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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 <br /> Generator: Cit of Manteca <br /> Y I Manifest Tracking Info. <br /> Address: 1001 West Center Street <br /> Manteca,CA 95337 9-q'g( 65-q — J J K <br /> _ __ EPA ID#: CAL000095996 - -Sales Order No: 1701080820 - - -- - - <br /> LINE ITEM INFOR_M_ATIO_N__ ___ _ _ _ _ _ __ <br /> - <br /> --- -- - - -I- - - -- --- -- -- - - - - - - <br /> Line Item: TPage No: Profile No: - Treatability Group: - LDR Disposal Category <br /> 1• - - 1 - -CH1312312B -+NON-WASTEWATER - 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> - <br /> -I- - -- - - - -'- - --- - - - - - - - - --- -- -'- -- - - - - - - - - --- -- - - <br /> - Waste Code - -- - - - -- -- - - - - - - - - - - - - EPAWasteSubCategoor� - - - - - - - -- - _ <br /> D008 I Toxicity Characteristic for Lead <br /> - - - - - --- - - - -- - - --- -- -- -- - - ---I-- - - - --- - - --- - <br /> Certification Ito ies to <br /> I Manifest Line <br /> I Items <br /> -� ! <br /> I certify under penalty of law that I personally have examined this contaminated soil and it does not contain 11. <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,4ere avail le, is attached. <br /> Signature : ;'f- � `� ___ Print Name �,� <br /> Title: l .fi- �_ �= - Date : o c_ cr_- <br /> c�t --- -- -- <br /> - -- - - - -- - -- --- --- - --- - --- -- - ---- - <br /> - - -- -- - -- -- - --- - -- <br />