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1_1 mW01101 VAIAyv11 U ♦/n eseVN1r6fl!!! u --y -r-.----- u — <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 12 an Mateo Road 1601 Dixon LaRoad 9999 S.Austin Road <br /> Pittsburg,CA 94565 Hal on Bay,CA 94019 Milpitas,CA 950 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 /> 7 ELEVEN <br /> MAILING ADDRESS 3406_ <br /> P.O. 1 <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> DALLAS TX.75221-0711 O GLOVES U GOGGLES U RESPIRATOR U HARD HAT <br /> PHONE <br /> 208-429.8466 U TY VEK U OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> FF ALIGHTERIONIEMM MANL Y AS AGENT <br /> SIGNATURE F AUTHORIZED AGENT/TITLE DATE <br /> GEI'dikATORS CERTIFICATION:I hereby certify that 6Aamed material is not a hazardous <br /> waste as defined by 40 CFR Part 261 or life 22 of the CalfoTia,6ode of regulations,has been properly <br /> described,classified and packaged,and Is in proper condi transportation a-.,cwding to applicable <br /> regulations;AND,If the waste is a treatment residue of a provkmoly restricted hazardous waste <br /> subject to the land Disposal Restrictions,I car*and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part261. <br /> WASTE TYPE: <br /> O DISPOSAL O SLUDGE <br /> U CONSTRUCTION U WOOD <br /> O DEBRIS U OTHER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> 23W GRANI Llfqt . <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> 9151 GERBER ROAD <br /> CITY,STATE,ZIP <br /> RAM NTO,CA 95829 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 916-689-4464 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> 4 -( <br /> CUBIC YARDS 16 YAKU6 <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 /> �. U SOIL <br /> MARKS <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER / DEBRIS <br /> NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED A-GENT <br /> ` U WOOD <br /> I t U ASH <br /> U SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TRAN. , RTER COPY: MANIFEST# <br /> 226335 <br />