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CleanHarbor Land Disposal Restriction Page : 1 of 1 <br /> Notification Form <br /> Printed Date :Mar 03, 2017 <br /> ENVIRONMENTAL SERVICES° <br /> MANIFEST INFORMATION _ _ _ _ _ __ <br /> - - - - -- - - - -- - - - - - <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 /> — - -- - -- - — - - T—- - <br /> — — — — — - - - — — — — — — —— — — — — — <br /> —— — — — — — — — — — — — — — <br /> LINE ITEM INFOR_M_ATIO_N__ _ _ _ _ __ _ _ _ __ __ _ _ __ _ __ _ _ _ __ <br /> - -- -- - -- -- - - - - <br /> Line Item: image No: 3 Profile No: Treatability Group: I LDR Disposal Category <br /> �CH13123126 — +NON-WASTEWATER —� 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> 11 <br /> —— —— J- --- --- - - — — —— — - - — — — —— — —— — — —— —— — — — —— — ——— <br /> - - -- <br /> EPAWasteCode - -- - - - --- - - - - - - - ---- - - EPAWasteSubCategor- _ -- - -- -- -- - <br /> D008 I Toxicity Characteristic for Lead <br /> -- - -- - - - - - -- - - ----- - -- ------- - - -- - - - - - -- - - <br /> Certification 1 Al2plies to <br /> s- I Manifest Line <br /> M����►t - �t� �-A e&8 r 1�1L.) I Items <br /> — <br /> - - - - - - - --- - - - --- - - --— — —— —— ———— ————— — — — —— ——I— — —— — —— <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, ere avail lei is attached. <br /> Signature : = _ ——— ——_ Print Name - <br /> Title — — -Date : o c_ — vys— Z— t —— — —— — - <br /> - - - -- - -- - -- -- - ------ - --- - - - - -- - - -- - -- - - - - - - - - ---- - - <br />