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:lean Harbors Environmental Services,Inc. Califomta Land Disposal/Restriction Information Notification/Certification Form his form is submitted in accordance with the requirements of 22 CCR 66268.7(a) Chapter 18 Which restricts land disposal of Certain hazardous wastes. The ppropriate California waste code(s)and applicable non-RCRA hazardous waste listings from CCR 66268.29 are noted below.Complete all portions of Part I. If the este is iron-hazanbus or not restricted then Complete only the applicable portions in Part 1 and sign t date the Form at the bottom of page. Otherwise Complete Part II,and III,and sign/date 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: 209-320-3714 _SIT E LOCATION:-2526 W.Washington Street Stockton,CA 95203 PROFILE NUMBER: CjWjlfi�X0 IS THIS WASTE NON HAZARDOUS? X NO YES (1f YES,stop here and sigrWate kxm at 6)e bottom of page) GENERATOR'S EPA ID&: CAL000359102 MANIFEST is Q IZJ;?dFLE CA WASTE CODE(S): 571 IS THIS WASTE RESTRICTED? X YES i NO(lf NO,stop hate and sigridate form at the bottom of page) THIS NOTIFICATION&CERTIFICATION IS BASED ON THE FOLLOWING WASTE STREAM INFORMATION: (A)CHEMICALIPIIYSICAL ANALYSIS OF THE WASTE, C$B)GENERATOR KNOWLEDGE OF THE WASTE;OR L(C)BOTH - :heck the appropriate 6otres in Parts 11 and Ifi.H only one applies,Cheri III(A)is not required.For muMille certificationsfiotifications,the appropriate choices from Part (1-3)may be marked in Part III(A)to indicate how waste 6 to be managed to conform with Land Disposal Restrictions. By selecting an item in Part III(A), 1-3,you re making the certification l notification noted in Part Ii. - TYPE OF LDR NOTIFICATION I CERTIFICATION - 0 1.> NOTIFICATION ONLY: WASTES THAT CURRENTLY REQUIRE TREATMENT TO MEET THE 22 CCR ARTICLE 11 TREATMENT STANDARDS:a 22 CCR§66268.7(x)(1) X ' 2:>NOTIFICATION&CERTIFICATION:WASTE THAT MEETS THE 22 CCR ARTICLE 1I TREATMENT STANDARDS,NO ADDITIONAL TREATMENT REQUIRED:0 22 CCR 966268.7(a)(2) I certify under penalty of law that 1 personally have examined and am famdiar with the waste through analysis and testing through knowledge of the.Waste to support chis certification, that the Waitscomplies with thefieatment standards specified in CCR Title 22,Division 4.5, Chapter 18, Articles 4 and t t and all applicable prohibitions set forth in CCR Title 22, Section 66268.32 or RCRA Section 30046002 U.S.C. Section 6924(d)l.l believe that the'idformation I submitted is true,accurate and complete.I am aware that there are significant penalties for submitting a false certification,including the possilu7ity,of a fine or knionsormenL 3.>NOTIFICATION&CERTIFICATION: NON-RCRA WASTE THAT HAS BEEN TREATED AT AN OFFSITE TREATMENT FACILITY SO AS TO MEET ALL APPLICABLE 22 CCR ARTICLE 11 TREATMENT STANDARDS:a 22 CCR §66268.7(b)(5) 1 certify undo penalty of law that/personally have examined and am faahar with the waste through analysis and testing through krmwledge of the waste.to support this certification, that the waste complies with the treatment standards specked in CCR Title 22,Division 4.5, Chapter 18, Articles 4 and I T and all applicable prohibitions set forth in CCR Title 22,Section 66268.32 or RCRA Section 3004(01(42 U.S.C. Section 6924(d))./believe that the infomration/submitted is true,accurate and complete./am aware that there are significant penaffies for submitting.a false certification,including the possibility of a fete or impnsonment. I.LDR NOTIFICATION I CERTIFICATION INFORMATION REQUIRED BY 22CCR Checa 2. (e) m) Col appropriate CheeY 1,2.a 3 flan nArtBamotto Eoaea xwdfin9 I^rarnalbn ProM1ai[vn 5ubcet<9w'I of amaicbtl Weare 122 CCR 6626e.a an,l rtl Trasumn,Stanaua (Part a) Effecthfe Date Treatability(swupls)66269.100(a)ll-14) (F.22 CCRI 1.71 .]t 02. -C3 126190 A9ueous wares caltamha m ulit 19626829W 8 66268.1100W Illl 1 66266.107 Table II CCW. 2.0 01 02 03 5/8/91 Auto sNNdw wrote IM268.29(c)&66268.100(x11371 2 69258.105 Table-A CCWE 3.1-1 Ill 82 03 1/1/91 Hazardous waste foundry sand 166268.29(e)&66268.100(a)(5)l 4 66268.106 Table 1-5 CCWE 4 x 01 X2 03 1/1191 Fl,ash.bottom ash,retort ash w baeFnuse waste 1662681901 8 66268.100(x)1811 7 662611.106 Table 1-D CCWE 5.0 01 02 M 1111191 Ba9nouse waste from foundries 1662682901&66268.1001811911 8 66268.106 Table 1-E CWE 6.0 El D2 03 3/1193 Asbestos oontainm9 waste identlfiM in septbn 16926829(m)6 6625e.1001a1113)1 12 66268.114 7.❑ r`t 02 M 011'er(Speoeyl: 13 Copies of applicable treatment standards and waste analysis data(where available)are maintained at the facility identified on the manifest referenced above. V. GENERATOR AUT4ORizATI0WCERTIF1CATION I hereby certify that an information submitted in this and all associated documents is true,complete,and accurate to the best of my knowledge and-Information,and that no omissions or errors e)dsL I warrant that 1 am an authorized representative of the generator. Authorized Sigliatury Printed Name Title IDate NIS DOCUMENT, WITH AN ORIGINAL SIGNATURE, MUST ACCOMPANY EACH WASTE SHIPMENT. A COPY OF THIS CERTIFICATION, AND ALL: IUPPORTING DATA,MUST BE RETAINED BY THE GENERATOR FOR A LEAST FIVE(5)YEARS AS PER 22 CCR§66268.7 Rev.1 trot Page_of