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811 Zephyr St, Stockton, CA 95206 Record ID# PR0539941 Date of Inspection 09/12/2018 PHOTO 22: Unsigned land disposal record POSAL RES —M NOTIFICATION FORM FOR WASTES SUBJECT TO THE TREATMENT STANDARDS FOUND IN 40 CFR 268 h1ANIFEST NUMBER GENERATOR NAME 011046701FLE Niagam Bottling LLC NW W Special UHCS or WW Conditions TSD Waste Subcategory .Approvel• Code(s) OXIDER NVVW 701377081181! 791 070137708- D002 11181 CONDITIONS: waste Requiring No Further Treatrnent Lab Pack Waste Qualifying for,atematan Treatreat entl eq CFR 268.440 CFR 26840 Hamrdous Waste Debris subject to sanded treatment requirements, Hamrdous Waste Debris subject to alternative standards in 40 CFR 266(list contaminants) ;{Waste Qualifying for 6amption and notsubject to Land Disposal Restriction(FJrplain) F Characteristic waste that a conte subject toa treatment them douscon constituents as definedndards in 268.40 n1268.2(i);are treated onan th to lremoxe hamordous charactethat are ristic; and am sartof-:te for ant underlying hazardous constituents(list constituents) „ C G Chamcaristic wastes that contain underlying hazardous constituents as defined 2682(i)that are treated on to remove the hazardous 61 s chamderistic and the underlyi^9 Hazardo Petroleum Refineries,us constituents to levels in 268.48 Universal Treatment StandStandards,H. IvlanufacWrers, Coke By-Product Facilities and RCRA TSDF handling wastes subject to 40 For Chemical CFR 61 subpart FF ONLY.This waste is"Controlled Benzane Waste"which is subject tothe notification requirements of 40 CFR subpart FF. I. Certification for contaminated soil indicating the presence or absence of characteristic and I or listed hazardous wastes. J. Certification for contaminated soil treated in accordance with 40 CFR 268.49 Waste analysis is attached where available;otherwise the information contained herin is based upon my thorough knowledge of the waste(s). I hereby certify that 1 believe that the information I have submitted is true,accurate and complete. yy SIGNATURE TITLE DATE �3�� ASTESTREAMS IDENTIFIED SYSPECIAL CONDDTONA 1W 1 cerefyunderpenaltyoflaw that I personallyhave examined and am familiarwith the waste through analysis and testing or through knowledge of the waste to supportthis certification that the waste complies with the treatment standards specified in 40 CFR part 268 subpart D and all applimble, prohibitions set forth in 40 CFR 268.32 or RCRAsection 3004(d).I believe that the information I have submitted is true,accurate and complete.I am aware that there are significant penalties for submiltlng a false certification,including the possibility of fine and imprisonment WASTESTREAMS IDENTiRED BY SPECIAL CONDITION B I certify under penalty oflaw that I personally have examined and am familiar with the waste and that lab pack contains onlywastes which have not been excluded under appendix 1vto 40 CFR 268.lam aware that there are significant penalties for submitting a false certification,including fine and imprisonment. WASTE STREAMS IDENTIFIED SYSPECIAL CONDITION F 1 certify under penalty oflaw that the waste has been treated in accordance with the requirements of 40 CFR 286AO to remove the hazardous characteristic.This decharacterizad waste contains underlying hazardous constituents that require further treatment to meet universal treatment standard' I am aware that there are significant penalties for submitting a false certification,including the possibility of fine and imprisonment. WASTE STREAMS IDENI7FIED BY SPECIAL CONDITION G I cerhyunder penalty oflaw that the waste has been treated in accordance with the requirements of 40 CFR 286AO to remove the hazardous characteristic,and that the underlying hazardous constituents,as defined in 268.2 have been treated on site to the 268.48 Universal Treatment Standards. I am aware that there are significant penalties for submitting a false certification,including the possibility of fine and imprisonment. WASTE STREAMS IDENTIFIED BYSPECIAL CONDITION I I certify under penalty of law that I personally have examined this contaminated soil and it[DOESIDOES NOT]contain listed hazardous waste and [DOESIDOES N071 exhibit characteristic of hazardous waste and requires treatment to meet the soil treatment standards as provided by268A9(c). WASTE STREAMS IDENTTRED BY SPECIAL CONDITION J I certify under penalty oflaw that I have personally exam ined and am familiar with the treatment technology and operation of the treatment process used to support this certification and believe that it has been maintained and operated properly so as to comply with treatment standards specified in 40 CFR 268.49 without impermissible dilution ofthe prohibited wastes.I am aware there are significant penalties for submitting a false certification,including the possibilityoffine and imprisonment. Tricia Dai, EHS Page 22 of 24