Laserfiche WebLink
�, •..•..�. ...arryvtt jJ V7 �►IUliflldlrl IJ rvCwuy lible--V rvrwaru <br /> Sanitary Landfill Sti„iary Landfill Sanitary L,,,dfill 'Landfill <br /> 4 .901 Bailey Road 12310 San Mateo Road 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(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR —! WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> 1 _ <br /> CITY, STATE,ZIP­ <br /> 4 An REQUIRED PERSONAL PR OT E EQUIPMENT <br /> PHONELa ❑GLOVES Ell GOGGLES ❑RESPIRATOR jfwl .41ARD HAT <br /> 'e 4411f 41A ❑TY-VEK ❑OTHER 'S <br /> CONTACT PE SON <br /> SPECIAL HANDLING PROCEDURE <br /> SIGNATURE OF THOAIZE. TTIT DATE }�, <br /> GENERATO CERTIFICATION:I hereby cfertity tri6 the aboy timed material is not a hazardous <br /> waste as V1' <br /> by 4 CFR Part 261 or 22 of the Calito de of regulations,has been properly <br /> describedified qhd packaged,and m proper conditio or transportation a cording to applicable <br /> regulation ,h tdddddhe waste is a tree ant residue of e vlousfy restricted hazardous waste <br /> subject tond D�S�Osal Restdctio certify and wary nt that the waste has been treated in RECEIVING FACILITY <br /> accordance with the r uirements of 4 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261. <br /> WASTE TYPE: l ' ,� <br /> U'bISPOSAL ❑SLUDGE t o <br /> 1N'�ONSTRUCTION ❑WOOD <br /> ❑DEBRIS O OTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER .�- NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS F ! f <br /> ..,� 1r <br /> CITY,STATE,ZIP <br /> PHONE �r <br /> END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNATVIRE OF A RNT OR RIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> �• ❑ ❑ <br /> F-11111 I <br /> CUBIC YARDS <br /> �Lreby rtify that a above amed material has been <br /> accepted <br /> id 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 U SOIL <br /> O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑NON-FRIABLE <br /> SIGNATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> i ! � <br /> U WOOD <br /> i ❑ASH <br /> I } t I r r ❑SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 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 WITH THE LANDFILL THE DAY BEFORE.. . <br /> GENERATOR COPY MANIFEST# 444 "336 <br /> 1 /j4J36 <br />