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LAND DISPOSAL RESTRICYIGN IVI0YUm = 9CATk0ty . . Manifest Manifest l�tal, ileot Line # Approval # Llne # Approval # 9b1 27b2 - 270 / — D 3150 EAST PICO BLVD , 9b2 27b3 -- --- --_ 27b8 - - - c7d is LOS ANGELES , CA 90023 - � � esource 9b3 27b4 — 27b9 PHONE : 800 . 499 . 7145 9b4 27b5 271) 7 0 Hecover'r FAX : 323 . 780 . 0078 27b1 127b6 --�— This notification form shall be completed by the generator and shall accompany each shipment of restricted wash . utjjuc ( 1 � the Land Disposal Restrictions (40 CFR 268 Subpart C ) . )P� Complete all information in Section I . y Check mark all appropriate Regulated Constituents in Section II , additional applicable Sections and/or complut (2 ? cction ui . Sign and date Section IV. SECTION I JUL 2 6 2016 GENERATOR ' S NAME Production �'AL 0441LYZ - - EPA I . D . NUMBER CAL000398410 MANIFEST NUMBER m4466 &9426ddIi TREATABILITY GROUP Check one Wastewater IX Non -Wastewater T HAZARDOUS DEBRIS I- : Yes IX No EPA HAZARDOUS WASTE CODE( S) - tj 'f - - iJ t X There are no underlying hazardous constituents of concern , or I There are underlying hazardous constituents of concern which do not meet the treatment standards of 40 GFF1 2 (38A8 , Table ' UTS - Universal Treatment Standards (see Section II ) . ` I have used the following to make the above determination : JX Knowledge of the waste producing process , raw materials used and reaction products , or F' Results of analysis for the constituents in Table UTS , Waste analysis data attached ? r Yes No NON- RCRA WASTE LIQUID SOLID _ Effective 1/31/96 — (Check all that apply) ❑ 9bl ❑ 9b2 9b :3 9b4 Pursuant to Section 25179. 6 of the Health and Safety Code, NON-RCRA ❑other ( 27b1 -27b10) I aqueous and solid waste containing organics has been repealed from i Land Disposal Restriction Notification requirements. FT��_� UNIVERSAL TREATMENT STANDARDS SECTION II _ _- ----------- - - -_ _. - --� 7e Underlying Hazardous Constituents must be identified for waste streams which cavy the EPA Waste Codes FOOL —FUOS, FuJ9, DOU I (unly DOO I f not treated by RORGS; CMBST or POLVM), D005—D043 (only D005—D043 if treated in Non -CWA, Non-CWA equivalent a" Nun• SD6YA facilities), The wastes identified on the aforementioned manifest document number and bearing the EPA Hazardous Waste Number (s ) identified in Section I are subject to the Land Disposal Restrictions of 40 CFR 268 Subpart C . The wastes do not meet the applicable treatment standards spgcified in 40 CFR 268 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 the requirements of 40 CFR 268 . 7 and 268 . 9 we are indicating below the applicable constituents of concern . PRR Fo.m LORN - 12010 - _ -- - - -