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C/ V <br /> CleanHarbor Land Disposal Restriction Page 1 of 1 <br /> Notification Form <br /> ENVIRONMENTAL SERVICES° Printed Date :Mar 03, 2017 <br /> MANIFEST INFORMATION <br /> Generator: Ci of Manteca <br /> City I Manifest Tracking Info, <br /> Address: Mante 01 West <br /> 95337treet ; (T�(� C{p t 6SQ 3,�K <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> —FN N -- -- --- --- ---- - ------ -- <br /> -- --- ---- - ------ ------ - - - - - -- --- -- - -- -- <br /> LETUM ITEM INFORMATION <br /> Line Item: Page No: Profile No: Treatability Group. LDR Disposal Category <br /> 1 —+1 — +CH13123128 —+NON-WASTEWATER —� 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste onl <br /> - - - - --1------ i - - - -- - L- - -- -- - - '- ---- - - - -- - -- - -- Y)) <br /> EPA Waste Code ---- -- -- - - - - - - - - - I_EP_AWasteSub— egory- _ _- --- -- - - - <br /> --- ---- <br /> D008 I Toxicity Characteristic for Lead <br /> - - - - - - - - - - - - --- --- - - - --- ------- --- - -- - ---- - 1'--- <br /> Certification l Applies to <br /> Manifest Line <br /> I certify under penalty of law that I personally ave 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). <br /> - -- - - - - ------- - -- ------ -- --- ----- - - -- - --- -- I --- - - - <br /> Waste analysis data,/w��ere avail a is attached. <br /> Signature : C_�.> +_+_�_ _ Print Name <br /> Title : �-��J�n — Date: c_ <br /> - ------- - -- --- ------ - - --- - -- - - - - - - - - - - - - -- - - - --- - - - <br />