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CROSBY & OVERTON, INC. <br /> 4 CROSBY &. OVER OVERTON, INC 1610 West 17 " Street ( Long Beach I CA 90813 <br /> PH : (562) 432-5445 <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM ( LDRNF) FAX (562 ) 495-2181 <br /> For Wastes Subject to the Treatment Standards Found in 40 CFR 268 <br /> INSTRUCT IONS: Complete Part I, check and complete Part Ii . Complete and sign Part 111, if applicable. <br /> PART I . Generator, Reference and Manifest Information <br /> Generator Name: EAST BAY MUD-MOKELLIMNE RIVER FISH HATCHERY CA DFW EPA I D # CAL000431278 <br /> Address: 26800 NORTH MCINTIRE ROAD City : .CLEMENTS <br /> State: CA <br /> ZIP: 86227 _ Manifest Numher: .018474994JJK _ <br /> This stream is (check one) wastewater ( Per Section 40 CFR 268. 2(f ) ( 1 ) (2) (3)) ✓ non-wastewater. <br /> PART II . Waste subject to Land Disposal Restrictions <br /> Pursuant to 40 CFR 268. 7 (a), I hereby notify that this waste shipment contains one or more of the following waste (s) restricted under <br /> the land disposal restrictions for which applicable treatment standards are set forth in 40 CFR, 268.40 or 42 USS(, 6924(d). <br /> EPA Hazardous Waste Numbers <br /> F listed Solvents (check all that apply) <br /> F001 , F002, 1`003; F004 or F005 (Underlying constituents must be identified, Use Form LDRN- 1 A) <br /> F005 Containing 2 -Nitropropane or 2-,Ethoxyethanol <br /> _ F0014005 Containing carbon disulfide, cyclohexanone, methanol, or a combination of these constituents as the sole F001 - S <br /> regulated constituent. <br /> Other Wastes <br /> D001 X LP56064 551 <br /> Hazardous Debris Notification <br /> This hazardous debris 1s subject to the alternative treatment standards of 40 CFR, 268 .45 <br /> Contaminants subject to treatment (please list waste codes applicable to the debris) <br /> FACILITY: Note that "Contaminants Subject to Treatment" are those constituents applicable to waste code listed above for which <br /> a BDAT treatment standard established In 40 CFR, 268.40, including underlying constituents where applicable. <br /> 1 of 5 <br />