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SAFETY-KLEEN 06/22/2020 PAGE: 1 <br /> PLANT: SSL LpR, NOTIFICATION FORM 11 :26: 16 <br /> GENERATOR NAME: O' Rei lny # 3610 MANIFEST NO. : uu-ri{ 3ti1� 1�u� <br /> OR SALES SERVICE NO. : <br /> ;SK Shipping #: 23179101t/ OUST#: OR12254 <br /> Pursuant to 40 CFR 269. 7 (a) I hereby notify that this shipment contains waste <br /> restricted under 40 CFR part 268 land disposal restrictions (LDR) . <br /> i ----------------- ----------- --- --------------------------------- <br /> A. GENERAL WASTE NOTIFICATION <br /> ---------------------------------- ------------------------------------------------ <br /> I LDR FORM LINE NO: i MANIFEST PAGE/LINE# 01/001 SKPRFL NO: 2031004 <br /> SKDOT#: 8869577 <br /> EPA WASTE CODES & LDR SUBC EGORiES (IF ANY) : <br /> D020 <br /> Treatability group: NNW Non-Waste Water <br /> Waste Constituent Notifical .ion : None <br /> __________________________________=_____==_=____=___________________ <br /> II <br /> I <br /> i <br /> f ' <br /> 1 � J <br /> ---------------NOTES------------------- — --------------- <br /> �,�, Po� — <br /> &GEN m- <br /> TT uFi Vt <br /> ATURE (PRINTED OR TYPED) <br /> ( PLAN SSL CSG: REF#: BOTTOM COPY: TRANSFER <br /> �Op CO ATOR MIDDLE COPY: FACILITY <br />