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05/01/97 14:28 TOXIC SUBSTANCES CONTROL 4 912095990202 NO.091 P03 <br /> EPA ID NUMBER. h <br /> C . „I 1 1 14 Y Page L of <br /> CONDTIIONALLY EXEMPT- SPECIFIED WABTESTREAMS <br /> UNIT SPECIFIC NOTIFICATION <br /> (pursuant to Health and Safety Code Section 25201.5(c)) <br /> 8. Gravity separation of the following, including the use of flocculant3 and demulslflers if: <br /> ❑ a. The settling of solids from the waste where the resulting aqueous/liquid stream is not hazardous. <br /> El b. The separation of oil/water mixtures and separation sludges, if the average oil recoverctl per month is less <br /> than 25 barrels (42 gallons per barrel). (NOTE: AB 483 (Ch 625, 1995) allows certain used oilhwater <br /> separation under new the CEL category. See Form 1772L and CEL Fact Sheet.) <br /> ❑ 9. Neutralizing acidic or alkaline (basic) material by a state certified laboratory, a laboratory operated by an <br /> educational institution,ora laboratory which treats less than one gallon of onsite generated hazardous waste <br /> in any single batch. (To be eligible for conditional exemption,this waste cannot contain more than 10 percent <br /> acid or base by weight.) <br /> ❑- 10. Hazardous waste treatment is carried out in quality control or quality assurance laboratory at a facility that <br /> is not an offsite hazardous waste facility. <br /> ❑ 11. A wastestream and treatment technology combination certiried by the Department pursuant to Section <br /> 25200.1.5 of the Health andSafetyCode as appropriate for authorization under CESW. <br /> Please enter certification number: (See Appendix 5) <br /> ❑ 12. The treatment of formaldehyde or glutaraldehyde by a health care facility using a technology <br /> combination certified by the Department pursuant to section 25200.1.5 or the Health and <br /> Safety Code. <br /> Please enter certification number. <br /> Il. NARRATIVE DESCREMONS:. Provide a brief description of rhe specific waste treated and the treatmeerprocess.{P4 used- <br /> 1. <br /> 4w •� �1��� <br /> 1. SPSCfF/C WASTE TYPES.TREATED: � �t� t�ti C <br /> LAq .lam <br /> 2. TREATME T PROC Ss[ESj USED: <br /> t <br /> M. RESIDUAL MANAGEMMNT: Check Yes ar No to each question as It applies to all residuals from this treatment unit. <br /> YES NO <br /> ❑ 1- Do you discharge tion-hazardous aqueous waste to a publicly owned treatment works (POTW)/sewer! <br /> ❑ 77 2. Do you discharge non-hazardous aqueous waste under an NPDES permit? <br /> ❑ K5.1 3. Do you have your residual hazardous waste hauled offsite by a registered hazardous waste hauler? <br /> If you do, where is the waste sent? Check all that apply. <br /> ❑ a. Offsite recycling <br /> ❑ b. Thermal treatment <br /> ❑ C. Disposal to land. <br /> ❑ d. Further treatment <br /> ❑ - 4. Do you dispose of non-hazardous solid waste residues at an offsite location? . <br /> ❑ 5. Otkterthod of disposal- Specify: <br /> t �f <br /> S ✓�1�2 . ON SI � ��-h �llS.��sv` � [' tf��� �foasS' <br /> DTSC 17122 (1/96) .('`J '��(; Page 11 <br />