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Crosby &Overton <br /> p'iS.311: <br /> Environmental Services <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM (LDRNF) <br /> For Wastes Subject to the Treatment Standards Found in 40 CFR 268 <br /> INSTRUCTIONS: Complete Part 1,check and complete Part II. Complete and sign Part III,if applicable. <br /> PART I. Generator,Reference and Manifest Information <br /> Generator Name: UNIFIED WASTERN GROCERS—STOCKTON EPAI.D.# CAD982508251 <br /> Address: 1990 PICCOLI ROAD City: STOCTON <br /> State: 95215 Zip: CA Manifest Number: 0039146514 r TK <br /> This stream is(check one)_wastewater(Per Section 40 CFR 268.20(1)(2)(3)) X non-wastewater. <br /> PART 11. Waste subject to Land Disposal Restrictions <br /> Pursuant to 40 CFR 268.7(a),I hereby notify that this waste shipment contains one or more of the following waste(s)restricted <br /> under the land disposal restrictions for which applicable treatment standards are set forth in 40 CFR,268.40 or 42 USSC, <br /> 6924(d). <br /> EPA Hazardous Waste Numbers <br /> F listed Solvents(check all that apply) <br /> _F001,F002,F003,F004 or F005(Underlying constituents must be identified Use Form LDRN-IA) <br /> _F005 Containing 2-Nitropropane ort-Ethoxyethanol <br /> _POOI-F005 Containing carbon disulfide,cyclohexanone,methanol.,or a combination of these constituents as the sole FOO 1-5 <br /> regulated constituent. <br /> Other Wastes <br /> Lfatan DFX-UorP subcategory wastewater or C&O Profile Applicable - <br /> Codes(ifmy) (if any) See Non-wastewater Number California Codes <br /> Fool,D003,etc. LDRN-IB ww NWW <br /> D001 NONE X 51192 331, 343 <br /> Hazardous Debris Notification <br /> This hazardous debris it subject to the alternative tnt trnent standards of 40 CFR,268.45 <br /> Co-ntaminants subject to beaonent(please list waste codes applicable to the debris) <br /> FACU Y: Note d. 0;taminmts Subject to TreatmenP see those constituents applicable to a ware code listed above for which a BDAT treatment standard <br /> established in 40 CPR.268.40,including underlying constituents where applicable. <br /> 1 of 5 <br /> 1610 West 17th Street,long Beach,California 90813 <br /> (562)432-5445 (800)8 CROSBY FAX(562)436-7540 <br />