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Underlying Constituents to be Monitored F039(Constituents to be monitored must be indicated. Use Form LDRN-IA) Fo01-FOO5,DOol{other than residues from RORGS or CMRST),D002,DO (Underlying constituents must be indurated. Use from LDRN-1A} Defined_ An underlying constituent includes any constituent luted in 268.48_ Tabic Ul`S-Universal Treatment Standards,except zinc,which can reasonably be expected to be present at the point of generation of the hazardous waste at a concentration above the constituent specific U S treagnent standard. _ The waste is a characteristic hazardous waste D001 or D002 which is intended for treatment/disposal in a CWA system, CWA-equivalent system,or Class I SDWA system. Underlying Hazardous Constituents(UHC's)are NOT required to be identified. _ The waste is a characteristic hazardous waste D001 High TOC Ignitable Liquids Subcategory(i.e.,greater than or equal to 10%TOC). Pursuant to 40 CFR 26$_40,the waste must be treated using organic recovery(RORGS) or combustion technology_ UHC°s are NOT required to be,identified. _ Check here if the wate is a D012-17 non-wastewater or a D018-43 that is intended to treated in a CWA system,CWA- equivalent system, or Class I SDWA system. If so,the waste is EXEMPT from the LDR regulations,and no further information is required. Deadline Extensions and Variances Certain wastes may be subject to a deadline extension or variance(e.g.treatability variance,case-by-case extension). Describe below any extension that applies to a waste in this waste shipment(include dates and waste codes). NOTICE: This section must be completed(attach additional sheets if necessary) Basis for this certification. Describe the knowledge upon which the certification is made. ARE THERE ANY CONSTITUFNTS WHICH DO NOT MEET APPLICABLE LDR TREAT MNT STANDARDS?If X-,please list the comituents which require further treatment Waste Code Constituent(s) l Signature Printed Name Date i 2of5