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c% r n rc�nnnc. AIU1PnNitAF11aT,IC1L'. SERVICES, <br />PNIONS: Complete Part I. Check and complete Part 11 or Part III. Complete and sign Part IV. <br />Generator Profile and`Manifastinformation CAc001052136r Name: RAYt`�ID AGRICULTURAL EPA ID #• <br />2245 W. CHARTER kmy - - 95206STOCKTON State: CA Zip:mber: ` ( l Irl Manifest Number. ILine Item Number: 1)Waste' subject to LandDis osalRestriction`. - Z bsuant to 40CFR 268.7, 1 am notifying Statewide Environmen Services that under the above profile <br />ber and manifest number, 1 am shipping to you a waste which is subject to the EPA Land Disposal <br />strictions, as checked below. <br />Mark one or more as appicablo. <br />El 1.A wastewater identified by the EPA Waste Code/subcategory that I have checked -in Part V; OR <br />[1�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 weigh <br />Total Suspended Solid (TSS). 40CFR 268.2 (d)(f) <br />California List Notification, If applicable <br />4.A D001 -D011 waste which (a) does (b)y does not meet the definition of a 'California List waste <br />(see definition below). If (a), I have also checked <br />the "California List section of Attachment I, which I <br />am enclosing. Additionally, DO1 B -D043 apply f <br />5.A nickel, thallium, FCB, or HOC 'California List waste )see definition below). I have checked the <br />'California List' section of Attachment 1, which I am enclosing. Additionally D018 -D043 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 ;-> 1000 mg/kg or mg/I, or (b) a liquid hazardous waste having a pH < 2.0 and/or <br />fee cyanides, 1000; As, 500; Cd, 100; Cr (VI) 500; Pbowing materials at a o500 that specified: <br />20cNed:34; Se. 100; 00; T1 0 ppm �130.mgA) <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 II, 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 I am enclosing. <br />❑ 8.Lab Pack. I have Signed the required certification page of Attachment t, which I am enclosing. <br />Pursuant to 40 CFR 268.7, 1 am notifying Statewide Environmental Services that, under the above <br />profile number and manifest number, I am shipping to you a waste which is non-RCRA or <br />non -hazardous. The waste is not currently subject to EPA Land Disposal Restrictions because the waste <br />is non-RCRA or non -hazardous. <br />Signature: VV I <br />Print Or Type Name: <br />