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Applicable Certifications <br /> PART Ili- Anthorized Pe resentafive <br /> Gey&Overton Profile Number Manifest and Line item Number associated with waste shipment <br /> 51192 000250097 JJK 9b.1 <br /> CIECKTHE APPROPRLA-TE CERTIFICATION <br /> 1. G'enerator's Certification(268.7(a)(2)(ii))for waste that meets Treatment Standards <br /> I certify under penalty of law that I personally have examined and am familiar with the waste through analysis <br /> and testing or through knowledge of the waste to support this certification that the waste complies with the treatment <br /> standards specified in 40 Com,Part 268 Subpart D and all applicable prohibitions set forth in 40 CFR 26832 or RCRA <br /> Section 3004(d)_ I believe that the information I submitted is true,accurate and complete. I am aware that there are <br /> significant penalties for submitting a false certification,including the possibility of a fine and imprisonment. <br /> 2. Waste Treated to Remove Characteristics(268.7(b)(5)(iv)) <br /> I certify under penalty of law that the'waste has been treated in accordance with the requirements of 40 CFR 268.40 to <br /> remove the hazardous characteristic. This decharacteiized waste contains underlying hazardous constituents that <br /> require further treatmeat to meet universal treatment standards. I arra aware that there ale significant penalties for <br /> submitting a false certification including the possibility of fine and imprisonment <br /> 3. Debris Treated to meet Alternative Standards(268.7(d)(3)(iu)} <br /> I certify under penalty of law that the debris has been treated in accordance with the requirements of 40 CFR 268.45. I <br /> am.aware that there are significant penalties for making a false cettif5cation=Iudmg the possibility of fine and <br /> b1prisouramt <br /> 4_ Lab Packs to be Treated by Incineration(Certification must be completed.)Appendix IV Lab Packs <br /> I certify under penalty of law that I have personally examined and am familiar with the waste and that the lab pack <br /> contains only wastes which have not been excluded under Appendix N to 40 CFR fart 268 or solid wastes not subject <br /> to regulation under 40 CFR Part 261. I am aware that there are significant penalties for submitting a false certification, <br /> including the possibility of fine or imprisonment <br /> 5. Appendix V Lab Pack: <br /> I certify under penalty of law that I personally have examined and am fam"'nr'with the waste through analysis testing or <br /> through knowledge of the waste and that the lab pack contains only organic waste specified in Appendix V to part 268 <br /> or solid wastes not subject to regulation under Part 261. 1 am aware that there axe significant penalties for submitting a <br /> false certification,including the possibility of fine m imprisonment <br /> Signature 11rintName <br /> AUM ,fiI 60W <br /> Title ! /' Date �f~ 0 <br /> 3 of 5 <br />