Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island ❑ Forward <br />' Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Battey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> Pittsburg,CA 94565 Half Maon 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 />' GENERATOR WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS � <br /> CITY, STATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE U GLOVES Q GOGGLES Q RESPIRATOR `<❑HARD HAT <br />' - Q TY-VEK Q OTHER <br /> CONTACT PERSON <br /> r>� 4 SPECIAL HANDLING PROCEDURES <br />' SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br />' GENERATORS CERTIFICATION I hereby certify that the above named material Is not a hazardous <br /> waste as defined by 40 CFR Part 261 or title 22 of the California code of regulations has been property <br /> described classified and packaged and is in proper condition for transportation a-cording to applicable <br /> regulations AND If the waste Is a treatment residue of a previously restricted hazardous waste <br /> subject to the Land Disposal Restrictions I certify and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordance twth the requirements of 40 CFR Part 268 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 Q WOOD <br />' ©DEBRIS Q OTHER <br /> U SPECIAL WASTE <br /> GENERATING FACILITY <br /> 1 TRANSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br />' ADDRESS `"-' <br /> CITY, STATE, ZIP <br />' PHONE _ END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER BATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ;k <br /> ? r. <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 DISPOSAL METHOD (TO BE COMPLETED BY LANDFILL) <br />' Is true and accurate <br /> DISPOSE OTHER <br />' ffEMARKS Q SOIL <br /> Q CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON-FRIABLE <br />' <br /> SIGNATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> ❑WOOD <br /> Q ASH <br /> Q SPECIAL OTHER <br />' SCHEDUI LING MUST BE MADE PRIORTO 3 00 P M.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 /> MANIFEST# <br /> SALES COPY <br />