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LDR NOTIFICATION FORM CONTINUATION SHEET Generator Name Lawrence Livermore National Laboratory Manifest No. 005865488 JJK Pursuant to 40 CFR 268.7 a I hereb noti that this shipment contains waste restricted under 40 CFR Part 268 Land Disposal Restrictions LDR A. GENERAL WASTE NOTIFICATION Form Line No. Profile No. EPA Waste Codes & LDR Subcategories (if any) List codes or use Attachment 1 NWW W`W Waste Constituent Notification Check the "None" box or List Legend Constituent b or use Attachment 2 7 Doro113-1 D008 ® ❑ i --_ ❑ Check if Attachment I has been used ® None ❑ Check if Attachment 2 has been used I s D002 ® El Check if Attachment 1 has been used Check ® None ❑ Check if Attachment 2 has been used 9 DOP0116-1 D001 LQ, U002, U077, U159, D035 D006, D002, D007 ❑ Check if Attachment 1 has been used ® None ❑ Check if Attachment 2 has been used 10 DOP0117-1 D035, D001 ® ❑ Check if Attachment I has been used ® None ❑ Check if Attachment 2 has been used 11 DOP0121-I D001 IC4V ® 1:1Check EJ if Attachment I has been used ® None ❑ Check if Attachment 2 has been used 12 ❑ ❑ Check if Attachment 1 has been used ❑ None ❑ Check if Attachment 2 has been used 13 ❑ ❑ Check if Attachment I has been used ❑ None ❑ Check if Attachment 2 has been used 14 ❑ ❑ Check if Attachment 1 has been used ❑ None ❑ Check if Attachment 2 has been used 15 ❑ ❑ ❑ Check if Attachment I has been used ❑ None ❑ Check if Attachment 2 has been used 16 ❑ ❑ Lj Check if Attachment I has been used ❑ None ❑ Check if Attachment 2 has been used 17 ❑ ❑ Check if Attachment I has been used 0 None 0 Check if Attachment 2 has been used 18 ❑ ❑ Check if Attachment 2 has licca used RECEIVED M.. 14 2014 ENVIRONMENTAL HEALTH DEPARTMENT