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ss uoderwng Constituents to be Monitored _ 17039(Constituents to be monitored must be indi=ted. Use Form LDRW 1A) _F001-FOGS,DWI(other than residues from RORGS or CUBST),DOOZ D012-DO43(Underlying constituents must be indicated. Use from LDRN-1A) Dafuied- An andedying constiwent includes any constituent listed in 258.48. Table UT-,Unrvrssal Treatment Standards,except zinc,wbicb can reasonably be expected to be present at the point of generation of the hazardous waste at a concentration above the constituent specific UFS omtment standard. _ The waste is a characteristic hazardous waste DOOI or D002 which is intended for treatment/disposal in a CWA system, CWA-equivalent system,or Class I SD WA system Underlying Hazardous Constituents(LJHC's)are NOT required to be identified _I O The waste is a characteristic hazardous waste D001 High TOC Ignitable Liquids Subcategory(ie.,greater than or equal to °10 TOC}. Pursuant to 40 CFR 268.40,the waste must be treated usiog 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 DOI8-43 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 Certainty may be subject t:o a deadline extension or variance(e.g-treatabi7x#'y variance,case-by-case extension). Describe belowatt.`y extension That applies to a waste in this waste shipment(include dates and waste codes). NOTICE: This section.mtrst be completed(attach additional sheets if necessary) Basis foritthis certifiaahou- Describe the knowledge upon which the certification is made. s ARE THERE ANY CONSMT]ENTS WMCH DO°NOT MEET APPLICABLE LDP,TREATMENT STANDARDS?If es, lease list the consitaents which require further treatment waste Code Constituent(s) • E } Signattrze; Printed Name Date 2ofS