Laserfiche WebLink
❑ Keller Canyon <br /> y El Ox Mountain ❑ Newby Island ❑ Forward <br /> Sanitary Landfill Sanitary Landfill , Salnitary Candflll Landfill <br /> 901 Bailey Road 12310 San M4teo 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 /> GENERgEManchez WASTE ACCEPTANCE NO. <br /> MAILIN — # 3111 <br /> CITY, S_ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE Q GLOVES Q GOGGLES O RESPIRATOR Q HARD HAT <br /> Q TY VEK Q OTHER <br /> CONT T P SO <br /> SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR S CERTIFICATION I hereby certify that the above named material is not a hazardous <br /> waste as defined by 40 GFR Part 261 or title 22 of the Caldomia code of regulations has been Property <br /> described alassrf,ed and packaged and is in proper conddw for transportation a-cording to appircable <br /> regulations AND,If the waste Is a treatment residue of s previously rastrieted hazardous waste <br /> subject 10 the Land Disposal Restrwtions I certify and warram that the waste has boon treated In RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 266 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> Q DISPOSAL Q SLUDGE <br /> Q CONSTRUCTION ❑WOOD <br /> Q DEBRIS Q OTHER <br /> Q SPECIAL WASTE <br /> GENERATING FACILITY <br /> 1876 Country Club Blvd, Stockton, CA 95203 <br /> TRANSPORTER NOTES VEHICENS ER TRUCK NUMBER <br /> a^ley _ ns Fu mi nr, / <br /> ADDRESS 110 <br /> 3896 Elder Creek Rd <br /> CITY, STATE,ZIP <br /> S;m�a�neata_ CA A5828 <br /> PHONE I EN9, MP BOTTOM DUMP TRANSFER <br /> SIGNAT E A ORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> r <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 /> REMARKS ,- -- <br /> Q SOIL <br /> ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> f]NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> U WOOD <br /> ❑ASH <br /> NEEL— <br /> ❑SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 3 00 P IIA THE 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 /> GENERATOR COPY MANIFEST# <br /> 52897 <br />