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Page 1 of 1 <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM FOR WASTES SUBJECT TO THE TREATMENT STANDARDS FOUND IN 40 CFR 268 <br /> GENERATOR NAME MANIFEST NUMBER <br /> JOHN NEIL STEVENS/JH SIMPSON CO 011925653FLE <br /> Line TSD Waste Subcategory UHC'S NWW Special <br /> Approval# Code(s) or WW Conditions <br /> 1 ACT82426I D002 NWW <br /> ACT82426 <br /> 551 <br /> TSD Waste NWW Special •i <br /> Line Approval# Code(s) Subcategory UHC'S or WW Conditions <br /> 2 ACT82441/ D002 NINW <br /> ACT82441 <br /> 551 <br /> I <br /> TSD Waste NWW Special <br /> Line Approval# Code(s) Subcategory UHC'S or WW Conditions { <br /> 5 ACT82445/ F003 ACETONE',METHYL ETHYL NWW y <br /> ACT82445 KETONE*,TOLUENE`, <br /> D001 Ignitable Wastes(TOC>10%) XYLENES- <br /> MIXED ISOMERS(SUM OF s <br /> 343 O,M,&P)` i <br /> D035 <br /> SPECIAL CONDITIONS: <br /> A. Waste Requiring No Further Treatment <br /> B. Lab Pack Waste Qualifying for Alternative Treatment and 40 CFR 268.40 <br /> C. Hazardous Waste Debris subject to standard treatment requirements,40 CFR 266.40 t <br /> D. Hazardous Waste Debris subject to altemative standards in 40 CFR 268(list contaminants) <br /> E. Waste Qualifying for Exemption and not subject to Land Disposal Restriction t <br /> fY 9 P ) P {Explain) <br /> F. Characteristic waste that are subject to the treatment standards in 268.40(other than those expressed as a required method of treatment)that are <br /> reasonably expected to contain underlying hazardous constituents as defined in 268.2(i);are treated on-site to remove hazardous characteristic; <br /> and are sent off-site for treatment underlying hazardous constituents(list constituents) <br /> G. Characteristic wastes that contain underlying hazardous constituents as defined 268.2(1)that are treated on-site to remove the hazardous <br /> characteristic and the underlying hazardous constituents to levels in 268.48 Universal Treatment Standards. <br /> H. For Chemical Manufacturers,Petroleum Refineries,Coke By-Product Facilities and RCRA TSDF handling wastes subject to 40 CFR 61 subpart FF <br /> ONLY_ This waste is"Controlled Benzene Waste"which is subject to the notification requirements of 40 CFR subpart FF. j <br /> I. Certification for contaminated soil indicating the presence or absence of characteristic and/or listed hazardous wastes. 1 <br /> J. Certification for contaminated soil treated in accordance with 40 CFR 268.49 <br /> Waste analysis is attached where available;otherwise the information contained herin is based upon my thorough knowledge of the waste(s). } <br /> t <br /> 1 hereby certify that I believe that the information I have submitted is true,accurate and complete. <br /> j <br /> SIGNATURE TITLE DATE <br /> f <br /> f <br /> i <br /> I <br /> " ORIGINAL SIGNATURE PAGE TO ACCOMPANY MANIFEST" <br />