11 TREATMENT STANDARDS:>22 CCR §66268.7(b)(6) /certify under penalty of law that I persona//y have examined and am familiar with the waste through analysis and testing through knowledge of the waste to support this certification, that the waste complies with the treatment standards specified in CCR Title 22,Division 4.5, Chapter 18, Articles 4 and 11 and al/applicable prohibitions set forth in CCR Title 22, Section 66268.32 or RCRA Section 3004(d)(42 U.S.C. Section 6924(d)). I believe that the information I submitted is true,accurate and complete. l am aware that there are significant panahies for submitting a false certffication,including the possibility of a line or imprisonment. 1.LDR NOTIFICATION/CERTIFICATION INFORMATION REQUIRED BY 22CCR cheek (Al IBI526 IckA3)112 tot .Altoprlete Ger 1,2 or 3 from Corresponding b0ae¢ handling inla.metion Robibltlon 6uhcalagoRestricted Waete 122 CCfl 66288 29 a-ml endTreatment 9tantlard IParl111 EINctWe 0e1< Tmalabilily862.."a"aln 141 (Form 22 LCNl 'I '2 ]3 1/26/90 Aqueous wainmg me als 166268.291a1&66268.1001a111160.10)Table II CCW 2,- -1 ;2 3 5afln Auto shoo166288.291[1&66288.1001a11311268.106 Tebl<A CCWE 3 .1 ]l 72 '3 1/1/91 Meemdous Mry sand 188288.291¢1&66268.100(¢11511268.106 Table l B costs a x Cn x2 3 1/1/91 Fly ash,boratan ash or bainG.Ae waste 156268.291h18 2fiGl >2 :3 111/91 Bagnause foundries 166268.291i1866268.1sx11a119" 268.106 Table bE CWE & Jt @ .3 3/1/93 Asb<voscontelMnp wa¢t<IdenHned in¢<Csion(66260.291Mb68260.11a l2 '3 am m l6peciryl: 13 Copies of applicable treatment standards and waste analysis data(where available)are maintained at the facility identified on the manliest referenced above. J. GENERATOR AUTHORIZATION/CERTIFICATION I hereby certify that all information submitted in this and all associated documents is true,complete,and accurate to the best of my knowledge and information,and that�nuc �sayna or errors exist.I warrant that I am an authorrzed representative of the generator. I "-T�� ,/Elly/ A�/rm[e ..)nlfiL(SA1� Fr/�ai �Rt' last S�/D-20 Authorized Si alar Print Name Tlile Date HIS DOCUMENT. WITH AN ORIGINAL SIGNATURE, MUST ACCOMPANY EACH WASTE SHIPMENT. A COPY OF THIS CERTIFICATION, AND ALL a IPPnRTVdG nATA.MUST BE RETAINED BY THE GENERATOR FOR A LEAST FIVE(5)YEARS AS PER 22 CCR§66268.7 Rev.11102 Page—of