DSHW-2024-007398

DSHW-2024-007398
Clean Harbors Aragonite, LLC
11600 North Aptus Road
Aragonite, UT 84029
435.884.8100
www .cleanharbors.com
July 17, 2024
Sent via email to [e-mail]
Mr. Douglas J. Hansen, Director
Division of Waste Management & Radiation Control
Department of Environmental Quality
195 North 1950 West
P.O. Box 144880
Salt Lake City, UT 84114-4880
RE: Unresolved Manifest Discrepancies
Clean Harbors Aragonite, LLC
EPA Number-UTD 981552177
Dear Mr. Hansen,
In accordance with Module 2 condition 2.K of Clean Harbors Aragonite's (CHA) State RCRA
Permit, 40 CFR 264. 72( c) and R315-264-72( c ), this correspondence serves as written
notification of three (3) unresolved manifest discrepancies. The manifest information,
discrepancy and what is being done to resolve these issues can be seen below:
• Manifest 019195525FLE-Upon receipt of the shipment, it was discovered that one
container was missing from line 1. CHA is working with the transporter to get this
resolved.
• Manifest 019447714FLE-Upon receipt of the shipment, it was discovered that one
container was missing from line 9. CHA is working with the transporter to get this
resolved.
• Manifest 019056296FLE-Upon receipt of the shipment, it was discovered that one
container was missing from line 2. CHA is working with the transporter to get this
resolved.
I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision according to a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
"People and Technology Creating a Better Environment"
Oe~ap~~r~IJi?s· ~-
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Should you have any questions regarding this matter, please contact me at the number listed
below.
Sincerely,
William Simmons
Facility General Manager III
Clean Harbors Aragonite/Clive Incinerations
11600 North Aptus Road
Dugway, UT 84022
(o) 435.884.8351
(c) 870.310.6029
Simmons. [e-mail]
www.cleanharbors.com
Please pnnt or ~e( for acknowle,jgss thslt no material change nas oc.curred etttier in the charnctenst1cs or 1n the procass geoar m#)q,~t~B No. 2050-0039
UNIFORM HAZARDOUS 1 Generato: ID Nwte 2. Page 1 of 3 Emergency R&5r,ons@ Phone 4. Manifest Tracl<lng Number
WASTE MANIFEST O 1919 5 5 2 5 FL E
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Gc!NiraiDl's Name and Mailing Address
SalonCentric Inc
M~s~l~ ijiiT,s
Genernro~s FfloM·
6 T ranspoocr C:O,,,par.y Name
Clean Harbors Environmental Service;;, Inc
De ,nal.ed F • t Na,-ne and Site Address
Cl an H rbo • ,agoni te LLC
11600 North Aptus Road
Grantsville, UT 84029
Foolrt'{S Phone (43 5 ) 884-8100
9a
HM
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9b US DOT Description (includmg Pxper Shipping Name . Hazard Class . ID Num!ler
and Packing Group (ii any;}
UN2984 , WASTE HYO OGEN PEROXIDE, AQUEOUS
SOLUTIO S, 5.1 , PG Ill, LTD QTY)
2 NON D.O.T. REGULATED
3
U.S EPA ID Number
MAD0393.22250
U S_ EPA 10 Numbe<
U S EPA ID Number
UTD981552177
10 Con1ainers 11 Tola\ 12 Unit 13 Waste Codes
No. Typo Quantity WtNol .
