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Sa <br /> LeapHarbor Land Disposal Restriction Page : 1 of <br /> Notification Form <br /> ENVIRONMENTAL SERVICES° Printed Date :Mar 03, 2017 <br /> MANIFEST INFORMATION <br /> Generator City of Manteca i Manifest Tracking Info. <br /> Address: 1001 West Center Street I 15 <br /> Manteca,CA 95337 I <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> ---- ------ <br /> — T—- - --- - <br /> - --- - - - - - --— ———— — — — — —— ——— —— ——— —— <br /> LINE ITEM INFOR_M_ATIO_N__ _ _ _ _ _ <br /> - --- -- - - -- - - - <br /> Line Item: Tage No: Profile No: TTreatability Group: I LDR Disposal Category <br /> 1. —t1 — 23 <br /> +CH13112B —+ON-WASTEWATER —�10(Alternate Soil Std-does not meet std. <br /> I I 1 I(with characteristic hazardous waste only)) <br /> --1- - -- --- 1'----- - 1 - - - -- --- - - -1--- -- - - - <br /> ---- - -- ----- - -- <br /> _EP_A_Waste_Co- - - --- - - --- - - - - - - - - - -- -- EPA WasteSubCa--- - -- - - - -- -- - <br /> D008 I Toxicity Characteristic for Lead <br /> - - - -- -- - - - - - ----- - -- -- ------- --- -------- -- - - <br /> Certification I Aol2 ies to <br /> Ikmsest 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 I <br /> meet the soil treatment standards as provided by 268.49(c). I <br /> - ----- - - - - - -- - ---- - - -- - ------ ---- -- <br /> Waste analysis data, ere avail is attached. <br /> Signature: __ Print Name <br /> Title Date Z— ,i�——— —— —- <br /> - -- -- - -- - -- --- --------- - - - -- - - - --- - -- ---- - - - - ---- -- <br />