Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Islandorward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill AlLandf i 11 <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> Pittsburg,CA 94565 Halt 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 /> GENERATOR WASTE ACCEPTANCE NO. <br /> City of Bwddm <br /> MAILING ADDRESS 2328 <br /> A� <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 8todct o%CA95202 ❑GLOVES 4 GOGGLES ❑RESPIRATOR ❑HARD HAT <br />' PHONE <br /> (209)937-8374 d TY VEK 0 OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES <br /> ShfflxHwdy <br /> SIGNATURF,OF AUTIJORIZED AGFNT/TITLE DATE <br /> (iENERAToFrS or FICATION I wmy em above named material Is nota hazafcTws <br /> waste as defined by 40 CFR Part 261 or Litt domia code of regulation has bean properly <br /> describod,class><led and packaged,and is in proper corKRion for transportation a-cording to applicable <br /> reputations AND,if the waste is a treatment residua of a previousty restirtcted hate ntlous waste <br /> subject to the Land disposal Restrict",i certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> 40 Maes with the requirements of 40 CFR Part 268 and is no kmger a hazardous waste as defined by <br /> 4t?CFR Part 261 <br /> W STE TYPE <br /> ISPOSAL ❑SLUDGE <br /> C�ISTRUCTION O WOOD <br /> 0 DEBRIS 0 OTHER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> 110 Writ sand met St, STOCKMN <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> Thom <br /> Qx <br /> ADDRESS <br /> 251 «m Rgimm RAy�X�33p <br /> CITY,STATE,ZIP <br /> 1ANkCA95240 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (200 3a-61?5 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD (TO BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br />' <br /> KS L3 SOIL <br /> EMAR <br /> ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br />' C1 NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> E00D:: <br /> 400 O ASH <br />' * ❑SPECIAL OTHER <br />' SCHEDULING MUST BE MADE PRIORTO 3:00 PI.M.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 DAYBEFORE <br /> lAaIUIFFCT @ .F C-7 /l'2 tZ <br />