Laserfiche WebLink
i i VX iIv1uu(nal" Lj newoy isiano {Xj horward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 12310 San Mateo Road y ' 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 Half Moan 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 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> C evron #9-0557 <br /> MAILING ADDRESS 3139 — <br /> P-0. Box <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> San ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> PHONE <br /> 40$_ _ 0TY-VEK IROTHER Level D <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> Tom Delon for Robert Cnchran <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION:I oby codify[hal the above named material Is not•hazardous <br /> waste as defined by 40 CFR Part 281 or title 22 of the California Code of regulations,has been properly <br /> descriheG,dassiW and packaged.and Is In proper condition for transportation according to applicable <br /> regulations;AND,If the waste Is a treatment r"Iduio of a prevlousty restricted hazardous waste <br /> subject b the Land Disposal Restrictions,I Codify and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 288 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 281. <br /> WASTE TYPE: <br /> WISPOSAL 0 SLUDGE <br /> 0 CONSTRUCTION 0 WOOD <br /> 0 DEBRIS 0 OTHER <br /> ❑SPECIAL WASTE <br /> GENERATING FACILITY <br /> v on ent7Street, Stocton <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> I <br /> ADDRESS <br /> CITY, STATE,ZIP <br /> Milpitas., CA 99015 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 408-942-8955 <br /> SIGNATURE <br /> 08— 4 - <br /> SIGNATURE OF,41#THORIZED AGENT OP DRIVER DATE ROLL-0 S FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> r <br /> CUBIC YARDS <br /> I, hereby certify that the above named material has been + 20 CY - <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 /> 0 SOIL <br /> EMARKS <br /> O CONSTRUCTION <br /> DEBRIS <br /> FACILITY TICKET NUMBER 0 NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OFA HORIZED AGENT) DATE <br /> O WOOD <br /> O ASH <br /> It <br /> 0 SPECIAL OTHER <br /> SCHEpULIN UST BE MADE PRIORTO 3:00 P.M.YHE 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 /> RE <br /> MANIFEST - 44407 <br /> TRAWPORrI=R rnPv <br />