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LAND DI:DPOGAs NO 7FICAMH AND CERT9NCA ION FORM PHASE V1
<br /> trWR❑NMENTAL SaRVICr5
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<br /> Ge"gra or ilrwFflO: fr�C ��Z "EPA fD m / fr Manifas#Tracking s fl Z! ?D"/�
<br /> 1.i!W9sts la S Wasfa'tlater(Sec 40 GFR 263.2)piaca'4v,next ID tha apaGcabla r odea}
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<br /> 2.CODER y✓ITH SU?3CATEGORtEs'(pr❑pliat0lstterfrom section 3 bafrre each code Eiet applies)(see 40 CFF{2E3 for datatts)
<br /> —DOCI fif•TOC
<br /> eco I w —W05 Lead acid batteries —;(ORO Not r`afc+um CdfaFe ,^00."Li n'41!Me 1 a. �rJ I bI Hl Hg
<br /> pie I a,li DWO Organic Ng>280pprn K071 Smart Res. __U243 2,4 b
<br /> a,��G03 RCacUva Cyani✓n —COCA fnorg.!-ig 5 2t# —1(071 Not Rmerc Res, �'�'NOS imlRfrlERG Res,
<br /> D003 Reacffvo SuNtds 13009 H, <26r3 V,-, 035 HI n0JRMEERC Aar. _0240 2,4 eattlrm&Sells
<br /> Mee-
<br /> D003 c lastva 1 KI06 Lo Rmerc Ras, _P092 La In,Mee-
<br /> p _F02.5 Light ants —Kids Not Rmafo R:s.
<br /> D003 V ater ReacI1yas P025 2FWA filter K10e>20 pPm Fig 13092 FI t InNRMEAC Res.
<br /> _00C3 Unexp Ord.Rmg F009 drated —POQ2 lit i f hU M E9 Rea.
<br /> DOW Othar Reec6vaa K00o AAnhydraue --POQ7 Sells
<br /> �.D�Yai3;tteAes i'047NoncaRa —Ufs1 LuKMEFIC,Qmy,
<br /> —K069 Calcium Sulata —P063 Lo Inc.fees, _U151 Lo Not PNFRC Res,
<br /> The sUfcCatecory for 0013-004.3 viaate i9'*rsated In t1Or,GWArhOrSDYJA fnHtit,r, rinle9s the fcrtowing bar l3 ohaair :L7"fteated 111 GWA/SD`NA Paclltty"
<br /> 3,COf IMON CODES(peace aprpropriale iattar from section a befo e each code thzt adios)
<br /> 13002 _13012 13030 _may L �P10S F2a5 _may —FCa7 �Fa 9 FOU3 —F310 FO 1 F01?_ —F019 F039
<br /> D020 DQ'jI �r' _, DON =D016 _`Ll0{t D013 D01:3 =ppti �a)i5 —A]�6 —'p01i —t70]8 �D�13
<br /> 0020 Do21 0022 �Dp23 �D024 �,CO25 �CO2d —x127 `DD"c2 -p029 �CO.Z7 —r�034 —U034 ui�[13?
<br /> 413036 D037 ^p0'; G09q `VAO '�g04i r1042 —0343 —FD01 FCW2 F0fJ3 �PW4 FOGS —U002 -1J —"tDom Ojcr
<br /> __U007 �UL'43 UG91 _ U072 _U030 _U1O8 wtJ117 _IJ722012,3 _U139 -U!•;4 U183 —U273 _UP20 �U?2a -0273
<br /> ADOITiOhtAL CODES(Entar all wdesnot!dentlftari Ebova wh!ch are aesocla;ed wlt>5 wasta) �,KCE1
<br /> 4,USEPA KAZARDOUS WASTE 5.TREATMENT STANVASD8 FOR NON•?RASE it STATE3(INDICATE THE APPUCARLE 9,HO•cMV9T THE WASTE aR
<br /> iCODE(s) TREATMENT STANDARD.5&41,2Bgd3 OR pp' CHNOLOi3't BEL,OY,D MANAGED?ENTER THE LETTER
<br /> FROM 6ELONl
<br /> l
<br /> To 02ritify Foaa,or UHC3 managed in nnn-CWA,use th9'F039JUndarfyfno Hezerdeui Constituents Pcrri"pru•fdad a d mac%here:❑
<br /> If no UHCs are present upon gmaratlon check hare:Q Chock here if disposal facility will cheek rot ail UHCs❑(i-a,no UHC form required)
<br /> Ta list additional EPA wade coda(s),use the supplemental aheat and rhaok nor-:❑In iiau a:upplamenlal ahcat you may u9a multipfa copleg of lhia torn.
<br /> 7.SOLVENT CONSTITUENTS[POG I-r3o5)Gtieok hers 4 dtspogal Facility will cheek for afl apeni solvents
<br /> —Acetone �aarZBna �n-Butyl a coflol Carbon disWida
<br /> CarbonTetrachlpride _ Chlorobenzena O-Craaol �0n9ofs(m§p)
<br /> Cyclohexsnana _•c-Dlchforcbenzena 2 EtFoXye hsrol E It l acetate
<br /> EiFryi benzene _Ethyl:th:e _Isobutenol 14.1hancl
<br /> Mathytane chlorides _M61hyl ethyl ketone „^we-thyl i=obutyl katona _ N hoharzars
<br /> 2-Ni#r6propan9 _Py cine Tetra hloroethylene _Tolusna
<br /> �_1,1,i Trich{orvathane _1,1,2-rr<chbroathana `•_„
<br /> 1.1.&Tdchloro,1,2,s-1r9fluoroethane• Trichloroathytena -
<br /> __Tr chlvmmonotltJotorrtsUlane _419nes
<br /> 8. (stal9a authorized by EPA to manage the LDR program may have raQutatory cltallona different from the 40 CFFI cltattons Fisted heiow.PJhars lhase r9outalory citaflons differ,ycur
<br /> cerlIncatlon vnll be deemed to refer to Zhosa slats dta6ona instead of the 40 GFR dtal!ons.)
