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CleanHarbor 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 ( Manifest Tracking Info. <br /> Address: 1001 West Center Street I ��� ��/ <br /> Manteca,CA 95337 1 665 <br /> ` ( L <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> - --- - -- - — — - - — - - - - - - - - --— — — —— ' — — — —— — — — — — —— — — — — ———— — — <br /> LINE ITEM INFOR_M_ATIO_N__ ___ _ _ _ <br /> - -- - - - - - -I-- - -- -- - - - -- ---- - - <br /> Line Item_ Tage No: Profile No: Treatability Group: LDR Disposal Category <br /> 1 I 1 - CH1312312B — +NON-WASTEWATER 10(Alternate Soil Std-does not meet std. <br /> (with characteristic hazardous waste only)) <br /> - -t- - - - - - - L - - - - - - - - - -- - - - -- - - -— —— — — — — — — ——— — — —— <br /> EPA Waste Code - -- - -- - - - - - - - - - - - - -- - I_EPA_Waste_Su_bC_ategor� _ __ _ __ _— _- - <br /> D008 I Toxicity Characteristic for Lead <br /> - -- - - -- - - - -- - - - --- -- -- -- ----- = - - -- --- -- -- - - <br /> Certification 1 A olives to <br /> 1 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 containt <br /> Jisted hazardous waste and does exhibit a characteristic of hazardous waste and requires treatment to 1 <br /> meet the soil treatment standards as provided by 268.49(c). 1 <br /> - -— _ _ I <br /> Waste analysis data- ere avail let is attached _ _ — <br /> • Signature : = Print Name �� t - <br /> Title — — — Date : <br />