Laserfiche WebLink
, E V; - <br /> � Ox <br /> Sanitary 4ounLt�andj�filrlSanitaLandfill _ <br /> Wbaay"{ ayLla"anynj2dd"f ��' - •_ �_ . }L"a <br /> 7 <br /> 901,Bailey Rad 12310 San Mate`�,Road4 1601 Dixon Landing Road 9999S faAinluld stin. <br /> Road <br /> Pitfsburg, CA 94565` - Half Moon Bay,'CA 94019 Milpitas, ,r <br /> r <br /> CA 95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone (650)726-1819 Phone(408)945-2800 Phone (209)982-4291 <br /> Fax (925) 458-9891 "-k Fax(650)726-9183 Fax(408) 262-2871 Fax(209) 982-1 <br /> �� NON-HAZARDOUS WASTE MANIFEST ' <br /> 4 � <br /> GENER__nATO � F - r WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> CITY, STATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE ❑GLOVES ❑GOGGLES ❑RESPIRATOR 0 HARD HAT <br /> ❑TY VEK O OTHER <br /> CONTACT PERSONJ, <br /> a SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR S CERTIFICATION I hereby certify that the above named malenal is not a hazardous <br /> waste as defined by 40 CFR Pert 281 or title 22 of the California code of regulatrona has been property <br /> descnbed Clasedied and packaged and is in proper oondaion for transportation a'omdmg to eppltcaWe <br /> regulatrons AND,if the waste is a bvetment residue of a previously restricted harardou=waste <br /> subieGt to the Land p,sposat Restnetwna i eertity and warrent that the waste has been treated In <br /> ACCOrdance wdh the requirements of 40 CFR Part 288"is no longer a hazardous waste as defined by RECEIVING FACILITY ' <br /> 40 CFR Part 261 <br /> WASTE TYPE ; <br /> ❑DISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION C3 woo <br /> O DEBRIS <br /> a SPECIAL WASTE <br /> GENERATING FACILITY <br /> fV A <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> Ael <br /> ADDRESS r 5� ems/ �- <br /> TW <br /> CITY,=STATE,ZIP �— - <br /> PHONE �— <br /> END DUMP BOTTOM DUMP TRANSFER <br /> _-- SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED TVAN DRUMS <br /> Ll d ❑ , <br /> CUBIC YARDS <br /> 1 hereby certify that the above named material has been <br /> accepted and to the best of my knoWledge the foregoing <br /> DISPOSAL MET <br /> Is true and accurate. fiDD (f0 BE CdMi / ED BY LANDFILL) <br /> DISPOSE OTHER <br /> EMARKS O SOIL <br /> ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> Q NON-FRIABLE <br /> GNA E F UTHO IZEDAGENT ASBESTOS <br /> DATE <br /> ❑WOOD <br /> R ASH <br /> 14 r <br /> =61AL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3.00 P.M THE DAY PRIORTO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SU13JE� <br /> TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILLTHE DAY 13EFORE■ <br /> MANIFEST�k -4 U > <br />