Land Disposal Notification & Certification Form - Calgon Carbon ... 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Generator Name, Manifest Document No., and Carbon Acceptance No. in the designated fields at the top of the form.
3. In Section I, check the appropriate classification(s) that indicate the Land Ban status of your waste. If treatment is required, mark Box A.
4. For restricted waste requiring treatment, list all applicable EPA hazardous waste numbers and California List constituents in the provided table.
5. If your waste can be land disposed without further treatment, complete Section B by confirming compliance with treatment standards and listing relevant hazardous waste numbers.
6. In Section C, if applicable, indicate any exemptions from prohibition on land disposal methods and provide necessary details.
7. Finally, ensure you sign and date the certification statement at the bottom of the form to validate your submission.

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