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CleanHarbar Land Disposal Restriction Page : 1 of 1 <br /> Notification Form <br /> ENVIRONMENTAL SERVICES- Printed Date :Mar 03, 2017 <br /> MANIFEST INFORM_A_TI_ON_ __ _ _ __ _ _ _ _ _ _ _ _ __ <br /> Generator_ Cit of Manteca — <br /> Y I Manifest Tracking Info. <br /> Address: 1001 West Center Street <br /> Manteca,CA 95337 I <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 01 jj y I (110 <br /> - --- - -- -- - -- ———— — — —— — — — — — — — — — — — —- <br /> -- - - - - - - - - -- - -- - - - <br /> LINE ITEM INFOR_M_ATIO_N__ _ _ _ _ _ __ <br /> - - - - -- - - -I-- - -- - -- - - - - - - -- - -ne Item: Page No: Profile No: Treatability Group: LDR Disposal Category <br /> ---- -- -- - -- yy <br /> 1. 11 i H1312312B — +NON-WASTEWATER 10(Alternate Soil Std-does not meet std. <br /> (with characteristic hazardous waste only)) <br /> - -t- - - - -- - -�-- - - -- - 1- - - - - - - - ---- - - - - -- - <br /> - - -- - -- - -- - - <br /> EPA Waste Code - -- - -- -- - - - - - - - - - - -- - I_EP_A_WasteSu_bC_ategory _ __ _ _ _ __ -- _ <br /> D008 I Toxicity Characteristic for Lead <br /> -- - - - --- - - -- -- - -- - -- ---- - ---- I-- --- - - -- - -- - - <br /> Certification l Applies to <br /> Manifest Line <br /> Items <br /> -�- -- - - - --- --- -- - - -- - - - - - - <br /> 1 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), l <br /> Waste analysis data, ere avail le is attached. <br /> Signature : :; _ _amu ___ Print Name - <br /> Title : 15�. J __ _ _ -Date : oc_ Mist'G zvt __ —_—_- <br /> - - - - - --- - -- - - - - ----- - - - - - - -- -- - - - ------------- --- - - <br /> 9 <br /> I <br />