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UmEardie <br /> Land Disposal Restriction Notification <br /> GaneratorName: 99 Cents Onry#I57 EPA Nuri bib C,4LCO4WSKS <br /> Generator Address: 3{34 VV.Kmtieman Lone Lodi.CA <br /> Manifest TracRing Numbor- 01- 5798SFk F <br /> Instructions <br /> Calutnn I-Listxhe Manifest Line murntsm or Manifest Line mm- <br /> Oafumri 2:ldeglify all US-EPA hazaRJOLcs VV2ste tiodtrs M&apply la this shipment <br /> Coie+mn 3:Cherie the appropriate treatebuity group'.liar-WuMemlee(TWVV)or VVmtewater(VJW!. <br /> -Ctrtumn 4:1=nler the apprgpriate 3ubcate9ary 1,pw 44 CPR 2B6-4C}.if gpplirable,-und also enter"Contaminated Suit'flr LDOris'if the waste wN be <br /> treated using one of the al€ernative tmaimeni te;3hrvcgies provided by 26t.49 of 266-45-iris. <br /> Cprurnn 5:Fntef thE)letter caf the-Qippropriolig pArz3groph from w(r m-Apptmdix 1 fDr 4thor Gptipns If n ed) <br /> Cokurari 6.Fnr FMI-FORS.plr�sA r±ntar ih3 R efwgnca N urnbor{s}locatod belew for thin D3ttir m nts in your v< mmam vuh,ieM to treaEmm7:. <br /> Column T;FQr F039.Q001-DG43,Di3brj5S Cgn!�itranc tt 5QH.pbm a 10 the Refevwca Nombcars listed 4%Affix 2 for 8ny Llndef+mg Ftaxardws <br /> Cbnstilverim <br /> Check One <br /> � Jndertyirroa S iaaurdous <br /> Man2ferA Line Number U-S. EPA.I-f�zardrnrs Ha v Must Thi: Goroskd�a rrL� <br /> cw Manifew Line item LVam Codes 1%11'-Cal�ary Waste Be ComStitLYeniS for DO01-0043. <br /> 7W1 n8g9d7 <br /> %W4V UV Fga F{30i-Fom Debris or SoO <br /> I-1011M 0001 Yea rtigh TOC Igra e A <br /> Liquid <br /> 2-#D79tDW7,X1r, Yes A <br /> Gaiumn 5 Waste Management Codas <br /> A TOS RCST-RtC T Ell WASTE Rf! U.l RES TREATMENT TO THE APPUC;ABLE STANDARD-This wasls mvsd be'tnawed to <br /> the appbiceble perfor'rnknee,Erased Weartrr of star4dhM so ttuth in 41X--FR Part 268 Subpart C.266. 2-Sud,- iDn 266-40 or <br /> RGI;,4 Saction 3A04{d}ps?cir to kartd disposal. <br /> Co€trrnn 6 FWI-FOgS Rwforence Nornbors <br /> Column 7 DDO'I-DO43 Refertnoe Numbers <br /> I hweby certify that au informratiort subscribed 8t thy:and 0 as400iated&oc�nts.is Gmplete an O accurate to the besi of tti}kmmvle <br /> irsfgrmatpy.7 <br /> Generator Stgriatura: iTRS: <br /> Printed tame: p ' trate <br />