/)()J Cf 0001 :
COo J.h p '
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:'.:onlra.., r ne llV qe111:rat01 confc; ,; cl,Q6flt cJu on on in1t1al tmnsp(ll'rort ~aor subslmJt0ddd1nunat •i arlSOOfters on oe eramrs oa11 11 rcr ouroose; rtrBnscon r1on ffl.ci , CT: n _.,c r .;-1
15 GENEAATOR'S/OFFEROR'S CERTIFICATION : I hereby declare ttial tne contents of this consignment are ~Jlly and accurately described above by the proper sh,pp,ng name. ard are classified packaged
marked and labeled/placarded. and are ,n all respects in proper cond1bon for transr:ort according !o applicable ,nlemal1onaland na~onal governmental regulations If export shipment and I am the Primary
Ex~orter I certify t.,al :he contents of this cons,gnmerll conform to lhe lerms of the attached EPAAcknowiedgmenl of Consent
I certify that the ·,YaSle m1nim1zal 100 staterren! identified ,n 40 CFR 262 27ia) i1f I am a large quanllty generator) or /b) (~I am a smaN
18a Discrepancy !nd1calr0."i Space
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18 Discrepancy
~ 18b A!lernate Facil,:y 10, Ge"cratc"
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if: f ac,,t s Peons
0 Export from U S
Signature
0 Quant,~, OResidue
Day Yea,
Day Year
0 Part,a, Re1eclion LJ Full Re/ect,or.
U S EPA ID Number
fil lc,c=--:: -=s,a"":-,a-11-,re-,-.""~J-ll!_I\.J_:-=F-ao..,.l,-t,-:o-r""~-e-r;i ____________________________ _.__ ________ --,-.,..M,-,onl~:-----.O:-a-. --,,v:-ear-1
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0 H040 H040
l ,c Des,gna:ed Facility r , e-O' Q;:ttlllOf Cert11ica~on ol rece,p\ ol •azard~cs materials co,:ered by lhe man,fes! e,cepl as ccled ,a !lent 1 Ba
°'10100 ·'IOOil ilrr •gratu'!!
EPA Form 8700-22
·:);~,-11; I . -: . . ..._ _ ~ ... •;i ....:c~:er:: -::,~; \'tC!-<;l,G
ENVIRONMENTAL SERVICES"
Land Disposal Restriction
Notification Form
Page: 1 of 1
Printed Date :May 21, 2024
MAN IF EST IN FOR MA Tl ON -------------------------------------------------=--------------------------------------------------------·
----------------------------------------------------------------------------r------------------------------------------------------------· Generator: SalonCentric Inc : Manifest Tracking Info.
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Address: 11720 Peel Circle l 019195525FLE
La Vista.NE 68128 :
:
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EPA ID# N E RO 0 0 5 0 9 5 9 6 l Sales Order No: 2402642484
LI NE ITEM INFORMATION ------------------------------------------
Line Item: ----"f Page No :--------I Profile No -------r Treatab ility Group : ---------··1 LOR Disposal Category----------------
1 • T1 fCH549742 fNON -WASTEWATER • 12 (This is subject to LDR)
-----------______ 1 _ ----------------_ :._ _ ------------------:._ __ ---------------------------_J_ --------------------------------------------·
EPA Waste Code ! EPA Waste Subcategory
-~-□-~~-----------------·-----------------------------________________________ ! lgnilables, except High TOC Liquids -~-· ____ _
Certification ! Appl ies to
: Manifest Line
: Items
' ' ----------------------------------------------------------------------------------------------------------------t-------------------Pursuant to 40 CFR 268 . 7(a), I hereby notify that this shipment contains waste restricted under 40 CFR ! 1.
~rt~8. :
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I ---------------------------------------------------------------------------------------------------------,.------------------This waste is not restricted as specified in 40 CFR 268 Subpart D. 12
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Waste analysis data, ~he
Signature : __ J;. ~..,,.,_
Title : __ _ __ _
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Generator admowledges that no mateoal change has ac:curred either in the charactenstics Of in the process ganerati aa th e maten r l No 2050-00Jg
!e'"';e pnn or IYJ)!!. FOrmAJ)proved. 0MB .
UNIFORM HAZARDOUS 1 Generator iD Number 2 Page 1 of 3 Emergency Resp0f1Se Phone 4. Manifest Tracklng Number
WASTE MANIFEST N V7 5 7 0 0 2 41.1. 0 2 [phone] 019 4 4 7 714 FLE
Gener.il Of's So lo Address (ii different than ma.ing address)
CtNn Harbors Envtronm.ntal Ser\lic.a, Inc.
