Laserfiche WebLink
LI Keller Canyon- _.U❑Coffin Butte ❑Ox Mountain ❑ Newby Island ® Forward <br /> ' Sanitary Landfill Landfill 3 Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 28972 Coffin Butte Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg, CA 94565 G°orvallis,OR 97330 Half Moon Bay,CA.94019 Milpitas,CA 95035 Manteca, CA 95336 <br /> d ' Phone(925}458-9800 Phone(541)745-2018 Phone (650)726-1819 Phone(408)945-2800 Phone(209)982-4298 <br /> Fax(925)458 9691 Fax(541)745-3826 Fax(650)726-9183 Fax(408)262-2871 Fax(209)882-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> lRea Iwattr RCPMTM <br /> MAILING ADDRESS 690 <br /> sEa IN ve — <br /> CITY STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 3t.oddcn,CA 56203 5 GLOVES U GOGGLES ❑RESPIRATOR .XO HARD HAT <br /> PHONE <br /> 469.0625 0 TY-VEK U SAFETY VEST <br /> CONTACT PERSON <br /> �, SPECIAL'HANDLING PROCEDURES: <br /> Brdtoulom <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE . DATE <br /> GENERATOR'S CERTIFICATION;I hereby canify that the above named material Is not 9 hazardous. <br /> waste as defined by 40 CFR Pad 261 or title 22 of the California Code of regulations;has been properly <br /> dssorlbad,classified and pablined,and Is In proper condition for transportation a cording to applicable <br /> regulations;AND,it the waste Is a treatment realdue of a previously restricted hazardous waste <br /> subject to the Land Disposal Resirlctlons,I certify and warrant that the wast#has been treated to RECEIVING FACILITY <br /> accordance with the requirements of 40 GFR Pert 268 and is no longer a hazardous waste as defined,by <br /> 40 CFR Part 291. <br /> WASTE TYPE; <br /> X DISPOSAL U SLUDGE <br /> ❑CONSTRUCTION U WOOD <br /> i 0 DEBRIS ❑OTHER ` . . <br /> U SPECIAL WASTE <br /> i — <br /> GENERATING FACILITY -- — <br /> 2025 W.Haaeitcn Avt STOlCITON' <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> tvtr.Tref+:�,er . <br />` ADDRESS L` ` �]. AD <br /> 2710 Lc>aniis Rum <br /> CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRAM ER <br /> -209 456-1145 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> Is.true and accurate. <br /> DISPOSt OTHER <br /> ❑SOIL . <br /> EMARKS <br /> 0 CONSTRUCTION <br />' FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS' <br /> SIGNATURE <br /> E SIGNATU E OF AUTHQAIZED AGENT DATE <br /> j U WOOD <br /> i 0 ASH <br /> U SPECIAL OTHER <br /> SCHEDULING MUST B DE PRIOR TO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL*ANY UNSCHEDULED LOADS ARE SUBJECT <br /> tO-REFUSAL IPPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED,WITH THE LANDFILL THE-DAY BEFORE: <br /> MANIFEST# I /[ <br /> GENERATOR CORY4 <br /> _ � 3 :19 0.1 <br />