Laserfiche WebLink
I 'all#es' Can ontF-iTa���r r�T-^ ydgti c+i zr:.w ar {a+t ,r F t rl 'r - , a 7+ e t <br /> er, �> yR [j,[]x,hliountain ❑ Wift Island ( Forward w <br /> $ani#a`ry Landfill Sanitary Landfill Sanitary Landfill ' Z,an" ill - <br /> 901 Bailey Road -" ' 12310 San Mateo'Road 1601 Duron LandlN 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(20 )982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR C f <br /> WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS "� , '� <br /> CITY,STATE,ZIP r REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE Q GLOVES ❑GOGGLES 0 RESPIRATOR ❑HARD HAT <br /> 0 TY VEK ❑OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATORS CERTIFICATION I hereby certify that the above named material is not hazardous <br /> waste as defined by 40 CFR Part 261 or tette 22 of the California code of regulations,has been properly <br /> eson <br /> dbed clasalfied and packaged and is m proper condition for transportation a-oording to applicable <br /> regulations AND If the waste ks a treatment residue of a pravlou*rastrletsd hazardous waste <br /> subtest to the Land Disposal Restncums I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> 80001dance with the requrrernems of 40 CFR Part 268 and is no longer a hazardous waste as defined b1 <br /> 40 CM Part 261 <br /> WASTE TYPE <br /> BEI ❑DISPOSAL Q SLUDGE <br /> 0 CONSTRUCTION ❑WOOD <br /> 0 DEBRIS '?QTHER <br /> M ❑SPECIAL WASTE <br /> GENERATING FACILITY <br /> P <br /> NSPORTER 1{ NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> JADDRESS ") L <br /> CITY, STATE,ZIP <br /> PHONE q C END DUMP BOTTOM DUMP TRANSFER <br /> ❑ <br /> 51GNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> S t-p ❑ ❑ ❑ ❑ <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 /> EMARKS © SOIL <br /> r 0 CONSTRUCTION <br /> FACILITY TICKET NUMBER / DEBRIS <br /> ❑ NON-FRIABLE <br /> SIGNATURE OF AUTHORIZED A T TE ASBESTOS <br /> 0 WOOD <br /> A <br /> ` 0 SPji6IAL OTHE01� R <br /> HEDULIN MUST 13,16MADE PRIORT0 3 00 P.M TH DAY PRIORTO EXPECT6 ARRIVAL-ANY UNSCHEDULED LOADS ARE SUBJECT <br /> REFUSA UP ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> "�., MANIFEST f �OSS <br /> � h < `" !?Cf lr=1'fATh�l�r'►r7\/ Z <br />