Laserfiche WebLink
LJ netler Loanyon U Ux Mountii n LJ Newby Island ® Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary:Landfill Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon i�nding Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 Half Moon Bay, GA 94919 Milpitas,CA 95035 Manteca,CA 95336 <br /> Phone (925)458-9800 Phone{650726-1819 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 /> n 3--05 7 _ <br /> MAILING ADDRESS <br /> x #6004 <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> San Ramnnt r' Q GLOVES Q GOGGLES Q RESPIRATOR 0 HARD HAT <br /> PHONE O TYVEK OOTHERLevel D <br /> _ _ <br /> ��_l <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> Tom Delon for Robert Cochran <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> 193 <br /> GENERATOR'S CEFMFICATI :I hereby certify that the above narrwd matarlal is not a hazardous <br /> waste as defined by 40 CFR Pan 261 or title 22 of the Calilomta oode of regulations,has been properly <br /> described,classified and packaged,and 1s In proper condition for transpodatlon according to applicable <br /> regulations;AND,it the waste is a trwtment residua of a previously restrkted hazardous waste <br /> ,aped to the Land Disposal Raeulcb ,I certify and warrant lhat the waste has been treated In RECEIVING FACILITY <br /> *=WW"with the requirements of 40 CFR Part 268 and is no longer A hazardous waste as defined by <br /> 40 CFR Part 261, <br /> WASTE TYPE: <br /> I DISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION O WOOD <br /> Q DEBRIS Q OTHER <br /> Q SPECIAL WASTE <br /> GENERATING FACILITY <br /> Chevron #9--0557 )c <br /> 139 So. Center Street Stocton <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER I TRU�7CK NUMBER <br /> 14*I Inc. ��J'.3 054'_ <br /> ADDRESS <br /> 950 Armes <br /> CITY, STATE, ZIP <br /> Mid itas CA 95035 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> --942-8955 <br /> SIGNATURE OF AUTHORIZED AGENT OR D,EIIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> ' C CUBIC YARDS <br /> 1 hereby certify that the abcye named material has been + 20 CY <br /> accepted and to the best of my �nowiedge the foregoing DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> Q SOIL <br /> EMARKS Q CONSTRUCTION <br /> DEBRIS <br /> FACILITY TICKET NUMBER O NON-FRIABLE <br /> _ <br /> ASBESTOS <br /> SIGNATURE/OFA THORI D AGENT DATE ❑WOOD <br /> ( O ASH <br /> .Q SPECIAL OTHER <br /> SCHEDULING MUST BE MADE"PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAYBEFORE <br /> MANIFEST N - 44411 <br /> -rn x+icrs�+n'rcn r�nov <br />