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Sterfcyele Ellvironrllental Solutions RCRA Laud Disposal Rettriefiatt Notification Form Work order 4 Generator: L. IAJIV Q � US EPA ID :I No. PSG Profile No. Manifest t - No. The wastes identified on this form are subject to the land disposal restrictions of 40 CFR Part 269.The wastes do not meet the treaurrent standards specifled 1r, Part 268,,SUbpan D or do not meet the applicable prohibition levels specified in 268.32. Pursuant to 40 C1=R, 268.7(a),the required infonnation,applicable to each waste is identified below(check all boxes that apply); Treatability Grotip: Wastewater X Nonwastewater Of"asteiraters contain less than I%filterable solids and less than 1%Total Organic Carbon) ED. D041 Ignitable(except for High TOC)managed in non-CWAlnon-MA-equivalentlnon Class I SDWA systems ❑ DOO1 Ignitable(except for High TOC)managed in CWA/C'itirA-equivalent/Class I SDWA systems ❑ DOW High TOC Ignitable(greater than 10%total organic carbon) ❑ D002 Corroslve'Tttn"Aged in non-CWAlnon-MA-equivalent/non Class[SDWA systems ❑ D002 Corrosive managed in CWA/MA-equivalent/Class I SDWA systems ❑ D003 Reactive Sulfides based.on 261.23(a)(5) ❑ D003 Reactive Cyanides based on 261.23(a)(5) [] D003 Water Reactives based on 261.23(a)(2),(3)and(4)managed in non-CWA/non-CWA-equivaleatlnon Class I SDWA systems ❑ D003 Water Reactives based on 261.23(a)(2),(3)and(4)managed in.CWA/MA-equivalent/Class 1'SDWA systems ❑ D003 Other Reactives based on 261.23(a)(1) IfD004-43 boxes.are checked, complete and attach Form UC to address underlying hazardous constituents(wiless these wastes are to be Managed in CI11AI.CU'A_equivalent/Class ISDIpA systerars): D004 ArsenicD005 Barium ❑ D006 Cadmium .DO06 Cadmium-containing batteries D007 Chromium 'R ❑D008 Lead ❑ DO08 Lead acid batteries ❑ D009 High mercury inorganic(>260 mgtkg total),including incinerator residue and residues from RMERC ❑ D.009 High-mercury organic(>260 m&g total),not including incinerator residue ❑ D009 Low-mercury(<260 mg/kg total) © D009 All D009 wastewaters ❑ DO 10 Selenium ❑ DOI I Silver D012 l;ndrin ❑ D023 o-Cresol ❑ D033 Hexachlorobutadiene ❑ D013 Lindane ❑D024 pax-Cresol ❑ D034 Hexachloroethane ❑ D014 MethoVychlor ❑ D025 p-Cresol ❑ D035 Methyl ethyl ketone ❑ D0.15 Toxaphene ❑ D026 Cresols(Total) ❑ D036 Nitrobenzene ❑ D016 2,4-D ❑ D027 p-Dichlorobenzene ❑D037 Pentachlorophenol ❑ D017 2,4,5-TP(Silvex) ❑ D028 1,2-Dichloroethane []D038 Pyridine ❑ D018 Benzene ❑D029 14-Dichloroethylene ❑ D039 Tetrachloroethylene ❑ D0I9 Carbon tetrachloride ❑D030 2;4-Dinitrotoluene ❑ D040 Trichloroethyiene ❑ D020 Chlordane ❑ D031 Heptachlor ❑ D041 2,4;5-Trichlorophenol ❑ D021 Chiorobenzene ❑D032 Hexachlorobenzene ❑D042 2,4,6-Trichloro henol IJ ,D022 Chloroform p ❑ I7043 Vinyl chloride Notg: If any bolded entries are checked,form UC must be completed to-address underlying hazardous constituents,unless the material is treated in a Clean Water Act(CWA)treatment process. In ddi ion.the fiollowin wastes are ingluded in this shi meat; ❑ E001-FOO5 spent solvents, (lf this bax is checked, complete the F001-F003 section on the back of this farm. Check the ha=dome waste number(s)that applies, and Mena&the cpnstitrrents likely to be present in the ivaste,) If this shipment carnes additional waste codes that are not addressed above,identify thein here: EPA Waste C de Su cafe o (if applicable) EPA Waste Code Subcatea„ory(if applicable) Form EZ Revised 07131/98 This is a two sided form