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Experts <br /> ^-� °•''i �^"` Land Disposal Restriction Notification <br /> Generator Name- CVS#M30 EPA Number. CAR000231712 <br /> Generator Address: 6632 Pacific Avenue Stockton,CA <br /> Manifest Tracking Number. 009157113FLF. <br /> instructions <br /> Column 1:list the Manifest Line number or!Ytanifest Line item. <br /> r <br /> Column 2;Identify all U.S.EPA haz-wdous Waste Codes that apply to this shipment. <br /> Column 3:Choose the appropriate treatabdity group:Non-Wastewater(N W W)or Wastewater(WW). <br /> Column 4:Enter the appropriate Subcategory(per 40 CFR 268_40),if applicable,and also enter'Contain Sol'ar"Debris'if the waste will be <br /> treated using one of the alternative treatment technologies provided by 268-49(c}sol,or 268.45-debris. <br /> Column 5:Enter the lcftcr of the appropriate paragraph from below(see Appendix 1 for other options if needed) <br /> Column 6:For F001-F005,piease enter the Reference Number(s)located below for the constituents in your waste stream subject to treatment. <br /> Column 7-For F039,0001-0043,Debris&Contaminatod Sal•please list the Reference Numbers listed in Appendix 2 for any Underlying Hazardous <br /> Constituents. <br /> Check Qnc <br /> How Must Tnis <br /> ReguLated Undertying Hazardous Manifest Line Number U.S.EPA Hazardous Constituents Cons&tuoms <br /> Sub-Category Waste Be for 0007-13043, <br /> or Manifest Line Item Waste Coc:es V, l For F001-F005 Debris or Sail <br /> N W'PI V.`7 <br /> Column 5 Waste Management Codes <br /> Column 6 F001-F005 Reference Numbers <br /> Column 7 D001.DO43 Reference Numbers <br /> hereby certify that all informaticr subscribed at this apda.l associated dxurncnts is complete and accurate to the gest of my knowledge arab <br /> information. <br /> Generator Signature: rte: 17 <br /> Printed Name: i f.c r r t c �' c Date: <br />