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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 /> Generator : City of Manteca i Manifest Tracking Info. <br /> Address: 1001 Wes:Center Street I <br /> Manteca,CA 95337 <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> — - - - - — - - — — - - — - - — — — — — - - - — — — — — — <br /> — — — — — — — — — — — — — — — — — — — — — — <br /> LINE ITEMINF_OR_M_ATIO_N _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br /> - - - - - - - - - - - - - - - - - - <br /> Line Item: Page No: Profile No: Treatability Group: — I LDR Disposal Category <br /> - - - - - - -- - - - - - <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 /> — — — — — — �— — — — — — — — — — — — — 1 — — — — — — — - - — —�— — — — — — — — — — — — — — — — — — <br /> EPA Waste Code � EPAWasteSubCategor�L — _ _ _ _ _ _ _ — _ - <br /> D008 I Toxicity Characteristic for Lead <br /> - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - <br /> Certification I Applies to <br /> •Tr_ N�� �,� c �Z-'rte s�'at ilt✓t IIt ms Line <br /> I <br /> -1 certify under penalty of law that I personally have examined this contaminated soil and it does not containt <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,v�r ere avakila t, is attached. <br /> Signature . — „� __�= �—_ _ Print Name - <br /> Title Date <br /> - - - - - - - - - - - -- - ---- --- - -- - - - - - - - - - -- -- - - - - - --- ---- - - <br />