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CleanHarbor Land Disposal Restriction Page : 1 of 1 <br /> Notification Form <br /> ENVIRONMENTAL SERVICES° Printed Date:Mar 03,2017 <br /> MANIFEST INFORMATION <br /> Generator City of Manteca I Manifest Tracking Info. <br /> Address: 1001 West Center Street <br /> Manteca,CA 95337 <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> --- - - - - - - -- - -- - - - - - -- - <br /> LINE ITEM INFOR_M_ATIO_N __ _ - - - - - - - -- -- - - - - - - - - - - - - - - - - - - <br /> Line Item: Page No: Profile No: Treatability Group: I LDR Disposal Category <br /> —1-- 1 �CH1312312B - -INOWWASTEWATER - 10(Alternate Soil Std-does not meet std. <br /> _ ___ - _ _ _ -__ i _ - - -- - _ _ - - - - - i <br /> D008 (with characteristic hazardous waste only)) <br /> EPA_WasteCode - -- - - - - - - - - - - - - _ <br /> - - - - - - - - EPAWasteSubCategory. - -- - _ - -- -_ _ <br /> — I Toxicity Characteristic for Lead <br /> - - -- - -- - - -- - - <br /> Certificwion I Applies to <br /> crwMI - �I I Manifest Line <br /> _ _ ___ _ __ _ __ _ __ I I Items <br /> I certify under penalty of law that I personally have examined this contaminated soil and it does not contain�1 <br /> listed hazardous waste and does exhibit a characteristic of hazardous waste and requires treatment to . <br /> meet the soil treatment standards as provided by 268.49(c). I <br /> - - - - - - - - - - <br /> -- - -- - - - - - - - - - - - _ <br /> Waste analysis data, ere avail le is attached. - - - - - - -" ------ <br /> Signature Print Name �sr� <br /> Title. - J_ �_ - - Date: <br /> - -- - ------- ------- --- - --- --- --- --- - --- - - -- -- - ---- -- <br />