Laserfiche WebLink
1\C11t-1 l .Lly Vll .j UX -i1Lll 1lil111 14tJWUy IJlawl L41 8 U1 willU <br /> Sanitary Landfill Sak ary Landfill Sanitary LyJfill Landfill <br /> 901 Bailey Road--- 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg, CA 94565 HallMoon Bay, CA 94019 Milpitas, CA 95035 Manteca,CA 95336 <br /> Phone(925) 458-9800 Phone(650) 726-1819 Phone(408)945-2800 Phone(209)982-4298 <br /> 'Fax (925)458-9891 Fax (650) 726-9183 Fax (408)262-2871 FaxS209)982.1009 <br /> NON-HAZARDOUS WASTE MANIFEST 7, <br /> GENERA OR WASTE ACCEPTANCE NO. <br /> 134 1, <br /> MAILIN(pA QBE. $ _ <br /> CITY,S ATE .zIP,.., REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE - ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ❑TY-VEK POTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION:1 hereby i,arthy that the above darned material is not a hazardous <br /> waste as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been property <br /> described,classifietl and packaged,and is in proper condition for transportation a-corcing to wple,able <br /> regulations;AND,If the waste Is a treatmmd residue of a weelously restricted hazardous waste <br /> wbiect to the tand Disposal Restrictions,I oed8y,and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance with the requirednents of 40 CFR Pad 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Pad 261. <br /> WASTE TYPE: <br /> ❑DISPOSAL ❑SLUDGE <br /> O CONSTRUCTION ❑WOOD <br /> O DEBRIS - ❑OTHER <br /> ❑SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRAN,SPO NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS. , .2t"06 <br /> CITY, STATE,ZIP <br /> PHONE ENDU— M �� BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> " ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been Yards, <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS - - Ll SOIL <br /> ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER - --- DEBRIS <br /> -- -- ❑ NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE - <br /> ..- U WOOD <br /> U ASH <br /> rU SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> SALES COPY MANIFEST e >J 6 6 ") <br />