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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 i Manifest Tracking Info. <br /> 100 <br /> Man <br /> Address: West Center Streetl <br /> anteca,CA 95337 I () (7 \� K <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 O J <br /> ---- - -- - -- ------ - ------- - - -- - - <br /> - -—— — — — — — ——— — — ———— ——— <br /> LINE ITEM INFORMATION _ _ __ _ _ _ _ _____ _ <br /> -- ---- - - ---- - <br /> Line Item: Page No: �Profile No: Treatability Group: 1 LDR Disposal Category <br /> —1-- —+ —�H13123I —B —+ON-WASTEWATER —� 10(Alternate Soil Std-does not meet std. <br /> I I I I(with characteristic hazardous waste only)) <br /> —i- -- --- --- --- - � - - - - - - - --- - - - - - <br /> - - - -- -- - --- - - - - <br /> EPAWasteCode - --- - - - - - -- - - - - - - - - - - I_EP_A_WasteSu_bC_ategorL - -- - -- -- -- _ <br /> D008 I Toxicity Characteristic for Lead <br /> - - - ----- ---- -- - -- - -- -- - - - - - - - -- - -- - - - - - - - - --'--- <br /> Certification L '' _1 1 Applies to <br /> `� `�A�` —� ' Y' ��t'I I Manifest Line <br /> I certify under penalty of law that I personally ave examined this contaminated soil and it does not contain I <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). <br /> --- - - - - --- - --- - - - --- -- - -- --- ---------------I ---- - - <br /> Waste analysis data, ere avail e1 is attached. <br /> Signature : 15— Print Name <br /> Title: AC 7-1- J ��,lm Y' Date <br /> - - - - - - -- - -- -- - ------- - - -- - -- -------- -- ----- - - --- -- - <br />