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- Crosb &Iavedon <br /> Enviro=ental Services <br /> LAND DISPOSAL RESTRICTION NOTTFICATION FORM (LDRNF) <br /> For Wastes Subject to the Treatment Standards Foulad in 40 CFR 268 <br /> 1NSTRUCTIONS: Complete Part 1,check and complete Part LI. Complete and sign Part M,if applicable. <br /> PART I.'f Generator,Reference and Manifest Information <br /> If Generator Name: U- N.G. — Stockton EPAS.D.# ' CAD982508251 <br /> Address:. 199Q_..p'.�ccol i P9 City:, g ock.h= <br /> State: r Zip: 95 115 ManifestNu=ber _p0925�}269 a <br /> This strearn is(check one) wastewater(Per Section 40 CFR 268.2(#)(1)(2)(3))X__noii wastewater. <br /> PART DC: 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 thz: and disposal restrictions for which,applicable treatment standards are set faith.in 40 CFP,268.40 or 42 USSC, <br /> d <br /> 6924 . <br /> ( ) ea <br /> EPA Hazardous Waste Numbers <br /> A <br /> F listed Solvents(check all that apply) <br /> _FOU 1,F002,1~003,F004 or F005(Underlying constituents must be identified_ Use Fo='LDRN-1A) <br /> FOO5 Containing 2 Nitropropane or 2-FJthomyethanol <br /> F001-F005 Containing carbon disulfide,cyclohexanone,methanol or a combination of these constituents as the sole F001-5 <br /> regulated constituent <br /> E� <br /> Other Wastes <br /> List all DI.KU or P Subcategory Wastewater or C&o PruHlc Applicable <br /> Codes(if any) (if arty) See Non-wastearater ?lumber a Califomia Codes <br /> FW1,Do03,etc_ LDRN-IB WW N'W� <br /> D001 K 51192 343 <br /> sl s <br /> k. . <br /> F <br /> $:urdo¢s xlebris Notification <br /> _This hazardous debris is subject to the alternative hcatment standards of 40 CFR,269.45 <br /> Contaminants subject to trcxilncnt(please list waste codes applicable to the debris) <br /> Note that"Contaminants Subject to Treatment"arc those constituents applicable to a waste code listed above for which a BDAT urabmcnt standard- <br /> cstablishcd in 40 CFR,269-40,including underlying constituents where applicable. <br /> S - <br /> I of <br /> 1610 West 17th Street,Long Beach,California 90813 <br /> (562)432-3445 (800)8 CROSBY' FAX(562)436-7540 <br />