Clean Harbors Aragonite LLC
11600 North Aptua Road
Granta,iille. UT 840~
~ao f~Phone
9a 9o US DOT Descr1p~on unC:ud,ng Proper Sh rvp•ng Name Hazard Class, ID Numbo r
HM and Packing Group 111 any))
1 UN1090, WASTE ACETONE, 3, PG II, SOLUTION a::
0 ~ X
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SAME
1 o Conta,ners
No , Type
001 DF
U S EPA ID Numbe r
MA0039322250
U S EPA 10 Number
U S EPA ID Number
UTD981552177
11 Tola!
Quantity
00005
12 Urnt
Wt/Vol.
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13 Waste Codes
0001 :
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UN1133, WASTE ADHESIVES, (SEALANTS AND ADHESIVES), 3,
PG II
UN2924 , WASTE FLAMMABLE LIQUI DS, COR ROS IVE, N.O.S.,
(METHYL MElHACRYLATE , METHACRYLI C ACID), 3, (8), PG 11
15 G
r•1arkeJ ae.d labe'edip!ac.a 'dec aod are ,r. a respects ,o proper oond,t,on :or transpon acco rd,
b;,one, I certify that tr,e co111erHs of lh1s oonsIgnmenI conro,m 10 tne terms -~1 :ne a1Iached EP
I cen,fy !1 1.:!l tne waste m11,,m,zat,on slate,rent •denOfiod "' 40 CFR 262 27(a) (1f I am a large qu
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C H040 H040 H040 H040
l L.'.C ~:, 9n:3red = 3c1i,ty Ow,-:-:"· J' Cp~; .,rr:r Ce.-..~catc n of re-::E•p! ol ~azardous IT'atanals cov~re~ by !he mani~est excepl a.s r:Jed n :?err. :ea
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Ct~ri H-1~ trm_; t!i~ -1pr.ropril!tiJ oorm1~ for .1.nd v.11i oc..c.ei:it the w<1i;t.i the !lMGr'1tor 1s ::,hippmg CVS 24024 52519-001 PPW
Please print or type . CVS 2402462519-001 SC PPW 4/1/2024 Form App,oved 0MB No. 2050-0039
UNIFORM HAZARDOUS WASTE MANIFEST 121 GcMtaior ID Number
(Continuation Sheet) N V 7 5 7 0 0 2 4 11 0 1
22 Pago
2of2 1
2.3. M1nifH1 T<J~l ng Number
01944TI14FLE
24 Generator's Name USAF Nellis Air Fon. Bae
25 Transporter __ Company Name
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U S. EPA ID Number
26 Transpor1er __ Company Name U S, EPA ID Numbe{
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27a 27b . U.S DOT Oesaiption (including Proper Shipping Name, Hazan:! Class, ID Number, 28. Conlainers 29 Total 30 Urnl 31 Wasle Codes HM and Packing Groop (~ any)) No Type Quantify Wt/Vol
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: Gen erator I l'J mber I
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Clean Harbors Manifest Addendum
Paae 1 of 1
---------------------------
Sales Order Number:
!NV 7 5 7 0 0 2 4 1 1 0 019447714FLE 24024525W-001
L.------------------------------· ---------.. _ ... --... ------.... -----· -------------------------, 1 USAF Nellis ,Ajr Force Bas~ :
4350 GRISSOM ,.o,\/E STE 101
NELLIS AFB. NV89191
tl,no0.>H-··-·p··"1··-1,,-'--:···pr--1 ... n -,-" .: .-...... -·· :: : .. '/\iast.Ei:Cocles: ,~ .. r.011 e ,u. . . . . .,.Ol'I -.eSC1:4J0,Dn:.: . . . · ·: ·: · -1----·--------------. -......... -............... -... -.. ---.......... _. ---------. -----·---'-
: 2 CH2725573 DC. 19 [,;J.22 D027
' DIJ28 C-029 D:J32-
:JJJ;;,:l [;:J~5 [11J:39
[1()·10 [>'J,t 1 [104 2
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__________________ ,:-H Container# ------~~~?~e!S:~:t~.:~~_:: _______________ _
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CH26,5822
·-------------------
F005
Land Disposal Restriction
Notification Form
Page 1 of ..J
