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❑ Keller Canyon ❑ Ox Mountain L NewDy I§Ilajla-� LJ >rp Wgrgaz P - <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill �rantlfill' <br /> 901 Dailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> Plttsburd,CA 94565 Half Moon gay,CA 94019 AlpltA! tX,'9$031a`t ° `M�litowrcA 95336 <br /> PK6ne(9 5)458-9800 Phone (650)7261819 Phone(408)945-2800 Phone(2b9)982-4298 <br /> Fax(925458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982.1009 <br /> NON-HAZARDOUS WASTE MANIFEST' , <br /> GENERATOR WASTE ACCEPTANCE N0. - <br /> MAILING A DRESS _ <br /> CITY,STATE,ZIP REQUIRED PER ONAL PROTECTIVE UIPMENT <br /> S 0 GLOVES 0 GOGGLES 0 RESPIRATOR O HARD HAT <br /> PHONE <br /> 0 TY-VEK 0 OTHER <br /> 51n 66A-5399 I <br /> CONTACT-PERSON <br /> SPECIAL HANDLING PtiOCEpURES <br /> Dave Th <br /> SIGNATURE OFAUTHORIZED AGENT/TITLE DATE <br /> GE TOR S CERTIFICATION F hereby osrtify that the above named material Is rroi a hazardous <br /> w 6 as defined try 40 CFR Part 261 or title 22 of the California code d reguta�icns,has been property <br /> jd scribed dasslfied and packaged and Is in proper condition for transportation a-v6ding to sppficabis <br /> regulagons ANO,if the waste Is a trsatmont residua of a previously restricted hazardous waste <br /> subject to the[and Disposal RestAdions,I eertty and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordance with Cte raquirementa of 40 CFR Peri 268 and Is no linger a hazardous waste as defined by <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> C1 DISPOSAL CI SLUDGE <br /> O CONSTRUCTION ❑WOOD <br /> 0 DEBRIS 0 OTHER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> 876 Country Club plvd, Stockton, CA 95203 <br /> TRANSPORTER NOTES VEHICLESLLIC/ENSE NUMBER TRUCK NUMBER <br /> A©DREinleyIr-C scLn "21 <br /> CITY, S <br /> W,�ioef GFeek Rd <br /> PHON eaefarmemte, GA 95828 END DU BOTTOM DUMP TRANSFER <br /> SIGNA RIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been 18 Yards <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 /> . r <br /> EMARKS <br /> 13 CONSTRUCTION <br /> FACILITY TICKET NUM ER DEBRIS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE UT R Z A9;E1AT DATE <br /> U woob <br /> ©Asti <br /> * Q SPECIAL OTHER <br /> 1 <br /> IL <br /> � <br /> _'SCHEDULING MUST BE MADE PRIORTO 3 00 P M THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> #0 REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> - - _---—___------ __----�_--- TRANSPORTER COPY MANIFEST# - <br />