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Feb 23 10 D8:55a Bev (209) 462-9861 p.2 <br /> LJ VX.igAounLaite ISI IYCYYL/j/ B®BBr B /r_J�Wr tlesase <br /> Sanitary Landfill Sanit andfill Landfill <br /> Coffin Butts Road 12310 San Mateo Road 1601 D.xcn"Snd1iiq Road 9999 S.Austin Road <br /> Cxvallls,OR 97330 W Meer Bay,CA 84019 Milpitas,CA 95035 Manteca.CA 95338 <br /> p Pnon6(541y 745.2008 Pkom(650)726.1819 Phone;408)945.2800 Phono(209)982-4298 <br /> 989' Fax{641}745.3626 Fax(SR 7265183 Fax(406)262.2971 Fax(209)962-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> f <br /> MAILING ADDRESS A.4 <br /> CITY STATE,ZIP REQUIRED PERSONAL PROTECTIVE MENT <br /> [SIGNATURE <br /> OVF_S C GOGGLES C RESPIRATOR D HAT <br /> 'OTY-VEK . C111 FETYVEST <br /> NTACT PERSON SPECIAL HANDLING PROCECURES: <br /> OFAUTHOR DAG T/TITLE rDATE rf <br /> 0 <br /> w� <br /> 3ENF.PIATORS CERTIFICATION.I hateby oatify @tat 11*above raTo material Is not a NasardCUa <br /> waslb as defined W 40 CFA Part 261 or+k®22 of Me CaWorms coria bt regulations.nas been pt"riy <br /> dent jw_dassww anj packaged,and 4 in propos condition for trawortation a^cording to opplioablo <br /> rogutariona;AMM If Me Warta Is a traatraent r9ekkn o9 a PtaWiousryr MSWW ad INEU etous WUN <br /> 3u ect tc tha land oispcaat Reatr tiora B certify ane werrom thatthe'wasto has boon twatae in RECEIVING FACILITY <br /> aaaxelan +wah the nqW romanls at 40 CFR Pan 260 and is no longera razartlous waste as eerinod toy I <br /> 40 CFR Pan 261. 1}31 <br /> WASTE TYPE: <br /> POSAL 4 SLUDGE <br /> D CONSTRUC71ON O WOOD <br /> ❑DEBRIS rJ OTHER <br /> C SPECIAL WASTE <br /> GENERATING FACILITY - <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> Ll <br /> SIGNATURE OF AUTHORIZED AGENT DR CIRIVER DATE ROLL-OFFS FLAT-6ED VAN DRUMS <br /> CUBIC YARDS <br /> I hereby certify that the above named'mr aterial has been <br /> accepted and to the beat of my knowledge the foregoing DISPOSAL METHOD: CTO BE COMPLETED BY LANDFILL) <br /> is true and accurate. <br /> DISPOSE OTHER <br /> Z SOIL <br /> FIEMARKS <br /> 0 CONSTRUG.TION <br /> FACILITY TICKET NUMBER DEBRIS <br /> a NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OFAUTHOMEDAGENT DATE �— <br /> f l r 0 O WOOD <br /> O ASH <br /> _r <br /> r > O SPECIAL OTHER <br /> S+CHftfJiLJNG MUST BE MADE PRIOR TO 3:00 RM.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 /> GENERATOR COPY <br />