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El Keller Canyon 13 Ox'MoOntain ❑ ���+�!"���1����d`i:r; �'��;h�j►�Tdr <br /> Sanitary Landfill Sanitary Landfill Sanitory°UhAh' Landfill <br /> 901 Galley Road 12310 San <br /> ,l,l w Roo ,1�Q1�Dixqn � I q RQI�d Rg9F�S_pus(in R4Qad <br /> Pittsburg,CA 94565 Half Moors Bay,CA 94019 I Iflpitas;G��'VOO - Iran ,CA 95339 <br /> Phone(925)458-9800 Phone(650)726-1919 - Pho4( ),9?* #uv Ph64(�69)982-4298 <br /> Fax(925)458-9891 Fax(650)726-9183 Fax(408)262.2571 F*(�06)982-1009 <br /> NONHAZARDOUS WASYr; m NiFE$T< <br /> PNETOR , _ y {��{ ■/yam,{^•y. Y'jYay�N` <br /> ary Sanchez <br /> ADDRESS <br /> 633 W Walnut Street - - -` 13212 <br /> ATE,ZIP REQUIRED PERSONAL' PROTECTIVE EQUIPMENT <br /> tockton CA 95203 O GLOVES O GOdGLES ❑RESPIRATOR ❑HARD HAT <br /> PHONE <br /> 530 668-5399 C]TY-VEK Q OTHER, <br /> CONTACT PERSON <br /> DayeThrelfg1lSPECIAL HANDLING PROCEDURES- <br /> SIGNATUREOFAUTHORIZEDAGENT/TITLE DATE <br /> X?43 <br /> G P RATOR S CEPMFICA3ION I herby ceNy that the above named material is not a h6rerdous <br /> Waste as defined by 40 CFR Part 261 or btle 22 of the CaobrrAs code W reguladona.has Leen properly <br /> described chastised and packaged,and Is in proper condition for transportation a-cording to apPlioa6W <br /> repulatlons AND.If the+waste is a treatment residua of a p wA mely nmbk0sd hazardous waabs <br /> a�d�the Disposal Restrklo a.I cemy and warrant that C,e waste has bow treated in RECEIVING ACiLITY <br /> 40 CFR Part with <br /> requirements of 40 CFR Part 26a and is no longer a hazardous waste as definod by <br /> WASTE TYPE <br /> ❑DISPOSAL ❑SLUDGE <br /> •CONSTRUCTION ❑WOOD <br /> ❑DEBRIS Q OTHER <br /> ❑SPECIAL WASTE — <br /> GENERATING FACILITY <br /> 1876 Country Club Blvd, Stockton, CA 95203 <br /> TRANSPORTER NOTES V ICI.E LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> 4ee7. � <br /> - SA09;=fear Crook Req <br /> CITY, STATE,Zlf <br /> PHONE jCA END DUMP, BOTTOM DUMP TRANSFER <br /> SIGNA ORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAIN DRUMS <br /> CUBIC YARDS <br /> I hereby certify that the above named materlal has been - IX YAlyd$ <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD (TO BE COMPLETED BY LANDFILL) <br /> Is true and accurate, t <br /> DISPOSE OTHER <br /> q.ni.y - <br /> EMARKS <br /> O CONSTRUCTION <br /> FACILITY TICKET NUMBER ; DEBRIS <br /> 'O NON-FRIABLE <br /> _ SIGNATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> Cl WOOD- <br /> �j ' <br /> ' O ASH <br /> * � a SPECIAL OTHER <br /> SCHEDULING MU E MADE PRIORTO 3 00 R M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE 9U8.IECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERI*S MUST BE SCHEDULED WITH THE LANDFILL THE DAY BIEFORE. <br /> 'T6'N`_OPORTER DOPY _ MANIFEST 1;9 Q Q 9 - <br />