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n, Ll Keller Canyon L\Ux Mountain L Newoy Island Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Batley Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> Pittsburg,CA 94565 Halt Moon Bay,CA 94019 Milpitas,GA 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 /> 0NON-HAZARDOUS WASTE MANIFEST <br /> GE' E, <br /> .- " ' WASTE ACCEPTANCE NO. <br /> MRE <br /> CfZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHO GLOVES U GOGGLES U RESPIRATOR - ARD HAT <br /> F WA 1,750 — (TF7 q 5 U TY-VEK OTHER <br /> CONTACT nRSON, SPECIAL HANDLING PROCEDU uSr r� <br /> SIGNATU HOWED AGENT/TITLE DATE •a� ,F L r t _ <br /> 4-4;71o, <br /> GENERATOR S XRT WAtio f ebrtfty that the abp+e named mater si is not a hazardous f - <br /> waete as defined by 40 CFR P 1 or b9e 22 0!the COW=code of reguiatlons hes been p"dy <br /> described aiassUled end end{e to proper corWNion for transportation-zon ni;to applicable <br /> regulations AND.K the wssts b tr!eJrtrerK rafdue of a previously rssbicW hazardous wests <br /> •subject to the Land Dlaposel Ras I cartify and warrant that the waste has been treated In RECEIVING FACILITY <br /> acoordance with the requirements of%OAr Part 289 and is no longer a hazardous waste as defined by <br /> 40 CFR Pert 281 l <br /> WASTE TYPE N <br /> DISPOSALk 0 SLUDGE <br /> CONSTRUCtiQ,f� U WOOD r~ ✓� � r a <br /> - U DEBRIS U OTHER <br /> 0 SPECIAL V , TE - � - <br /> y <br /> ` GENERATING ACILITY <br /> RANSPORT R - NOTES .VEHICLE LICENSE NUMBER Y ,TRUCK NUMBER <br /> A D E <br /> CI ,STATE,ZIP" -. <br /> PHONF= END DUMP, 'BOTTOM DUMP - TRANSFERTy f} <br /> SIGNATUREOF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS 'w FLAT-BED VAN QRUMS" <br /> ❑ .r ❑ ❑' - <br /> 5_ <br /> CUBIC YARDS' <br /> I hereby certify that the above named material has been J "- lyn S;, <br /> accepted and to the best of my knowledge the foregoing Bir t11nIDFlLL) "-I- <br /> . ' <br /> }_ y -, DISPOSAL METHOD - (TO BE COMPLETED, <br /> Is true.and accurate. <br /> DISPOSE OTHER <br /> U SOIL <br /> REMARKS - <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> fl NON-FRIABLE <br /> ASBESTOS <br /> SIGNATU E OF AUTHORIZED AGENT DATE <br /> 0 WOOD; ' r <br /> ` - U ASH <br /> SPECIALOTHER <br /> SCHEDULING MUST BE MADE PRIOR, ftAO P.M.THE DAY PRIORTO EXPECTED ARF11VAL a ANY-UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL-'ONGOING DAILY DELIVERIES MUST BE SCHEDULED_1fH 7HE'LANDFILL THEyDAY BEFORE-,; <br /> �. ; -= _ y . , - OPy- F- MANIFsT y 30 2 5 2 y <br />