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` STATEWIDE EN1/IRQIUMENTAL SERVICES_ r INC. II <br />°_ t ri1U'n nfSPriSAf *R�STRIC`_T'fON NOTlF1CATIOfV <br />INSTRUCTIONS: Complete Part I. Check and complete Part 11 or Part III. Complete and sign Part IV. <br />PART I: o. Generator Profile and ManifestInformatiom <br />Generator Name: <br />RAYMOND AGRISEEPTlb'ErTnV/eSVrjge, EPA ID X: CAC001052136 <br />Address: 2245 W. CFS WAY <br />City SiOCKTON State: rA. -- Zip: 95206- -- <br />Profile Number. 1(aln(l�Fi Manifest Number:. 9 � rJ t a Line.Itern Number: <br />_._�.. ;-.: _....,__._:__.,.t_��a�f �.:J'r1:�..nmf'Ondrinfinn '• :f> �'R .e• !'. - '. <br />❑ Pursuant to 40CFR 268.7, 1 am notifying Statewide Environmental Services that under the above profile <br />number and manifest number, 1 am shipping to you a waste which is subject to the EPA Land Disposal <br />Restrictions, as checked below. <br />Mark one or more as appicable. <br />❑ 1.A wastewater identified by the EPA Waste Code/subcategory that I have checked in Part V; OR <br />❑ 2.A non -wastewater identified by the EPA Waste Code/subcatergory that I have checked in Part V; OR <br />❑ 3.A hazardous debris identified by the EPA Waste Codelsubcatergory that I have checked in Part V. <br />Note: A wastewater is a waste that contains < 1 % by weight Total Organic Carbon (TOC) and < 1 % by weic <br />Total Suspended Solid (TSS). 40CFR 268.2 (d)(f) <br />California List Notification, it applicable <br />C]4. A D001.0011 waste which la► does (b) does not meet the definition of a 'California List' waste <br />(see definition below). it (a), I have also checked the 'California List section of Attachment I, which I <br />am enclosing. Additionally, D018-0043 apply if wastewater. <br />❑ 5.A nickel, thallium, FCB, or HOC 'California List* waste (see definition below). I have checked the <br />'California List' section of Attachment I, which I am enclosing. Additionally D018-0043 apply if <br />wastewater. <br />Note: If any of the above California List Notifications were checked, identify ALL UNDERLYING HAZARDOUS <br />CONSTITUENTS in Section VI which can reasonably be expected to be present in the waste at a <br />concentration above the constituents - specific treatment standard listed in 40CFR 268.48. <br />Note: A 'California List' waste is (a) a hazardous waste containing Halogenated Organic Compounds (HOC) at <br />a concentration 2. 1000 mg/kg or mg/I, or (b) a liquid hazardous waste having a pH < 2.0 and/or <br />containing any of the following materials at a concentration > that specified: PCBs, 50 ppm or (in mglll <br />free cyanides, 1000; As, 500; Cd, 100; Cr (VI), 500; Pb, 500; Hg, 20; Ni, 134; Se, 100; TI, 130. <br />❑ 6.A specific extension or variance (other than a 'capacity variance extension'), as I have checked on Line <br />B or C of Attachment 11, which I am enclosing. <br />❑ 7.The waste already meets all relevent treatment standards. I have signed the required certification page <br />of Attachment 11, which 1 am enclosing. <br />❑ 8.Lab Pack. I have Signed the required certification page of Attachment 1, which I am enclosing. <br />PART 1pr:. Wastes currently NOT subject `to Land Dis osal Restrictions <br />Lnon-luhazarmdous. <br />rsant to 40 CFR 268.7, 1 am notifying Statewide Environmental Services that, under the above <br />fle nuber and manifest number, I am shipping to you a waste which is non-RCRA or <br />The waste is not currently subject to EPA Land Disposal Restrictions because the waste <br />non-RCRA or non -hazardous. <br />Signature: <br />Print Or T, <br />