Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island ❑ Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill 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(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 />' MAILING ADDRESS 2328 <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ❑GLOVES 0 GOGGLES Q RESPIRATOR 0 HARD HAT <br />' PHONE <br /> ❑TY-VEK ❑OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES <br /> MwkHwdy <br />' SIGNATURE OF AUTHORIZED AGE 1 TITLE DATE <br /> �b�� (i/[ <br />' oFN!«RAT F—rs CiERTtFICAmON I hereby Cerny that the alAbAuned matedai is not a hazardous <br /> waste as defined by 40 CFR Part 261 or title 22 of the Califortua code of reguiadons,has boon Property <br /> described clasaffiW and packaged and Is In proper cor46on for transportation a-cording to applicable <br /> �Iecttl 1p the AND <br /> Land Okspasal Restnct�sl certify and nt residuewarraf a nthat the wastteUted has beenteated,ous nom <br /> accordance with the requirements of 4o CFR Part 266 and Is no longer a hazardous waste as defined by RECEIVING FACILITY <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> ❑DISPOSAL 0 SLUDGE <br />' 0 CONSTRUCTION U WOOD <br /> 0 DEBRIS U OTHER <br /> Q SPECIAL WASTE <br /> GENERATING FACILITY <br />' 114 V sates RL 9TOCKToN <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ThQffP Oil C&' ADDRESS 9219 7 3O <br /> 351 Z-110 X 33 k(f_�> <br /> CITY,STATE,ZIP <br /> rPHONE END DUMP BOTTOM DUMP TRANSFER <br /> 17 or ❑ ❑ <br /> SIGNATURE OF AUTHORIZED A ENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br />' CUBEC YARDS <br /> 1 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 />' 0 SOIL <br /> EMARKS <br /> 0 CONSTRUCTION <br />' <br /> FACILITY TICKET NUMBER DEBRIS O NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF-AUTHORIZED AGENT D E tt <br /> ❑WOOD <br /> LA <br />' 0 ASH <br /> '11C 0 SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.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 DAY BEFORE <br /> 1JANIFEST# -1 C 7 7 7 A <br />