<br /> A-or ✓ RESTRICTED wASTE REQUIRES TREATMENT
<br /> This waste must be traatedlto the appGrabls treaiment stsndares set forth in 40 CFR Part 2Ba.40.
<br /> ❑ •For hazardous Dabda!•This hazardous debris is subject to the alferna lva 4valment standards of 40 CFR 233,45'
<br /> 9.1 RESTRICTED WASTcTREATLAENTTOPERFORUANCRSTANDARDS
<br /> "I c9rtlfy Under penalty of law that I have personally examined and aryl familiar wlt5 the treatment technology and oparaffon of the treatment process used fo suppod this rArtff callDr.Saeed
<br /> on my inquiry of thoee indlVlduaTs;inmadfalaiy razponsible,for Dtietning this information,I baQcva lhat the treatment process has bean oparaigd and ma-kilatnsrl properly so ss to comply
<br /> with the treatment standards specified in 40 GFR 28.40 without impermtssibfe cTudon of the prchlbltad wasta.I am aware that therm ani significant p 3IJas for submlttlng s falaa
<br /> certificalion,including the posslbllily of m Pne and Im prtsonment.'
<br /> 0.2 (CEFIMCAlIONREYQVY D9YPHASE N)
<br /> 6.3 GOOD FAITH ANA ANALYTICAL CERTIFICATIQN-FOR INCiNERATnD QRGAfrICg
<br /> 'I c9rtl y under penalty a F,w that I have psrsor lly examined and Em fan1arrdth tha iraatrnwt lachnotogy and operation of the treatr.ent process us�d to supportt-.12 certikaBom Bzsed
<br /> on my inquiry of those individuals tmmEc la:aly responslbip fbr obtaining oris information,l believe that the nonwastewalor organic wrl:filuenta have baen traatad by combu3tlon units as
<br /> Bpe flied in 269-42,Table 1,f have b•_ r1 unable to Qefect the nonwast¢watat omy xflc oonsfi5u9nts,daapfta having used best good faith efforts to analyze for euoh constituents.I am aware
<br /> that there are elgrilfluent penalties for Ful m"w a false cawrltfloa1Dn,hc!udirtg the poasmilr^y of fine ane lrnprsenr::ant
<br /> E3.4 F)ECHARACTERIZEDWASTE REOWSES-MEATMENTFOR UNDERLYING HAZARDOUS CDNSTITUnTS
<br /> "Lcemy undx Penalty r law that Ina waste hes been lreat_ed In acccrdnn_G with Ute requi.-emsnts of 40 CFFi 268.40 to remove the hazardous characters5c-This dacha,raele zed waste
<br /> COnta1113 underlying hazardous cmtiituants that regcrit4 further treatment to meat unlvarsal Irsatm4nt standards,lam Aware that theta are slimfhcantpenaltlea for submitting a(also
<br /> rarfiacatiort,Inducting Ino pcsalbllthy of tine end imPAs0 meat'
<br /> C RFZTRICTr=D WASTE GUIUSCT TO A VARIANCE
<br /> This waste is eUbjed to d nalLunal capacity valiance,a lreatablllty variance,or a casa•by-case 9xtenelon.Elver tlhe ef1eLlPt2(late of pmhlbi:jDn N column 7 above,
<br /> ❑ For hazardous debris:`Tula ha:vdoua 6abris la rubjact to;ha allsmailve treat.-rant s�nGarda of 4o CFR 2eSAV
<br /> D. RIIISTF cTA0 WASTE cAN BE LAND DISPOSED WITHOUT FURTKIERTREATIAENT
<br /> '1 certify under panalty of taw that f have perronaCy,examined and am.rerefer with the waste through analysis shd testing or thmugh knowledge of the waste to 1;upp6n thia c wEficaLm EhM
<br /> the w is ramplioa WM ire treatment 8:land3nds zpa nd is 40 CFR Pa12613 Subpar D.I baRave Vint]ha informagan i auhn)Nad fa tn,a,eeCUf41S and cDmptelm.f am aware ihet IhCra are
<br /> =19011cent penalffea for submitting a falx certification,including the pc-,slblllty of a!1a and imprtaonmenL'
<br /> E WASTE NOT CURFIENTILY 31.12JECT.a PART 269 8EZ7RICTIONa
<br /> This waste is a newly identified waste that is not ourrontly,subject to any 40 CFR Part 268 reatIcIlone.
<br /> I h®rally tartly,that ail Wornadon inrlhta and all aeaodalad documents is compfata sod accurate,to the Iasi of my l,=wIadga and Inforrnatlon.
<br /> Signature C- <e_��1�1 -S2-L SLQS'f \
<br /> Titf9 <7 Data Q,
<br /> FORMS VES-7313
<br /> GI_i'J�RATOR COPY
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