Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby lsland ❑ 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 3 ¢ <br /> WASTE ACCEPTANCE,NO. <br /> JE MAILING ADDRESS 1 <br /> TT- <br /> CITY, <br /> ` �t�,l <br /> CITY, STATI ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE ❑GLOVES Cl GOGGLES a RESPIRATOR Q HARD HAT <br /> U TY-VEK O OTHER <br /> CONTACT PERSON <br /> a Z. 7­1,t ;, •,f SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT!TITLE DATE <br /> =eERATOA S CERTIFICATION I hefeby certify that the above named material is not a hazardous <br /> wastas defined by 40 CFR Part 261 or title 22 of the California code of regulations has been property <br /> described classified and packaged and is in proper condition for transportation a^cord g to applicable <br /> regulatwrts AND If the waists is a traetment residue of a previeusfy restricted hazardous waste <br /> subfect to the Land Disposal Restrictions I certify and warrant that the waste has bean treated to RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFA Part 261 <br /> WASTE TYPE <br /> O DISPOSAL a SLUDGE <br /> Q CONSTRUCTION ❑WOOD <br /> 0 DEBRIS -OTHER <br /> •SPECIAL WASTE <br /> GENERATING FACILITY <br /> 1 <br /> RANSPORTER _ Y 4 <br /> NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> III <br /> CITY, STATE,ZIP <br /> PHONE t t r e , -t END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> _ r- ❑ ❑ ❑ ❑ <br /> - - A r <br /> CUBIC YARDS <br /> 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 /> EMARKS Cl SOIL <br /> ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> •NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> Ll wooD <br /> G ASH <br /> ©SPECIAL OTHER <br /> no-WH EDULING MUST SE MAGE PRIOR TO 3-CM P M THE DAY PRIOR TO EXPECTED AaRRIVAL.a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> REFUSAL. UPON AIRRI�AL, ONGOING DAILY DELIVERIES GUST BE SCHEDULED WITH THE L-ANDFILIL. THE DAY BEFORE <br /> MANIFEST # El A <br />