MANIFEST INFORMA.TlON ------------------------------------------------------------·-----· --·----· ·--·-··--·-----------------
----------------------------------------------------------r------------------------------------~ ------------
Generator USAF Nelhs .AJr Force Base Man1fesr T,.;ci-,r:g11-ifo
Address :l 350 GRI SSQM AVE STE 1 0 1
NELLIS .AFB .NV 89-191
EPAIO#: l'J\/7570024110
0194477-1.ffLE
Sales Order f·Jo 2402452519-001
LINE ITEM I NFORMATION -
Line Item :Page No :Profile No . :Tre:1 .ao ,hty Gro1.Jp -L C'": Disposal Categcri
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! 1 : VE -P 3-:f',JON-\V. '= d::.\-'-ATER 11 (Labpack AJt,:a,rnate S~a:-,dard
/ :LCCR0-2 '. : __________________________ ..1., _____________ L ________________________ _; ___________________________________ _
EPA W aste -o_ e _________________________________________________ : EPA W3ste Sui:>C at€'~r,i_ __________________ _
D001 : High TOC Ignitable Liquids -------------.. -.. -----------------·---.. ·----------_.&.----------------------------_ ... ____ --Lll'-JE ITEM INFORMA.TlOt-.J
Line Item :Page No ; Profile No: :Trearab 1h / Group ! LDR Disposal Categor/
• I • ------------~----... -.. --.. --------------------,---------------------------------------------2. :1 :CH2725573 :NO/1-W.S"'""E W -TE~ •~1This1ssubJecttoLOR1
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-----------..L..----------____ _._ _________________ .L, _____________ -------------·-------------·------------------------------
EPA Waste Code -----------------D001
0005
D005
D007
0010
I
---------------------------EP-~ -\-\'a~t.e s ... ": =•t;;<~Ot"' .. --------------·-·-···
: High TO •::: lgr•irab!e L1Qu1ds
: fo :<1c 1t~• Ch3ractensnc for 8anurr -
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Land Disposal Restriction
Notification Form
0018 0019 0022 0027 0028 D029 0033 0034 0035 D039 D040 0041 D04 :f1J •J NE
Page : 2 of '1
Pnnted [,ate :ivla 1 9 2024
0043 F003 F005 __________________________________________ : _______________________________________ _
Chemical
1 1-DI CHL OROETK4NE
1. 1-DI CHLOROEH·NLENE
2.4 ,5-TRI CHLOROPHEI\IOL
2.4.6-TRICHLOROPHENOL
BARIUM
BENZENE
CADMIUM
CARBON TETRACHL·)RIDE
CHLOROFORM
CHRotv11UM
HEXACHLOROBUTAOI Ef\JE
HEXACHLOROETHAI\JE
METH 'l'L ETHYL V.ETOl'JE
SELENIUM
TRI CHLOROETHYLENE
·Jlt·.JVL CHLORIDE
L!~JE ITEM INFORMATlmJ
LOR Chemical Data
Underlying
Hazardous
Constituents
y
y'
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C ontarninants
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-------------,--·-· --·--...•••• ··-r,-----------------r.-------·-·----------,----------------------------------••• 3 : 1 :WE-LP03--•NON-WASTE'l✓.ATER : 11 (Labpac~; ,.O.Jterr,ate-Standard !
• (LCCRD-2
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EF· . .:._ vVaste Code ______________________________ .. _______________ : E?;., \Nast.: S•.J ::.2 s.9 _..,,:_ ___________________ _
DG01 : High TQC Ignitable L1,:iuids
0018 0035 : NONE
--------------------------------------------------------------.L------------------------------------------------
LINE ITEM INFORMATION
------------,-----------------,--.----------------r-----------------------·--, -------------------r • --· ---------
Line I tern :Page No : rro . le ~,Jo : -e Jt.;;bi!ir; Grc.;::, : LDR D:s;::~s~I C-at,:;g □r-'.
