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Stericycle Environmental Solutions MCRA Land Disposal Restriction Notification Form Work Order 0 Generator. US EPA ID _b3 No. -U,46_XV1—6- PSC Profile u Manifest No. No. The wastes identified on this form are subject to the land disposal restrictions of 40 CFR Part 268.The wastes do not meet the treatment standards specified in Part 268, Subpart D or do not meet the applicable prohibition levels specified in 268.32. Pursuant to 40 CFR 268.7(a),the required information applicable to each waste is identified below(check all boxes that apply): Treatability Group: [3 Wastewater X Nonwastewater (Wastewaters contain less than I yoftiterable solids and less than I%Total Organic Carbon) ❑ D001 Ignitable(except for High TOC)managed In non-CWA[vton-CWA-equivalent/non Class I SDWA systems ❑ DOOt Ignitable(except for High TOC)managed in CWA/CWA-equivalent(Class I SDWA systems E-1 DOO1 High TOC Ignitable(greater than I 01/o total organic carbon) F-1 D002 Corrosive managed in non-CWAInon-CWA-equivalent/non Class I SDWA systems ❑ D002 Corrosive managed in CWAI CWA-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-equivalent/non Class I SDWA systems ❑ D003 Water Reactives based on 261.23(a)(2)..(3)and(4)managed In CWA/CWA-equivalentfC[ass I SDWA systems 0 D003 Other Reactives based on 261.23(a)(1) If D004-43 boxes are checked,complete and attach Form UC to address underlying hazardous constituents(unlessI these wastes are to be managed in CM41CWA-equivalentlC1ass I SDWA systems): M D004 Arsenic ❑D005 Barium D D006 Cadmium El D006 Cadmium-containing batteries DO07 Chromium ❑D008 Lead D D008 Lead acid batteries D009 High mercury inorganic(>260 mg/kg total),including incinerator residue and residues from RMERC D009 High-mercury organic(>260 mg/kg total),not including incinerator residue ❑ D009 Low-mercury(<260 mg/kg total) C3 D009 All D009 wastewaters ❑ DOW Selenium ❑ DOI I Silver D D012 Endrin ❑ D023 o-Cresol D033 Hexachlorobutadione El D013 Lindane M D024 m-Cresol ❑ D034 Hexachloroethane ❑ D014 Methoxychlor 7 D025 p-Cresol 0 D035 Methyl ethyl ketone D015 Toxaphene 0 D026 Cresols(Total) El D036 Nitrobenzene D016 2,4-D M D027 p-Dichlorobenzene M D037 Pentachlorophenol D017 2,4,5-TP(Silvex) D D028 1,2-Dichloroethane r7l D038 Pyridine D D018 Benzene 0 D029 IJ-Dichloroethylene [I D039 Tetrachloroethylene ❑ D019 Carbon tetrachloride D D030 2,4-Dinitrotoluene F1 D040 Trichloroethylene ❑ D020 Chlordane M D031 Heptachlor 0 D041 2,4,5-'Trichlorophenol D021 Chlorobenzene D D032 Hexachlorobenzene M D042 2,4,6-Trichlorophenol 0 D022 Chloroform M D043 Vinyl chloride No—te, 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 additionthe following wastes are included jathis shipment: M F00I-F005 spent solvents.(If this box is checked complete the F001-F005 section an the back of this form.Check the hazardous waste number(s)that applies,and ident#y the constituents likely to be present in the waste) If this shipment carries additional waste codes that are not addressed above,identify them here; EPA Waste Code Subcategory(if applicable) EPA Waste Code jabcateXory(if applicable). .�_ Form EZ Revised 07131198 This is a two sided form