Per that publication:
"For any distributions, attributable to elective deferrals designated as Roth Contributions, all distributions will be reported as taxable in the year distributed. Designated Roth contributions will have already been included in income in the year of deferral."
Which means that when distributed the amount of excess plus and earnings will be included in your income as taxable income.
The 10% is not an alternative. The 10% is an ADDITIONAL early distribution penalty in addition to the normal tax that applies if you are under age 59 1/2 at the time of the distribution for late distributions of excess contributions not withdrawn by the due date of the tax return.
**Disclaimer: This post is for discussion purposes only and is NOT tax advice. The author takes no responsibility for the accuracy of any information in this post.**
