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RECEIVE, <br /> i <br /> CIVarrEarth Environmental Solutions h1AR 1 2023 <br /> RCRA Lrrnd Disposal Restriction :Notification Form <br /> Work Order # <br /> N' I RON M IF N IA 1, 111�� fiL1' 1� <br /> Generator: US EPA [D I) I? 1' ! I2 OIC NT <br /> Profile No. Manifest <br /> C ) 44 - oNo. 02 .1 <br /> In accordance with 40 CFR 268. 7(a), the underlying hazardous constituents must be addressed in this haste. Per <br /> 268. 2(1), "underlying hazardous constituent " means any constituent listed in 268. 48, Table US— Vntversal Treatment <br /> Standard which can reasonably be expected to be present at the point of generation of the hazardous waste, at a <br /> concentration above the constituent-spe ific UTS treatment standard Refer to Form-EZ (attached) fore the waste <br /> code(s), treatability group, and subcategory applicable to this waste. <br /> In order to address underlying hazardousconstituents in characteristic wastes, please check the appropriate box: <br /> r <br /> Cl I have reviewed the UTS list of 268 . 48, and per 2687(a) , I have determined that there are no <br /> underlying hazardous constituehts reasonably expected to be present in this waste. <br /> i <br /> I have reviewed the UTS list of; 268 .48 , and per 2687(a), I have determined that underlying <br /> hazardous constituents are present in this waste. The underlying hazardous constituents are <br /> identified as follows : <br /> The determination of underlying hazardous constituents was based :on: <br /> ® Generator's knowledge of the waste <br /> f <br /> ❑ Analysis { <br /> I <br /> i <br /> I certify that I personally have examined and am familiar with the waste through analysis and testing, or through <br /> knowledge of the waste to support this! certification . I certify that as an authorized representative of the generator <br /> named above, all the information submitted in this notification is true a correct to the best of my knowledge. <br /> Ron <br /> Printed Name Signature 000or <br /> Date <br /> Gush m� c cA <br /> Form EZ Revised 07/31/98 This is a two sided form <br /> 1 <br />