Laserfiche WebLink
�. Kellar Canyon ❑ Ox ' untain ❑ Newby Islane orward <br /> Sanitary Landfill Sana Landfill Sanitary Lanl r -Landfill <br /> 901 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(550)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 /> ILIN ADDRESS <br /> MXSTATE.21P . . •. REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHO E LOVES a GOGGLES ❑RESPIRATOR ARD HAT <br /> O ❑TY VEK U OTHER <br /> COV18,194UERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATUR E OF AUTHORIZED AGIENT/ TLE DATE <br /> GENERATOR'S CERTIFICATION:I her oerdfy dral the above named material Is not a hazardous <br /> wade as dafhed by 40 CFR Part 261 or title 22 Of the Calltomla code of roguladons,has been propery <br /> dust rbed,deeatlied and packaged,and Is in proper c6ndiflon for transportation&motdng to appf ceblo <br /> repulatbns;AND,If the waste Is a traatmant resldae of a prevtously restricted hm allow wade <br /> sublect to ths,Larrd 0Isposat Resid doria;I oerdfy and wartani that the waste has been treated in RECEIVING FACILITY <br /> e000rdance with the regtdrements of 40 CFR Part 266 and is no longer a hazardous waste as defined by <br /> 40 CFft Part 261. <br /> WASTE TYPE: <br /> O DISPOSAL LI SLUDGE <br /> O CONSTRUCTION GI WOOD <br /> ©9EBRIS ❑OTHER <br /> ,pBPECiAL WASTE <br /> GENERATING FACILITY <br /> Allf y / <br /> TRANSPORTERNOTES: VEHICLE LICENSE Nt1MBER TRUCK NUMBER <br /> ADDRESS <br /> CITY,STATE,Zip: <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUT" IZED AGENT OR DRIVER DATE ROLL-01 F 5 FLAT-BED VAN DRUMS <br /> n ❑ <br /> 04� <br /> CUBIC YARDS <br /> hereby certifythat the above named material has been r <br /> accepted and to'the best of my knowledge the foregoing. <br /> Is true and accurate. DISPOSALMETHOD: (To BE connPLETED sY LANDs 1LL) <br /> DISPOSE OTHER <br /> EMARKS 4 SOIL <br /> 0 CONSTRUCTION <br /> FACILITY TICKET NUM fl DEBRIS <br /> 0 NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OM AUTHVRIZED AGENT DATE <br /> o WOOD <br /> * � o ASH <br /> R SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIOR TO EXPECTED ARRNAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> -TO REFUSAL UPON:ARAIVAL.' ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL-THE DAY BEFORE. <br /> MANIFEST f <br /> 53759 <br /> LANDFILLCOPY <br /> ry.w+.®. ...,a�w..wa.,»...,.«.,„tp.Www,w......w.,w«., -,...:.........r.»,,...,«.--.....«r-,......-...,» . .. + ....I..I ...„,...... <br />