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LeanHarbor Land Disposal Restriction Page : 1 of 1 <br /> Notification Form <br /> _ENVIRONMENTAL SERVICES• Printed Date :Mar 03, 2017 <br /> MANIFEST INFORMATION s s - - - - - - � _ � - - - - - - - _ - - - - � <br /> -- -- - - -- --- - -- - <br /> Generator: City of Manteca i Manifest Tracking Info. <br /> Address: 1001 West Center Street <br /> Manteca,CA 95337 1 <br /> 1 0/ 55/ 81 � 2d <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> LiN 'F- - - - - - - - - -- -- --- - - - - --- - - -- - --- - - - - - -- - - - - - - - <br /> L INE ITEM INFORM_ATIO_N__ _ _ _ __ __ _ ___ _ _ _ _ _ _ _ <br /> Line Item: TPage No: �Profile No: Treatability Group: I LDR Disposal Category <br /> - - -- - - - <br /> ---- -- -- --- <br /> 1. i -CH13123128 -+ON-WASTEWATER -� 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> - -- --- - - ---- - 1--------- --t--- -- - - - -- - -- - -- - - <br /> WaI EPA <br /> EPAste-Code - - - --- -- - - - - - - -- - - ------ -- —WasteSubCategory. - -- - -- -- - - _ <br /> DD08 I Toxicity Characteristic for Lead <br /> - -- -- -- - - - - - -- - - - - - - -- - - - ----=- - -- - .. .. ... . .IF <br /> Certification I I Applies to <br /> orcc�Y�_-tom .c,• �¢ 'anlV) Manifest Line <br /> lt <br /> I certify under penalty of law that I personally ave examined thls contaminated soil and it does not contain It. <br /> listed hazardous waste and does exhibit a characteristic of hazardous waste and requires treatment to I <br /> meet the soil treatment standards as provided by 268.49(c). I <br /> - -- - - - - - - - ---- - - ---- - -------- -- -- - - -- - - -- -- - - --- -- <br /> Waste analysis data, where avail is attached. <br /> Signature : __� __=_ _ Print Name <br /> Title : /5�.� J � -Date: t <br /> ------ -- -�------- <br /> - -- -- --- - -- ---------- ---- --- --- - -- - - - -- - --11------- -- <br />