Laserfiche WebLink
i <br /> From 7074477043 Page: 1/1 Date: 112/2008 10:40:10 AM <br /> ❑ Keller Canyon ❑ Ox Mountain ❑ Newby Islandonward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill andfill <br /> 901 Bailey Road _ 12310 San Mateo Read 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg,CA 94565_ Half Moon 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(406)262-2871 Fax(209)982-1009 <br /> I <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR 15 P &V.Ir37 WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS /"Gr V 5 <br /> CITY,STATE,ZIP n r' l,,- ? „x 6ki 'f- REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> cY — S �r/tTU G ip S GLOVES 4G0(3GLEs O RESPIRATOR AHARD HAT <br /> PHONE <br /> O TY VEK O OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATUR OF qJTHORIZED AGENT 1 TITLE DATE <br /> ;I <br /> GENERATOR'S CERTIFICATION:I hereby comity that the above named materw a nota nazardous <br /> waste as Canned by 40 CFR Part 261 or title 22 o11he Cal"ornrta--Oda of regulations hu bean properly i <br /> deectibee,classl5ed and packaged,and`.s In proper oonditicn lot transportation a•cording,o rropNcable <br /> requlat'ons:ANR It the wets Is a treatment residue of a prevlcusly restricted bmrdotts waste ` <br /> subject to lihLand Disposal RestNetlws,I comity and warrant that 1ho wasle teas been treats In RECEIVING FACILITY <br /> accordance with the requirements 0140 CFR Part 2266 and is no cnger a hazardous wase es def'.ed by f <br /> 40 CFA Pa.,t 261. <br /> WASTE TYPE: <br /> ❑DISPOSAL 7 SLUDGE <br /> 0 CONSTRUCTION 7 WOOD j <br /> O DEBRIS / 7 OTHER, <br /> ❑SPECIAL WASTE lVe l ,4Z 6 R <br /> GENERATING FACILITY L <br /> TRANSPORTER i NOTES: VEHICLE LICENSE <br /> /NUMBER TRUCK NUMBER <br /> ADDRESS <br /> _ I <br /> CITY, S7ATE-,ZiI' 1:1r yj'f/l(/ -� <br /> i <br /> PHONE END UMP BOTTOM DUMP TRANSFER j <br /> SIGNATU E OF AUTHORIZED AGENT OR DRIVER JDATE ROLL-OFFIS) FLAT-BE VAN DRUMS <br /> CUBIC YARDS <br /> I 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 /> DISPOSE OTHER <br /> O SO'L <br /> REMARKS Q CONSTRUCTION <br /> FACILITI'TICKET NUMBER DEBRIS <br /> O NON-FRIA13LE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> O WOOD <br /> 0 ASH <br /> Q SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WrrH THE LANDFILL THE DAY BEFORE. <br /> rFAl45_03 1.7c1 COPY MANIFEST# ��T r� <br /> �L e ��:7 <br />