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Land Disposal Restriction
Notification Form
---------------------------------------------------------, -------------------------------------------
D033 D034 D036 D042 : I l '.J M:: ______________________________________________________________________________ .,. ____________ _
LOR Chemical Data --------------------------------------------------------------------
Chemical
;Jnderly1ng
Haz3rdous
C;orist:Jtl.i!ents
C ar,sbn.Jent.=;
of
Cc;1tar,,1, ;::ir,t.:,
Sub1ect to
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ACETONE:
BENZENE
,.,,
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METHYL ETHYL KETONE hJ v r· 1 ------------------------------------------------------------------------------.. -----------LINE ITEM INFOS'! T I OI\I
Line Item : :Page No :Profile No :Treatability Group 7 LOR Disposal Category
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: !LCCRD-2 ! :
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______________ .,L_ ____________ I -------------J..•---------••--,---..---------------------------------------
EPA Waste_ Code---------------------------· _____________ : EP., 'l•'=ste SubCate~L __________________ _
0001 : High TOC Ignitable Uqu1ds
LI NE ITEM I NF ORM.A.Tl ON -------------------------------··-··----..... ----------------------------·-· -------
-------·----~--------------,----• ----------------------------------,----------------------------·---Line Item :P;ige ~..Jo : Profile No :Trea!:ability Group : LOR Dispo.sal Category
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0001 : T1:•~Cft\_' C:h;~cteri~i: .::,-1:·r.r:-,-,·:1 ~:r
[IQ1 & DQ35 D040 F002 F!J03 FG!J5
LDR Chemic al Dat a ----------------------------------------·----.. --.. --·-----·-------------------·-----------
Chemical .. ----------------------------
BENZENE
Chromium
METI·lYL ETHYL hETOt\JE
METHYLENE (:-1-iLDRIDE
Unde-ny1r1g
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• I ' ' • •-•--•---• .,.._J __ ----■--■--•----_..__ _____________ L ____________________ , _____________ ----·---. ---
EPA Waste Code ___________________ , ________________________ ; EP.A. Waste S u bC;;te.g o '}_ ____________________ _
0005 : To'fIcIt11 criaractenstic for Cadrn1urn . '
~W>X"ff M>:« f t\t SY.R'J>t!f..$'•
Land Disposal Restriction
Notification F onn
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--------------------------------------------------------------------------------------------Llf\JE ITEM INFORlvlATlON
-----------,.------------------------r---------------· .--------,--------------------• -------------Line Item :P3g.;, N o : Profile f'Jo :Tredtability Group LOR Dispos3I Categori
' ' -----------.::------------r-------------------------·. ---------,----------------------------------9 : 2 ;CH2506292 ;N l t.:-·.•;ASTE'NATER ; 2 (This 1:; :;ubjectto LDR l
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-~f.:~_\'.:"2~_£<?~~------------------___ --------· ___________ :_~~~~~_§~-8_~!)~~~~ Of'-, ____________ • _ ··-·-
00Q5 l foxicrty charai::teri:bc fr,, Ca,jr,,rurn
D035 D042 D043 1 ~JONE
_· -----------------·---------·-------···LDR Ch en1i_ al Data ___________________________ . __________ ··----------··
Cr1em1cai
Undenying
Hazar-do•.Js
·: cnstitrJenG
Constituents
of
-----------------------------------... -------·---------------------.. -------""
1,1-DICHLOROETH\'LENE
2 ~ e~ TRI CHLOR·)PHEf-JOL
