ARCHIVED REPORTS_XR0008890 - Laserfiche WebLink

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�,� w < n'fby IsIand; orivi�d, r [j �I±;�(le Canyorr'r r _ w E1,0kMountaln. �,rw . p°N0* r Sanitary Lan dfI11, Sanitary,,Landfill= Sanitary Landfill Lan 11, 901`Bailey Road 12310 San Mateo,Road 1601 Dixon Landing Road 9999 S,Austin Road Pittsburg,CA 94565 Half Moon Bay, CA 94019 Milpitas,CA 95035 Manteca,CA 95336 Phone(925)458-9800 Phone(650) 726-1819 Phone(408)945-2800 Phone(209)982-429 Fax (925) 458-9891 Fax(650) 726-9183 Fax(408)262-2871 Fax (209)982-1009 NON-HAZARDOUS WASTE MANIFEST f GENERATOR`S - WASTE ACCEPTANCE NO. r € y MAILING ADDRES CITY, STATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT ! RHONE Q GLOVES ❑GOGGLES ❑RESPIRATOR Q HARD HAT Q TY VEK ❑OTHER CONTACT PERSON _ _ SPECIAL HANDLING PROCEDURES SIGNATURE OF AUTHORIZED AGENT/TITLE DATE ,,,j GENERATORS CERTIFICATION I hereby certAy that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or title 22 of the California code of regulations has been property described classified and packaged and is in proper condition for transportation a^cording to appircabte regulations AND,If the waste Is a treatment residue of a previously restricted hazardous waste subfect to the land disposal Restrictions I certify and warrant that the waste has been Vested m RECEIVING FACILITY accordance with the requirements of 40 CFR Part 266 and is no longer a hazardous waste as defined by 40 CFR Part 261 WASTE TYPE ❑DISPOSAL ❑SLUDGE ❑CONSTRUCTION Q WOOD a DEBRIS >aOTHER Q SPECIAL WASTE GENERATING FACILITY TRANSPORTER r , NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER IV ADDRESS r f, t I-- Lo CITY,-STATE;ZIP- - — PHONE— eT - - - __ —END DUMP-- BOTTOM DUMP-----TRANSFER-- SIGVATPRQOF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS ❑ ❑ ❑ ❑ * - lc�- o CUBIC YARDS I hereby certify that the above named material has been Q ^: accepted and to the best of my knowledge the foregoing DISPOSAL METHOD (TO BE COMPLETED BY LANDFILL) Is true and accurate DISPOSE OTHER Q EMARKS SOIL ❑CONSTRUCTION FACILITY TICKET MBER DEBRIS ❑NON-FRIABLE ASBESTOS SIGNATURE OF AUTHO IZED AGENT DATE a WOOD ©ASH l ❑SPECIAL C OTHER SCHEDULING MUST BE MAE PRIOR 3:00 RM THE DAY PRIOR`I"O EXPECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SUBdEC1 TO REFUSAL. UPON ARRI L. O OING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE MANIFEST # 43484,'"