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VV VY IJ IJ.:JG I nVl'I— UU106 urvi ronment.zai bUl—�SLL—iSt)i53 I-454 I'UUIU/VUI"L t--ybfi <br /> VV� vbJ ruull/uUIJ r--[U4 <br /> &Ott& verton RECEIVEp <br /> iRAVlronmental Services <br /> APR 08 2015 <br /> LAM DISPOSAL PEE 2uOTTONNOMICATION roRM (L ' NWRONMENTAL <br /> For Wastes Subject to the Treafinent Stuz(dWa Sound im40 CFR 268'NFA TM nFp4PTMFMT <br /> INS1•RUG IONS: Completepatt1,check andemnpletepart)t. Complcwnadeignpoiflll,itapplicnblo, . <br /> PA1tT7.GenerafoZr Cer ice and xanlCestlnformpt(on / C� ' <br /> Gaperatd[Name: <br /> Addteae: N .. 1 <br /> Stafa; ip��lvlopifbatNumbar ��� � 1 <br /> , <br /> Thisdtraam is(chock one)—Wastewater(per Section 40.CFR 265.2(f)(1)(2)(3)) pon tvssteWatdr. <br /> •PARTILt.'Sr/astesubachtoLacdl)Is osal$astrlcllons <br /> PuMautto 40 3)268.70,I hereby notify 1hetthis Vste shipment contains one or mnro of the following wacte(s)reshicted <br /> tinder the land disposal rasttielions for which applicable treatment standards arc noefod lu 40 CF t,268.40 or 42 U3SC, <br /> 692A(d), <br /> IftFfamdous Wei eaNumb am I <br /> V listed Solvents(check all thatappkv) <br /> F0t1,F002,17003,p00q orF005(O'nderiying conadtuepra moat hu;dantifiod, Una Fatm LpgN=1A) <br /> _17005 6n1ali ft2 Nitropropsne ca-13t imothenol <br /> H001 F005 Containtugcarbon disu%de,cyolohcaanono,molhanol,era combina&on of these conetituentdns ttiesole$0016 I <br /> ragolmad cwnstfdent <br /> Other Wastes <br /> UnullDAK,Uorl, Subcdcgory Wastchratcror CESOFoale Applkablo ' <br /> Codon OFagy (iFagr) Saa Nonmumm(ar Numbor tanP,mta Cedes t <br /> Paol,beod,eto, tnAfl•1N WW NWW . <br /> °" X 331 <br /> 4 <br /> _ HazardousDabrtsNmNmUan <br /> Thh hvmdaus44rls Issbbjeu to the allcmanYo tmatmantslandatds or4o M,265,45 <br /> CanftWoamiublecl to lfmttaant(please liatwsslo eudaeappliudle to Ihodcbds) <br /> A�° CIL1Tys oto thaP'ConlamfnanLV SubJat ta'ISwtmant°uret oYe wlutiNenls appttcoUcroawwla code tlstedebave ibrtybl n6DA as omnuhndordl <br /> catabtishad In 40 CPH,268A0,tncluding undedylagconstitums whoreappllrablb, . <br /> IoFS <br /> 1610 West 17th Street 4thg Heade,California 90B13 <br /> (56Z)432-5Q5 (800)B CRQSl3Y FAX(562)436-y64Q <br />