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LleanHarbor Land Disposal Restriction Page : 1 of 1 <br /> Notification Form <br /> 0% ofto ENVIRONMENTAL SERVICES' Printed Date :Mar 03, 2017 <br /> _ _ _ _ _ _ _ ___ ___ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ e= ® = = = _ _ _ _ _ _ _ _ _ _ _ _ _ <br /> MANIFEST INFORMATION <br /> Generator: City of Manteca i Manifest Tracking Info. <br /> Address: 1001 West Center Street <br /> Manteca,CA 95337 /n I L/1S`.1 8 11; 70 <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> - ---- -- - - - ----- - - ----- ------- -- --- - - - -- -- ----- - - - - - <br /> LINEI -M7- FOR_M_ATIO_N__ __ _ _ _ ___ _ ____ ___ _ _ _ _______ _ <br /> - ----- - -- - - - - <br /> Line Item: T age No: Profile No: Treatability Group: l LDR Disposal Category <br /> 1. - 1 - H1312312B -+ON-WASTEWATER -I 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> - J- - - - --- --- ---- -1- - ---- ----- -'- - - ---- --- - --- --- - <br /> EPA Waste Code _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ __ _-EPAWasteSubCalegor� _ __ _ _ _ _ _ _ _ - <br /> D008 I Toxicity Characteristic for Lead <br /> Certification I Applies to <br /> .n [L7, I Manifest Line <br /> I Items <br /> 'I certify under penalty of law that I personallyhave 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). l <br /> = -- - - - - - -- ---- - - - - -- - -- - - ---- -- --- - -- - - - -- -- - -- --- <br /> Waste analysis data, ere availle, is attached. <br /> Signature : L- -—_---- Print Name G,Y�S�- <br /> Title - <br /> M.� �� rt7 04 M/�iL. Zul <br /> : �c� JT�__s-: _�.�_ -Date: <br /> - - - - - - -- - -- ----1----- -- --- --------- ------ ------- - - - - <br />