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�,rosb &ovelton <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 11. Complete and sign Part III,if applicable. ' <br /> 3 <br /> PART L Generator,Reference and Manifest Information CAD 9 8 2 5 0 8 2 51 <br /> CxweratoT Name: U.W.G .— Stockton EPA LD.# <br /> Address 1990 PiccOli R _City: Stockton <br /> State: C A Zip: 9 5 215 Manifest Number 5,JJK --— s <br /> This stream is(check one) wastewater(Per Section 40 CFR 268.2(f)(1)(2)(3))L non-wastewater. Y <br /> PART IL Waste subject to Land Dis sal Restrictions <br /> pursuant to 40 CFR 268.7(a),i hereby notify that this waste sbipment contains one or more of the foUawing waste(s)restricted <br /> ander dw land disposal=strictiow for which applicable treatmEelt standards are set forth in 40 Com,268.40 or 42 USSC, 1 <br /> 6924(d). <br /> �i. <br /> EPA Hazardous Waste Numbers <br /> F listed Solvents(check all that apply) <br /> F001,F002,F003,F004 or FW5(Underlying constituents must be identified. Use Form I-DRN-IA) <br /> _F005 Containing 2-Nitropropme or 2 Ethoxyedumol <br /> ^_F001-F005 Containing carbon disulfide,cyclohexanone,methanol,or a combination of these constituents as the sole F001-5 <br /> regubtcd constituent <br /> other Wastes <br /> i.ist all D.F r U or P Sub—ory Wasuwatar or C&O Profile Applicable <br /> codes(If-Y) (if-Y) 5ce Non-meter Nun tier ealmffuia codes a <br /> F001;D003,ctc_ LDRN-1B WW www <br /> i <br /> }x0.01 NONE X 51192 331 j <br /> I <br /> pv"riemcatioa <br /> _-_.__ aaaardousde is is subjortto rice altar ve_treatraot sw dards of-W-Cm268-45.---.._� <br /> its subject to treaurmt(please list waste codes applicable%o fic debris) <br /> FACuly-. Note brat-Contarrnimmts subject to Tl ;trrimt"aae those eonAituents applicable to a wwft code fisted rbwe for wbich n BDAT±em*�t standard <br /> esublished in 40 CFR,268_40,including underlying constibawts where applicable. <br /> I of 5 <br /> 1610 West 17th Street,Long Beach,California 90813 <br /> (562)432-5445 (800)8 CROSBY FAX(5(2)436-7540 <br />