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2128 Industrial Drive PR0521427
<br /> December 26, 2018
<br /> PHOTO 2: Land dis osaI restriction notification and certification form not signed at the bottom.
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<br /> * � LAND DISPOSAL RESTRICTION(LD R)NOTIFICATION AND
<br /> n CERTIFICATION FORM(PHASE IV)
<br /> m ' Generator Name:`/
<br /> �`- ��•- Profile Number'Y'/e�3.C._ �.�--
<br /> Ref.p 2 US FPp XA1pg000.S 3.SURCATEGORY ENTER TNF SUBI.EEORY
<br /> W0.5TE COOf(s) (If not aDESNOTION
<br /> ppNcable,simply a h eCk4.HOW MUST THE WASTE
<br /> NINF) ETTE
<br /> E MANAGEOT ENTER LR
<br /> a• FROM BELOW
<br /> 3.
<br /> r az.Ir ous ens e o n"(see a.xo(n x:d(xo
<br /> n 's a rmnN w.Isle ( ons osa
<br /> cos an zn py emmfics e^nau een
<br /> e u s^rfi(Iw0 5�o)i6e men rvo<:O
<br /> um .area ws c e r ntiF,U,,-,,-, ovb,,me c ewasr<c a as no su
<br /> (sra wlAo.Btnf ortiMun9
<br /> egulamryt0tabo�s nirharryy um.fo mer.�ll ce deeme6 m reaie�me n setsrnu citnons as�we lugs w csa.l40 fa crtao^ns nstee oe tn�s sarin,where mese
<br /> atmenU aE concern mr waste caves Foot-was and F019 ane u�tlens4ng na.amous consdtuems(UNcsI far On05-0045,must be idennt+ea unless the
<br /> tufacii;ry wilt moniwr for a0 cansntuents.5f
<br /> nny cons«taco rn for FOo5.Fa05.m eo cgnsbwentx of Concern Form 1(wM-too»ane coed nere:O
<br /> If UxCs are applimlde�but cone are preserve at[he pm t of genemti........NcherekaOn o
<br /> Dry will mpniwi for all constiblents.f comm(e.cep tlip.inx),ded nere:O
<br /> MANpGEMcENT<METHOD S
<br /> RESTRILTEO MEII REQUIRES TREATMENT
<br /> le treatment amndards set forth in 4o IFR—.10.
<br /> mapplicab
<br /> WASTE iAFATFO i0 PFRJORMAN[E ARDS
<br /> ernfyfOSTAND
<br /> n nalry of law that l personally nave.-ldane am familiar with the1-11nt techllb-antl^p-0.1 of the treatment pmcers—I
<br /> ee pe aced on mY inquiry cf those indivi—immediately responsible car o ling ma
<br /> this infmbon,I"Neve that the tieatment
<br /> atl been<operateduand mainrainetl prop<r1Y so as to mmpLY witM1 the 11t—d—Nl,61 in 40IFR x68.40 witnou[impermissible dilution
<br /> impd<gnment:waate.I —1—< ubm , b< firabpn innpdimg the poaaimrlr^f Rn<ane -
<br /> 8.3 hnee DFAITHAXA—CERTIFE—FORSIN FINUFFDORGANICS
<br /> G,Omortu111 p"Illb atl M1av nallye in ntl is M1 tmen[ecM1^lo bon oftn
<br /> I
<br /> d
<br /> 'ry d d' '1 k—,,mg Mise'nPo— eonons use
<br /> ce by b d. ble 3.I have been unabl kws 111-1n a
<br /> .9 ware Nat there ar g
<br /> b'If ffi
<br /> BA ARA,d,,,p O WASTE Rf t IR iR q1,1,,FOR OOUS CONSTITUENTS
<br /> —1,,d,,,p i,allyl-,at REQUIRES
<br /> waste M1as been Id 1,a4cordan a lb a reguiremepts of 40[FR x68.40 qr 3Re.t t-t I tM1e hazarI
<br /> 2 M1is dcCM1araRedzetl iN.11Ilrontains untlerlying ceza—comutuent,.M1 -RIL furtM1er«eatmenttome<t neatmen[smntlaNs.lam -
<br /> 9nifica submi afalsec mcWding the possibility olfine antl imp sOnment.
<br /> RFSTRI(TEDoeEBRIUSTfTEOui,ALTER NATE PERFORMANCESTANOAR05n n
<br /> G p—IN.y Vnderp<nal Nb,
<br /> F,A tlebds M1as been treatedin a cc.Nance with Ne..M.re en4.f 4ofFR 266.43.tam aware that Uele are significant
<br /> enalNes kr maNing a false certification,including tM1e possibility pf fine and impdsonment:
<br /> C. WASTE SUBOECT TO A VARIANCE
<br /> T4isT=�s subjeRmanatlonaI capacity variance,a beatabibby vaname,ora Ca.by-case xtensron,Enter lheeff<etive dlte d prohibition in column
<br /> (4)abpve.
<br /> 0"^ . REST RICTEOWASTECANBELANOOISPOSEOWAHOUTII""ERTREATMEHT
<br /> I.Man "I certify Ander pens,afi law E personally have euminetl and am familial d Newaste throuOM1 analysis and testing U ltd I M1 knpwledge of the waste
<br /> support this CeTfication tM1at tM1e waste cpmplies witM1 tM1e treatment xrzndards specifietl in 40 CFR Part 268 Subpart 0 and LAC 33:V.12x32233.I
<br /> ,,H believe[ha[[rte information I submitted is true,acrprate and complete.1 am aware thlt there are significant penalties for submitting a FILse—ficalion,
<br /> Conr unlading the possibility of fine and imprisonment'
<br /> 1IN by certifythat all information submitted in this and A associated documents Is c,.pt,W and accurate to the best of my knpwledge and information.
<br /> TNI/
<br /> Name:(Print) title:
<br /> Signature: __Oa[e:_ —
<br /> 2pOJ Waste Management,Ins. (WM x005[ 9 t x00J
<br /> Lydia Baker, REHS Page 2 of 5
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