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PATTACHMEINTI:,_— TT CALIFORNIA LIST CONSTITUENTS AND THEIR PROHIBITION LEVELSbox of constituents likel to be resent Constituent Concentration (mg/L)Cyanides 1,000Arsenic 500 ®Cadmium 100 ❑Chromium VI 500 ❑ Lead 500 ❑Mercury 20 ❑Nickel 134 ❑Selenium 100 ❑Thallium 130 ❑Liquids with pH <_2.0 — ❑Liquids with PGBs 50 ppm ❑Waste containing HOCs' 1,000 mg/kg Halogenated organic compounds LAB PACKS EPA Code(s) oyC,J, 7 exr ❑ Lab Packs with EPA Code(s) not specified by 40 CFR 268 Appendix IV or Appendix V must be referenced in Part VI of this form and may not be packaged of manifested with Appendix IV or Appendix V materials. ❑ This stream contains Organometallic Lab Packs. As required by 40 CFR 268.7(a)(8), the following certification is made for these restricted wastes: I certify under penalty of law that I personally have examined and am familiar with the waste and that the lab pack contains only the waste specified in appendix IV to Part 268 or solid wastes not subject to regulation under 40 CFR part 261. 1 am aware that there are significant penalties for submitting a false certification, including the possibility of fine or imprisonment. ❑ This stream contains Organic Lab Packs. As required by 40 CFR 268.7(allB), the following certification is made for these restricted wastes_ I certify under pena)ty'of law iiiat I personally have exammeo ano am ianroci ---- .. analysis and testing or through knowledge of this waste and that the lab pack contains only organic waste specified in Appendix V to Part 268 or solid waste not subject to regulation under 40 CFR Part 261. 1 am aware that there are significant penalties for submitting a false certification, including the possibility of fine or imprisonment. I hereby certify that the of the materials. Signature:,F 1 0 IQ Print Or Type Name: — provided on this form is complete and accurate based upon my knowledge EW -WA Title::