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Feb 23 10 09:03a Bev (209) 462-9861 P.8 <br /> 001111111119M-Ox Mountain U lamprwara <br /> Sanitary Lan..dfilf Sanit L-ardfill Landfill <br /> Coffin Butte Road, :2310=•8ap Mateo Road 1601 Dixon Landing Road 9889 S,Ausiin Road <br /> CarvalE%OR 873301 Hail Won Bay,CA 94019- Milpitas,CA 95035 Manteca CA 95336 <br /> 8-9W PtKm(541)745.201.8. Phone(650)726.1$19 Phone(408)945-2330 Phone(209) 962.4298 <br /> (926)466 9691 Fax(541)745-S826, Fax(650)726.9163 Fax:408):262-2871 Fax(209)cE•2 1009 <br /> NOR-HAZARDOUS WASTEMANIFEST <br /> GENERATOR 7 WkSTE ACCEPTANCE NO. <br /> MAILING ADDRESS _ <br /> GITv sTA 2 ':IREDREIig LP ECTIVE EQUIPMENT <br /> wES O GOGGLES O RESPIRATOR W19D HAT <br /> PHONE <br /> A 3.TY V EK OWFETY VEST <br /> CONTACT PERSON <br /> SPFCTV HANDKING.-.PRQiEDURES: <br /> SIGNATURE OF AUTHMMO AGENT!TITLE RATE <br /> '� ►�R../ IIII <br /> =MFkATOWS fIRCATIONA fNe aba" c awsrW met ahaiaMour <br /> wdnt4 a0 1 40 CPR:Part 241 or ilAe?2 of the Ca mia a of beenpropaty - <br /> a^d pec(caged,:fir l'i perprr 00WRi00.Tor ftrjpro dan a-tading b epptldade <br /> regUlatim;AND6.Wdw WWS Is a UVWMMrwWwofapr.WdQU4ycmtlktoe.hazardwrwmrta <br /> wbpotromruatdD:$Pr®a Reside,1ZW-" r_w v,toate,a,aastasms.e.4'ealedin RECEIVING FAC[LrrY <br /> vrlth the requimytents of 4a&A-Part Zea wW is no longw a haiardbus waste at Mned by <br /> 40 C FR Pan 26t <br /> WASTE TYPE: „. <br /> POSAL 13.SLUDGE- T <br /> 0 CONSTRUCTION o WOOD <br /> O DEBRIS U O'T'HER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER HItOT S'• VEHICLE,L10ENSE NUIa ER TRUCK NIUMBER <br /> ADDRESS <br /> CITY, STATE,ZIP <br /> r. <br /> PHON END DUMP, BOTTDM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT ORL DRIVER: DATE ROLL. 3 FLAT-BED VAN DRUMS <br /> > <br /> CUBIC YARDS <br /> I hereby:certify that the above named fnatedal has been. <br /> accepted and to th .:best of my knoWl a th.a foragolng DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> Is true and accumte. <br /> DCSPOSE OTHER . <br /> O SOIL I <br /> EMARKS D CONSTRUCTION <br /> FAGILITYTICKET.NUMBER DEBRISa NO <br /> ASBESTOS <br /> SIGNATURE QF U.NORIZ)EDAGr=NT DATE <br /> r O WOOD <br /> (3 ASH: <br /> 0 SPECIAL OTHER <br /> SC <br /> NG MUST BE E RRIORTO?S:(*P.M.-rHE VAY Pfli ORTO EXRECT O WAL•ANY UNSIPHEDULEDL LOADS ARESUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING.DAILY DELIVERIES MUST-8E.SCHEO D W[TI4 THIS.LAN.DRLL T"R DAY BIEFORIE. <br /> MANIFEST al O <br /> rFNFR&-rf}R n6py <br />