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❑ Keller Canyon OX Montain�„ El Newby Island E] Forward <br /> -Sanitary Landfill Sanitary Landfill 'AtSanitary Landfill Landfill <br /> 901 Bailey F 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> PlttOurg,CA 94S65,.%, Half Moon Bay,CA 94019 Milpitas,CA 95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Pqne(650)726-1819 Phone(408) 945-2800 Phone(209) 982-4298 <br /> Fax(925)458-9891 Fax W)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> 7. ELEVEM <br /> MAILING ADDRESS _ 3432 <br /> CITY STATE,ZIP REQUIRED PERSONAL PROT CTIVE EQUIPMENT <br /> PHONE 0 GLOVES 0 GOGGLES ❑RESPIRATOR 0 HARD HAT <br /> ❑TY VEK ❑OTHER <br /> CON A ON SPECIAL HANDLING PROCEDURES <br /> SfyG A DATE <br /> GEN R S CERTIFICATION I r carUfy am ve nam ter s a hazardous <br /> waste as defined by 40 CFR PpR 2 hila 22 Cal i e lot s hes been properly <br /> deaoribed dasaillad end paekaGed rs h proper vo n f t orta on a•cording to apphcabie <br /> regulations,ANC,If thgwaste is a treatment reehlus of sty reetrkted hexerdoue westa <br /> eubled to the land Disposal Restrrdlona I cerpiy and w that the waste has been treated in RECEIVING FACILITY <br /> accordarwe with the rarlulrements of 40 CFR Pan 266 and is no Longer a hazardous waste as defined by <br /> 40 CFA Pert 261 <br /> WASTE TYPE <br /> ❑DISPOSAL U SLUDGE <br /> 0 CONSTRUCTION I7 WOOD <br /> ❑DEBRIS 0 OTHER <br /> O SPECIAL WASTE — - <br /> GENERATING FACILITY % <br /> 7 ELEVEN#19976 978 1399 NORTH MAIN STREET <br /> *NSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> TI A MANLEY TRUCKING INC <br /> ADDRESS <br /> 9151 GERBER ROAD- - <br /> CITY,STATE,ZIP <br /> SACRAMENI 0,CA 95829 <br /> PHONE ENIDMP BOTTOM DUMP TRANSFER <br /> SIG A UR OF 6AAUTHORIZED AGENT OR DRIVER DATE ROL F S FLAT-PED VAN DRUMS <br /> ' a a a <br /> V 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 /> O SOIL <br /> EMARKS <br /> 4 CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> •NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑WOOD <br /> BASH <br /> f , <br /> ' O SPECIAL OTHER <br /> SMEDUUNWAM BE MpfrPRIORTO 3:00 W.THE DAY PRIORTO EXPECTED ARRIV4111.a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST 06 SCHEDULED WITH THIS LANDFILL THS DAY BEFORE. <br /> r <br /> SALES COPY 4:,. ,� � MANIFEST#2 2 511 8 <br />