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. r <br /> Ondcrlying.cnrestituents to ue mmilfured <br /> F039(Conslitucrsts to be monitored most Ice iusllcalad. Use 1'umt 1,DRN-ll,) <br /> �F001-17005,DOOI (otlicr Shan rrsiducs fmnl RORM or U14-11S C),D007,DOI2-DOU([7:idwIlyicrg consfifuenfs rrur�t(jrindic-all:d. U."frurrl LORIN-1A) <br /> -Fincd: A'n tin drrlying colisIitucnt includes tiny con5titucut 11,icd in 269.4g.. Tablc u'rs-uni;,cmuI Trcatrtfr-tct rauyr:rl-JrdS,csr.-rc-zinc,tvluch c�,c rc"urtahly t,c <br /> axpecicd to UC present at the pnint orgcncration of(lic ftaYRnlnui vr"v9lq of 0 cunrcritrudrru r.l,6VL t114 r-rarr5�ifurut El,eciOc I IT:;I,r,rlrncn+stanrjnid. <br /> _ Thcwaste is a characteristic hazardous waste 1 001 or D002 which is iniend'ed for'rcalfflE:lti,rrlislrnsal irl a (-WA.syslestt, <br /> CVA-cgl_iivalent system, or Class I SDWA system. t-iitdcrlying Ija7.,Lrtlntcs C(J+lstiltrenis (tif rC:';) ;:tr?•If�'T'rc tltiir+�tl.tn lsa <br /> identified' <br /> Tlic waste is a cltanwterisIic bazvtlous eraste DrIOI"IfigltTOC Tgrrlilablr', Nquic.fs Stll,r'A[C!'It-y (I-L, l'lroltt-r those rcr rCilratl to <br /> 10%TOC), Pursuant to 40 C.FR 265.4"0, Iltc waste wast be it-cated using orLatric rc:crivery(IirJitC;^} sir crrftrl]uslinu <br /> technology. UIIC's are NOT required to be identified. <br /> i <br /> _ Check here i€'tllc wale is a D012-17 anon-wastewater or a D018-43 arw is ir,tCndCd RI lreaiacl-;n a CAVA sys[mi <br /> cquivalcnt system, or"Class I SDWA system." 1150,the ivzrLe is E1IIIMPT frunl the LDR rc:t;11ln6i,ns, ni,d no Alrfltcr <br /> information is required, <br /> 10 <br /> Deadilue'Extcusions and Variattt;es <br /> CcrLain wastes may be subject to a deadlioc extension or-variaTicc(G,b. i3c[rtal;ilit}r vsstittltr:e, t:�;e 1?}�-r:ase esttcsfsisrii) ➢?t:st rilsc <br /> be e <br /> loty try extensicu U�at applies to a ivestc it1 (Lis waste s11i t�ier3E iucluClc states :tuts w a,tt,s'., �1 <br /> P ( c tr ie-,,- . <br /> NOTICE; This sectiast rnustbe completed(att:tcll adclitictual sltecLy icrlraccssttry}" <br /> Basis For this certilicatiola. Describe die kiio rlctige upon vvhiCl3 d'G GCrtlTleat U11 rG t Udr- <br /> ACRE T=,RE ANY CONSTITUENTS WfUULI V0 N 0 T NT I,,I-'.T.n.I'-_€'LUTAJll�l; t�i)f�'l']-cl�rl'1'i431;i�''['SI't1IVI1i1LUaS'I IC <br /> es lease list the consitucnls which ret 1rirC !'ils-[ltei-itr'.91b)Gr]t.' <br /> II <br /> Waste Code C437SIltEtCsi{(s) <br /> I iF <br /> d <br /> E � <br /> Signature ) Ptiu[ctI N:tntc — - — -- Dstc <br /> I <br /> 2 oF5 <br />, <br />