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LAND DISPOSAL RESTRICTION NOTIFICATION FORM FOR WASTES SUBJECT TO THE TREATMENT STANDARDS FOUND IN 40 CFR 268 <br /> GENERATOR NAME MANIFEST NUMBER <br /> Manteca Unified School District(Sierra High) 008824363FLE <br /> TSD Waste NWW Special <br /> erne Subcategory UHCS <br /> Approval# Code(s) or WW Conditions <br /> 1 070137750271 / 541 NVWU <br /> 070137750-271 <br /> D011 <br /> SPECIAL CONDITIONS: <br /> A. Waste Requiring No Further Treatment <br /> B. Lab Pack Waste Qualifying forPJtemative Treatment and 40 CFR 268.40 <br /> C. Hazardous Waste Debris subject to standard treatment requirements,40 CFR 268.40 <br /> D. Hazardous Waste Debris subject to alternative standards in 40 CFR 268(list contaminants) <br /> E. Waste Qualifying for Exemption and notsubjectto Land Disposal Restriction(Explain) <br /> F. Characteristic waste thatare subjectto the treatment standards in 268.40(other than those a)pressed as a required method of treatment)that are <br /> reasonably expected to contain underlying hazardous constituents as defined in 268.2(i);are treated on-site to remove hazardous characteristic; <br /> and are sentoff-site fortreatrrrentunderiying hazardous constituents(list constituents) <br /> G Characteristic wastes that contain underlying hazardous constituents as defined 2682(i)that are treated on-site to remove the hazardous <br /> characteristic and the underlying hazardous constituents to levels in 268.48 Universal Treatment Standards. <br /> H. For Chemical Manufacturers,Petroleum Refineries,Coke By-Product Facilities and RCRATSDF handling wastes subject to 40 CFR 61 subpart FF <br /> ONLY. This waste is"Controlled Benzene Waste"which is subject to the notification requirements of 40 CFR subpart FF. <br /> I. Certification for contaminated soil indicating the presence or absence of characteristic and 1 or listed hazardous wastes. <br /> J. Certification for contaminated soil treated in accordance with 40 CFR 268.49 <br /> Waste analysis is attached where available;otherwise the information contained hehr is based upon mythorough knowledge of the waste(s). <br /> I hereby certlfythat I believe that the information I have submitted is true,accurate and complete. <br /> I r_`SIGNATURE TITLE DATE <br /> ATE STREAMS IDENTIFIED BY SPFM�t CONDITION A <br /> I certify under penalty of law that I personally have examined and am familiar with the waste through analysis and testing or through knowledge of the <br /> waste to support this certification that the waste complies with the treatment standards specified in 40 CFR part 268 subpart D and all applicable <br /> prohibitions set forth in 40 CFR 268.32 or RCRAsection 3004(d). I believe that the information I have submitted is true,accurate and complete. 1 am aware <br /> that there are significant penalties for submitting a false certification,including the possibility of fine and imprisonment_ <br /> WASTE STREAMS IDENTIFIED BY SPECIAL CONDITION B <br /> I certify under penalty of law that I personally have examined and am familiar with the waste and that lab pack contains only wastes whic'l have not been <br /> excluded under appendixivto 40 CFR 268. 1 am aware that there are significant penalties for submitting a false certification,including fine and <br /> imprisonment. <br /> WASTE STREAMS IDBJTIRED BY SPECIAL CONDITION F <br /> I certify under penalty of law that the waste has been treated in accordance with the requirements of 40 CFR 286.40 to remove the hazardous <br /> characteristic. This decharacterized waste contains underlying hazardous constituents that require further treatment to meet universal treatment <br /> standards. I am aware that there are significant penalties for submitting a false certification,including the possibility of fine and imprisonment. <br /> WASTE STREAMS IDENTIRED BY SPECIAL CONDITION G <br /> I certifyunder penalty of law that the waste has been treated in accordance with the requirements of 40 CFR 286.40 to remove the hazardous <br /> characteristic,and that the underlying hazardous constituents,as defined in 2682 have been treated on site to the 268.48 Universal Treatment Standards. <br /> I am aware that there are significant penalties for submitting a false certification,including the possibilityof fine and imprisonment, <br /> WASTE STREAMS IDENTIFIED BY SPECIAL CONDITION I <br /> I certifyunder penalty of law that I personally have examined this contaminated soil and it[DOES/DOES NOT]contain listed hazardous waste and <br /> [DOES/DOES NOT]exhibit a characteristic of hazardous waste and requires treatmentto meet the soil treatment standards as provided by268.49(c). <br /> WASTE STREAMS IDENTIRED BY SPECIAL CONDITION J <br /> I certifyunder penalty of law that 1 have personally examined and am familiar with the treatment technology and operation of the treatment process used <br /> to support this certification and believe that it has been maintained and operated properly so as to complywith treatment standards specified in 40 CFR <br /> 268.49 without impermissible dilution of the prohibited wastes. I am aware there are significant penalties for submitting a false certification,including the <br /> possibilityof fine and imprisonment. <br /> ***ORIGNAL SIGNATURE PAGE TO ACCOMPANY MANIFEST*** <br />