Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill ' Landfill <br /> -a-1-Bailey Road 12310 San Mateo 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 /> GENER TOR WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS _ <br /> CITY,STATE,ZIP _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE <br /> 6GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ❑TY VEK ❑OTHER <br /> CONTACT PERSON S f d+�'V �- D5�3:5 <br /> P>~CIALHANDLIN�C PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE 7-19-/W > <br /> 14 <br /> GENERA3bF1 s CER'nFICATiON I hereby certify that the above named materiel to not a hazardous <br /> waste as defined by 40 CFR Part 281 or He 22 of the Celtfomia coda of regulations,has been properly <br /> described dasal8ed and packaged and is in proper aondMion for transportation ar-carding to applicable <br /> regulations AND,If the waste Is.a treahnent residue of a previously restricted hazardous wasts <br /> subject to the Land Disposal Restrictions I oertify and warrant that the waste has been treated In RECEIVING FACILITY (.!� / t <br /> accordance with the requirements of 40 CFR Part 288 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> ❑DISPOSAL U SLUDGE <br /> ❑CONSTRUCTION ❑WOOD <br /> ❑DEBRIS ❑OTHER - P <br /> ❑SPECIAL WASTE 5 a f L <br /> GENERATING FACILITY r31'C -1 0 '>C r <br /> TRANSPORTE / <br /> ADDRESS <br /> CITY,STATE,ZIP 17ENWDUMP BO,, OM-DUMP TRANSFER f' r <br /> PHONE BOLL-OFFS FLAT-BED VAN DRUMS <br /> SIGNATURE-,OF AUTHORIZED AG NT OR DRIVER DATE ❑ ❑ ❑ <br /> YARDS <br /> G <br /> hereby certify that the above named material has beep I6POSAL METHOD (TO BE COMPLETED BY LANDFILL) <br /> accepted and to the best of my knowledge the foregoiR9 <br /> DISPOSE OTHER <br /> Is true and accurate. <br /> 0 SOIL <br /> )CONSTRUCTION <br /> EMARKS DEBRIS <br /> 0 NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> o WOOD <br /> SIGNATURE OF AUTHOR ED AGENT/ DATE <br /> ASH <br /> 1F�tI'! 0 SPECIAL OTHER <br /> * r f GEED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> f EA <br /> SCHEDULING MUST BE MAGE PRIORTO3 00 PM THE DAY PRIORS ST 0 MANIFEST# 38132 <br /> TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES M0 <br /> 4r <br /> r,FNFRA fOFR <br />