BENZENE
C.ADMIUM
CHLDROFORM
CHROMIUM
HEX.ACHLOROBUT ADI ENE
HE;•:ACHL•)RGETH.ANE
METHYL ETHYL KETONE
J\ll TROBENZHJE
F-OlCHLOROBE lZENE
TETRA.CHLOROETHYLEl'JE
TR! CHLOROETHYLENE
y
'(
y
y
f.J
y
0:/untc;;T,,, ,arrt::;
Suo1ei:t !o
Tre2tr,:ent
111 r\JYL CHLORIDE f,J l\i
------------------------------------------------·-·----------------------------------------
Certification ~ ~p pll a>$ 0
This labpack is ::;ubject to the treatment standards specified 1n ~O CFR 258 S1.1bpart D I certify ur,de,
penatty of la1,•, thar I per.,;onaily have e)(arrnned and am familiar .r,itr-, t11e >·faste 3nc that t!ie l3t p3cK
contains only wastes tr,at h -3\'e not beer. excluded ,_,nder appendix I\; to 40 CFR part 268 a,id t}--,3t :his ii;b
pack will be serrt to a COt"flbustion facility 1n compliance with the atterr,abve treatment standaras tor tab
p3C~'.5 :it 4:J CFP. 258 42f_c) ! am aw3re tr,at there ::rre ::,gni fie a,,~ ;:er1alti2:;; for s0b1-r,,:t,,g = f;:;!se
certification , including the poss1bdit,· of :'ine or impnscnment
Part 268
, ltems
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Please print or type. Form Approved . 0MB No . 2050-0039
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UNIFORM HAZARDOUS • Ge!ieraroc 10 Number
WASTE MANIFEST C0D983802448
5 Generakx's Name acid Maili ng Alld!ess
Nattonal Renewable Energy Laboratory -Stm
Genora lofs SireAOdress ( d i!ereOI "1a mailing address)
NREL Flatirons Campus
15013 Denver West Pkwy Golden. CO 80401-3111 18200 State Highway 128
NMENTAL INC.
CLEAN HARBORS ENVIRO svs, INC -Aragonite
11600 NORTH APTUS ROAD ARAGONITE, UT 84029
Fooll'{5 Phone:
9a. 9b US DOT Description fmd
HM and Packing Group (if any))
UN3286 Waste Flammable liquid, toxic, COITOSive, NOS, X 3(6.1 )(8) PG II
2.
X UN3105 Waste Organic peroxide type D, liquid, 5.2 PG II
3
X UN3470 Waste Paint. corrosive, flammable, 8 (3) PG II
4
10 Containers
No Type
D
, Sooc:al H.Jnd ,109 tn~lroct.:nnS :ird AllMon.a1 In10,ma~n
11 ~,u;; .. ,-:;, ~-.:>~-'7' \'V.lo
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l, L<'..C.'2--0
~-LQ.~
~-1,...cc..U
CC. I ljl..O-S\>
WAZ..(..5lC
3-~~--,,'L. l• ::,)-e,'3 \X.S
EPA 10 Number
11 Tolal
Quantity
12 Unil
WtNol
UTD981552177
I 3 Waste Codes
i:>001 :t>oOI VOD2
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15 GENERATOR'SIOFFEROR 'S CERTIFICATION : I hereby declare that the contents of this consignment are fully and accurately descnbed above by lhe prop<!f shipping name. anJ are classrfied pac~aged
marked and labeled/placarded . and are in all respects in proper coodibon for transport according to applicable in\ematiooal and national governmental regulabons ,• e,po:1 shipment and I am lhe Pnmary
Exporter I certify Iha! the cootenls of this consignment confonn 10 the tenns of the attached EPA Ad<nowledgment of Consent
t certify that the wasre m,nrmizaaon statement ,dentified ,n 40 CFR 262 27(a) (if I am a large quantity generator) or (b) (if I am a small quanbtJ generatorJ ,s true
1 Ba D,screpancy Indication Space
1
18 Discrepancy
~ 18b .~rtemate Facrl,ry :or Genera?or /
...J
c3
OE,portfrom US
Quantrt/ Orype
Port of entry /exit _______ _
Date teav,og U S
0Res,due
.--,
L Partial Re,ection
Marutesl efe re ca lwmter
cl S EPA ID Ncrrber
Month Day
:J Full Rejec; on
~ =,10'11) Pnone
fi:l 1-.,a c-. ""s;,i-na-rure-~t'"';a.._e_m_a_:e""F,...ai:1_1_l)'_lo-•""G_e;i_,a_~-----------------------------'---------,...,.,M-0!1-lt--0=-a-;--Y-ea-r-i
