Laserfiche WebLink
Y "' Grx t ,a xY r- Maty "? r <br /> - l� ayantk� � =,;OeflxalApuntafna t y'Y DyNWYlsl�ned aFQrward �, <br /> 'W' 4, <br /> HIM,.Y*tts^k4 < "' ''i t,.c+_ -+.-rttw.w Sr c a',-'x. X _Ala'S+ 1- <br /> a Lary Landrtillv_�, Sa�(f# j_andfill -F� Sanitary Landfill dfill <br /> '901�Badey Raadx�,-, ` 12310 Safl'Mateo Road 1601 Dixon Landing Road 9999 S Austin ROO <br /> Pittsburg, CA 94565 Half Moon Bay, CA 94019 Milpltas,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 /> J <br /> MAILING ADDRESS <br /> 1 P3i7 — <br /> CITY, STATE, ZIP,— S REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE ' <br /> U GLOVES 0 GOGGLES Q RESPIRATOR U HARD HAT <br /> U TY VEK U OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE" - DATE /� J\f R T <br /> r i <br /> 1!40 <br /> NERATOR S CERTIFICATION I hereby certify that the above named material is not a hazardous <br /> ste as defined try 40 CFR Part 261 or title 22 of die California code of regulations has heart property <br /> scribed classified and packaged and is in proper condition for transportation a-cording 10 applicable <br /> gulations AND,if the waste is s fnatment residue of a previously restricted hazardous waste <br /> b#W to the Land Disposal Restrictions I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> cordance with the requirements of 40 CFR Part 2613 and is no longer a hazardous waste as defined by <br /> CFR Part 261 <br /> MELWASTE TYPE <br /> 0 DISPOSAL U SLUDGE <br /> 0 CONSTRUCTION U WOOD <br /> 0 DEBRIS "�HER <br /> U SPECIAL WASTE <br /> GENERATING FACILITY <br /> RAN PORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS -w 5-Z -� -� <br /> 3' e - 77� <br /> CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> * S -f�-nc <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 /> REMARKS 0 SOIL <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br />' ❑ NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORS ED - DTE <br /> � r ❑WOOD <br /> Q ASH <br /> r 0 SPECIAL.OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:80 P.M. f 3AY PRIORTO EXPECTED ARRIVAL!ANY UNSCHEDULED LOADS AR' JE <br /> SUBCT <br /> MTO REFUSAL UPON ARRIVAL. ONGOING DALL)�UVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEpFORE. <br /> 7-� MANIFEST k ^' t;7 <br />