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Psge I. of I <br /> Tank Processing JOB <br /> 'DANK CFiRIpICATION <br /> krrPARTI—To becompleted bythe Customer*"'*x`"`**xx.xx+ . xx k.xaxAxai:� <br /> CUSTO)alz:49__I'L.o✓%_ GENERATOR,SHCV State Waste Codec: ' <br /> ,7071 /V MA)N ST <br /> LOCATION:MAI7TCGA GA EPAI.D.#:rilD9$1HS6�/ TEPAwasteCodes: <br /> T'RANSPORTL'Ro�C�R MANIFEST#:ZZlO$7bQ6. <br /> TANIC I TAMC 2 TANIC 3 TMUC{4' TAMC 5 TAMC 6 <br /> TANK#: 3_168 <br /> CAPACITY: lac. <br /> DIAMETER; <br /> LENGTFI: Z <br /> STLELJGLASSi �K 1l/ <br /> LAST CONTAINED: JAG <br /> LG=Leaded Gas,UG=Unleaded das, D =Diesel,UO=Used Oil;FO =Fuel Oil <br /> Specify the materieI.Last Contained if other than above. " <br /> LAND DISPOSAL RESTRICTION NOTMCATION FORM <br /> The waste represented on this manifest"is not generated'by a chemleal manufacturing plant, cola-by product recovery plant of <br /> petroleum refinery. As such,itis not regulated under 40 CFR Part 61,Subpart FF(NE+Sl7APS for Benzene Operations): <br /> .Pursuant to 40-CFR 268.71 dm notifying Ecology Control Industries that the material described by the above manifest is <br /> a n6nwastewater,Non-RCRA solid hazardous Waste and not currently subject to EPA Land Disposal Restrictions. <br /> Fur saint to CCR 22 66268:7 T am nbtifying-Eaology Control Industries that the material described by the nianifert is.a <br /> ma aj containing Non-RCRA solid hazardous waste (662683.29(g)), and an organics containing Non-RCRA solid hazardolas <br /> waste'(66268,29(Ic)). The treatment standards for these Wastes have been repealed. This waste is no longer subject to Iand <br /> disposal mstkictions. , <br /> I.am at, authorized agent/representative of the generator. I certify that all informatfon'submitted in this and 'associated <br /> .documents is complete and accurate to the best of Tay knowledge. The tanks on the transport equipment have-been numbered to <br /> correspond with the informafion provided 'above. In the event that the tanks do not correspond to the form,I will pay any and <br /> all costs incurred in rectifying the discrepancies between the tanla(s) and the form. In the event that the tank(s) co4titn excessive <br /> solids or Iignids,I agree to pay the cast of preparation, transportation and disposal recycling of he excess material a.ccbrding to <br /> the schedule of charges in effect at tie time of receipt of tae tank(s). Furthe.; I will not hold Yea logy Control Industries <br /> responsible,for any damage to tanks Which becnrs after the tank are removed from the ground, <br /> AUTH0R=D RL7PR2SENTATIVE <br /> SIGNATURE: ���� -`!�' DATE: <br /> PRINT NAME: G�IRI'� W} TITLE:. <br /> g'd VGbLOL60491 puowyol�j - 1 0 3 Bet 14 90 bl 0e0 <br />