< Q t-1_9_H_a,-a-rd-ou_s_'.'l-a-ste_R_e-po_rt_M_a-na-g-em_e_n_1 M-e-L,-od_C_od_e_s-1,-e-co-de-s-fo-r -ha-za_rd_o_us-wa-ste-t-re-at-m-en-t.-a1-,posai--an-d-re-cy_c_iin-g-sy-s·-:em_s_) _____________ .___ ...... _ __,~--i
:fl1----------..;_---~------------~-----'-...;_-------~---------------l
0 Ol1,D 2 HD¼ b
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j 20 Des:gnated Fac,lity Owner or Operator Ce1"1ca hon of eeceipt or hazardous mater:als w,ered by the manifest e,cept as oaed rn llem ,Ba
onn,2<.! fD!!d Narre ,-, _,,,.~,A ,gna re
DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
~------------------------------------------------~
: ~ Crystal Land Disposal Restriction Page 1ol1 :
I Clean· N t"fi t· F I
L O I 1ca 10n orm Date J -------------------------------------~----------:MANIFEST INFORMATION :
!Generator: ---NREL Flatirons canip7,;■' --------,.-------M-.-f -t T--k.--I:■" ------7
I I am es rac mg n,o 1
:Address : 18200 State Highway 128
I Golden, CO 80401-: 019056296FLE
I 3111 I
IEPA ID#: COO983802448 I Sale Order: I
L--------------------------~---------------------J l.!:l!!EJ.T!~l~.Q'!.,M~'!!_O~ ______________________________________ j
I line Item : !Page No : I Profile No . I Treat ab ility Group : I LOR Disposal Category I
.,----,1-------7--------liioN-:WASTEWATER--r; (This Ts S~jectto LOR.)-----,
I I I I I I ~~~~~~~]@[o~I @~!~~~~I~::::::~~~\§~J~§~I~:::::::::::~
I IN/A I
L--------------------------~---------------------J l.!:l~EJ.T!!.1~.Q'!.,M~ '!!_0~ ______________________________________ J
!Line Item : !Page No : !Profile No : ITreatabi litv Grou o : I LOR Disoosal Cateaorv I 12----,1-------7--------f'NoN:-w1trewATER--'1(ThisTss~JecTtoLDR.t;;.J. ___ ,
I I I I I I ~--------------------------.---------------------~ ~~~~~~~~~L-----------------➔~~~~~~~~~~-----------~ I IN/A I
L--------------------------~---------------------J l.!:l!!EJ.T!~l~.Q'!.,M~ !!_0~ ______________________________________ j
!Line Item : !Page No : !Profile No : jTrealabilitv Group : I LOR Disposal Category I
13----,1-------7--------f'NoN:-wAti-EWATER--r; (This is S~j';cttoLOR.)-----,
I I I I I I rc--------------------------,---------------------~ ~~~~~~~E~LD~~---------------➔~~~~e_S~~~~~-----------~
I IN /A I
L--------------------------~---------------------J 1.!:l~EJ.T!~l~.Q'!.,M~'!!_O~ ______________________________________ j
!Line Item: !Page No : !Profile No : t Treata bility Group : I LOR Disposal Category I
14 ----11-------7--------liioN:-WASTEWATER--r; (This Ts S~j';cttoLDR.)-----,
I I I I I I ~--------------------------.---------------------~ ~~~~~~~--------------------➔~~~~~~~~~~-----------~ I IN/A I
L--------------------------~---------------------J L----------------------------------------~-------J
I I Applies to I
: Certification :Manifest Line :
I 1ltems I
F~hua7ct~~~~~;-~~ct~theAAe7natei-Te~~ntstan~rd;"o~oCFR~a45----y-------7
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I I I ~----------------------------------------~-------~ 1Pursuant to 40 CFR 268 .7(a), I hereby notify that this shipment contains waste restricted under 40 11 I
!CFR Part 268. I I
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I I I c------------------------------------------------1
1waste analysis data, where available, Is attached. 1 i---S~n~t~e ~~oJJ1-----------~=t~a~:1J,~J~-D~F,-k,t;~:~J7
I l I ~---3~~-~t~~~-5p.e:9BJJf: ______ ~~-£.a!~JP-_~../_--------~