Laserfiche WebLink
.VA_ J tela 1� .!s! + y., latli�■e•'11-T R •Jy _ ae � f-.i•.- _ , <br /> iP' r�� � 'i �a�'s� Z"S�kMd.n <br /> a{S e �Lndfiil r=5anlaryadfill, Sanitary Landfill Landfill <br /> i-231,,0 ySan[yAateo,i3oad y 160i�lixon landing Road 9999 S{Austin Road <br /> Pittsburg,CA 94565' HaIf"Moon Bay,CA 94019 Milpitas;CA95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone(650)726-1.819 Phone(408)945-2800 Phone(209)982-4298 <br /> 1 Fax(925)8-98§1 Fax (650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> &GE—N—ERAXTOFAWASTE ACCEPTANCE NO. <br /> IZPHONE <br /> EAD S r <br /> ATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> O GLOVES Q GOGGLES Q RESPIRATOR Q HARD HAT <br /> U TY-VEK Q OTHERII& , <br /> CONTACT PERSON f SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT 1 TITLE DATE <br /> td <br /> TORS CERTIFICATION I hereby certify that the above named material is not a hazardous <br /> defined by 40 CFR Part 261 or bile 22 of the California code of regulatwns has been property <br /> classified and packaged and is in proper condition for transportabon a-cording to applicable <br /> s AND,If the waste Is a treatment residue of a previousty restricted hazardous waste <br /> the Land Disposal Restrictions I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> e with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> art 261 <br /> TYPE <br /> JQ DISPOSAL Q SLUDGE <br /> Q CONSTRUCTION ❑WOOD <br /> ❑DEBRIS HER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> ANSPORTE5 NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br />.I[ADDRESS f 3 , <br /> n C Ea 0`r7 �L_ M -ir ! <br /> CITY,STATE, ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> _ d <br /> iWr <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S)__ FLAT-BED VAN DRUMS <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 /> 1 DISPOSE OTHER <br /> EMARKS Q SOIL <br /> Q CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑NON-FRIABLE <br />' ASBESTOS <br /> SIGNATURE OF AUTH RIZED GEN DATE <br /> ❑WOOD <br /> 4016 ❑ASH <br /> ❑SPECIAL OTHER <br /> SCHEDULING MUS E MADE PRIORTO 3 00 P M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br />'TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> MANIFEST# 43483 <br /> s" <br /> GENERATOR COPY TSY a r " s . <br />