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0 Page 1 t t t 1 LAND DWP0M R95TR![M0N t4 MFICATiON FORM FOR WASTES SUI JECT TO THE TREATMENT STANDARDS FOUND IN 40 CM 266 I —GE149 tATOR NMIE MANIFEST NUTAEM Sera ktalor Freight- STK OZO140383FLE Llr» TSD Waste Subcategory NWW Spacial Appeal N Code(*) or W W Cond Akan 1 070297592STK DOM NW" 1070297862-11 D001 SPECIAL CONDITION& A. Waste Requiring No Further Treatment B. Lab Pads wasia Qualifying for A ematito Treatment and 40 CFR 268.40 C. Hazardous Wasis Debris subject to standard treatment requirements,40 C FR 268.40 D. Hazardous waste Debris subject to atternad%e standards in 40 CFR 268(list contaminants) E Waste aaNhry forE)rnption end not subject to land Disposal Resticlon(E*ain) F. CheraaMrisle waste that are subject to the treatment standards In 268.40(other then those expressed as a required method of treatment)that are reasonablyeipecled to contain underlying hazardous constituents as defined in 2882(i);are treated on-site to remove hazardous characterislic; and are sent oft=site for treatment undertying hazardous constituents pistconstituents) Ca Characteristic wastes treat contain undergiing hazardous constituents as defined 26820)that ere treated on-site to remove the hazardous characteristic and the undwtying hazardous constituents to levels in 268.48 Universal Treatment Standards. H. For Chemical Manufacturers,Pelroieum Refineries,Coke By-Product Facilities and RCRATSDF handling wastes subject to 40 CFR 61 subpart FF ONLY. This waste is"Controlled Benzene Waste"which is subject to the notification requirements of 40 CFR subpart FF. L 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 whets available;otherwise the information contained herin is based upon mythorough knowledge of the wastes) 1 hereby certtfy that I beiiiew that the ItTImmation I have submitted Is true,accurate and complete. S13NATURE TITLE DATE WIRg?E 87Ti]FJ1MS IFAui1 By BP -gMQgiON A I certify under penaitjrof law that i personalty have examined and am familiar with the waste through analysis and tssiung or through knowledge of the waste 10 support this ceMC;able tion that the waste complies with the I believe that theinformation l have submitted is true,specified in 40 C FR part 268 ecxuraMatinte ndart 0 andicomplleto I am aware prohibitions setfortti in 40 CFR 268.32 orRCRAsection 300 that there are ttpan@KWG for submitting a>eisa certifications including the possibility of fine and imprisonment. WASTE STIit�AM8 � .CODWN e I certify under penalty of lava Surat I personalty have examined and am familiar with the waste and that lab pack contains only wastes which have not been excluded under appendix w to t I POMCFR 2fs8. I am aware that there are significant pensities for Submitting a false certification,including tine and imprisonment I pOj, tON F WASTE STREAMSthe I Certify under penattyol law that the waste has been heated to hazardous constituents tituentgs them squire furlhtor treatment toR 286AO ID most universal treatment characteristic This decharacteriaad waste contains underlying for s standards. 1 am aware that theca are significant penal the hazardous ties for submitting a false c�rfificattion,including the possibility of fine and imprisonment. Y -�- 4f law that the waste hasubean treated in es definad i 268.2 have been treated on site m the 288.48 Univ�ersccordance with the requirements of 40 CFR 286-40 to MMOVS ef Treatment Standards. I cewh under penalty hazardous characteristic,and fiat fie under) ' g aides for submitting a false certification,including fine possibility of fine and imprisonment I am aware that Urere are significant pen TE 8 BY SPECIAL CONDITION 1 5 NOTj contain listed haArdous waste and I��y under penaltyof law that I personally have examined file contaminated r matrrentdto it mosttsihe sal treatment standards as provided by 268A9(c). poES tDOES NOT)etdtibit a chBY cte r-ft of hamrd u Waste and req and operation of the treatment process used l o ,,,,ally SX1101ned and am familiar fie treatment technology and treatment sadndards specified in 40 CFR 14yrd(y under penattyodlaw nam r iigv im,,N.� , rl so as to comply to suppon this 086fwadan and beHave that it has been maintained and operated props y �,,�gwiihcwt impemmiss ible difudon of the prohibited wastes. I am aware there are significant penahies for submitting a false certlflcatiart,Including e possityilityof fine and imprisonment. .,0M(VNAL SIGNATURZ P TO AC"PANY MANIFEST"'