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Page 1 01- <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM FOR WASTES SUBJECT TO THE TREATMENT STANDARDS FOUND IN 4G CFR 26^c <br /> GENERATOR NAME MANIFEST NUMBER <br /> Pacific Southwest Container 011094643FLE <br /> TSD waste NWW Special <br /> Line Approval# Code(s) Subcategory UHCS or W W Conditions <br /> 1 ACT72617/ 214 <br /> ACT72617 <br /> DOM <br /> Line <br /> TSD Waste NWW Special <br /> Approval# Code(s) Subcategory UHC'S <br /> or WW Conditions i <br /> i 3 ACT64082/ F003 ACETONE•,ETHYL BENZENE`, NVIFW <br /> ACT64082 214 METHANOL*, METHYL ETHYL <br /> KETONE', <br /> TETRACHLOROETHYLENE', <br /> F005 TOLUENE%XYLENES-MIXED <br /> D001 - <br /> ISOMERS(SUM OF O,M,&P)- <br /> F002 <br /> D035 <br /> { <br /> SPECIAL CONDITIONS: <br /> A. Waste Requiring No Further Treatment <br /> B. Lab Pack Waste Qualifying for Alternative Treatment and 40 CFR 268.40 <br /> C. Hazardous Waste Debris subject to standard treatment requirements,40 OFR 268.40 <br /> D. Hazardous Waste Debris subject to alternative standards in 40 CFR 268(list contaminants) <br /> E. Waste Qualifying for Exemption and not subject to Land Disposal Restriction(Explain) <br /> F. Characteristic waste that are subject to the treatment standards in 268.40(other than those expressed as a required method of treatment)that are <br /> reasonably expected to contain underlying hazardous constituents as defined in 268.2(1);are treated on-site to remove hazardous characteristic: <br /> and are sent off-site for treatment underlying hazardous constituents(list constituents) <br /> G. Characteristic wastes that contain underlying hazardous constituents as defined 2682(i)that are treated on-site to remove the hazardoajs <br /> characteristic and the underlying hazardous constituents to levels in 268.48 Universal Treatment Standards. <br /> H. For Chemical Manufacturers,Petroleum Refineries,Coke By-Product Facilities and RCRA TSOF handling wastes subject to 40 CFR 61 subpart FF <br /> ONLY. This waste is"Controlled Benzene Waste"which is subject to the notification requirements of 40 CFR subpart FF. <br /> I. Certification for contaminated soil indicating the presence or absence of characteristic and/or listed hazardous wastes. <br /> J. Certification for contaminated soil treated in accordance with 40 CFR 268.49 <br /> Waste analysis is attached where available:otherwise the information contained herin is based upon my thorough knowledge of the waste(s). <br /> I hereby certify that I believe that the information I have submitted is true,accurate and complete. <br /> SIGNATURE TITLE .y DAT- <br /> -4—Z' 'JLLts n... t T6"7, leo e <br /> RE0F �1 VEE <br /> NOV 0 32017 <br /> ENVIRONMENTAL HEALTH <br /> 7FPAQTRAFKIT <br /> —ORIGINAL SIGNATURE PAGE TO ACCOMPANY MANIFEST— <br />