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Form Approved.OMB No.2050-0039 designed for use on elite(12-pitch) Tracking Number r Response Phone P11"ase pf"It or type.(Form desk Page I of I Emergency pspw -G-�.—,)rator—10NI-1-i j UNIFORM HAZARDOUS Generator ID Number (800)424-9-100 016542706 J MANIFEST CAL 000095996 nt than an mail7ng address) Generator's Name and N%Jinq Address City of Manteca City of Manteca 1077 Milo Candini 1)jive,Manteca,CA 95337 CA 95337 IGO I West Center Street,Manteca, c.Orm. lor'sPhone:(209)456-8415 Atte:Greg Greg Showennan U Lim Name U.S.EPI ber Transporter2CO nyNarne 7 U.S.EPAID NunroT 3.Designated FaNity Name and 0111 M-- Buttorivivillow Landfill llow,CA 93206 .2500 West Lokm Road,Buttortwi CAD 980675276 designed for us,,ol-h-I I "or" n'""ly'jR HAZARDOUS prim RM H I) 0 W ST M IF ST WASTE E .. (661)762 -6200 E.Transporter 1 Company Facility's Prone: 10.Containers 1.Total 12.Unit 11 Waste Codes ibel, 9a. To,U.S-DOT Description(including Proper SN*n9 Name,Hazard Class,ID Number, No. T)pe Quantity Wt.(Vol. HNI. and Packing Group 0any))) 1. 6 1 1-- 0 001 D'r 1 8 Y NCIN-RCRA Hazardous Waste,Solids,(Lead) I ful 2 UJI F 3. 4, 4 Instructions and Additional InfOrmatiOn 114.Special Handling I W n 'fi;n -I " - 95 an eNjimber:C H 1 31 2 3 0 7 B Soil: 95-100% Clean Harbors Profile H Ve etation:0-5% Wean nate Personal aPro2k�� qand are classified,packaged, ear o y_,,,,zd above by the proper ShiPssary Ping name, SC �7c N r, FVERO'R� E �b� 15, GENERATOR'Slo ON: I hereby declare that the contents of this consignment are MY and if export shipment and I air,the Primary marked and labeledipjacarded,and are in all respects'm proper condition for transport according to applicable intemationaiand national governmental regulations. Expwmr,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowedgmew,of Consent. enenal0r)is true. I certify that the waste m:nimizalion statement kJantfied in 40 CFR 262.27(a)(9 1 am a large quantly generator)or(b)(if I am al small quantity gN+,onth Day Ir Generetoes/offeroes"�.ed/Typed Name signature (on behalf of the City of Manteca) I"k-�4LXU-1 Tj 16,1ptemaificnal Shipments import tc U.S. ❑Expert from U.S. poll entry/Exit e n Shipments '�"mpoitic U E, "Ports only -'it of Rec.pt.f Matenals e Ea Sh Veda -"0 a' '6 In'M' Date leavino U.S.: 2 pent Transporter signature rV�Xmd'Onfv): Tmn�ponar ri� C 17.TransporerAcknowledgMent of Receipt of MaterialsMonth Day Year V -t.17 Signature Ic Transporter I printelTyped Name 1/? nth Day '(S ar g ature sooner Hyped me afsooirler2 On d Name ce 18.Discrepancy D Full R�ecdon i8a,Discrepancy indication Space Quantity� Type ❑Residue ❑Partial Rejection L Manifest Reference N imber: EPA ID Number 18b,Alemnate FaidIty(or Generator) i 'Generator)V"'y tomato ay Month �D Facifilys Phone: fear U- Month Day r C 18c.Signature Of Poemate Facility(oi,Generator) Signature Of Mama Signature Of Allem zardous,waste treatment disposal,and recycling systems) je.r 19,Hazardous Waste Report Management Method Codes(i.e.,codes for ha Po 3, 4. full the manifest except as noted in Item I Ba (e Mo h pay fear TO Designated Facility Owner or Operator:Cert fiat of receipt of,hazardaus materials covered by Signature PrmtedfTyped Name 3� 1 -7 Previous editions are obsolete. IlON STATS(IF I E tJUIED) EFA Form 8700-22(Rev.3-05)