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IeanHarbor 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 i %15 <br /> -_- EPA ID#_ CAL 0 0 0 0 9 5 9 9 6 TUU Sales Order No:7177001080820 <br /> - ----- - ----- - -- - - - -- - --- ----- - - -- ---- - - -- - - <br /> LINE ITEM INFOR_M_ATIO_N__ _ _ _ _ _ __ <br /> ------ -- -- -- -- <br /> Line Item: rage No: rrofile No: Treatability Group: I LDR Disposal Category <br /> 1 - + - +CIT1312312B -+ON-WASTEWATER - 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> -- -- <br /> --L------ ---- -- -� -- - - - -- t--- -- - - - -- - -- - -- - - <br /> - AW <br /> _EP_A_WasteCode - -- --- - - - - - - - - - - - - - - - IEPasleSubCategory <br /> D008 I Toxicity Characteristic for Lead_ __ _ __ __ _ _ - <br /> - -- - -- - - - - - - -- - -- -- - - -- - - - ---I- --- - -- - --- - - -' <br /> Certification I Applies to <br /> j/ 1 _� Manifest Line <br /> I certify under penalty of law that I personallyhave examined this coonttaa'minated soil and it does not contain+. <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). <br /> - - - - - - - - - - - - -- - ------ --- - -- - ---- - -- - - --- -- ----- - - - <br /> Waste analysis data, ere avail e1 is attached. -G.Y� <br /> Signature : _ _ Print Name <br /> Title : lac_ _C~ t,41 Date: c_ M�Z Zo t�---- -- <br /> - -- - - - -- - -- --- - ----- ----- --- ---- ---- -- - - -- -------- - <br />