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Applicable Certikications <br /> AT T.H. Authorizer] RepresenWive <br /> ,osby&Oycrinn Mork Num1wr — <br /> Muniftst mid Line 1!cnl Nua;b_s'as,;,C1c+lc-i u•(ili wnslr.strtliracnl <br /> 51192 23758727 11 .a <br /> ,HECK THE AP PROPRIxrla CERTIFICATION <br /> I. Generator's Cer(Ifientlon (268.7(it)(2)(iI)) fnr wilste t}lnt nter:(s Treatrnetit Sl.ut,.i;+r[Is <br /> I certify under penalty of law that I pcisonally have exaniittecl c,tici ant falniii tr tvit!t Iii',,va5tc lltrnul it analysis <br /> and testing or through knolvledgc of We zva;;(e to srtl)nori lltia c•;iti(ice.iiilt� (h,it t}ic tt';istc rc.itiplics rvidi. [tic IrcatJitcitt <br /> standards specified in 40 CFR, Part 26)8 `Alhpa,� [) and all applicalilu prolJibitiono ¢;cr reaG iri 40 C'YR 2618-32 or RCRA <br /> Section 3004(4). I believe that the inforilltiliori I subrni(tt td is (sue, aCcura(e Uld cr)"Tletc- I am 4v•are that i]iere arc <br /> significant penalties for subtr6tWit; a false rertiCcalior,, incliitJiug(110 possibility of a fin,.;t[tul iinprisourn ent. <br /> 2. 'Waste Treated to Remove Chnrarivi- iic3 (26t3.7(b)(5)((t•)) <br /> I certify under penalty of lacy that the«>aste h:is I,eeii liea(e.rl iJl n1:(:tl1di1L•C:L'wiQt Er;rccit+irclneiils ni'd(}Cl 1Z 268.40 to <br /> remove the hazardous characteristic. This dediuraclericeri waste con(ab,5 ultlurl"r lt[;L'J[(ilin5 CUi1S(1lUP,lItS Mitt <br /> requirc further treatment to meet uni',•ersal tt•catnieat standar-L.,, l ails at.are tlJai iltrrr ;ir_'siguJ�ll Rift IaPr.allie.s for <br /> submitting a false certilication including, ittc possibilit}, of fine artcl i;rlprisouinetit. <br /> 3. Debris Treated to meet Al(errlatit•e Siarttlards(268.7(d)(3)(iii)) <br /> I ucitify luicler pc;ntalty oflaw that the dclms has b:cn ticatet( ill ac.cvrdanct ",jL4 ilrc e .Ic,icuLtciil5 8.i5, i <br /> am aware that there are significali(ltettaltics fol.nlak-ing a False cerlificaliou irJcludirjg .tc poisihih(y of(lilt:srJtl <br /> imprisonment. <br /> _4, Lab Packs to be'I)-Mcif by Incineration (CcNificatiou inust Ix crlutlFIt:ic(I,)Alip<:tirli IS I,stly packs <br /> I certify underaster of law (list I Irn•e pr.rsr�nal[} exanunr,.i} and ani familiar ivitli (l;a 11 Jere and thilt die lair luck <br /> contains only wastes t�frith have]tot Merit nxr:Iitcled unilrr Appendix IV to oto CFR part 26R or solid waste!;nr,l subject <br /> to regulation under 40 CPR Part 2fi1. I alit aware that diene are sigttilicanl penaifics r��E sulJiuillirig a Iaisc e'eti.iJ;catect <br /> including the possibiUty of ftnc or irnl�r is��tiinen[. <br /> _5. Appendix V Lab Pack: <br /> I certify under penalty of law ilial I per5onaliy liave exanjirieci ji,id Mil F;ui liar vvi(ii rine «rtr;Ec:thruu h [err ily�is tec(ing or <br /> through knowledge of the waste and that t1.ic lata park contains uitly orgatlic«as(c�liocifir..cl in,4ltPun[lix It si pat•[ ria <br /> or solid wastes not subject to rcgulaticin uuclr_r pair 2.6 I. I anti aic 268 <br /> ]re Utut ilu're an s,gnific int I�cna[ties CC�r svbtttitlin a <br /> false certification, including the.pcassibilky of Gitw or imprisonnlent. <br /> atur� LA� <br /> Prlrlt 1312 <br /> —z 0 <br /> Date <br /> Z—QJt"' <br /> 3 or5 <br />