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c� <br /> IeanHarbor Land Disposal Restriction Page : 1 of 1 <br /> Notification Form <br /> ENVIRONMENTAL SERVICES° Printed Date :Mar 03, 2017 <br /> MANIFEST INFORMATION <br /> Generator: City of Manteca <br /> I Manifest Tracking Info. <br /> Address: 1001 West Center Street <br /> Manteca,CA 95337 ; blSyg / 6 72 <br /> EPA ID#: CAL 00 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> - -- - - -- - -------- ----- - ------------ - - - - - -- --- ----- -- <br /> _LI_NE_IT_E_M INFORMATION _ ___ ___ __ <br /> Line Item Tage No: TProfile No: Treatability Group: I LDR Disposal Category <br /> 1• -+ -iCH13123128 - +NON-WASTEWATER -� 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> —1- -- -- - 1- -- - - - 1- - -- -- - - - --- --- -- --- -- - - -- -- - - <br /> _EP_A_Waste_Co_de- ---- -- --- --- - - - - - - - - - I EPAWasteSubCategory. - -- - - - - - - - _ <br /> D008 I Toxicity Characteristic for Lead <br /> - -- ----- ---- -- - ------ - -- - - -- - = - - -- - - - - ---- - 7 <br /> Certification I Applies 10 <br /> i Manifest Line <br /> I certify under penalty of law that I personally�ve 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 <br /> meet the soil treatment standards as provided by 268.49(c). I <br /> - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - -- -- --- - - - - - -- - -- - - - <br /> Waste analysis data, ere avail a is attached. <br /> Signature : f'- _ wx �- _ print Name <br /> Title : /.Y�'=�iJ"�t� --Date <br /> - -- -- - -- - -- -- - - ------ ------- ---- ---- -- - - - - - - - -- - - - - <br />