Laserfiche WebLink
# anEartKa <br /> Land Disposal Restriction Notification <br /> P <br /> a <br /> Go nomtor Name: gReillyAuto Parts#2567 EPA Number. CALG35i92478 <br /> } <br /> Gonerator Address: 1440 EAST HARDrNG WAY STOCKTON,CA � <br /> Manifest Tracking Number: 2 022205DCLE <br /> Instructions <br /> Column 1: List the Manifest Line number or Manifest Lina item. <br /> Column 2: Identify all U.S. EPA hazardous Waite Codes that apply to dtis shipmenl- <br /> Column 3:Ctraose the appropriate treatability group' Non-Wastewater(NWW)or Wastewater(VVW). <br /> Colwnn 4, Enter the appropriate Subcaf e y(par 40 CFR 266-40), if applicable,and also enter'Caitaminated Soil'or`Debris'0 the waste will be <br /> treated using a*of the akernalive lre lment technologies provided by 268-49(c)-soar or 268-45-debris- <br /> Column 6: Enter the knitter of the appropriate paragraph from below(see Appendix 9 tar otlier oplions rf needed) <br /> Column 6: For F001-FOa5. please enter the Reference Numbers)IocaW below for the ovViG ijents in your waste streams subject to treatment. + <br /> Column 7: For F039,D001-D043,Debris$Contaminated Soil please list the ReleferKs Numbers lisled in Appendix 2 fpr any Underlying Hazardous # <br /> Oonr,muenis. <br /> check One <br /> How Must TFus Regulated Underlying Hazardous ; <br /> Manifest Line Number U.S. EPA Hazardous C4nslauerll5 <br /> or Manifest Line liem Waste Codes Su alegoY asle Be FConstituents for D001 D043. <br /> MWW Managed orFOO i•F005 Debris or Soil <br /> 1 - 100663 D001 Yes High TOC Ignitable= A <br /> lugwd <br /> Column 5 Wasw N4 anagarnent Codes <br /> A THIS RESTRIOTED WASTE REQUIRES TRFATMFNT TO THE APPLICABLE STANDARD.This waste must be treated 1a <br /> the appiicab5e performance basad ireatmenl standard set Forth in 40CF R Part 268 Subpart C,268-32-S u bW D. 268-40 or <br /> RCRA Section 3004(d)prior to land disposal- <br /> Caiumn 6 FQQi-r-M Reference Numbers <br /> Column 7 D001-17443 Reference Numbers <br /> f <br /> l hereby cedify that all information subscribW at this and all associated dccumvnts is compkele and accurate to the bast of my kngrrredge and <br /> information. <br /> Geri f-ator SignaWre: _ Title: <br /> Printed Nome: � '� Date: + <br /> r <br /> i <br /> t <br /> t <br /> r <br /> rt <br /> 7 <br />