Laserfiche WebLink
N q.ra-+- jj�'�Ci'�"w <br /> ' ''a� "11;' o F= D IY1�1W�1ZlIlrlr;k Nk W y`I Y d t' f <br /> h � , 1 rm 53} k d yr �rsr <br /> > h+ f e <br /> r e� _ slap - <br /> { rSanita La"ndtill 4 � wW xP, <br /> ry -Sanitary;Landflit', Sanitary Landflll" 'All <br /> ditfl r <br /> 9011 Bailey Road w 12310.San M#eo Raad 1601 Dixon Landing Road 9999 S^Austin Road <br /> K <br /> Pittsburg, CA 94565- Halt Moon Bay,CA94019 MIIPItas, CA 95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone (650}926-1819 Phone(408)945-2800 Phone (209)982-421 <br /> Fax(925) 458-9891 Fax (650) 726-9183 Fax(408)262-2871 Fax(209)982-1 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATO ; - <br /> f WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> CITY, STATE, ZIP <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> AT <br /> PHONE ❑GLOVES U GOGGLES 0 RESPIRATOR O HARD H <br /> Y V <br /> CONTACT PERSON 0 TEK U OTHER <br /> ' SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR S CERTIFICATION I hereby certify that the above named maleriat is not a hazardous <br /> waste as defined by 40 CFR Pail 261 or title 22 of the Cafdomia code of regulations has been Properly <br /> described classified and packaged and is in proper condition for trartsportatwn a cording to apphcabte <br /> regulations AND,If the waste Is a treatment raaldw of a previously restricted hazardous wept@ <br /> subject to the Land Disposal Restrictions I certfty and warrant that the waste has been treated in <br /> accordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by RECEIVING FACILITY <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> U DISPOSAL U SLUDGE <br /> Q CONSTRUCTION O WOOD <br /> 0 <br /> ❑SPECIAL <br /> L WASTE <br /> GENERATING FACILITY <br /> f <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> _f <br /> ADDRESS z <br /> CITY, STATE,ZIP--- <br /> PHONE —END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER= `- DATE— C] <br /> ROLL--OFF( FLAT-B a VAN_ DRUMS <br /> Ll <br /> CUBIC YARDS <br /> j I hereby certify that the above named material has been f r <br /> accepted and to the best of my knowledge the foregoing _ _ <br /> Is true and accurate. DISPOSAL METHOD 00 BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> EMARKS U SOIL <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> SIGNATURE OF AUT 6 ENT DATE ASBESTOS <br /> o WOOD <br /> * ►� a ASH <br /> a SPECIAL OTHER <br /> SCHEDULING MUST <br /> BEA DE MORTO 3.00 P.M-THE DAY PRIOR TO EXPECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SUBJE <br /> TO REFUSAL UPON A IVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> s " 43662 <br /> MANIFEST� <br />