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Ian Earth',, <br /> Land Disposal Restric�lfion Notification <br /> Generator Name: 98 Cents Cnfy*177 E?A Number, CA°.000361 5 <br /> Generator Address= 1120.12.Hammer Lane Stockton,CA <br /> Man itestTracking Number' 0140V409FLE <br /> h7sbucaarr5 <br /> CGtwrtn 1:List the Uanifest Line number or Manffest tine km. <br /> Cplumn 2:Identify ori U-S.EPA hazardous Waste Co*m#ltW appry tottl�s shipmwt. <br /> Column 3_Chong the appropriate treatabillity qmFy.Teton-Wastepratgr(NMFW)or Wastewater OXW). <br /> Column 4-Entfv the approprbte Subcabeguy(pet 40 CFR 268.40),if applieL�,and a[so enter'C.Dntw inatod S(xil"or`Debris"if the waste%rill be <br /> "f "ted using one of the altemsative trent tedxro]agies proWded by 268.49(Q-sora,or 26$-4,�-debrs. <br /> Column 5:Enter the letter of the approprL-Ae paragraph from t ., we Appendix 1 for othcz options if needed) <br /> Column 6'For fp01 F4CS, please eater the Reference Numbers.)locat9d l7 ew for the oanstituartts in your waste stream subject tv treatment <br /> Column 7--For F03S,LOCH-D043.❑ebris&GontarminaGed Soil:Please 3ist the Rebamnpe Nutntets Irsted"n Appercft 2 fpr arty Under[ying H2zw „us <br /> Constituents. <br /> Check One <br /> l0W Must This I ukrLad <br /> llndertying Hazardous <br /> Manifest Line Nur+�ler U.S.EPA Hazard=sCons# #s <br /> or Manifest line Item Waste Godes autrCategocy Mrs��? For F001-FG05 for D001-07043, <br /> NVV W In W a9 Debris or Spic <br /> 1-101998 0C13" Yes agrtitabre A <br /> C hamcwristic <br /> Waste <br /> Column 5Waste Manageniont Codes <br /> A THIS RESTRICTED WASTE REQUIRES TREATMETfr TO THE APPLI�,ASLC STANDARD-This waste must lie treated m <br /> Vie app icaUe pefformanpa based te,, aent standard set forth in 40CFR Part 268 SubtW C,268.32,Subpart D,268 40 or <br /> RCRA Section' d)prig to land disposal_ <br /> Column 6 F001-FO05 R4fLhrenrre Numbers <br /> Column 7 0001-17043 Reference Numbers <br /> I hereby certify that all intvamabon subsc:2bed at this and all associmed dcCuments is complete and accejeate to the best of my knrwledge and <br /> infbrrnatian. <br /> Generator Signature- I Titic, — <br /> Pty:nMt= Name: <br />