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❑ Keller Canyon ❑ Ox Mountain do ❑ Newby Island ❑ Forward <br /> Sanitary-Landfill- - --Sanitary Landfill Sanitary Landfill Landfill <br /> 90,E Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> Pillssufig,�0194565 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 /> 40 NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> 7 ELEVEN <br /> MAILING ADDRESS _34'32 <br /> 711 <br /> CITY, STATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE Q GLOVES ❑GOGGLES ❑RESPIRATOR O HARD HAT <br /> O TY VEK ❑OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES <br /> SI NATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR 3 CEFITiFlCAT10N I reby certdy that above named mate Is ra hazardous <br /> waala as defined by 40 CFR P or title 22 of aldamra q�e o1 r g been pfopedy <br /> daecribed daastNad and packs and is M p rn6ondRion for tr tin ng to applicable <br /> ANq H the wants Ia a traatmant Idus oT u ted hazardous waste <br /> au to the Land Disposal Realrietlone I ee ry and w [ waste has been treated In <br /> as defined by RECEIVING FACILITY <br /> aooardanca with the raquremenls of 44 CFR art 26B en f o onger a hazardous waste <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> ©DISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION 0 WOOD <br /> ❑DEBRIS O OTHER <br /> ❑SPECIAL WASTE <br /> GENERATING FACILITY <br /> 7 ELEVEN#19978 13W NORTH MAIN STRIETEET <br /> k=SPORTER NOTES VEHICLE LICENSE NUMBEFIf TRUCK NUMBER <br /> TIM A MANLEY TRUCKING, INCP�t -1 r� <br /> ADDRESS <br /> 8151 GERBER ROAD <br /> CITY, STATE,ZIP <br /> SACRAMENTO,CA 96829 <br /> PHONE END D MP BOTTOM DUMP TRANSFER <br /> 915- -4464 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROL FS FLAT-0 VAN DRUMS <br /> A14 <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing <br /> is true and accurate. DISPOSAL METHOD (TO BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> r: <br /> ❑ <br /> REMARKS SOIL <br /> ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑NON-FRIABLE <br /> ASBESTOS <br /> SIGNATUREO IZEDAGE , "' DATE <br /> k,,,V <br /> ❑WOOD <br /> 11 Ld <br /> LSH <br /> '* OTHER <br /> SCHEDULING IkUST B DE PRIOR 3:00 P.M.THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL LVXWARRIVAL, ONGOING DAILY DELIVERIES MUST BE 'SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SALES COPY MANIFEST#225105 <br /> 22510C <br />