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LAND DISPOSAL RESTRICTION NOTIFICATION <br /> too Manifest Manifest Manifest <br /> Line# Approval# Line# Approval# R Line# Approval <br /> 9a� I i1 (�� � t 27b2._.r) 27b7a <br /> �c3C1 (C 3150 EAST PICO BLVD. 9b2 I m 27b3 ! 27b8 <br /> Pacificsource LOS ANGELES, CA 90023 9b3 j 27b4 -- 27b9 <br /> Recovery <br /> 800.499.7145 19b4 27b5 27b1 0 - <br /> Recovery FAX; 323.780,0078 <br /> 27b1 27b6 <br /> This notification form shall be completed by the generator and shall accompany each shipment of restricted waste subject to <br /> the Land Disposal Restrictions (40 CFR 268 Subpart C). <br /> >- Complete all information in Section 1. <br /> >- Check mark all appropriate Regulated Constituents in Section 11, additional applicable Sections and/or complete Section 111. <br /> �- Sign and date Section IV. <br /> SECTION I <br /> GENERATOR'S NAME ! Ramos Oil Co. <br /> EPA I.Q.NUMBER CAL000420961 <br /> MANIFEST NUMBER 017145974JJK _ W„ <br /> TREATABILITY GROUP (Check one) Wastewater X Non-Wastewater <br /> HAZARDOUS DEBRIS i Yes !X No <br /> EPA HAZARDOUS WASTE CODE(S)- <br /> D001 D018 <br /> I . <br /> a <br /> t <br /> I <br /> fThere are no underlying hazardous constituents of concern, or <br /> There are underlying hazardous constituents of concern which do not meet the treatment standards of 40 CFR 268.48,Table <br /> UTS-Universal Treatment Standards(see Section II) <br /> I have used the following to make the above determination: <br /> X Knowledge of the waste producing process, raw materials used and reaction products, or <br /> T <br /> Results of analysis for the constituents in Table UTS. ; <br /> Waste analysis data attached? � YesNo <br /> NON-RCRA WASTE LIQUID SOLID <br /> (Check all that apply) ❑9b 1 9b2 ❑9b3 9b4 <br /> Effective 1131196- -]other 27b1-27b10) <br /> Pursuant to Section 25179.6 of the Health and Safety Code,NON-RCRA t. <br /> aqueous and sabd wasw cDn1ainm9 !9anics has ewer, repealed from F7 <br /> land Dfs,�sosa,ResirlcNbf,?Votificatior�mquirerarents. l <br /> UNIVERSAL TREATMENT STANDARDS <br /> SECTION If <br /> The Underlying Hazardous Constituents must be identified for waste streams which carry the EPA Waste Codes F001-FOO5,F039,0001(only 0001 <br /> not treated by RORGS;CMBST or POL YM),D005-DO43(only D005-DO43 if treated in Non-CWA,Non-CWA equivalent or Non-SDWA facilities). <br /> The wastes identified on the aforementioned manifest document number and bearing the EPA Hazardous Waste Number(s)identified in Section I are <br /> subject to the Land Disposal Restrictions of 40 GFR 268 Subpart C The wastes do not meet the applicable treatment standards specified in 40 CFR 268 <br /> Subpart D or exceeds the applicable prohibition levels specified in 40 CFR 268,32(California list wastes)or RCRA Section 3004(d) In compliance with <br /> the requirements of 40 CFR 268-7 and 268.9 we are indicating below the applicable constituents of concern. <br /> agave-.,�prr+-,u,o page i of <br />