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21 st Century EMI Land Disposal Restriction R6tification Gerlerstrarl Ap r r 't- Profile # 1599 EPA ID # CAb095654273 Manifest # S]7 For Waste on Manifest Line# : �1 la F-11 l b tic l a d .. . .... ..... - ......._. This waste is subject to the Land Disposal Restrictions of 40 CFR 268: It is (check one): A Wastewater A Non-Wastewater [40 CFR 268.2(t)J Halogenated Organic compounds (HOC) >_ 1000 ppm [40 CFR 2ee.2(tl)J (40 CFR 268 MPrxdbt III) Debris subject to Treatment Standards. (40 CFR 26x.40) Debris subject to Alternative Treatment(40 CFR 268.46) PCB >_ 50 ppm xb'sa�"Rz'@Yrs�q%.,v;�';t�.>e�.'ax w< s'£Y �csE?tL.t?�43i�:J'.xA:o;,^ ^pix'r�avebS:c�z�bAsi-«..«�'4Y>w• '- '^ List in the spaces below the required EPA Waste Code(s), Subcategory(ies),Debris Contaminants) requiring treatment. b applicable five(5) letter treatment coders). EPA Waste #, "Code" Subcategory Debris Contaminant 5 Letter Treatment Code D002 If applicable, check all underlying constituents(UHC) on the UHC List(located on reverse side or on attached sheet) which can reasonably be expected to be present in this waste at a concentration above the constituentspecific treatment standard. Check the One Category Beiow Which Describes This Material and Then Sign in Space at the Bottom of This Form Material NOT Subiect to Land Disposal Restrictions BECAUSE, Material is a NON-RCRA Waste _ Restricted Waste Exempted from Prohibition on Type of Land Disposal Method for Waste Type. (40 CFR 268.7(x)(3)) Date Waste will be subject to prohibitions Restricted Waste Meets Treatment Standards without Treatment [40 CFR 268.7(a)(2)(ig) I certify under penalty or law that I personally have examined and am familiar with the waste through amaysls and testing or through knowledge of the waste to support this certification that the waste complies with the treatment standards specined in 40 CFR 268.32 pr RCRA section 3004(4). 1 beliewe that the information I submitted is true,accurate and complete.I am aware that there arc significant penalties for submitting a false certification,including the passibility of a fine and impnsonment. Restricted Waste Treated to Treatment Standards. (4o CFR 2e8.7(b)(5)pp I cmtify under penalty of law that I have personally examined and am familiar with the tmoit nant thou"a,xd operation of the lrcatnient process used to support this certification and that.based on my Inquiry of those indhtduals Immediately rnsponslble for obtaining this Information. I believe that the treatment process has been operated and maintained property so as to comply with,the performance levels specified in 40 Cl R part 260,subMrt U,aril all applicable prohibitions set froth w 4o CFR 2611.32 or RCRA sectad 3004(4)without Impermissible dilution of the prohibited waste.I am aware that there are SlymfKan[.p1:nalt Ka for wOrorthny,a false'certlllcation, Including the rossiblllty of fine and imprisonment. Restricted Waste Treated to Technology Based Treatment Standards) 140 CFR 268•7(b)(s)(r)] I certity under penalty of law that the waste has been treated In accordance with the requirements of 40 CFR 268.42.1 am aware that them am significant penalties for submitting a false certmlpten,including the possibility of fine and Imprisonment. aRestricted Characteristic Waste Treated to Remove the Hazardous Characteristic Only(40 CFR 268.7(a)(10)(b)(5)(W)) I certify under penalty of low that the waste has been treated in accordance with the requirements of 40 CFA 268.40 to remove the hazardous characteristic.This decharacterized waste contains underlying hazardous constituents that require further treatment to meet uniwesal treatment standards.I am aware that there are significant penalties for submitting a false certification, including the possibility of rite and imprisonment. FR Restricted Waste Exceeds Treatment Standards or Prohibition Levels (40 CFR 268.7(m)(1)) The restricted waste Identified above must be treated to the applicable treatment standards promulgated in 40 CFR 268.40 or treated to campy with ap able prohibitions set forth in part 268.32 or RCRA Seellon 3004(d). Arraytkal attached:where available a Io Signature Date '