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02/27/2018 16:57 FAX 6615876328 1@0003/0003 <br /> jeanHaEU' e� <br /> Land Disposal Restriction Page: 1 of 1 <br /> Notification Form <br /> ENVIRONMENTAL SERVICIIEV Printed Date:Feb 26,2018 <br /> AfIFEST INFC3RMA'f101+F <br /> ------ ---- ------ .. _ ._- -_ _.--- --------------- --_« - - ..--------_---------------------------------------------------------- <br /> Generator: Owens-Brockway Glass Container Manifest Tracking Info. <br /> Address. 14700 Schulte Rd a' ALVA <br /> Tracy,CA 95377 0 02 42 . <br /> F <br /> 4__-2 <br /> EPA EQ#: CAD 0 0 8 1 4 6 9 2 9 Sales Order No: 1$00822990 <br /> ---------- ------------..--- ----------------------------••---------------'-- r.__ _____- -_.--------------------------�;cbt <br /> LINE ITEM iNf=aRMATFOIV <br /> ------------------- ---------- --- y p:-----:_____ .__�_.___ ___--____ -------__ <br /> f'sr•51e tJo: �Treatabdifi C'art?U ; [_dR l]�sposal Category -"`"=`—"'"_- <br /> ----- -- --------' ------------_ ---- <br /> CH1592618 �N(3N-WASTEWATEit 2( his Is subject to LDR.7 <br /> _EPAWasteCod-a -------------'�.__ .--------...__: __=._ __----------]-SPA_Waste;-ubCate�ory_-_--__-----_......_..-.__.,�-- <br /> D004 -t-Toxicity-Characteristic for Arsenic0006 <br /> = -- <br /> _-... TOAicily charaCteriBticfoT Eodndumr <br /> D008 ;Toxicity Characteristic for Lead - <br /> - LDR Chemical D_Data _ _ _ <br /> ��--� Underlying -� �-Constituents ^^ Contaminants <br /> Hazardous of Subject to <br /> Chemical_ _ Constituents Concern Treatment <br /> ---------------•------ ----------•---------._----_------------ ----•------ <br /> - - N . <br /> --- ..- - _ ------ --------- - . ------ Y___1_:__1:_-:_1__1__,_ ----- <br /> Certification -f-- N - <br /> 1 . <br /> Pursuant to 40 CER 268.7(a}, 1 hereby notify that this shipment contains waste•restricted under 40 CFR 1 <br /> Part 268. ' <br /> 3 <br /> n <br /> -.---- --------- -------"------------------ ------------------------------ --- --- <br /> Waste analysis data-- ,wh B �a�l fe, is attached � tt - -------------- <br /> '-- -- "-`-••"`"` - <br /> -• Signature: - Print Name <br /> Title . -- -�Y' Date __ - <br />